Clinical and Laboratory Factors Related to Seizure and Serotonin Toxicity in Tramadol Intoxication: An Egyptian Study.

IF 2.9 3区医学 Q2 PHARMACOLOGY & PHARMACY

Clinical Drug Investigation Pub Date : 2023-12-01 Epub Date: 2023-11-25 DOI:10.1007/s40261-023-01326-y

Ahmed Amin Ali, Mahmoud Mohamed Abdeshafy, Khaled Abdelkawy, Ramy M Elsabaa, Fawzy Elbarbry

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Abstract

Background and objectives: Tramadol is a centrally acting analgesic with a lower risk of addiction compared to opioids. Tramadol overdose is becoming a health crisis in Egypt and is associated with serious and severe adverse effects. This study aims to identify clinical and laboratory findings associated with tramadol-induced seizure and serotonin toxicity in adult Egyptian patients with tramadol overdose.

Methods: This prospective study included adult patients admitted for tramadol overdose with or without symptoms of seizure or serotonin toxicity. Basic demographic information, clinical symptoms, laboratory measurements, and plasma tramadol concentrations were collected.

Results: A total of 71 patients (79% males) were included in the study. Seizure occurred in 38% of the subjects and was prevalent in male patients with metabolic acidosis or high tramadol concentrations. Serotonin toxicity occurred in 41% of the subjects and was prevalent in patients with hyperthermia, high pulse rate, and high tramadol levels.

Conclusion: Seizure and serotonin toxicity are severe adverse effects of tramadol overdose that occur in high frequency among young Egyptians. High tramadol concentrations in plasma seem to play a key role in prevalence of seizure and serotonin syndrome in tramadol-intoxicated adult Egyptians.

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曲马多中毒中癫痫发作和血清素毒性相关的临床和实验室因素:一项埃及研究。

背景和目的:曲马多是一种中枢作用镇痛药，与阿片类药物相比，成瘾风险较低。曲马多过量正在成为埃及的一种健康危机，并与严重的不良反应有关。本研究旨在确定与曲马多过量埃及成年患者曲马多诱发癫痫和血清素毒性相关的临床和实验室结果。方法:这项前瞻性研究纳入了曲马多过量住院的成年患者，伴有或不伴有癫痫发作或血清素毒性症状。收集基本人口统计信息、临床症状、实验室测量和血浆曲马多浓度。结果:共纳入71例患者，其中79%为男性。38%的受试者发生癫痫发作，在代谢性酸中毒或曲马多浓度高的男性患者中普遍存在。41%的受试者出现血清素毒性，在高热、高脉搏率和高曲马多水平的患者中普遍存在。结论:癫痫发作和5 -羟色胺毒性是曲马多过量在埃及年轻人中高发的严重不良反应。血浆中高曲马多浓度似乎在曲马多中毒的埃及成人癫痫发作和血清素综合征的患病率中起关键作用。

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来源期刊

Clinical Drug Investigation 医学-药学

CiteScore

5.90

自引率

3.10%

发文量

108

审稿时长

6-12 weeks

期刊介绍： Clinical Drug Investigation provides rapid publication of original research covering all phases of clinical drug development and therapeutic use of drugs. The Journal includes: -Clinical trials, outcomes research, clinical pharmacoeconomic studies and pharmacoepidemiology studies with a strong link to optimum prescribing practice for a drug or group of drugs. -Clinical pharmacodynamic and clinical pharmacokinetic studies with a strong link to clinical practice. -Pharmacodynamic and pharmacokinetic studies in healthy volunteers in which significant implications for clinical prescribing are discussed. -Studies focusing on the application of drug delivery technology in healthcare. -Short communications and case study reports that meet the above criteria will also be considered. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Clinical Drug Investigation may be accompanied by plain language summaries to assist readers who have some knowledge, but non in-depth expertise in, the area to understand important medical advances.