PETHIDINE RELATED SUDDEN DEATH

Year 2013, Volume: 27 Issue: 1, 41 - 43, 30.04.2013

Zehra Bozdağ Emine Türkmen Şamdanci Nurhan Şahin Nasuhi Engin Aydın Sadegül Sayın

https://izlik.org/JA38SR74ND

Abstract

Pethidine, the first synthetic opioid analgesic, was developed as
a potential antispasmodic agent.
Pethidine is used to treat moderate to severe pain. It is safer than
morphine and carries less risk for
addiction. Pethidine overdose can
cause respiratory depression or
coma.
The case we present is a 34 years
old male doctor found dead in his
room at the hospital. Doctor was
found dead sitting on an armchair
where there was a used 100 mg
Aldolan (Pethidine) ampoule and
an injector. According to information taken from his relatives, he
had been operated for cervical
disc hernia a few years ago and
complaining about headaches after operation. He had been frequently using oral analgesic drugs
because of his headaches.
In the microscopic examination,
there were thrombi in the lumens
of pulmonary artery branches,
arterioles and capillaries. A detailed medical history, a systemic
autopsy, histopathological examination and toxicological analysis
revealed that the cause of death
was the pethidine-related respiratory arrest. In this study, we
wanted to point out that drug
usage in patients should be under supervision of a doctor even if
they are health care workers.

Keywords

pethidine , sudden death , respiratory arrest

References

• Chou R, Fanciullo GJ, Fine PG, et al. Opioid treatment guidelines: clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009;10(2):113–30.
• Trescot AM, Helm S, Hansen H, et al. Opioids in the management of chronic noncancer pain: an update of American Society of the Interventional Pain Physicians’ (ASIPP) guidelines. Pain Physician. 2008;(special issue 11):S5–S62.
• Latta KS, Ginsberg B, Barkin RL. Meperidine: a critical review. Am J Ther. 2002;9(1):53–68.
• Mather LE, Meffin PJ. Clinical pharmacokinetics of pethidine. Clin Pharmacokinet.1978 Sep-Oct;3(5):352-68.
• Tuğcu H, Özdemir Ç, Dalgıç M, Ulukan MÖ, Celasun B: GATA Adli Tıp Anabilim Dalı’nda 1995-2002 yılları arasında düzenlenen adli raporların yeni Türk Ceza Kanunu açısından değerlendirilmesi. Gülhane Tıp Derg 2005, 47:102-5.
• Yavuz MS, Ozguner IF: Süleyman Demirel Üniversitesi Tıp Fakültesi Acil Servis’ine 1999-2001 yılları arasında müracaat eden adli olguların değerlendirilmesi. Adli Tıp Derg 2003, 17:47-53
• Buyuk Y, Uzun I, Koçak U, Ozer E. Bir Sağlık Çalışanında Petidin Kötüye Kullanımına Bağlı Ani Ölüm: Olgu Sunumu. Adli Tıp Dergisi 2005;19(1):33-6.
• Sternbach H. The serotonin syndrome. Am J Psychiatry 1991;148:705-13.
• Dunkley EJC, Isbister GK, Sibbritt D, Dawson AH, Whyte IM. The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity. Q J Med 2003; 96:635-42.
• Micromedex. Thomson Micromedex. Micromedex(R) Healthcare Series. 1974- 2004; Vol 119.
• Levy JH, Rockoff MA. Anaphylaxis to meperidine. Anesth Analg 1982;61:301-3.
• Daldrup Th. A Forensic Toxicological Dilemma: the interpretation of post-mortem concentrations of central acting analgesics. Forensic Science International 142z(2004) 157-160.