Clinical Study of Acute Tramadol Poisoning in the Poison Control Center, Ain Shams University in 2012

Abstract

All rights reserved. AbstractAn increasingly alarming phenomenon of tramadol abuse in Egypt has been demonstrated in the recent years. Although the issue of drug abuse is not a newly introduced issue to Egyptian society but the wide range of usage and illegal transactions associated with tramadol abuse making it the most easily accessible and readily provided drug at low cost. Aim of the work: is to highlight the magnitude of tramadol poisoning and its patterns during the year 2012. Interpretation of the poisoning data through an annual report would be essential to face continuously challenging hazards. Patients and methods: This study was carried out on 1581patients presented to the emergency department of the Poison Control Center, Ain Shams University Hospitals (PCCA)due to acute tramadol poisoning, in the period from 1, January 2012 to 31,December 2012.A descriptive analysis and statistics of the medical records is accomplished. Results: The majority of patients (54.6%) were between 19 and 30 years, with male predominance representing (79.8%)of the total presented cases. The majority of admitted patients (56.6%) were male drug addicts, followed by suicidal attempt in (26.6%).Co-ingestion of other drugs or agents was recorded in (16%) of admitted tramadol patients which increase toxicity significantly. The most frequent clinical manifestations in admitted tramadol patients were coma in (52%), Constricted pupil in (30%)and seizures in (17.5%). Respiratory failure was present in 12.6% of admitted patients. Death occurred in 14 cases (0.9%) of the presented cases. The main cause of death was acute respiratory failure.

Prevalence and health consequences of nonmedical use of tramadol in Africa: A systematic scoping review

“…The second category includes professionals such as drivers and their assistants (motorcycle, tricycle, taxi, bus, private car, and truck) [ 41 – 52 ], workers in the construction and textile industries [ 42 ], skilled workers (hairstylists and mechanics) [ 53 ], hospital cleaners [ 54 ], and coffee shop workers [ 55 ]. The third category includes patients with tramadol dependence or opioid use disorders attributed to tramadol [ 56 – 65 ], patients with unintentional intoxication [ 66 ], patients with substance use disorders or drug addiction [ 67 , 68 ], patients admitted to Neuro-Psychiatric Hospital [ 69 ], patients with seizures or psychotic episodes [ 70 , 71 ], treatment-seeking men [ 72 ] or trauma victims [ 73 ], adults attending family medicine center [ 74 ], pharmacy/dispensary customers [ 75 ], patients undergoing surgery [ 76 ] or admitted for acute myocardial infarction [ 77 ], women admitted to addiction treatment center [ 78 ], patients attending psychiatric clinic [ 79 – 82 ], and individuals presenting to poison control center for tramadol [ 83 ]. The fourth category pertains to students in both public and private schools in rural and urban areas, including secondary school students aged 13–18, upper secondary school students, and graduate or undergraduate university students [ 10 , 72 , 84 – 105 ].…”

“…Among those with substance use disorders and opioid dependency, there is a high rate of NMU of tramadol, with prevalence rates at 77.1% to 92% [ 58 , 62 ]. In psychiatric settings, a significant percentage of patients misuse tramadol, with 48.8% of those admitted to psychiatric hospitals and 46.9% of those attending psychiatric clinics reported [ 79 , 82 ], and more than half of the patients (56.6%) presented to the Poison Control Center were tramadol nonmedical users [ 83 ].…”

“…Symptoms in this category include loss of consciousness, incoherent and irrational speech, and altered consciousness levels [ 11 , 109 ]. Physiological symptoms commonly associated with the disease include seizures, headaches, dizziness, nausea, vomiting, muscle pain, abdominal cramps, and skin rash [ 17 , 36 , 44 , 83 ]. A study conducted in Togo found that after ingesting tramadol, convulsions occurred in 33.3% of cases, headaches in 60.3%, dizziness in 62.2%, skin rash in 67.6%, muscle aches in 54.9%, stomach cramps in 60.4%, and nausea/vomiting in 58.9% [ 44 ].…”