The Drug-Induced Respiratory Disease Website and App

Frequency - Incidence

Incidence of respiratory adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for respiratory adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic

IX.d

Respiratory failure from ventilatory depression (due to neuromuscular blockade/paralysis)

Risk of developing this complication appears to be higher in patients with baseline respiratory impairment including COPD (PMID 25174016). Opiates in the parturient may cause respiratory depression in the newborn (PMID: 29769809, 30311212)

Publications

Jungquist CR, Card E, Charchaflieh J, Gali B, Yilmaz M

Preventing Opioid-Induced Respiratory Depression in the Hospitalized Patient With Obstructive Sleep Apnea.

Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses. 2018;33(5):601-607

Stevens JP, Wall MJ, Novack L, Marshall J, Hsu DJ, Howell MD

The Critical Care Crisis of Opioid Overdoses in the United States.

Annals of the American Thoracic Society. 2017;14(12):1803-1809

Van Ryswyk E, Antic NA

Opioids and Sleep-Disordered Breathing.

Chest. 2016;150(4):934-944

Lee LA, Caplan RA, Stephens LS, Posner KL, Terman GW, Voepel-Lewis T, Domino KB

Postoperative opioid-induced respiratory depression: a closed claims analysis.

Anesthesiology. 2015;122(3):659-65

Biesiada J, Chidambaran V, Wagner M, Zhang X, Martin LJ, Meller J, Sadhasivam S

Genetic risk signatures of opioid-induced respiratory depression following pediatric tonsillectomy.

Pharmacogenomics. 2014;15(14):1749-1762

Cobaugh DJ, Gainor C, Gaston CL, Kwong TC, Magnani B, McPherson ML, Painter JT, Krenzelok EP

The opioid abuse and misuse epidemic: implications for pharmacists in hospitals and health systems.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists. 2014;71(18):1539-54

Zedler B, Xie L, Wang L, Joyce A, Vick C, Kariburyo F, Rajan P, Baser O, Murrelle L

Risk factors for serious prescription opioid-related toxicity or overdose among Veterans Health Administration patients.

Pain medicine (Malden, Mass.). 2014;15(11):1911-29

Niesters M, Overdyk F, Smith T, Aarts L, Dahan A

Opioid-induced respiratory depression in paediatrics: a review of case reports.

British journal of anaesthesia. 2013;110(2):175-82

Yamanaka T, Sadikot RT

Opioid effect on lungs.

Respirology (Carlton, Vic.). 2013;18(2):255-62

Boyer EW

Management of opioid analgesic overdose.

The New England journal of medicine. 2012;367(2):146-55

Boom M, Niesters M, Sarton E, Aarts L, Smith TW, Dahan A

Non-analgesic effects of opioids: opioid-induced respiratory depression.

Current pharmaceutical design. 2012;18(37):5994-6004

Levine M, Brooks DE, Truitt CA, Wolk BJ, Boyer EW, Ruha AM

Toxicology in the ICU: Part 1: general overview and approach to treatment.

Chest. 2011;140(3):795-806

Sam WJ, MacKey SC, Lötsch J, Drover DR

Morphine and its metabolites after patient-controlled analgesia: considerations for respiratory depression.

Journal of clinical anesthesia. 2011;23(2):102-6

Ostermeier AM, Roizen MF, Hautkappe M, Klock PA, Klafta JM

Three sudden postoperative respiratory arrests associated with epidural opioids in patients with sleep apnea.

Anesthesia and analgesia. 1997;85(2):452-60

Gill AM, Cousins A, Nunn AJ, Choonara IA

Opiate-induced respiratory depression in pediatric patients.

The Annals of pharmacotherapy. 1996;30(2):125-9