A 5-Year-Old Boy Is Brought to the Emergency Department Due

A 5-year-old boy is brought to the emergency department due to accidental drug ingestion.  His mother states the patient was playing by himself earlier today and 2 hours later she found him unresponsive in the bathroom.  There was an empty bottle of hydrocodone-acetaminophen next to him, but she does not know how many pills were in it.  The emergency medical team found the patient stuporous and with bradypnea.  His mental status and respirations promptly improved after 1 dose of intravenous naloxone was administered, and he was transported to the hospital.  On arrival, the patient is sleepy but arouses easily to voice and follows simple instructions.  Vital signs, including respirations, are normal.  One hour later, he has worsening lethargy, bradypnea, and miosis.  Which of the following most likely accounts for this patient's current clinical deterioration?

A) Acetaminophen-induced liver failure
B) Coingestion of benzodiazepine
C) Incomplete CNS penetrance of naloxone
D) Partial agonistic effect of naloxone
E) Short half-life of naloxone

Correct Answer:

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