A Case of Oxycodone-related Respiratory Depression Induced by Tumor Lysis Syndrome

Koji Teramoto; Komaki Hayashi; Chiaki Hasegawa; Hiroaki Morii; Yuri Kimura; Seiko Hattori; Sachiyo Morita; Hidetoshi Sumimoto; Kazuya Teramura; Yataro Daigo

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A Case of Oxycodone-related Respiratory Depression Induced by Tumor Lysis Syndrome

VernacularTitle:腫瘍崩壊症候群が原因となって出現したオキシコドンによる呼吸抑制の1例
Author: Koji TERAMOTO ¹ ; Komaki HAYASHI ² ; Chiaki HASEGAWA ³ ; Hiroaki MORII ² ; Yuri KIMURA ³ ; Seiko HATTORI ⁴ ; Sachiyo MORITA ³ ; Hidetoshi SUMIMOTO ⁵ ; Kazuya TERAMURA ³ ; Yataro DAIGO ⁵
Author Information

1. Department of Medical Oncology, Shiga University of Medical Science Hospital
2. Cancer Center, Shiga University of Medical Science Hospital
3. Palliative Care Team, Shiga University of Medical Science Hospital
4. Nursing Division, Shiga University of Medical Science Hospital
5. Department of Pharmacy, Shiga University of Medical Science Hospital
Keywords: tumor lysis syndrome; oxycodone; respiratory depression; systemic chemotherapy
From:Palliative Care Research 2020;15(2):161-166
CountryJapan
Language:Japanese
Abstract: Tumor lysis syndrome (TLS) is a metabolic disorder that is caused by acute lysis of massive tumor cells. We report a case with opioids-related severe respiratory depression induced by TLS. A 39-year-old man received chemotherapy for mycosis fungoides. Two hours after administration of chemotherapeutic agents, his renal function worsened, and he was diagnosed with TLS by laboratory and clinical findings. Moreover, he showed severe respiratory depression and pinpoint pupils, and become drowsy. These symptoms were attributed to oxycodone that had been administered to treat his tumor-related cutaneous pain, and were improved by injection of anti-opioids agent naloxone. In this case, we consider that the clearance of oxycodone was disrupted by renal dysfunction caused by TLS, leading to enhancement of the effects of oxycodone.