Channell Jessie S, Schug Stephan
Medical School, The University of Western Australia, Perth, Western Australia.
Pain Manag. 2018 Sep 1;8(5):327-339. doi: 10.2217/pmt-2018-0027. Epub 2018 Aug 6.
Tapentadol is a novel atypical opioid. Anecdotal evidence suggests that tapentadol has a lower toxicity than conventional opioids.
To evaluate all single-drug mortality due to tapentadol and assess serious adverse events caused by tapentadol.
The Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) reporting guidelines, an evidence-based minimum set of items for reporting in systematic reviews, were followed in this systematic review.
24 peer-reviewed papers were identified. They indicate that tapentadol toxicity can cause mortality and serious adverse effects.
CONCLUSION(S): At least four confirmed fatalities, and serious adverse effects have been documented for individuals abusing or using tapentadol as prescribed. Serious adverse effects of tapentadol use may include respiratory depression, confusion, coma, hallucination/delusion, seizures, tachycardia, hypertension, agitation, tremor, miosis, hypotension, dyspnea, electrolyte abnormality, atrial fibrillation or severe upper abdominal pain. Tapentadol is unlikely to cause serotonin syndrome. The toxicity of tapentadol is significantly less than pure mu opioids, such as oxycodone.
曲马多是一种新型非典型阿片类药物。轶事证据表明，曲马多的毒性低于传统阿片类药物。
评估曲马多所致的所有单药死亡率，并评估曲马多引起的严重不良事件。
本系统评价遵循系统评价与Meta分析方案的首选报告项目（PRISMA-P）报告指南，这是一套基于证据的系统评价报告最少项目集。
共识别出24篇经同行评审的论文。这些论文表明，曲马多毒性可导致死亡和严重不良反应。
至少有4例确诊死亡病例，并且已记录到滥用或按处方使用曲马多的个体出现严重不良反应。使用曲马多的严重不良反应可能包括呼吸抑制、意识模糊、昏迷、幻觉/妄想、癫痫发作、心动过速、高血压、激动、震颤、瞳孔缩小、低血压、呼吸困难、电解质异常、心房颤动或严重上腹部疼痛。曲马多不太可能引起5-羟色胺综合征。曲马多的毒性明显低于纯μ阿片类药物，如羟考酮。
