heroin and Vomiting

Topics: Analgesia; Analgesics; Animals; Blood Pressure; Cyclizine; Heart Arrest; Heroin; Humans; Injections, Intravenous; Methadone; Morphine; Myocardial Infarction; Nausea; Pain; Pentazocine; Pulmonary Circulation; Respiration; Shock, Cardiogenic; Spirometry; Vomiting

Topics: Administration, Oral; Dose-Response Relationship, Drug; Drug Evaluation; Drug Stability; Female; Heroin; Humans; Male; Morphine; Sex Factors; Vomiting

Intramuscular pethidine is routinely used throughout the UK for labour analgesia. Studies have suggested that pethidine provides little pain relief in labour and has a number of side effects affecting mother and neonate. It can cause nausea, vomiting and dysphoria in mothers and can cause reduced fetal heart rate variability and accelerations. Neonatal effects include respiratory depression and impaired feeding. There are few large studies comparing the relative side effects and efficacy of different opioids in labour. A small trial comparing intramuscular pethidine with diamorphine, showed diamorphine to have some benefits over pethidine when used for labour analgesia but the study did not investigate the adverse effects of either opioid.. The Intramuscular Diamorphine versus Intramuscular Pethidine (IDvIP) trial is a randomised double-blind two centre controlled trial comparing intramuscular diamorphine and pethidine regarding their analgesic efficacy in labour and their side effects in mother, fetus and neonate. Information about the trial will be provided to women in the antenatal period or in early labour. Consent and recruitment to the trial will be obtained when the mother requests opioid analgesia. The sample size requirement is 406 women with data on primary outcomes. The maternal primary outcomes are pain relief during the first 3 hours after trial analgesia and specifically pain relief after 60 minutes. The neonatal primary outcomes are need for resuscitation and Apgar Score <7 at 1 minute. The secondary outcomes are an additional measure of pain relief, maternal sedation, nausea and vomiting, maternal oxygen saturation, satisfaction with analgesia, whether method of analgesia would be used again, use of Entonox, umbilical arterial and venous pH, fetal heart rate, meconium staining, time from delivery to first breath, Apgar scores at 5 mins, naloxone requirement, transfer to neonatal intensive care unit, neonatal haemoglobin oxygen saturation at 30, 60, 90, and 120 mins after delivery, and neonatal sedation and feeding behaviour during first 2 hours.. If the trial demonstrates that diamorphine provides better analgesia with fewer side effects in mother and neonate this could lead to a change in national practice and result in diamorphine becoming the preferred intramuscular opioid for analgesia in labour.. ISRCTN14898678Eudra No: 2006-003250-18, REC Reference No: 06/Q1702/95, MHRA Authorisation No: 1443/0001/001-0001, NIHR UKCRN reference 6895, RfPB grant PB-PG-0407-13170_IR5.

Topics: Analgesia, Obstetrical; Analgesics, Opioid; Apgar Score; Cardiotocography; Double-Blind Method; Feeding Behavior; Female; Heroin; Humans; Infant, Newborn; Injections, Intramuscular; Intensive Care, Neonatal; Labor Pain; Meperidine; Nausea; Oxygen; Patient Satisfaction; Pregnancy; Resuscitation; Vomiting

In a randomised study of analgesia following Caesarean section, we compared the efficacy and side effects of on-demand epidural diamorphine 2.5 mg with intravenous patient-controlled analgesia using diamorphine from the Baxter infusor system. Pain scores fell more rapidly in the epidural group, but by the fourth hour, and thereafter, both techniques had a similar analgesic effect. The patient-controlled analgesia group used significantly more diamorphine (p < 0.001), median 62 mg (range 18-120 mg) compared to the epidural group, median 10 mg (range 2.5-20 mg), over a significantly longer time period (p < 0.001), median 54.25 h (range 38-68 h) compared to the epidural group, median 40.75 h (range 6-70 h). The frequency and severity of nausea, vomiting and pruritus were similar in the two groups, however, the patient-controlled analgesia group were more sedated during the first postoperative day. This reached statistical significance (p < 0.05) between 9-24 h. Overall satisfaction scores (0-100) were high, but the patient-controlled analgesia group scored significantly higher: mean 85.5 (SD 12.2) compared to mean 77.0 (SD 11.7) in the epidural group.

