Abstract:
METHODS: A 36-year-old woman with a medical history of opioid use disorder and frequent urinary tract infections presented to the ED from her opioid use disorder clinic, where she was found to have an oxygen saturation by pulse oximetry (Spo2) of 82% on room air. Starting 3 days before presentation, the patient\'s family noted worsening pale complexion and blue lips at rest. These findings of cyanosis had occurred a few times before and always resolved within a couple days without any medical intervention. She had no pulmonary symptoms outside of long-standing dyspnea with moderate exertion when at work or doing chores around the house. Her medications included methadone 160 mg daily, acetaminophen 650 mg nightly as needed, and phenazopyridine 199 mg three times daily as needed for increased urinary frequency and urethral discomfort that lasted a maximum of 4 days at a time. She confirmed she had started taking a new course of phenazopyridine 4 days before presenting to the ED. She had no dietary restrictions, had been eating her normal diet, and lived in a mobile home with her family, two dogs, and a gerbil. The patient reported using less than 10 tobacco cigarettes per day, one marijuana cigarette nightly, and no alcohol or other drugs. She worked in a warehouse stacking prepackaged bread.
摘要:
方法:一名36岁女性,有阿片类药物使用障碍和频繁尿路感染的病史,从她的阿片类药物使用障碍诊所就诊。通过脉搏血氧饱和度(Spo2)发现她在室内空气中的氧饱和度为82%。从演示前3天开始,病人的家人注意到,在休息时,脸色苍白,嘴唇发青。紫癜的这些发现以前发生过几次,并且总是在没有任何医疗干预的情况下在几天内解决。除了长期呼吸困难外,她没有肺部症状,在工作或在房子周围做家务时,她会有适度的劳累。她的药物包括美沙酮每天160毫克,视需要每晚服用对乙酰氨基酚650毫克,和非那唑吡啶199mg,每日三次,用于增加尿频和尿道不适,每次最多持续4天。她确认她已经开始服用新的非那唑并吡啶疗程4天,然后才提交给ED。她没有饮食限制,一直在吃她的正常饮食,和她的家人住在一个移动的房子里,两只狗,还有一只沙鼠.患者报告说每天使用不到10支烟草香烟,每晚一支大麻香烟,没有酒精或其他药物。她在一个堆放预包装面包的仓库里工作。