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학습 자료 둘러보기 →| Option | Clinical Picture | Associated State |
|---|---|---|
| 1 | Constricted pupils and decreased respiratory rate | Opioid Intoxication/Overdose: Mu-receptor agonism causes pupillary constriction (pinpoint pupils) and respiratory depression. |
| 2 | Sedation and confusion with slurred speech | Central Nervous System Depression: This presentation is typical of intoxication with opioids, benzodiazepines, or alcohol, not withdrawal. |
| 3 | Dilated pupils, diaphoresis, and muscle aches with anxiety | Opioid Withdrawal: These signs directly result from noradrenergic rebound and loss of analgesic tone. |
| 4 | Euphoria and increased appetite with hyperactivity | Stimulant Intoxication or Hypomania: This does not align with the dysphoric and anxiogenic state of opioid withdrawal. |
Opioid withdrawal reflects unopposed noradrenergic hyperactivity from the locus coeruleus. Key signs include dilated pupils (mydriasis), diaphoresis, muscle aches, and anxiety.
Differentiate from intoxication: intoxication presents with miosis (constricted pupils), decreased respiratory rate, and sedation. Withdrawal is a hyperactive state.
Use standardized tools like the Clinical Opiate Withdrawal Scale (COWS) for objective assessment. Monitor for severe symptoms like vomiting and diarrhea, which can lead to dehydration and electrolyte imbalance.
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