What are potential adverse effects of naloxone administration?

• A. Sedation
• B. Hypertension
• C. Acute withdrawal symptoms in opioid-dependent patients, agitation, nausea, vomiting
• D. Hypoglycemia

Answer: (C)

Naloxone is an opioid receptor antagonist that rapidly displaces opioid agonists from mu receptors. In someone who is opioid-dependent, this sudden blockade can precipitate withdrawal because the body abruptly loses the opioid effects it has adapted to. The adverse effects most likely seen with naloxone in these patients are acute withdrawal symptoms, including agitation, nausea, and vomiting, often accompanied by sweating, tachycardia, and anxiety. Sedation is not typical here since naloxone removes opioid effects rather than causing sedation; while some patients may experience a rise in blood pressure as part of the withdrawal surge, the hallmark adverse effect is the abrupt withdrawal syndrome with GI symptoms. Hypoglycemia is not associated with naloxone administration.