Reversal of opioid-induced toxicity

Opioids are commonly used for pain control in palliative care setting. Accumulation of active metabolites of opioids can cause a well-recognized toxidrome including respiratory depression (RD), decreased conscious level, pinpoint pupils, and drop in blood pressure. Opioid toxicity is often associated with amount ingested and its speed of absorption in the body. This can have life-threatening effects on various body systems. Naloxone is an opioid antagonist that competitively binds to opioid receptors and reverses all their effects. The indication for use is RD because of known or suspected opioid overdose. This article presents a case report of 61-year-old female, a case of advanced pancreatic cancer, progressed on disease-modifying treatments and referred to palliative care for best supportive care. She developed features of morphine toxicity that was promptly identified and managed with use of naloxone and other supportive measures.