title: Oxycodone accumulation in a hemodialysis patient.
abstract: 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.
authors.affiliation: Alegent Health, Bergan Mercy Medical Center, and Creighton University, Omaha, NE, USA. pforal@creighton.edu
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Foral
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Ineck
authors.forename: Kelly K
authors.initials: KK
authors.lastname: Nystrom
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000493:pharmacokinetics*; D005500:Follow-Up Studies; D006801:Humans; D007022:Hypotension / Q000097:blood / Q000139:chemically induced; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy*; D053609:Lethargy / Q000097:blood / Q000139:chemically induced; D008297:Male; D010098:Oxycodone / Q000009:adverse effects / Q000493:pharmacokinetics*; D006435:Renal Dialysis; D012131:Respiratory Insufficiency / Q000097:blood / Q000139:chemically induced
chemical_list: D000701:Analgesics, Opioid; D010098:Oxycodone