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Published on: January 22, 2016
Hemodynamic effects of methadone and dihydrocodeine in overdose
R Afshari1, S R J Maxwell, D N Bateman
1Medical Toxicology Centre, Imam Reza (P) Hospital, Mashhad, Iran. R-Afshari@mums.ac.ir
Clinical Toxicology (Philadelphia, Pa.)
|September 14, 2007
Summary
Opioid overdose from methadone and dihydrocodeine significantly impacts cardiovascular hemodynamics, lowering blood pressure. These findings offer a potential explanation for the observed cardiovascular benefits of opioids.
Area of Science:
- Cardiovascular Pharmacology
- Toxicology
- Clinical Research
Background:
- Opioid overdose presents a growing global health challenge.
- Cardiovascular toxicity from opioids is a significant contributor to overdose morbidity and mortality.
- Existing research on opioid hemodynamic effects in humans and animals is contradictory.
Purpose of the Study:
- To prospectively investigate the central and peripheral hemodynamic effects of methadone and dihydrocodeine overdose.
- To clarify the contradictory findings regarding opioid cardiovascular toxicity.
Main Methods:
- Prospective observational study involving patients hospitalized after overdosing on methadone or dihydrocodeine.
- Continuous monitoring of cardiovascular indices (blood pressure, pulse rate, augmentation index) for up to 23 hours.
- Measurement of peripheral and central aortic pressures and derived hemodynamic parameters.
Main Results:
- Both methadone and dihydrocodeine significantly reduced peripheral and aortic systolic, mean, and end-systolic pressures.
- Dihydrocodeine decreased systemic and aortic diastolic blood pressure, while methadone reduced peripheral pulse pressure.
- Neither opioid altered augmentation index or heart rate, but both decreased arterial oxygen saturation.
Conclusions:
- Methadone and dihydrocodeine overdose significantly alter central and peripheral hemodynamics.
- The observed hemodynamic changes, particularly reduced afterload, may explain the therapeutic use of opioids in cardiovascular diseases.
- These findings contribute to understanding opioid cardiovascular toxicity and potential therapeutic applications.
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