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Propoxyphene in children with iatrogenic morphine dependence.

Abstract
In four children with iatrogenic morphine sulfate tolerance and dependence, narcotic withdrawal was successfully accomplished using propoxyphene napsylate. The patients showed signs and symptoms typical of narcotic withdrawal, which resolved with morphine administration and increased during attempts to lower the daily morphine dose. Propoxyphene napsylate at total daily doses of 25 to 65 mg/kg, administered at four-hour intervals, allowed rapid reduction of the morphine dosage, with few withdrawal signs and symptoms, and lessened respiratory depression. This treatment enabled patients to be rapidly weaned from the respirator. One child experienced increasing lethargy and respiratory depression and responded to naloxone hydrochloride and a decrease in the dose of propoxyphene; another had transient agitation, which may have been related to high levels of propoxyphene. Our treatment used alternating doses of propoxyphene and morphine, which allowed the child to be morphine free after four days and narcotic free after nine days.
AuthorsJ D Hasday, M Weintraub
JournalAmerican journal of diseases of children (1960) (Am J Dis Child) Vol. 137 Issue 8 Pg. 745-8 (Aug 1983) ISSN: 0002-922X [Print] UNITED STATES
PMID6869331 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Dextropropoxyphene
Topics
  • Child
  • Child, Preschool
  • Dextropropoxyphene (administration & dosage, therapeutic use)
  • Female
  • Humans
  • Iatrogenic Disease
  • Infant
  • Male
  • Morphine Dependence (complications, drug therapy)
  • Respiration, Artificial
  • Substance Withdrawal Syndrome (drug therapy, etiology)

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