Which adverse effects of opioids require monitoring in hospitalized patients?

• A. Respiratory depression
• B. Hypertension
• C. Hyperglycemia
• D. Weight gain

Answer: (A)

Opioids can slow and shallow breathing by activating receptors in the brainstem that control respiration. In hospitalized patients, this respiratory depression is the adverse effect that requires close monitoring because it can escalate quickly to dangerous hypoventilation, hypoxemia, or respiratory arrest if not detected and managed promptly.

Monitor respiratory rate, oxygen saturation, and level of sedation, especially after starting therapy or increasing the dose or when combined with other sedatives. Pay particular attention to high-risk groups—older adults, those with COPD or other lung disease, obesity, or obstructive sleep apnea—since they’re more prone to breathing problems. Have naloxone and appropriate supportive care available for rapid reversal if needed.

Hypertension, hyperglycemia, and weight gain are not the immediate, acute monitoring priorities with opioid use in the hospital setting.