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Læknablaðið - ágú. 2019, Blaðsíða 29

Læknablaðið - ágú. 2019, Blaðsíða 29
Barst til blaðsins 20. febrúar, samþykkt til birtingar15. apríl 2019. 1. Zanger UM, Schwab M. Cytochrome P450 enzymes in drug metabolism: Regulation of gene expression, enzyme activities, and impact of genetic variation. Pharmacol Ther 2013; 138: 103-41. 2. Maher RL, Hanlon J, Hajjar ER. Clinical consequences of polypharmacy in elderly. Expert opinion on drug safety 2014; 13: 57-65. 3. Waldhoer M, Bartlett SE, Whistler JL. Opioid receptors. Annu Rev Biochem 2004; 73: 953-90. 4. Kelly E. Efficacy and ligand bias at the mu-opioid recept- or. Br J Pharmacol 2013; 169: 1430-46. 5. Boyer EW. Management of Opioid Analgesic Overdose. The New England journal of medicine 2012; 367: 146-55. 6. Lalley PM. Opioidergic and dopaminergic modulation of respiration. Respir Physiol Neurobiol 2008; 164: 160-7. 7. Murray RB, Adler MW, Korczyn AD. The pupillary effects of opioids. Life Sci 1983; 33: 495-509. 8. Li Y, van den Pol AN. Mu-opioid receptor-mediated depression of the hypothalamic hypocretin/orexin arousal system. J Neurosci 2008; 28: 2814-9. 9. Hagelberg NM, Nieminen TH, Saari TI, Neuvonen M, Neuvonen PJ, Laine K, et al. Voriconazole drastically incr- eases exposure to oral oxycodone. Eur J Clin Pharmacol 2009; 65: 263-71. 10. Watanabe M, Homma M, Momo K, Okoshi Y, Wada T, Hara A, et al. Effects of voriconazole co-administration on oxycodone-induced adverse events: a case in the retro- spective survey. Eur J Clin Pharmacol 2011; 67: 859-61. 11. Alghothani L, Gustin J. Oxycodone-induced neurotoxicity secondary to concurrent voriconazole use in a patient with cancer. Journal of opioid management 2017; 13: 141-2. 12. Lalovic B, Kharasch E, Hoffer C, Risler L, Liu-Chen LY, Shen DD. Pharmacokinetics and pharmacodynamics of oral oxycodone in healthy human subjects: role of circulating active metabolites. Clin Pharmacol Ther 2006; 79: 461-79. 13. Smith HS. Opioid metabolism. Mayo Clin Proc 2009; 84: 613-24. Heimildir Arnar Bragi Ingason1 Magnús Karl Magnússon1 Gunnar Bjarni Ragnarsson2 67-year-old female who was taking oxycodone due to chronic chest pain suffered from opioid overdose after starting treatment with voriconazole. Voriconazole is an antifungal that inhibits CYP3A4 activity in the liver. In the case reported herein, this led to higher plasma concentration of oxycodone which caused severe opioid overdose. Opioid overdose following voriconazole treatment – case report ENGLISH SUMMARY 1Faculty of Medicine, University of Iceland, 2 Department of Medical Oncology, Landspitali University Hospital Keywords: Drug interactions, oxycodone, voriconazole, adverse effects, opioid, cytochrome P450. Correspondence: Magnús Karl Magnússon, magnuskm@hi.is S J Ú K R A T I L F E L L I LÆKNAblaðið 2019/105 337

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