Concordia University Wisconsin, School of Pharmacy, Mequon, Wisconsin; Wisconsin Poison Center, Milwaukee, Wisconsin;
Wisconsin Poison Center, Milwaukee, Wisconsin; Froedert Hospital, Department of Emergency Medicine, Milwaukee, Wisconsin; and.
Pediatrics. 2015 Feb;135(2):e392-6. doi: 10.1542/peds.2014-2096.
Tapentadol (Nucynta) is indicated for the treatment of moderate to severe pain in adults. Tapentadol's mechanism of action consists of acting as an agonist on the μ-opioid receptor and by inhibiting the reuptake of norepinephrine. There are no published reports on the toxicity of tapentadol in pediatric patients. The goals of this study are to describe the incidence, medical outcomes, clinical effects, and treatment secondary to tapentadol exposure.
This retrospective observational study used data from the National Poison Data System. Inclusion criteria were exposure to tapentadol from November 1, 2008 to December 31, 2013; age 0 to 17 years; single ingestion; and followed to a known outcome.
There were 104 patients who met the inclusion criteria. Eighty patients were aged ≤ 6, 2-year-olds the most common age group (60.6%). There were 52 male and 52 female patients. Of the 104 patients, 93 had unintentional exposures. No deaths were reported. Sixty-two of the patients had no effect, 34 had minor effects, 6 had moderate and 2 had major effects. Thirty patients reported drowsiness and lethargy. Other effects reported included nausea, vomiting, miosis, tachycardia, respiratory depression, dizziness/vertigo, coma, dyspnea, pallor, vomiting, edema, hives/welts, slurred speech, pruritus, and hallucinations/delusions. Fifty-three patients were reported to have no medical intervention.
This is the first study examining the toxic effects of tapentadol in a pediatric population. Although a majority of the patients in this review developed no effect from their exposure, two had life-threatening events. The most common effects reported were opioidlike.
盐酸他喷他多（Nucynta）被批准用于治疗成人中到重度疼痛。盐酸他喷他多的作用机制是作为μ-阿片受体激动剂，并抑制去甲肾上腺素的再摄取。目前尚未有关于小儿患者使用盐酸他喷他多的毒性的报告。本研究的目的是描述他喷他多暴露的发生率、医疗结果、临床效果和治疗情况。
这是一项回顾性观察性研究，使用了国家毒物数据系统的数据。纳入标准为：2008 年 11 月 1 日至 2013 年 12 月 31 日期间暴露于他喷他多；年龄 0 至 17 岁；单次摄入；并随访至已知结局。
符合纳入标准的患者共有 104 例。80 例患者年龄 ≤ 6 岁，2 岁年龄组最常见（60.6%）。男 52 例，女 52 例。104 例患者中，93 例为非故意暴露。无死亡报告。62 例患者无影响，34 例有轻微影响，6 例有中度影响，2 例有严重影响。30 例患者报告有嗜睡和昏睡。其他报告的影响包括恶心、呕吐、瞳孔缩小、心动过速、呼吸抑制、头晕/眩晕、昏迷、呼吸困难、苍白、呕吐、水肿、荨麻疹/风团、言语不清、瘙痒和幻觉/错觉。53 例患者报告无医疗干预。
这是第一项研究评估了他喷他多在儿科人群中的毒性作用。虽然本综述中的大多数患者接触后没有出现任何影响，但有 2 例出现危及生命的事件。报告的最常见影响是类阿片样。
