Poisoning propoxyphene

P.S. Madsen, et al., Acute propoxyphene self-poisoning in 222 consecutive patients. Acta Anaesthesiol. Scand. 28 661-665, 1984. 

SAFETY PROFILE A human poison by ingesdon. An experimental poison by ingesdon, intraperitoneal, subcutaneous, intravenous, and intramuscular routes. Human systemic effects by ingesdon anorexia, ataxia, chronic pulmonary edema, cyanosis, increased body temperature, jaundice, nausea or vomiting, sleep disturbance. Experimental teratogenic and reproducdve effects. When heated to decomposidon it emits very toxic fumes of HCl and NOx. See also PROPOXYPHENE. 

Propoxyphene is an agonist of opioid fi receptors. It is this opioid effect that is responsible for the central nervous system and respiratory depression seen in overdose. Both propoxyphene and norpropoxyphene are potent blockers of myocardial sodium channels, an effect identical to type lA antidysrhythmic agents. This myocardial sodium channel blockade may result in prolongation of the electrocardiogram QRS complex, arrhythmias, and cardiovascular depression seen in propoxyphene poisoning. 

Sodium bicarbonate (see p 419) may be effective for QRS interval prolongation or hypotension associated with propoxyphene poisoning. 

Koski A, Vuori E, Ojanpera I. Relation of postmortem blood alcohol and drug concentraticns in fatal poisonings involving amitriptyline, propoxyphene and promazine. HumExp Toxicol (2005) 24,389-96. 

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