Opioid hyperexcitability: the application of alternate opioid therapy

Three cases are reported where patients experienced severe central nervous system adverse effects on high-dose hydromorphone. These effects were rapidly alleviated following a change in therapy to morphine at 20–25% of the usually accepted potency equivalent dose. We recommend caution in using equiv...

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Bibliographic Details
Published inPain (Amsterdam) Vol. 53; no. 3; pp. 353 - 355
Main Authors MacDonald, Neil, Der, Linda, Allan, Sharon, Champion, Phillip
Format Journal Article
LanguageEnglish
Published Amsterdam Elsevier B.V 01.06.1993
Elsevier
Subjects
Adult
Aged
Biological and medical sciences
Cancer
Drug Tolerance
Drug toxicity and drugs side effects treatment
Female
Humans
Hydromorphone
Hydromorphone - administration & dosage
Hydromorphone - adverse effects
Hydromorphone - therapeutic use
Male
Medical sciences
Morphine
Morphine - administration & dosage
Morphine - adverse effects
Morphine - therapeutic use
Myoclonus - chemically induced
Narcotics - administration & dosage
Narcotics - adverse effects
Narcotics - therapeutic use
Neoplasms - complications
Pain - drug therapy
Pain - etiology
Pain - psychology
Palliative Care
Pharmacology. Drug treatments
Toxicity: nervous system and muscle
Hydromorphone
Morphine
Palliative Care
Cancer
Human
Opiates
Nervous system diseases
Toxicity
Excitability disorder
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Summary:Three cases are reported where patients experienced severe central nervous system adverse effects on high-dose hydromorphone. These effects were rapidly alleviated following a change in therapy to morphine at 20–25% of the usually accepted potency equivalent dose. We recommend caution in using equivalent dose tables when changing opioid therapy in patients receiving high-dose opioid treatment.
ISSN:0304-3959
1872-6623
DOI:10.1016/0304-3959(93)90232-E