Naloxone (intranasal) is indicated for which scenario?

• A. Altered mental status with suspected narcotic overdose
• B. Chest pain due to coronary artery disease
• C. Shortness of breath from COPD
• D. Hypoglycemia with confusion

Answer: (A)

Naloxone reverses opioid effects by blocking mu-opioid receptors, so it’s used when there is respiratory depression and altered mental status suspected to be from opioid overdose. When someone has an altered level of consciousness with potential narcotic overdose, intranasal naloxone can quickly displace opioids and restore breathing and awareness, buying time for transport and further treatment. The intranasal route is practical in the field because it doesn’t require IV access and still works rapidly. The other scenarios aren’t related to opioid effects—chest pain from coronary disease, COPD-related shortness of breath, and hypoglycemia with confusion each have different, specific treatments—so they don’t indicate naloxone use.