Heroin‐induced respiratory depression and the influence of dose variation: within‐subject between‐session changes following dose reduction.
Background and aims: Globally, more than 100 000 people die annually from opioid overdose. Opportunities to study physiological events in at‐risk individuals are limited. This study examined variation of opioid dose and impact on respiratory depression in a chronic injecting heroin user at separate...
| Publicado en: | Addiction Vol. 115; no. 10; pp. 1954 - 1960 |
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| Autores principales: | , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Wiley-Blackwell
Oct2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=145667452&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 145667452 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09652140 AIO jtl: Addiction issn: 09652140 maglogo: Y pubinfo: dt: Oct2020 vid: 115 iid: 10 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 145667452 145667452 145667452 10.1111/add.15014 145667452 ppf: 1954 ppct: 6 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Heroin‐induced respiratory depression and the influence of dose variation: within‐subject between‐session changes following dose reduction. aug: au: Tas, Basak Jolley, Caroline J. Kalk, Nicola J. Waal, Rob Bell, James Strang, John affil: King's College London, National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK sug: subj: Heroin Administration and Dosage Injections Heroin Adverse Effects Respiration Disorders Chemically Induced Human Academic Medical Centers Male Analgesics, Opioid Administration and Dosage Substance Abuse Drug Therapy Oxygen Saturation Respiratory Rate Apnea Physiopathology Descriptive Statistics Anoxemia Severity of Illness Male ab: Background and aims: Globally, more than 100 000 people die annually from opioid overdose. Opportunities to study physiological events in at‐risk individuals are limited. This study examined variation of opioid dose and impact on respiratory depression in a chronic injecting heroin user at separate time‐points during his long‐term diamorphine maintenance treatment. Design A single‐subject study over 5 years during which participant underwent experimental studies on diamorphine‐induced respiratory depression, at changing maintenance doses. Setting: A clinical research facility. Participant Male subject on long‐term injectable diamorphine (pharmaceutical heroin) maintenance treatment for heroin addiction. Measurements Physiological measures of oxygen saturation (SpO2), end‐tidal carbon dioxide (ETCO2) and respiratory rate (RR) were used to indicate severity of respiratory depression. Findings (1) After diamorphine injection, respiratory regulation became abnormal, with prolonged apnoea exceeding 20 sec (maximum 56 sec), elevated ETCO2 (maximum 6.9%) and hypoxaemia (minimum SpO2 80%). (2) Abnormalities were greater with highest diamorphine dose: average SpO2 was 89.3% after 100 mg diamorphine versus 93.6% and 92.8% for the two 30‐mg doses. (3) However, long apnoeic pauses and high levels of ETCO2% were also present after lower doses. Conclusions: With marked inter‐session variability, these findings corroborate observations of inconsistent relationships between opioid dose and overdose risk. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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