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The clinical picture of massive acute intoxication usually includes coma, with hypotonia, decreased reflexes, myosis, decreased respiratory function. Seizures have also been reported in presence of very high plasma levels.
The following measures should be implemented in hospitals: gastric lavage useful up to 10 to 12 hours following ingestion, institution of forced diuresis, cardiorespiratory monitoring. In very severe cases, dialysis or exchange transfusion may be necessary. Naloxone has been successfully used in a few isolated cases. Such intoxications usually have a good prognosis, though deaths have occurred following massive overdosage.
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