Sedation may occur during therapy with opioid analgesia. This is can result in significant impairment for the patient
Risk factors for sedation:
(1) advanced age
(2) renal insufficiency
(3) hepatic insufficiency
(4) dementia
(5) head injury or brain metastases
(6) high doses of the opioid
(7) drugs that interfere with opioid metabolism
(8) therapy with drugs that cause sedation
Management:
(1) Reduce the dose of the opioid.
(2) Select an opioid with a short half-life and inactive metabolites.
(3) Discontinue or reduce the dose of other drugs that may cause sedation.
(4) Avoid drugs that interfere with opioid metabolism.
(5) Consider therapy with a stimulant agent.
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Specialty: Toxicology, Emergency Medicine, Critical Care
