羟考酮治疗终末期心力衰竭合并肾功能不全患者呼吸困难的疗效

Tanaka Masayuki, Maeba Hirofumi, Senoo Takeshi, Iwasaka Junji, Ohkita Aki, Kita Haruna, Uchitani Kazuki, Hirota Yasuhiko

Department of Pharmacy, Kansai Medical University Hospital, Japan.

Division of Cardiology, Department of Medicine II, Kansai Medical University, Japan.

Intern Med. 2018 Jan 1;57(1):53-57. doi: 10.2169/internalmedicine.9216-17. Epub 2017 Oct 16.

A 67-year-old man with dilated cardiomyopathy and renal insufficiency was admitted to our hospital with dyspnea secondary to end-stage heart failure. We introduced oxycodone for medically refractory dyspnea instead of morphine because of the patient's renal insufficiency. After the administration of oxycodone, his dyspnea was alleviated without any adverse opioid effects, such as respiratory depression. After treating his heart failure, he was able to leave the intensive care unit. Oxycodone may therefore be a reliable agent for the treatment of dyspnea in patients with end-stage heart failure and renal insufficiency.

一名67岁患有扩张型心肌病和肾功能不全的男性因终末期心力衰竭继发呼吸困难入住我院。由于该患者存在肾功能不全，我们使用羟考酮而非吗啡来治疗药物难治性呼吸困难。给予羟考酮后，他的呼吸困难得到缓解，且未出现任何阿片类药物的不良反应，如呼吸抑制。在治疗其心力衰竭后，他得以离开重症监护病房。因此，羟考酮可能是治疗终末期心力衰竭和肾功能不全患者呼吸困难的可靠药物。