This is poisoning from taking an excessive amount of hydromorphone, a prescription medicine used to relieve severe pain.

Hydromorphone, a type of morphine. Hydromorphone is an opioid narcotic, which means it is an extremely powerful drug that can cause very deep sleep.

Patients who are prescribed hydromorphone for pain should not drink alcohol. Alcohol increases dangerous side effects, and can lead to overdose symptoms.

• Dilaudid
• Hydrostat
• Palladone (The FDA ordered this drug removed from the U.S. market in July 2005.)

NOTE: This list may not be all inclusive.

Nervous system

• Drowsiness
• Dizziness
• Lightheadedness
• Confusion
• Coma
• Muscle twitches
• Weakness
• Loss of consciousness

Lungs 

• Breathing  - slow and labored
• Breathing - shallow
• No breathing

Heart and blood 

• Weak pulse
• Low blood pressure
• Fatigue

Gastrointestinal

• Spasms of the stomach and intestines

Skin

• Bluish colored fingernails and lips
• Cold, clammy skin

Eyes, ears, nose, and throat

• Pinpoint pupils

Warning: A severe overdose of hydromorphone can cause death.

This can be a serious overdose. Seek immediate medical help.

Determine the following information:

• Patient's age, weight, and condition
• Name of the product (ingredients and strengths, if known)
• Time it was swallowed
• Amount swallowed
• If the medication was prescribed for the patient

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the U.S. use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

See National Poison Control center.

The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure.

The patient may receive:

• Medicine (narcotic antagonist) to reverse the effect of the hydromorphone
• Medicines to treat symptoms
• Activated charcoal
• A nasogastric (NG) tube thru the nose into the stomach to empty the stomach (gastric lavage)   
• Artificial respiration

Patients who quickly receive medicine to reverse the effect of hydromorphone can recover within 1 to 4 hours.

Drummer OH. Recent trends in narcotic deaths. Ther Drug Monit. 2005 Dec;27(6):738-40.

Everett S. Narcotic toxity. eMedicine. January 7, 2005. Available at: http://www.emedicine.com/emerg/topic330.htm (accessed March 18, 2006).

US Food and Drug Administration. FDA Asks Purdue Pharma to Withdraw Palladone for Safety Reasons. Rockville, MD: National Press Office; July 13, 2005. Release P05-42.