Klinikiniai opioidų perdozavimo atvejai = : Clinical cases of opioid overdose

Abstract

Opioidų perdozavimas (OP) pastaruoju metu tapo aktualia tarptautine sveikatos priežiūros problema. Tai viena pagrindinių jaunų žmonių ankstyvos mirties priežasčių daugelyje išsivysčiusių pasaulio šalių ypač Australijoje, JAV, Didžiojoje Britanijoje. [...]. There has been increasing recognition of the problem of opioid overdose. The aim of the present study was to evaluate causes, signs and symptoms, course, treatment and prognosis of patients with opioids overdose. 27 patients were included in this study (23 men and 4 women). The man age was 26,3 years. In many cases there was intravenous use of heroin, in other – various natural or semisynthetic morphine derivates. There was now considerable evidence that many instances of overdose were due to the combined effects of opioids with other drugs (sedatives, benzodiazepines, antidepressants) and alcohol. Clinical features were marked reduction in respiratory rate and depth, pinpoint pupils and coma (17 pts). Management included care of the airway and ventilation as a first step, prompt administration of the opioid antagonist naloxone. It was given immediately. There were a few complications: noncardiogenic pulmonary edema and pneumonia (2 pts), acute renal insufficiency (1 pt.), and only one fatal outcome. It occurred for woman, who had lacking spontaneous respirations, cardiac arrest, resuscitation during prehospital care and was transported to intensive care unit unconscious and in deep postanoxic coma.