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Massive OxyContin ingestion refractory to naloxone therapy
Aaron B Schneir1, Tyler F Vadeboncoeur, Steven R Offerman
1Division of Medical Toxicology, Department of Emergency Medicine, University of California San Diego Medical Center, 92103-8925, USA. aschneir@ucsd.edu
Annals of Emergency Medicine
|September 20, 2002
Summary
A massive OxyContin overdose caused severe poisoning, including respiratory depression and pulmonary edema, resistant to naloxone. The patient required mechanical ventilation but fully recovered, highlighting the risks of large oxycodone hydrochloride controlled-release ingestions.
Area of Science:
- Pharmacology
- Toxicology
- Critical Care Medicine
Background:
- OxyContin (oxycodone hydrochloride controlled release) is a long-acting opioid analgesic for chronic pain.
- Opioid overdose can lead to severe respiratory depression and altered mental status.
Observation:
- A patient ingested a massive quantity of OxyContin.
- The patient presented with altered mental status, noncardiogenic pulmonary edema, and hypoventilation.
- Symptoms were refractory to naloxone administration.
Findings:
- The patient required mechanical ventilation for three days.
- Complete recovery was achieved.
- Severity and duration of poisoning were linked to the quantity and controlled-release formulation of oxycodone ingested.
Implications:
- This case underscores the potential for severe toxicity with massive OxyContin overdose.
- The controlled-release formulation may influence the pharmacokinetics and duration of opioid toxicity.
- Management requires intensive supportive care, including mechanical ventilation, even with naloxone resistance.