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

Date: May 11,2021 |Hits: 239 Download PDF How to cite this paper

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


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.


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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 ExplorationInternational Journal of Clinical and Experimental Medicine Research5(3), 249-253.

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

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