| Summary: | No abstract available. Article truncated at 150 words. History of Present Illness: A 62-year-old man was brought to the Emergency Department with an altered mental status after a neighbor found him unresponsive. Medications the paramedics found in his home were cyclobenzaprine, duloxetine, gabapentin, levothyroxine, ibuprofen, and tramadol. Past Medical History, Social History and Family History: He had a past medical history of neck and back pain and hypothyroidism. He lived alone. There was a history of a C3-4 anterior cervical discectomy in 2010. Other history including family history was unobtainable. Physical Examination: • Vital Signs: HR 61 beats/min, BP 86/50 mm Hg, RR 8 breaths/min, T 32.2º C. • General: arousable but did not answer questions. He had multiple tattoos. No needle track marks are identified. • HEENT: pupils were small but reacted to light.• Lungs: clear to auscultation. • Heart: regular rhythm without murmur. • Abdomen: soft without organomegaly or masses. • Neurology: he moved all 4 extremities but minimally. Plantar reflexes were …
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