Tramadol-induced apnea

Hassanian‐Moghaddam, Hossein; Farajidana, Hoorvash; Sarjami, Saeedeh; Owliaey, Hamid

doi:10.1016/j.ajem.2012.05.013

Cited by 58 publications

(39 citation statements)

References 35 publications

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“…7,8 Soon after the approval, tramadol abuse, misuse, and overdose have been increasingly observed worldwide due to its opioid properties. [9][10][11] The most frequent side effects at therapeutic dosages include nausea, dizziness, somnolence, drowsiness, enhanced sweating, vomiting and dry mouth. 12,13 Both in therapeutic and toxic doses, seizure and apnea have been reported as the most severe adverse reactions, 9,10,14 along with hypoglycemia, hyperamylasemia, liver and kidney dysfunctions.…”

Section: Introductionmentioning

confidence: 99%

Severe acute lactic acidosis and hypoglycemia due to isolate tramadol poisoning

Granauro

Comite²,

Lippi

et al. 2016

Emerg Care J

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Section: Introductionmentioning

confidence: 99%

Severe acute lactic acidosis and hypoglycemia due to isolate tramadol poisoning

Granauro

Comite²,

Lippi

et al. 2016

Emerg Care J

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“…Maternal genetic polymorphism may affect the toxic effects of tramadol by increasing metabolism to an active metabolite; M1 (O-desmethyl tramadol). This active metabolite (M1) has a 300-400 times higher affinity to μ opioid receptors than the parent compound and has an elimination half-life of nine hours [8][9][10].…”

Section: Discussionmentioning

confidence: 99%

“…There is a large individual variation in the activity of CYP2D6 enzyme within a population and between ethnic groups [10][11][12][13]. The ethnic groups from the Middle East and East Africa are more likely to be ultrarapid metabolizers compared with those from Middle Europe and North America (incidence 21%-29% vs. 0.5%-1% respectively) so people in the Middle East are more susceptible to opioid effects, including dependency, seizure, sedation, and respiratory depression [10][11][12][13][14][15][16]. Ultrarapid metabolizer (UMs) have increased CYP2D6 enzymatic activity and may experience different degrees of pain relief and side effects of tramadol by converting it into its active metabolite; M1(O-desmethyl tramadol) more rapidly and completely than other people.…”

Section: Discussionmentioning

confidence: 99%

Tramadol Intoxication in an 8-Months-Old Infant through Breastfeeding: A Case Report

Hussien¹

2017

J Clinic Toxicol

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Tramadol is a widely used, synthetic centrally acting opioid analgesic commonly used for the treatment of moderate to severe pain. Very few reports about its excretion into breast milk were published and most of them suggested that short-term maternal use of tramadol is compatible with breastfeeding. No available data about its chronic daily use in addict lactating mothers. To date, there are no published reports of tramadol poisoning through breastfeeding. We report a case of tramadol intoxication in 8-month-old infant through breastfeeding as her mother was an addict on tramadol. The infant presented to the Emergency Department (ER) of the Poison Control Center (PCC) of Ain Shams University Hospital twice with 36 h apart. The first time, the infant was discharged from the hospital with no sequelae after receiving the appropriate management. The second time, the infant deceased due to cardiac arrest three days after tramadol poisoning. This case report highlights the dangers of excretion of tramadol in milk and the severity of complications that can even be near fatal to infant.

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“…2 However, this risk depends on genotype; tramadol abuse is well described in some Middle Eastern countries, 5 where the CYP2D6 ultra-rapid metabolizer phenotype is prevalent (Appendix 1). Opioid withdrawal is common following chronic tramadol use.…”

Section: Opioid Dependence Withdrawal and Toxicity May Occur With Trmentioning

confidence: 99%