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Propoxyphene in children with iatrogenic morphine dependence
American Journal of Diseases of Children (1960)
|August 1, 1983
Summary
Propoxyphene napsylate effectively managed narcotic withdrawal in children dependent on morphine sulfate. This treatment allowed for rapid morphine reduction and weaning from respiratory support with manageable side effects.
Area of Science:
- Pediatric pharmacology
- Pain management
- Neonatal intensive care
Background:
- Iatrogenic morphine sulfate tolerance and dependence can occur in pediatric patients.
- Managing withdrawal symptoms is crucial for patient recovery and treatment success.
Observation:
- Four children exhibited signs of narcotic withdrawal, which intensified with morphine dose reduction.
- Morphine administration initially resolved withdrawal symptoms.
Findings:
- Propoxyphene napsylate (25–65 mg/kg/day) facilitated rapid morphine dosage reduction.
- This regimen minimized withdrawal signs, symptoms, and respiratory depression, enabling faster respirator weaning.
- Alternating propoxyphene and morphine doses led to morphine and overall narcotic freedom within 9 days.
Implications:
- Propoxyphene napsylate offers a viable strategy for managing iatrogenic opioid dependence in children.
- This approach may improve patient outcomes and reduce the duration of intensive care.
- Careful monitoring for side effects like lethargy and agitation is recommended.