Poisoning methadone

Alkaloids range from the belladonna alkaloids, such as atropine and scopalomine—which are used as poisons, cold remedies, and truth serums —to dextromethorphan, a cough suppressant (anti-tussive). But the most widely known alkaloids are the opiates, such as morphine, heroin, fentanyl, oxycodone, and methadone. These act on... 

Fugelstad A, Stenbacka M, Leifman A, Nylander M Thibhn I (2007). Methadone maintenance treatment the balance between lifesaving treatment and fatal poisonings. Addiction, 102, 406-12... 

For the relief of pain arising from spasm of smooth muscle, as in renal or biliary colic, morphine is frequently employed. Other measures including antispasmodics such as atropine, atropine substitutes, theophylline, nitrites, and heat may be employed first however, if they are ineffective, meperidine, methadone, or opiates must be used. Morphine relieves pain only by a central action and may aggravate the condition producing the pain by exaggerating the smooth muscle spasm. Morphine may also be indispensable for the relief of pain due to acute vascular occlusion, whether this be peripheral, pulmonary, or coronary in origin. In painful acute pericarditis, pleurisy, and spontaneous pneumothorax, morphine is likewise indicated. Carefully chosen and properly spaced doses of codeine or morphine may occasionally be necessary in pneumonia to control pain, dyspnea, and restlessness. Traumatic pain arising from fractures, bums, etc., frequently requires morphine. In shock, whether due to trauma, poisons, or other causes, morphine may be required to relieve severe pain. 

Although methadone is used for the management of opioid dependence, symptoms of overdose are similar to those of morphine poisoning. 

SAFETY PROFILE Poison by ingestion, intraperitoneal, intravenous, subcutaneous, and intraduodenal routes. Human systemic effects coma, nausea or vomiting, respiratory changes, respiratory depression, somnolence. An experimental teratogen. Experimental reproductive effects. Caution Abuse leads to habituation or addiction. When heated to decomposition it emits toxic fumes of NOx. See also METHADONE HYDROCHLORIDE. 

Leikin JB, Paloucek FP, Methadone. In Leikin JB ed. Leikin Paloucek s poisoning toxicology handbook 3" Hudson, OH Lexi-Comp, Inc, 2002 806-8. 

W-Allylnormorphine does not antagonize the respiratory depression or the general central depression from the barbiturates. It is a specific antidote for morphine, meperidine, and methadone poisoning (Eckenhoff et al., 88). 

Natural or synthetic colouring agents or dyes can be added to match the taste (e.g. yellow for a banana taste) in order to improve the attractiveness of the product or, more appropriately in children, to enable easy product identification, particularly in the case of poisonous materials (e.g. green methadone mixture, external antiseptic). Colouring agents or dyes can also be used to mask an unpleasant drug colour or coloured degradation products, which do not always affect the use of the preparation but can hinder an easy visual appreciation of the quality of the preparation. 

Kintz P, Evans J, Villain M, Cirimele V. Interpretation of hair findings in children after methadone poisoning. Forensic Sci Int 2010 196 51. ... 

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