Chemical Agents of Opportunity for Terrorism: TICs & TIMs

Chemical Agents of Opportunity for Terrorism
Training Support Package
Participant Guide
Slide 21
The opioid toxidrome (toxicological syndrome) is relatively easy to recognize, particularly
for medical personnel, since it is commonly noted in heroin users. Treatment involves
administration of an antidote called naloxone (Narcan).
The opioid toxidrome consists of central nervous system depression, respiratory
depression and pinpoint pupils (miosis). Looking for and recognizing these findings on a
physical examination is very important since people with this condition require
emergency treatment. The failure to treat may result in a patient’s death.
The treatment of choice is naloxone, also known by its trade name as Narcan®. This
drug can be administered by the intravenous (IV) route (through a vein) or through an
endotracheal tube if the patient is already intubated. The usual dose for naloxone is 0.4
mg. It is usually pushed rapidly through the IV. Some patients may not respond to this
first dose and will require more naloxone. Typically patients respond to 2 mg of
naloxone although in some instances as much as 10 mg may be administered to reverse
the effects of respiratory and CNS depression.
December 2008 Version 2.0 Page 89