Ans. b. IV naloxone (Ref: Harrison 19/e 468e-3, 468e-3t, 473e-3, 473e-13t 18/e p3554 Reddy's Essential of Forensic Medicine and Toxicology 27/e p457-460, 552: Reddy 33/e p586)IV 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, Temperature)Q* Pupilary dilation, piloerectionQ* Methadone (1st choice)* Clonidine (2nd choice) Pupillary reactionMiosis (Constricted pupil)Mydriasis (Dilated pupil)* Carbolic acidQ* Chloral hydrateQ* Morphine (opium)Q* Organophosphorus poisoningQ* BarbituratesQ* Pontine hemorrhageQ* Muscarine* Nicotine* Viper venomQ* DhaturaQ* AlcoholQ* AconiteQ* Nux vomicaQ* Cyanide, cocaine, COQ* Chloroform* Ether* Pethidine