Lethargy in a 65-yr-old Man

History of Present Illness

A 65-yr-old man is brought to the emergency department (ED) because his neighbors noted that he was lethargic and confused. When emergency medical services (EMS) arrived at the man's home, they found an empty oxycodone pill bottle next to him, and they noted that he had pinpoint pupils. The neighbors stated that the patient has a history of chronic pain. In the ED, he is given naloxone 0.4 mg IV, resulting in prompt improvement in his mental status. Thereafter, the patient is able to answer questions and states that he wanted to die and had taken an overdose of several of his medications in an attempt to end his life. He is not sure exactly which medications he took.



Patient 012