IS THERE ANY REASON A DOCTOR WOULD ORDER SEVERAL OPIODS

Posted on Sat, 2 Jan 2021

Question: IS THERE ANY REASON A DOCTOR WOULD ORDER SEVERAL OPIODS AND ATIVAN, AND GABAPENTIN FOR SOMEONE WHO IS SUSPECTED OF HAVING PNEUMONIA. AND HAVING NO PAIN. OPIODS ORDERED MSCONTIN, HYDROCODONE, DILAUDID, FENT\ANYL,. HYDROMORPHONE.

Answered by Dr. Indranil Ghosh (7 hours later)

Brief Answer:
Apparently there's no reason

Detailed Answer:
Hi
Thanks for your query.

If a person is breathing him/herself and is suspected to having pneumonia, without significant pain, there's no apparent reason for opioids.

However, if the person is on mechanical ventilation, he or she may require opioids, or ativan for sedation so that ventilation is more effective.
Gabapentin is usually given for seizures or neuropathic pain.

Hope this helps.
Regards

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Indranil Ghosh (13 hours later)

lLET ME SEE IF THAT MAKES SENSE. YOU ARE SAYING THAT OPIODS HELP BREATHING . IF SHE WAS BEING GIVEN OXYGEN NOT ON VENTILATOR, THAN OPIODS ALONG WITH ATIVAN AND GABAPENTIN WOULD HELP. AND IF SO HOW MUCH. WOULLD SEV ERAL BOLUSES OF ATIVAN AND OVER 1600 MCG OF FENTINYL THAT WOULD HELP. HOW DOES THAT HAPPEN WHEN WORNINGS SAYCAUSES REPIRATORY DISTRESS AND POSSIBLE DEATH.

Answered by Dr. Indranil Ghosh (1 hour later)

Brief Answer:
No, I said opioids help when on mechanical ventilation

Detailed Answer:
In spontaneous breathing, opioids don't help and can cause severe respiratory depression.

On the contrary, if the patient is receiving mechanical ventilation, then opioids can help the ventilation being delivered.

Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Indranil Ghosh (25 hours later)

would their spo2 reading go down if taking a lot of opiods. would they have a higher oxygen demand.

Answered by Dr. Indranil Ghosh (9 hours later)

Brief Answer:
SpO2 may go down

Detailed Answer:
Oxygen demand doesn't increase but since the breaths may become shallow, spo2 may go down, especially if there's a pre existing lung condition.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Indranil Ghosh (11 hours later)

change gears a little. since you are an oncologist should be in your expertise.
this is question concerning A chemo drug called Gemzar. i understand that the drug is generally out of your system within 48 hrs. if a patient took this drug for five times over the course of two months. stopped taking it on may 18th. was putt in hospital on XXXXXXX second for some tests, started having breathing issues while in the hospital about two and a half weeks from date of last treatment of Gemzar.
Would it be likely that it was the gemzar that caused the lung issue. three and a half weeks from last treatment oxygen demand was over 50L.

Answered by Dr. Indranil Ghosh (46 minutes later)

Brief Answer:
Possibility is there

Detailed Answer:
Yes, gemzar is known to cause lung issues. Sometimes it's delayed manifestation. So it remains a possibility. However, there are numerous other causes of lung problems in a patient with cancer and all of them need to be ruled out before we can attribute it to gemzar.

Regards

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Above answer was peer-reviewed by : Dr. Raju A.T