Oxycodone accumulation in a hemodialysis patient

Oxycodone and oxycodone-containing analgesics are often used for the relief of pain. In the presence of renal dysfunction, the half-life of oxycodone and metabolites can be prolonged. We describe the case of a 41-year-old chronic hemodialysis patient who received multiple doses of oxycodone/acetamin...

Full description

Saved in:
Bibliographic Details
Published inSouthern medical journal (Birmingham, Ala.) Vol. 100; no. 2; pp. 212 - 214
Main Authors FORAL, Pamela A, INECK, Joseph R, NYSTROM, Kelly K
Format Journal Article
LanguageEnglish
Published Hagerstown, MD Lippincott Williams & Wilkins 01.02.2007
Southern Medical Association
Subjects
Adult
Analgesics
Analgesics, Opioid - adverse effects
Analgesics, Opioid - pharmacokinetics
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Complications and side effects
Dosage and administration
Drug therapy
Emergency and intensive care: renal failure. Dialysis management
Follow-Up Studies
General aspects
Hemodialysis
Humans
Hypotension - blood
Hypotension - chemically induced
Intensive care medicine
Kidney failure
Kidney Failure, Chronic - blood
Kidney Failure, Chronic - therapy
Lethargy - blood
Lethargy - chemically induced
Male
Medical sciences
Oxycodone
Oxycodone - adverse effects
Oxycodone - pharmacokinetics
Renal Dialysis
Respiratory Insufficiency - blood
Respiratory Insufficiency - chemically induced
United States
Human
Medicine
Extrarenal dialysis
Hemodialysis
Oxycodone
Opiates
Patient
Narcotic analgesic
Accumulation
Online AccessGet full text

Cover

More Information
Summary:Oxycodone and oxycodone-containing analgesics are often used for the relief of pain. In the presence of renal dysfunction, the half-life of oxycodone and metabolites can be prolonged. We describe the case of a 41-year-old chronic hemodialysis patient who received multiple doses of oxycodone/acetaminophen resulting in accumulation of the medication and consequent lethargy, hypotension and respiratory depression. These adverse effects were reversed with multiple bolus doses of naloxone, followed by a continuous infusion administered for 45 hours. Utilizing the Naranjo probability scale, the patient had a "probable" adverse drug reaction to the oxycodone. Oxycodone should be used with caution in patients with chronic renal failure.
ISSN:0038-4348
1541-8243
DOI:10.1097/01.smj.0000242876.45747.0a