title: [Accidental levomethadone intoxication in a palliative patient].
abstract: Levomethadone is a strong opioid which is used rarely in the treatment of special pain syndromes in Germany. A main field for the usage of Levomethadone, which has be applied as a oral fluid, is the opioid replacement therapy of heroin-addicts. Due to the long plasma half life and its high inter-individual variability, the application implies a risk of cumulation leading to an overdosage. It is not recommended to use a fixed equianalgesic formula for the dosage conversion from other opioids. The conversion starts with a low start dose, an individual titration follows. In this case-report, the difficulty of cumulation, inaccurate drug dispensary and the characteristic of dosage calculation of levomethadone is discussed.
authors.affiliation: Abteilung für Schmerztherapie, Klinik für Anaesthesiologie, Intensiv-, Palliativ- und Schmerzmedizin, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil Bochum GmbH, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Deutschland. beate.michel-lauter@ruhr-uni-bochum.de
authors.forename: B
authors.initials: B
authors.lastname: Michel-Lauter
authors.forename: C
authors.initials: C
authors.lastname: Maier
authors.forename: A
authors.initials: A
authors.lastname: Schwarzer
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000633:toxicity*; D001859:Bone Neoplasms / Q000556:secondary* / Q000628:therapy*; D001943:Breast Neoplasms / Q000628:therapy*; D003244:Consciousness Disorders / Q000139:chemically induced; D004305:Dose-Response Relationship, Drug; D004349:Drug Packaging; D057915:Drug Substitution; D005260:Female; D005598:Fractures, Spontaneous / Q000628:therapy*; D006801:Humans; D008508:Medication Errors; D008692:Methadyl Acetate / Q000008:administration & dosage / Q000633:toxicity*; D008875:Middle Aged; D010147:Pain Measurement / Q000187:drug effects; D010148:Intractable Pain / Q000188:drug therapy*; D010166:Palliative Care; D010384:Pelvic Bones / Q000293:injuries*
chemical_list: D000701:Analgesics, Opioid; D008692:Methadyl Acetate