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Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Werner, Mads


CiteScore 2018: 0.85

SCImago Journal Rank (SJR) 2018: 0.494
Source Normalized Impact per Paper (SNIP) 2018: 0.427

Online
ISSN
1877-8879
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Volume 16, Issue 1

Issues

Drugs that can cause respiratory depression with concomitant use of opioids

B.D. Sigmarsdottir / Th.K. Gudmundsdottir / S. Zoäga
  • Landspítali – The National University Hospital of Iceland, Surgical Services, Reykjavík, Iceland
  • Univeristy of Iceland, Faculty of Nursing, Reykjavík, Iceland
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ P.S. Gunnarsson
  • Univeristy of Iceland, Faculty of Pharmaceutical Sciences, Reykjavík, Iceland
  • Landspítali – The National University Hospital of Iceland, Pharmacy, Reykjavík, Iceland
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2017-07-01 | DOI: https://doi.org/10.1016/j.sjpain.2017.04.060

Abstract

Aims

Respiratory depression is a serious life threatening condition and a known adverse event of opioids. Little is known about the use of the opioid antidote naloxon in Iceland, and the additive effects of other potentially respiratory depressive drugs administered with opioids. The aim of the study was to review the literature on drugs that may cause respiratory depression and to assess medication use in patients receiving parenteral naloxone in Landspítali University Hospital.

Methods

A review and analysis of drugs that can cause respiratory depression based on information from the scientific literature, medicine databases and clinical guidelines. A retrospective study was performed using data collected from the electronic medical records system of Landspítali University Hospital for all patients, 18 years and older that had parenteral naloxon administered in the years 2010–2014. Information about the type of opioid and other respiratory depressive drugs was collected and the data was further investigated in regards to age, gender, and type of service.

Results

The most potential drugs and drug classes that can cause respiratory depression when used concomitantly with opioids are benzodiazepines and other anxiolytics, hypnotics and sedatives, antipsychotics, antiepileptics, antihistamins and anesthetics. When use was examined (N=138) morphine was the most frequent opioid given (49%). Concomitant use of opioids and other respiratory depressive drugs was seen in 63% of cases, and benzodiazepines were the most frequent drugs given with opioids (33%).

Conclusions

The concomitant use of benzodiazepines and other sedative drugs with opioids is frequent, despite the known risk of additive respiratory depression as described in the literature. Other patient risk factors such as medical condition, general health and consciousness should be considered in context with drugs used.

About the article

Published Online: 2017-07-01

Published in Print: 2017-07-01


Citation Information: Scandinavian Journal of Pain, Volume 16, Issue 1, Pages 186–186, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1016/j.sjpain.2017.04.060.

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