Upadhyay Surjya, Jain Roopesh, Chauhan Himanshu, Gupta Deepak, Mishra Seema, Bhatnagar Sushma
Department of Anaesthesia, All India Institute of Medical Sciences, New Delhi, India.
Am J Hosp Palliat Care. 2008 Oct-Nov;25(5):401-5. doi: 10.1177/1049909108319260. Epub 2008 Jun 6.
An 80-year-old male was diagnosed with carcinoma in the lung with multiple bony metastases and had been prescribed pain medications as per World Health Organization analgesic ladder guidelines. However, he was not getting adequate pain relief and there were difficulties in titration of the morphine doses on an outpatient basis. Therefore, he was hospitalized for dose titration of oral morphine and was coprescribed amitriptyline and ranitidine. During the titration of the analgesic dose, he developed severe symptoms of morphine overdose. He was immediately treated with intravenous naloxone. After prolonged infusion of naloxone, he achieved his baseline vital parameters without any permanent sequel to the overdose event. This case report describes the possible causes of oral morphine overdose in the elderly and its successful treatment. To prevent such complications, one has to be very cautious of other factors such as drug interactions, particularly in the elderly.
一名80岁男性被诊断为肺癌伴多发骨转移，已根据世界卫生组织镇痛阶梯指南开具止痛药物。然而，他的疼痛未得到充分缓解，且在门诊滴定吗啡剂量时存在困难。因此，他因口服吗啡剂量滴定而住院，并同时开具了阿米替林和雷尼替丁。在镇痛剂量滴定过程中，他出现了严重的吗啡过量症状。立即用静脉注射纳洛酮对其进行治疗。在长时间输注纳洛酮后，他恢复了基线生命参数，且过量事件未留下任何永久性后遗症。本病例报告描述了老年人口服吗啡过量的可能原因及其成功治疗方法。为预防此类并发症，必须特别警惕其他因素，如药物相互作用，尤其是在老年人中。
