An 18-year-old man is brought into the emergency department after being found on the street unresponsive
一位18歲的男士被送到急診室在他被發現躺在路上不省人事之後
he is lethargic and doesn't answer question
他目前不省人事他不能回答問題
he has been given 1 ampule of Dextrose intravenously without result
他目前已被施打葡萄糖但無明顯反映
On examination his heart rate is 60 beats per minute and respiratory rate is 8 per minute and shallow
透過檢常他現在的心跳是一分鐘六十下，他呼吸一分鐘8次並且呼吸很淺
His pupils are pinpoint and not reactive
他的瞳孔非常小並且無反應
There are multiple interventions track marks on his arms
他的手臂上有許多針頭的痕跡
The emergency physician concludes that the patient has had a drug overdose
醫護人員表示那位病人服藥過量(毒品)
問題:
What is the most likely diagnosis?
最可能的診斷是什麼？
What is the most appropriate medication for this condition?
這種狀況 最適當的藥物是什麼？
In addition to its therapeutic actions，what other effects might this medication produce?
除了治療功用之外 此藥物可能產生那些其他影響作用？
一位18歲的男士被送到急診室在他被發現躺在路上不省人事之後
he is lethargic and doesn't answer question
他目前不省人事他不能回答問題
he has been given 1 ampule of Dextrose intravenously without result
他目前已被施打葡萄糖但無明顯反映
On examination his heart rate is 60 beats per minute and respiratory rate is 8 per minute and shallow
透過檢常他現在的心跳是一分鐘六十下，他呼吸一分鐘8次並且呼吸很淺
His pupils are pinpoint and not reactive
他的瞳孔非常小並且無反應
There are multiple interventions track marks on his arms
他的手臂上有許多針頭的痕跡
The emergency physician concludes that the patient has had a drug overdose
醫護人員表示那位病人服藥過量(毒品)
問題:
What is the most likely diagnosis?
最可能的診斷是什麼？
What is the most appropriate medication for this condition?
這種狀況 最適當的藥物是什麼？
In addition to its therapeutic actions，what other effects might this medication produce?
除了治療功用之外 此藥物可能產生那些其他影響作用？
All Comments
最可能的診斷是什麼？
-> Drug Intoxication , 藥物中毒
-> 因為瞳孔縮小，需懷疑是嗎啡相關藥物 ， 嗎啡成癮者
What is the most appropriate medication for this condition?
這種狀況 最適當的藥物是什麼？
->Naloxone injection , 注射治療藥物
->此藥物可以使嗎啡的作用減少，漸漸恢復正常
->題目問的是藥物而已，但是一般都會 打點滴 / 給氧氣喔
In addition to its therapeutic actions，what other effects might this medication produce?
除了治療功用之外 此藥物可能產生那些其他影響作用？
->類似問 side effect 副作用
要注意大劑量的naloxone可能會逆轉麻醉藥止痛效應，一如逆轉呼吸抑制作用一樣。其劑量應該按照病人的反應加以調整，如果出現疼痛的臨床症狀(如發汗、心跳過快、臉部歪扭、嘔吐)， 就應停止使用這種拮抗劑。