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International Journal of Clinical and Experimental Medicine Research

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ArticleOpen Access http://dx.doi.org/10.26855/ijcemr.2021.07.003

Systemic Tremor Induced by Oxycodone Hydrochloride Controlled-Release Tablets in a Patient: A Case Report and Mechanism Exploration

Qirui Tai1,*, Mili Shi1, Qiuyan Song1, Yijie Shi1, Zhiwei Tang2

1Sixth Affiliated Hospital of Kunming Medical University, Yuxi, Yunnan 653100, China.

2First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650000, China.

*Corresponding author: Qirui Tai

Published: May 11,2021

Abstract

Rationale: ORCT drug instructions display, OCRT can induce a rare adverse reaction of systemic tremor. Patient after taking a series of drugs and OCRT, the patient experienced adverse event of systemic tremor. Hence, we hypothesize that tremor is caused by OCRT. Patient concerns: An 83-year-old male patient a hard mass sized about 5 cm × 3 cm could be touched on the inner side of anterior superior spine of left lower abdomen, local tenderness. Diagnosis: 1. Abdominal distension and poor appetite to be checked; 2. Previous operation for bladder cancer; 3. Acute exacerbation of chronic obstructive pulmonary disease; 4. Arteriosclerotic encephalopathy; 5. Prostatic hyperplasia; and 6. Sleep disorders. Interventions: After hospitalization, the patient was given symptomatic treatment with Corydalis Yanhusuo analgesic pills and Shubitong capsules. On October 29, the patient’s pain was still poorly controlled, so OCRT (10 mg, q12h PO) was given. On November 2, the dose of OCRT was adjusted to 20 mg, q12h PO. At 13:00 on November 3, the patient suffered from dizziness and systemic tremor for more than 5 h. On November 4, the patient suffered from dizziness and systemic tremor, without apparent neurological signs. Outcomes: On November 4, OCRT was discontinued, and morphine sulfate controlled-release tablets (30 mg, q12h PO) were administered. MRI examination: No abnormal findings on craniocerebral DWI scans; EEG examination: Abnormal findings, epilepsy was excluded tempora-rily. On November 4, the tremor in patient was improved. On November 5, the patient no longer complained of tremor. Lessons: Correlation analysis between the tremor and the case suggested that the tremor was an adverse reaction caused by OCRT. According to our analysis, relevant mechanism of action was probably associated with the lowered secretion of γ-GABA and NE caused by the action of OCRT on μ receptors, which led to rhythmic, involuntary tremor of muscles in one or more functional areas. Or it may be that the OCRT caused excessive production of 5-HT to induce the 5-HT syndromic tremor.

Keywords

Oxycodone, Tremor, Mechanism, Locus Coeruleus, Μreceptors, Gene Poly-morphism

References

[1] Pöyhiä, R., A. Vainio, E. Kalso. (1993). A review of oxycodone’s clinical pharmacokinetics and pharmacodynamics. J Pain Symptom Manage, 8: 63-67.

[2] Chen, T., H. Wu, C. Zhang. (2018). Literature Analysis on Adverse Drug Reactions caused by Oxycodone in China. Chinese Journal of Pharmacoepidemiology, 27: 53-57.

[3] Hu, J. N. (2014). Delirium induced by oxycodone hydrochloride for cancer pain control: A report and analysis of two cases. Chinese Journal of Pain Medicine, 20: 367-368.

[4] Xu, X., X. Wu, Z. Xue, X. Wang, L. Xiong, M. Tian, C. Yao. (2013). Efficacy and safety of oxycodone hydrochloride injection for postoperative analgesia in patients undergoing operation under general anesthesia: a prospective, randomized, blind, multi-center, positive-controlled, clinical trial. Chinese Journal of Anesthesiology, 269-274.

[5] Cao, Y., C. Zheng, Y. Yang. (2016). Two novel adverse reactions like convulsions caused by acetaminophen and oxycodone tablets. Chinese Journal of Hospital Pharmacy, 36: 785.

