Which of the following patient groups are at risk for opioid-induced respiratory depression?
Summary: Elderly, female sex, presence of obstructive sleep apnea, chronic obstructive pulmonary disease, cardiac disease, diabetes mellitus, hypertension, neurologic disease, renal disease, obesity, two or more comorbidities, opioid dependence, use of patient controlled analgesia, different routes of administration of …
What are the symptoms of respiratory depression?
Symptoms of respiratory depression
- tiredness.
- daytime sleepiness.
- shortness of breath.
- slow and shallow breathing.
- depression.
How do opioids affect respiratory depression?
Opioids induce respiratory depression via activation of μ-opioid receptors at specific sites in the central nervous system including the pre-Bötzinger complex, a respiratory rhythm generating area in the pons.
What is the most reliable clinical indicator of opioid-induced ventilatory impairment?
Recognition of OIVI Sedation scores should be monitored and documented in all patients receiving any opioid for management of their acute pain – increasing sedation is a more reliable indicator of early OIVI than respiratory rate.
How is opioid-induced respiratory depression treated?
The only treatment currently available to reverse opioid respiratory depression is by naloxone infusion. The efficacy of naloxone depends on its own pharmacological characteristics and on those (including receptor kinetics) of the opioid that needs reversal.
How can opioid-induced respiratory depression be prevented?
One important strategy to mitigate opioid-induced respiratory depression is cotreatment with nonopioid respiratory stimulants. Effective stimulants prevent respiratory depression without affecting the analgesic opioid response.
Which opioid causes most respiratory depression?
Synthetic opioids like fentanyl and oxycodone, or natural opioids like heroin and morphine are highly addictive (Wilkerson et al., 2016) and can lead to respiratory depression (Dahan et al., 2010; Montandon et al., 2016a; Nagappa et al., 2017), that can be lethal with overdose (Gomes and Juurlink, 2016; Jones et al..
Which drugs cause respiratory depression?
Drugs That Cause Respiratory Depression
- Alcohol.
- Benzodiazepines (Xanax, Valium, Ativan)
- Barbiturates (phenobarbital, secobarbital, amobarbital, and pentobarbital)
- Narcotics or opioids (morphine, Vicodin, OxyContin, fentanyl)
- Illicit drugs (heroin, GHB, desomorphine)
- Sleeping pills like Ambien and Ultram.
How can you prevent respiratory depression from opioids?
Why do opioids cause respiratory problems?
Their effects on the pulmonary system can be direct, such as causing granulomatous change, but they can also work indirectly. For example, opioids cause respiratory depression by decreasing sensitivity of peripheral chemoreceptors to carbon dioxide and decreasing activity in the central respiratory centers.
How does buprenorphine cause respiratory depression?
Buprenorphine causes limited respiratory depression with a ceiling effect at higher doses, while fentanyl causes dose-dependent respiratory depression with apnoea at high dose levels. In the rare instance of respiratory depression, reversal is possible with a sufficient and continuous infusion of naloxone.
What are appropriate interventions for respiratory depression?
Respiratory Depression Treatment Oxygen therapy, which delivers oxygen gas to support breathing. Continuous positive airway pressure (CPAP) or bi-level positive airway pressure (BiPAP) machine to keep airways open while sleeping. Surgery to correct chest deformity. Weight loss including surgery and medication.
How do opiates cause respiratory depression?
The concept of how opiates cause respiratory depression is complex, but in theory, it’s simple. When you take opiates, it slows your CNS, which in turns slows breathing. The more opiates you take, the more your breathing can slow. One of the first signs of an opiate overdose is someone who has a breathing rate of fewer than 12 breaths a minute.
What drug is used for respiratory depression?
Medication used in treatment. If respiratory depression is caused by an overdose of drugs like opioids, detoxification is carried out where medications like suboxone, naloxone, and methadone are used, since they reverse the effects of opioids.
How do opiates cause depression?
These neurons regulate your breathing and when affected, can affect the respiration rhythm. Opioids cause a depressive effect on these neurons and slow neural firing. The lungs receive delayed messages from it, and effectively slows your breathing down.
How does opiate addiction increase depression?
Opiate use also causes other chemical imbalances in the body, which can be the second main cause of depression after opiate detoxification. One example is a phenomenon known as opioid receptor down-regulation , which occurs when the number of opioid receptors on the surface of cells decreases as a result of long-term, chronic opioid use.