Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2025
Opioid Allergy Cross-Reactivity: A Retrospective Study Across Three Opioid Classes.
IgE-mediated opioid hypersensitivities, or true allergies, are rare and most adverse reactions to opioids can be attributed to side effects or to pseudo-allergies. Given that immune-mediated allergies to opioids are uncommon, literature regarding cross-reactivity among opioid classes are limited. This retrospective study aimed to determine the rates of cross-reactivity and tolerance among patients with previously documented opioid allergy or adverse drug reaction (ADR) across three opioid drug classes (natural, semisynthetic, and synthetic opioids). ⋯ A total of 1507 patients were identified with previously documented allergy or ADR to at least one opioid and at least one subsequent opioid drug exposure. No cross-reactivity among any of the opioid drug classes were found resulting in 100% re-exposure tolerance rates with all study arms. These findings could increase confidence in utilizing opioids in patients with historically documented opioid allergies or ADRs.
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J Pain Palliat Care Pharmacother · Jan 2025
Peripheral Edema as an Adverse Drug Reaction to Mirtazapine in an Oral Cavity Cancer Patient Receiving Palliative Care at Tertiary Care Centre: A Case Report.
Mirtazapine is a selective serotonergic antidepressant that functions by blocking adrenergic alpha2-autoreceptors and heteroreceptors and inhibiting 5-HT2 and 5-HT3 receptors. It is a noradrenergic drug. Mirtazapine has anxiolytic or sleep-quality-improving effects, aggravates appetite-stimulation, and has stomach emptying functions. ⋯ The peripheral edema completely resolved after stopping mirtazapine. To the best of our knowledge, this is the first instance of a patient with advanced oral cavity cancer experiencing peripheral edema as a result of receiving mirtazapine medication. Our study will assist medical professionals in identifying the potential use of mirtazapine in situations where peripheral edema develops quickly, facilitating its quick clearance.