Methadone-Induced Hypoglycemia in a Hospitalized Patient

IF 0.8 Q4 PHARMACOLOGY & PHARMACY
Drew A. Wells, Tara Parnacott, Krista Volberding, Emily Brandl
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引用次数: 0

Abstract

Methadone is used as an agent for chronic pain and management of opioid use disorder. While similar pharmacologically to other opioids, methadone does have unique characteristics, including long half-life, low cost, and high oral bioavailability. While advantageous in some ways, methadone is associated with unique adverse effects not seen with other opioids (ie, hypoglycemia). In this case, we describe a patient in his late-60s with opioid use disorder on chronic methadone who presents with symptoms of generalized weakness, fatigue, and decreased appetite for 2 days. The hospital course was complicated by hypoglycemia, without obvious cause other than methadone-induced hypoglycemia. The patient was managed with supportive care to maintain normoglycemia. He was continued on methadone and instructed to follow-up with his opioid treatment program to assess for dose de-escalation to minimize future hypoglycemia risk. While other case reports of methadone-induced hypoglycemia highlight the risk of this adverse effect, our case highlights the importance of assessing methadone as a cause of hypoglycemia and provides discussion around the legality of dose de-escalation at discharge from an acute care setting.
住院患者美沙酮所致低血糖
美沙酮被用作治疗慢性疼痛和阿片类药物使用障碍的药物。虽然与其他阿片类药物相似,但美沙酮确实具有独特的特点,包括半衰期长,成本低,口服生物利用度高。虽然美沙酮在某些方面是有利的,但它与其他阿片类药物所没有的独特副作用(即低血糖)有关。在这个案例中,我们描述了一位60多岁的慢性美沙酮阿片类药物使用障碍患者,他表现出全身无力、疲劳和食欲下降的症状,持续2天。住院期间合并低血糖,除美沙酮所致低血糖外,无明显原因。患者接受支持性护理以维持正常血糖。他继续使用美沙酮,并被指示随访他的阿片类药物治疗计划,以评估剂量递减,以尽量减少未来低血糖的风险。虽然其他美沙酮诱发低血糖的病例报告强调了这种不良反应的风险,但我们的病例强调了评估美沙酮作为低血糖原因的重要性,并提供了关于在急性护理机构出院时降低剂量的合法性的讨论。
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来源期刊
Hospital Pharmacy
Hospital Pharmacy PHARMACOLOGY & PHARMACY-
CiteScore
1.70
自引率
0.00%
发文量
63
期刊介绍: Hospital Pharmacy is a monthly peer-reviewed journal that is read by pharmacists and other providers practicing in the inpatient and outpatient setting within hospitals, long-term care facilities, home care, and other health-system settings The Hospital Pharmacy Assistant Editor, Michael R. Cohen, RPh, MS, DSc, FASHP, is author of a Medication Error Report Analysis and founder of The Institute for Safe Medication Practices (ISMP), a nonprofit organization that provides education about adverse drug events and their prevention.
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