Dani was given Dilaudid for pain. She’s sleeping and her respiratory rate is 4 breaths/minute. If action isn’t taken quickly, she might have which of the following reactions?
A. Asthma attack
B. Respiratory arrest
C. Improve cardiac output
D. Constipation
Correct Answer: B. Respiratory arrest
Narcotics can cause respiratory arrest if given in large quantities. Threatening life events are to be managed promptly as the respiratory depression it causes in overdose may lead to death. Hydromorphone is a target of research in intrathecal pumps, which has a promising role in refractory pain. Concurrent use of hydromorphone with other CNS depressants, including benzodiazepine and barbiturates, can induce severe respiratory and/or CNS depression. For this purpose, the use of alternative analgesic agents is necessary.
Option A: Asthma comprises a range of diseases and has a variety of heterogeneous phenotypes. The recognized factors that are associated with asthma are a genetic predisposition, specifically a personal or family history of atopy (propensity to allergy, usually seen as eczema, hay fever, and asthma).
Option C: Hydromorphone is a rapid-acting potent opioid used in acute and chronic pain. It is interchangeable with other opioids and has a specific conversion scale. Hydromorphone is available in multiple forms, including injection and oral forms, immediate-release, and extended-release forms. The risk profile of this drug requires careful prescription and administration, with thorough knowledge of the potential harms and interactions.
Option D: Hydromorphone is to be avoided in any gastrointestinal obstruction or hypomotility, including ileus. Postoperative ileus should prompt careful administration of hydromorphone, to prevent prolonged ileus.
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