The classical diagnostic triad of acute morphine poisoning consists of:

• A Coma, bradycardia, and cherry-red skin
• B Coma, dilated pupils, and hyperthermia
• C Coma, convulsions, and pin-point pupils
• D Coma, pinpoint pupils, and depressed respiration ✓

Explanation

Opioid poisoning presents with the triad of stupor or coma, miosis from mu-receptor mediated Edinger-Westphal stimulation, and respiratory depression, which is the usual cause of death. Dilated pupils with hyperthermia suggest sympathomimetic or anticholinergic poisoning, and convulsions point toward organochlorine, isoniazid, or tramadol toxicity rather than pure morphine. Recognising the triad guides immediate naloxone administration.

Reference: Essentials of Forensic Medicine and Toxicology, R.K. Narayan Reddy, 33rd ed.

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Written and medically reviewed by the StethoPrep medical team.