Massive hydromorphone dose delivered subcutaneously instead of intrathecally: guidelines for prevention and management of opioid, local anesthetic, and clonidine overdose
| Autor: | Jill Laird, Patrick J. Coyne, Patricia Buster, Thomas J. Smith, Lea Ann Hansen |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
medicine.medical_specialty medicine.drug_class Clonidine chemistry.chemical_compound Naloxone Medicine Intrathecal pump Humans Hydromorphone Infusions Parenteral Anesthetics Local General Nursing business.industry Local anesthetic Muscle relaxant Infusion Pumps Implantable Surgery Analgesics Opioid Anesthesiology and Pain Medicine Baclofen chemistry Opioid Anesthesia Female Neurology (clinical) Drug Overdose business medicine.drug |
| Zdroj: | Journal of pain and symptom management. 28(3) |
| ISSN: | 0885-3924 |
| Popis: | Increasing numbers of patients with refractory pain are receiving intrathecal drug delivery systems (IDDS). We describe a case to illustrate the clinical manifestations and management implications of inadvertent overdose with drugs used in IDDS, including opioids, clonidine, baclofen, and local anesthetics. An IDDS patient received a bimonthly dose of intrathecal hydromorphone subcutaneously. The patient received a total of 540 mg hydromorphone into the subcutaneous pocket around the intrathecal pump. She was treated with naloxone intravenously over 12 hours, and had no major adverse sequelae. Such occurrences may happen more frequently with the expanded use of IDDS and clinicians should be prepared to take quick action. Counteracting an opioid with naloxone until the opioid is metabolized and excreted can be done safely. Inadvertent subcutaneous administration of other types of drugs could be more difficult to manage. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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