Topics: Adult; Analgesia, Epidural; Analgesia, Obstetrical; Analgesia, Patient-Controlled; Cesarean Section; Female; Heroin; Humans; Infusions, Intravenous; Nausea; Pain, Postoperative; Patient Satisfaction; Pregnancy; Pruritus; Time Factors; Vomiting

Intrathecal diamorphine is associated with a high incidence of emetic symptoms. Six anti-emetic drugs representing various chemical groups were given in random order to patients undergoing total hip replacement and who had received intrathecal diamorphine 0.5-1.0 mg. The phenothiazines, perphenazine and prochlorperazine, were more effective than the others. It is suggested that this might be a useful model for the evaluation of new anti-emetics.

Topics: Aged; Antiemetics; Drug Evaluation; Heroin; Hip Prosthesis; Humans; Injections, Spinal; Nausea; Pain, Postoperative; Random Allocation; Vomiting

The analgesic effects of systemically administered diamorphine, caudal analgesia with 0.5% bupivacaine plain and caudal analgesia with 0.5% bupivacaine plain to which morphine sulphate had been added were studied in boys undergoing circumcision. Postoperative analgesia was assessed using a linear analogue scale. The time interval between operation and subsequent analgesic administration and the number of analgesic doses in 24 h were compared. The frequency of vomiting was noted. All three methods provided satisfactory results. The only detectable difference between the groups was a more rapid, but transient, recovery in the group receiving plain bupivacaine only. The frequency of vomiting was high in all groups. Caudal analgesia, with or without the addition of morphine, did not confer any advantage over injected diamorphine, and did not justify the extra time, risk and expense required to carry it out.

Topics: Anesthesia, Caudal; Anesthesia, Epidural; Bupivacaine; Child; Child, Preschool; Circumcision, Male; Heroin; Humans; Male; Morphine; Pain, Postoperative; Postoperative Complications; Time Factors; Vomiting

Topics: Acute Disease; Administration, Oral; Adolescent; Adult; Clinical Trials as Topic; Female; Heroin; Humans; Methadone; Nausea; Placebos; Propranolol; Substance Withdrawal Syndrome; Substance-Related Disorders; Time Factors; Vomiting

To investigate the manifestations and incidence of headaches caused by heroin in Chinese women.. This was a survey study conducted from 29 June to 3 July 2015 with women attending the Shanxi Drug Rehabilitation Centre for Women (China). All study subjects were newly admitted and had not begun their drug rehabilitation. Demographic characteristics, heroin usage and headache episodes within the previous 3 months were surveyed, especially the presence of a headache within 2 hours of heroin use. Details of the severity, location, premonitory symptoms and characteristics of headaches were recorded.. Of the 90 heroin-dependent patients, 74 experienced headache attacks within 2 hours of heroin use, and the headaches subsided within 72 hours of discontinuation of heroin use. Most heroin-induced headaches were similar to migraines and manifested as pulsating pain in 54 patients (51/74, 68.9%); bilateral pain was reported by 46 patients (46/74, 62.2%). Approximately half of the patients with heroin-induced headaches also reported accompanying symptoms of nausea, vomiting, and light and sound sensitivity.. Heroin-induced headache may eventually be listed as a new class of headache in the International Classification of Headache Disorders.

Topics: Adult; China; Female; Headache Disorders; Heroin; Heroin Dependence; Humans; Incidence; Nausea; Photophobia; Self Report; Severity of Illness Index; Vomiting; Young Adult

To estimate the range and severity of heroin overdose related morbidity.. Cross-sectional survey.. Sydney, Australia.. 198 heroin users.. Sixty-nine per cent had experienced a heroin overdose, 28% in the preceding 12 months. Of those who had overdosed, 79% had experienced at least one overdose-related morbidity symptom. An ambulance had attended overdoses for 59% of subjects, 33% had required hospital treatment for overdose, and 14% had experienced overdose-related complications of sufficient severity to be admitted to a hospital ward. Indirect overdose-related morbidity included: physical injury sustained when falling at overdose (40%), burns (24%) and assault while unconscious (14%). Direct overdose-related morbidity included: peripheral neuropathy (49%), vomiting (33%), temporary paralysis of limbs (26%), chest infections (13%) and seizure (2%).. There appears to be extensive morbidity associated with non-fatal overdose. This is clearly an area that requires more research to document the prevalence and nature of these harms, and factors associated with them.