[6] Zhang, S. Y., Zhang, T. (2003). Research status of tremor and its mechanism. Chinese Journal of Rehabilitation Theory and Practice: 21-23.

[7] Klein, M., Z. Rudich, B. Gurevich, M. Lifshitz, S. Brill, M. Lottan, N. Weksler. (2005). Controlled-release oxycodone-induced seizures. Clin Ther, 27: 1815-1818.

[8] Yang, L.Y., He, X. Y. (2011). Clinical observation of 222 elderly patients with cardiogenic cerebral ischemia syndrome from high-altitude areas. Chinese and Foreign Medical Research, 09: 95-96.

[9] Chen, W. B., Pan, X. L. (2008). Diagnostics (Seventh Edition). Beijing: People’s Medical Publishing House, 66.

[10] Zhang, X. H., Chen, B. Y. (2014). Sudden syncope and convulsions are not epilepsy Well-Being, 04: 44-45.

[11] Sun, C. J. (2008). A case report of 5-HT syndrome induced by paroxetine. Journal of Psychiatry, 6: 422.

[12] Deuschl, G., Raethjen, J., Baron, R., Lindemann, M., Wilms, H., Krack, P. (2000). The pathophysiology of parkinsonian tremor: a review. J Neurol, 247: V33-V48.

[13] Hardman, J. G. E. L. (2004). Goodman & Gilman’s The Pharmacological Basis of Therapeutics (10th edition). Beijing: People’s Medical Publishing House, 447.

[14] Xu, J. (2014). Pharmacology and clinical application of oxycodone hydrochloride. J Clin Anesthesiol, 30: 511-513.

[15] Benito-León, J., Louis. E. D. (2006). Essential tremor: emerging views of a common disorder. Nat Clin Pract Neurol, 2: 666-678; quiz 662p following 691.

[16] Wu, Y. W., Xiao, Q. (2009). Progress in the research of pathogenesis and treatment of essential tremor. Chinese Journal of Contemporary Neurology and Neurosurgery, 09: 235-237.

[17] Jiang, L. (2015). Locus coeruleus injury promotes the development and progression of Parkinson’s disease. Chinese Society of Toxicology: 233.

[18] Martin, T. G. (1996). Serotonin syndrome. Ann Emerg Med., 28: 520-526.

[19] Zafonte, R. D., Cullen, N., Lexell, J. (2002). Serotonin agents in the treatment of acquired brain injury. J Head Trauma Rehabil., 17: 322-334.

[20] Numenthaler, M., Mattle, H. (2004). Neurology. Stuttgart: Thieme, 274: 305-307.

[21] Richards, D., J. Aronson, D. John Reynolds, J. Coleman. (2006). Oxford Handbook of Practical Drug Therapy. Beijing: People’s Medical Publishing House, P. 299.

[22] Chen, M. (2010). One case of 5-HT syndrome induced by tramadol hydrochloride injection and paroxetine. Chinese Journal of Pharmacovigilance, 07: 185.

[23] Li, Q., Liu, Y., Yu, Y. (2016). μ opioid receptor A118G gene polymorphism predicts analgesic effect of oxycodone hydrochlo-ride. Medical Guide, 33: 481-484.

How to cite this paper

Systemic Tremor Induced by Oxycodone Hydrochloride Controlled-Release Tablets in a Patient: A Case Report and Mechanism Exploration

How to cite this paper: Qirui Tai, Mili Shi, Qiuyan Song, Yijie Shi, Zhiwei Tang. (2021) Systemic Tremor Induced by Oxycodone Hydrochloride Controlled-Release Tablets in a Patient: A Case Report and Mechanism Exploration. International Journal of Clinical and Experimental Medicine Research, 5(3), 249-253.

DOI: http://dx.doi.org/10.26855/ijcemr.2021.07.003

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