Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034063 (pulmonary edema)
 10,665 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During recent years, better awareness of the problem of cancer pain has resulted in the use of increased doses of narcotics. We report the cases of 3 patients who presented non-cardiogenic pulmonary edema while receiving large doses of narcotics for cancer pain. In all cases, pulmonary edema occurred after patients required large increases in the dose of narcotic over a short period of time for rapidly progressing pain. Although pulmonary edema has been described after overdose of narcotics, it had not been previously reported during the course of treatment for cancer pain. Its mechanism appears to be increased capillary permeability because of immunoglobulin and complement deposition of the lung, or due to neurogenic increase in permeability by the effect of narcotics on the brain-stem. We conclude that narcotic-induced pulmonary edema should be suspected in patients who require massive increases in the dose of narcotics. The use of adjuvant pharmacologic and non-pharmacologic analgesic treatments in order to minimize the need for dose increase, as well as the prevention of precipitating factors such as over hydration, corticosteroids or excessive oxygen therapy, should be contemplated in this population.
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PMID:Non-cardiogenic pulmonary edema after narcotic treatment for cancer pain. 197 76

Right hip replacement was scheduled for a 74-year-old man who was treated with morphine for cancer pain. As the patient developed dyspnea and hypoxia after anesthesia, he was intubated and kept under mechanical ventilation. A diagnosis of aspiration pneumonia with adult respiratory distress syndrome was made based on the detection of gall obtained from the endotracheal tube. A chest X-ray showed pulmonary edema. He was treated with positive pressure ventilation and inotropic support. As he developed severe shock 10 hours after the intubation, he was treated with 20 mg.kg-1 of methylprednisolone for 3 days. The steroid therapy was successful and he was extubated on the 6th postoperative day and was discharged from the ICU on the 7th postoperative day. High-dose pulse methylprednisolone therapy resulted in a remarkable clinical improvement. Corticosteroids rescue treatment is effective for such a severe case of aspiration pneumonia with shock when the treatment is done in the early phase of the pneumonia.
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PMID:[A successfully treated case of aspiration pneumonia with adult respiratory distress syndrome and shock]. 1205 43