<prompt> A young man with known history of heroine addiction is brought in the emergency in unconscious state by his friends. On examination his pupil are pin point. What will be the treatment of choice?Oral naltrexoneIV naloxoneOral diazepamOral buprenorphine  <response>: Ans. b. IV naloxone Ref: Harrison 19e 468e-3, 468e-3t, 473e-3, 473e-13t 18e p3554 Reddys Essential of Forensic Medicine and Toxicology 27e p457-460, 552: Reddy 33e p586IV naloxone is the treatment of choice in Opioid overdose.So, in this patient with suspected Opioid heroine overdose, treatment of choice is IV naloxone.Treatment of Opioid OverdoseTreatment of opioid overdose requires:NaloxoneQ: 0.4-2.0 mg IV or IM with expected response within 1-2 minutesSupport of vital functions:Oxygen and positive pressure breathingIV fluidsPresser agents for hypotensionCardiac monitoring to detect QT prolongationOpioidWithdrawal SyndromeDOC in withdrawal syndrome YawningQ, Insomnia, Dysphoric mood Water loss from different orificesQ LacrimationQ, sweatingQ, diarrheaQ, vomiting, rhinorrheaQ Increased vitalsQ BP, Pulse, RR, TemperatureQ Pupilary dilation, piloerectionQ Methadone 1st choice Clonidine 2nd choice Pupillary reactionMiosis Constricted pupilMydriasis Dilated pupil Carbolic acidQ Chloral hydrateQ Morphine opiumQ Organophosphorus poisoningQ BarbituratesQ Pontine hemorrhageQ Muscarine Nicotine Viper venomQ DhaturaQ AlcoholQ AconiteQ Nux vomicaQ Cyanide, cocaine, COQ Chloroform Ether Pethidine 