Clinical presentation

Effects of buprenorphine poisoning include:

• respiratory effects
  • respiratory depression is common and the most important clinical sign of buprenorphine toxicity; respiratory depression includes reduced minute volume, and reduced respiratory rate or apnoea
  • aspiration pneumonitis, pulmonary oedema
• central nervous system (CNS) effects—CNS depression, ranging from drowsiness to coma, frequently accompanies respiratory depression
• ophthalmological effects—miosis is common, but not present in all patients and is not specific for buprenorphine poisoning; many nonopioid drugs also cause miosis
• gastrointestinal effects—nausea, vomiting, constipation
• other effects—end-organ effects of hypoxia (eg myocardial ischaemia), rhabdomyolysis.