Like Michael Jackson's Performances, Pain Killers Can Literally Leave Us Breathless

An injection of propofol (Diprivan) could have led to respiratory depression -- and subsequently cardiac arrest -- if Michael Jackson indeed used the powerful anesthetic to battle insomnia, emergency physicians say.

“Propofol is an agent that requires very close monitoring and is often limited only to use by anesthesiologists,” said Dr. John Greer, PhD, from the University of Alberta. “The main concern with this agent is the risk of respiratory depression, which, in turn, could cause cardiac arrest.”

According to Dr. Greer, who has published on the issue of respiratory depression, the drug acts rapidly, inducing unconsciousness shortly after administration, and then lasts only a few minutes. “It is a very dangerous drug,” Dr. Greer states plainly.

Respiratory depression (RD) can arise during normal physician-supervised procedures such as surgical anesthesia, post-operative analgesia, and as a result of normal outpatient management. If RD occurs while under the supervision of an experienced anesthesiologist, the outcome can usually be managed to ensure there will be minimal long-term effects to the patient. Unfortunately, there are many situations during both in-patient and out-patient procedures where strong analgesic therapy is required but there is no attending anesthesiologist.

Researchers at the University of Alberta and Cortex Pharmaceuticals, a neuroscience company based in Irvine, California believe that a novel class of molecules know as AMPAKINE compounds called CX717 may provide protection from drug-induced respiratory depression while simultaneously allowing the sedative or analgesic to continue working as intended. 

In a recently published study, “CX717 appears to allow clinicians to reduce the incidents of respiratory depression during surgery in some cases, and, in other cases, be used as a rescue for people overdosing on opiates,” said Dr. Greer. “CX717 also generalized across families of drugs not limited to opioids. Combinations of alcohol and barbiturates can cause severe instances of respiratory depression, and CX717 was shown to work in these cases as well. This may lead the way in turning these compounds into rescue therapies.”

Expert Biography - About Dr. John Greer, PhD
Dr. John Greer, PhD, is an AHFMR Scientist and professor at the University of Alberta. Dr. Greer is a faculty member of the Department of Physiology, Centre for Neuroscience and Perinatal Research Centre.

Topics for discussion include:

• What causes respiratory depression?
• How common is this condition?
• What role may opiates have in causing this condition?
• How prevalent is RD?
• How does RD affect those who abuse painkillers?
• What are the danger signs of RD?
• What is being done to help patients who undergo respiratory depression?