Ostwal Shrenik P, Salins Naveen, Deodhar Jayita
Department of Palliative Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India.
Indian J Palliat Care. 2017 Oct-Dec;23(4):484-486. doi: 10.4103/IJPC.IJPC_117_17.
Opioids are commonly used for pain control in palliative care setting. Accumulation of active metabolites of opioids can cause a well-recognized toxidrome including respiratory depression (RD), decreased conscious level, pinpoint pupils, and drop in blood pressure. Opioid toxicity is often associated with amount ingested and its speed of absorption in the body. This can have life-threatening effects on various body systems. Naloxone is an opioid antagonist that competitively binds to opioid receptors and reverses all their effects. The indication for use is RD because of known or suspected opioid overdose. This article presents a case report of 61-year-old female, a case of advanced pancreatic cancer, progressed on disease-modifying treatments and referred to palliative care for best supportive care. She developed features of morphine toxicity that was promptly identified and managed with use of naloxone and other supportive measures.
阿片类药物常用于姑息治疗中的疼痛控制。阿片类药物活性代谢产物的蓄积可导致一种广为人知的中毒综合征，包括呼吸抑制（RD）、意识水平下降、瞳孔缩小和血压下降。阿片类药物毒性通常与摄入剂量及其在体内的吸收速度有关。这可能对身体的各个系统产生危及生命的影响。纳洛酮是一种阿片类拮抗剂，它与阿片受体竞争性结合并逆转其所有作用。使用指征是因已知或疑似阿片类药物过量导致的呼吸抑制。本文报告了一例61岁女性病例，该患者患有晚期胰腺癌，疾病改善治疗进展不佳，转诊至姑息治疗以获得最佳支持治疗。她出现了吗啡毒性特征，通过使用纳洛酮和其他支持措施迅速得到了识别和处理。
