In this episode, I’ll discuss an article about serious and general opioid-related adverse drug events.
Opioid-related adverse effects in hospital inpatients can be a significant cause of morbidity and resource expenditure in the form of rapid response calls, transfers to higher levels of care, and extended length of stay.
Being aware of risk factors that contribute to opioid-related adverse effects can help clinicians choose appropriate treatments for patients. Previous reviews have addressed only severe adverse event risk factors (for oversedation and respiratory depression), so a group of authors published a review recently in Pharmacotherapy that addresses risk factors not only for oversedation and respiratory depression, but also for common adverse events like nausea and vomiting, constipation, pruritus, dizziness, and drowsiness.
In total, 16 retrospective observational studies with a case-control design were analyzed for this review. The patient mix was roughly 2.5:1 in favor of surgical to medical patients.
The authors found that patients at high risk for severe opioid-related adverse events had COPD, neurological failure, or renal disease.
Patients at high risk for combined general opioid-related adverse events had acute MI, cardiac dysrhythmias, GI hemorrhage, and shock.
Many other minor risk factors were identified including but not limited to patient age, prior opioid use, co-administration of other sedatives, heart failure, and sleep apnea.
Hospital Pharmacists are often called upon during complicated cases to help guide clinicians and patients through the safe use of opioids, and taking these risk factors into account during decision making will help identify when extra caution with opioid dosing is warranted.
Members of my Hospital Pharmacy Academy have access to practical training on how to perform a pharmacy pain management consult, along with hundreds of other resources to help in your practice. To get immediate access, go to pharmacyjoe.com/academy.
If you like this post, check out my book – A Pharmacist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies.
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