Pattern of hydromorphone use in King Abdulaziz Medical City-Central Region (KAMC-CR)

Abstract Hydromorphone is a semi-synthetic opioid that acts mainly on the μ-opioid receptor. Hydromorphone has a fast onset of action, usually within 5 min, and its effectiveness peaks at approximately 20 min, which makes it favourable in the postoperative setting. It plays a role in the management...

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Autores principales:	Saja Alhabardi, Hind Almodaimegh, Maha Alammari
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6bc8069281064d0385a9e275b26a3bff
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spelling	oai:doaj.org-article:6bc8069281064d0385a9e275b26a3bff2021-12-02T15:26:58ZPattern of hydromorphone use in King Abdulaziz Medical City-Central Region (KAMC-CR)10.1038/s41598-021-88276-72045-2322https://doaj.org/article/6bc8069281064d0385a9e275b26a3bff2021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-88276-7https://doaj.org/toc/2045-2322Abstract Hydromorphone is a semi-synthetic opioid that acts mainly on the μ-opioid receptor. Hydromorphone has a fast onset of action, usually within 5 min, and its effectiveness peaks at approximately 20 min, which makes it favourable in the postoperative setting. It plays a role in the management of moderate to severe chronic pain. The most common adverse effects of hydromorphone are hypotension, bradycardia, and respiratory distress. The aim of this study was to determine the trend in the use of hydromorphone analgesics and to evaluate hydromorphone-related toxicity in King Abdulaziz Medical City-Central Region (KAMC-CR). A retrospective, cross-sectional study was carried out in KAMC-CR, and medical and pharmacological data were retrieved from electronic health records for adult patients who used hydromorphone between December 2014 and December 2015. The characteristics of the enrolled patients, including measured blood pressure, heart rate, respiration rate, oxygen saturation, and pain severity score, were collected. Moreover, we identified patients who received naloxone as a hydromorphone antidote. A total of 153 patients were included; 64.1% were male and 35.8% were female. The mean age of the included patients was 55.5 years old (+/− 18.6). Although the majority of patients reported an improvement in pain severity, 75 patients (49%) needed naloxone to overcome adverse effects of hydromorphone. The mean age of patients who received naloxone was 56.2 years old (+/− 20.5), their mean weight was 75.9 kg (+/− 17.2), and 61.3% of them were male (n = 46). Among those who received naloxone, 84% patients (n = 63) had received hydromorphone intravenously. The risk of respiratory depression was significantly higher in patients who received hydromorphone intravenously (IV) than in those who received it orally (p = 0.02). Hydromorphone can have adverse effect. Thus, we recommend evaluating cardiac parameters, oxygen saturation, respiration rate, and pain severity before administering hydromorphone, particularly in patients who have a high risk of cardiorespiratory adverse events, such as patients with cardiac disease, asthma, or chronic obstructive pulmonary disease. Additionally, we recommend the use of appropriate hydromorphone doses in cases of conversion from other opioid therapy or changes between oral and IV routes of the administration of hydromorphone. Moreover, we recommend establishing a policy to restrict the prescription of hydromorphone to avoid the overuse of hydromorphone and minimize the risk of adverse effects and medication errors.Saja AlhabardiHind AlmodaimeghMaha AlammariNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-5 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Saja Alhabardi Hind Almodaimegh Maha Alammari Pattern of hydromorphone use in King Abdulaziz Medical City-Central Region (KAMC-CR)
description	Abstract Hydromorphone is a semi-synthetic opioid that acts mainly on the μ-opioid receptor. Hydromorphone has a fast onset of action, usually within 5 min, and its effectiveness peaks at approximately 20 min, which makes it favourable in the postoperative setting. It plays a role in the management of moderate to severe chronic pain. The most common adverse effects of hydromorphone are hypotension, bradycardia, and respiratory distress. The aim of this study was to determine the trend in the use of hydromorphone analgesics and to evaluate hydromorphone-related toxicity in King Abdulaziz Medical City-Central Region (KAMC-CR). A retrospective, cross-sectional study was carried out in KAMC-CR, and medical and pharmacological data were retrieved from electronic health records for adult patients who used hydromorphone between December 2014 and December 2015. The characteristics of the enrolled patients, including measured blood pressure, heart rate, respiration rate, oxygen saturation, and pain severity score, were collected. Moreover, we identified patients who received naloxone as a hydromorphone antidote. A total of 153 patients were included; 64.1% were male and 35.8% were female. The mean age of the included patients was 55.5 years old (+/− 18.6). Although the majority of patients reported an improvement in pain severity, 75 patients (49%) needed naloxone to overcome adverse effects of hydromorphone. The mean age of patients who received naloxone was 56.2 years old (+/− 20.5), their mean weight was 75.9 kg (+/− 17.2), and 61.3% of them were male (n = 46). Among those who received naloxone, 84% patients (n = 63) had received hydromorphone intravenously. The risk of respiratory depression was significantly higher in patients who received hydromorphone intravenously (IV) than in those who received it orally (p = 0.02). Hydromorphone can have adverse effect. Thus, we recommend evaluating cardiac parameters, oxygen saturation, respiration rate, and pain severity before administering hydromorphone, particularly in patients who have a high risk of cardiorespiratory adverse events, such as patients with cardiac disease, asthma, or chronic obstructive pulmonary disease. Additionally, we recommend the use of appropriate hydromorphone doses in cases of conversion from other opioid therapy or changes between oral and IV routes of the administration of hydromorphone. Moreover, we recommend establishing a policy to restrict the prescription of hydromorphone to avoid the overuse of hydromorphone and minimize the risk of adverse effects and medication errors.
format	article
author	Saja Alhabardi Hind Almodaimegh Maha Alammari
author_facet	Saja Alhabardi Hind Almodaimegh Maha Alammari
author_sort	Saja Alhabardi
title	Pattern of hydromorphone use in King Abdulaziz Medical City-Central Region (KAMC-CR)
title_short	Pattern of hydromorphone use in King Abdulaziz Medical City-Central Region (KAMC-CR)
title_full	Pattern of hydromorphone use in King Abdulaziz Medical City-Central Region (KAMC-CR)
title_fullStr	Pattern of hydromorphone use in King Abdulaziz Medical City-Central Region (KAMC-CR)
title_full_unstemmed	Pattern of hydromorphone use in King Abdulaziz Medical City-Central Region (KAMC-CR)
title_sort	pattern of hydromorphone use in king abdulaziz medical city-central region (kamc-cr)
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/6bc8069281064d0385a9e275b26a3bff
work_keys_str_mv	AT sajaalhabardi patternofhydromorphoneuseinkingabdulazizmedicalcitycentralregionkamccr AT hindalmodaimegh patternofhydromorphoneuseinkingabdulazizmedicalcitycentralregionkamccr AT mahaalammari patternofhydromorphoneuseinkingabdulazizmedicalcitycentralregionkamccr
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Pattern of hydromorphone use in King Abdulaziz Medical City-Central Region (KAMC-CR)

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