In a suspected opioid overdose, if the first dose of naloxone is ineffective, what should be the next step?

In cases of suspected opioid overdose, the primary treatment is the administration of naloxone, an opioid antagonist. If the initial dose of naloxone does not result in an adequate response, the most appropriate next step is to provide another dose of intravenous naloxone. This is because naloxone has a relatively short half-life compared to many opioids; therefore, it’s possible that the opioids remain active in the system and a second dose of naloxone may be necessary to reverse their effects fully.

Intravenous administration provides a more rapid onset of action, which is critical in an emergency setting. If the first dose does not bring the patient back to a responsive state, repeating the naloxone can help combat the effects of the opioid more effectively.

The other options are not appropriate next steps. Forcing the patient to respond could result in additional harm, intravenous methylnaltrexone is not indicated in acute overdose situations, and inducing vomiting in an overdose can lead to aspiration or further complications. Thus, the best course of action is to administer a second dose of naloxone.