Topics: Adolescent; Adult; Age of Onset; Cross-Sectional Studies; Drug Overdose; Female; Heroin; Heroin Dependence; Humans; Length of Stay; Male; Middle Aged; Narcotics; New South Wales; Paralysis; Peripheral Nervous System Diseases; Pneumonia; Sex Factors; Time Factors; Vomiting

From July 1999 it became evident that a rising number of heroin users were presenting to the Dandenong Hospital Emergency Department with a rapid onset, florid opioid withdrawal syndrome following the intravenous injection of what they had believed to be heroin. We suspect that the injected substance was in fact naltrexone. This paper describes two such cases and reviews the literature on naltrexone. Recommendations regarding the management of the acute opioid withdrawal syndrome are made.

Topics: Acute Disease; Adult; Colic; Emergency Medical Services; Female; Heroin; Heroin Dependence; Humans; Injections, Intravenous; Naltrexone; Narcotics; Substance Withdrawal Syndrome; Vomiting

Topics: Adult; Body Weight; Bulimia; Female; Heroin; Heroin Dependence; Humans; Vomiting

One hundred and seventy-eight patients undergoing total hip replacement and 67 patients undergoing spinal surgery were given diamorphine intrathecally in varying doses. Doses in mg/kg were plotted against duration of analgesia and the absence of retention and emetic symptoms in each type of surgery. Analysis showed that these were not dose dependent within the therapeutic range of 0.005-0.015 mg/kg.

Topics: Dose-Response Relationship, Drug; Drug Evaluation; Female; Heroin; Hip Prosthesis; Humans; Injections, Spinal; Male; Palliative Care; Urination; Vomiting

Patients undergoing lumbar laminectomy were given extradural narcotic, either 5 mg morphine sulphate or 5.5 mg heroin (diamorphine hydrochloride); the extradural catheter had been positioned adjacent to the dura under direct vision. Plasma morphine concentrations measured by specific radioimmunoassay showed that peak concentrations occurred significantly earlier with heroin (4.7 +/- 0.6 min, mean +/- SEM) than with morphine (7.6 +/- 0.9 min) and that peak concentrations were significantly higher after heroin 5-10 min after extradural injection. The fraction of extradural heroin crossing the dura was estimated to be 55% of the fraction of morphine crossing the dura. Postoperative fentanyl requirements using demand analgesia were the same with extradural morphine as with extradural heroin (mean, 6.6 micrograms/hr). Clinically significant slowing of respiratory rate occurred only after extradural heroin (three patients).

Topics: Adult; Analgesia; Anesthesia, Epidural; Female; Heroin; Humans; Kinetics; Laminectomy; Male; Morphine; Pain, Postoperative; Radioimmunoassay; Respiration; Time Factors; Vomiting

Topics: Amphetamines; Behavior; Cannabis; Drug Therapy; Epilepsy; Heroin; Humans; Illicit Drugs; Lysergic Acid Diethylamide; Mental Disorders; Nausea; Obesity; Pain; Vomiting

Topics: Adolescent; Adult; Apgar Score; Birth Weight; Female; Heroin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Methadone; Neurologic Manifestations; Opium; Phenobarbital; Pregnancy; Pregnancy Complications; Substance Withdrawal Syndrome; Substance-Related Disorders; Vomiting

Topics: Analgesics; Diazepam; Female; Fentanyl; Heroin; Humans; Levorphanol; Male; Meperidine; Methadone; Morphine; Papaverine; Phenazocine; Preanesthetic Medication; Vomiting

Topics: Adult; Aged; Ejaculation; Heroin; Humans; Injections, Intramuscular; Injections, Intravenous; Male; Middle Aged; Nalorphine; Opium; Substance Withdrawal Syndrome; Substance-Related Disorders; Time Factors; Vomiting

Topics: Adult; Heroin; Humans; Methohexital; Morphine; Nausea; Nitrous Oxide; Preanesthetic Medication; Vomiting