Overdose results in respiratory depression and coma; pinpoint pupils are an associated sign. Pulse rate, temperature and blood pressure also fall.
Naloxone is a specific antidote which should be administered if the patient is bradypnoeic or comatose. Continuous infusion or repeated injections are necessary because naloxone is short-acting.
Overdoses of agents combining an opiate and paracetamol (such as co-proxamol), cause the same effects initially, and should also be treated with naloxone. Paracetamol hepatotoxicity should be anticipated.
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