Goudarzi Mohaddeseh Hedayati, Eizadi-Mood Nastaran, Mansourian Marjan, Mohammadi-Jouabadi Soroush, Peymani Payam, Sabzghabaee Ali Mohammad
Pharmacy Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.
Isfahan Clinical Toxicology Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Pharm Pract. 2020 Mar 28;9(1):44-49. doi: 10.4103/jrpp.JRPP_20_4. eCollection 2020 Jan-Mar.
We aimed to find the toxicoepidemiological indicators of tramadol poisoning in children and also the relationship of these indicators (such as demographic characteristics, and referral time) with the final therapeutic outcome.
In this cross-sectional study with retrospective data collection, we included the records for all the patients under 18 that have been admitted due to tramadol poisoning between 2010 and 2015 to Noor and Ali-Asghar (PBUH) University hospital which serves as the referral medical center for acute poisonings management in the central part of Iran and is located in Isfahan. Demographic characteristics, ingested dose, dosage forms, clinical manifestations, coingested drugs, and the outcome of treatment for all pediatric patients were documented and descriptively analyzed.
Demographic and clinical data of a total of 189 patients including 101 male (53.4%) with a mean age of 16.66 ± 2.64 years were abstracted and included in this study. The average time between tramadol ingestion and hospital admission was 3.39 ± 3.23 h. Mean duration of hospitalization was 12.3 ± 10.7 h. In all cases, the route of drug exposure was oral, and the most common form of drug dosage form was 100 mg tablets ( = 122) proceeded by 200 mg tablets ( = 32). The mean estimated dose of ingested tramadol was 1126 ± 1061 mg (median, 900 range, 50-7000 mg). 43.9% of the poisoned patients were high school students, and 23.3% had a high school diploma. Intentional intoxications were reported in 93.1% cases and 42.9% had coingestions. Activated charcoal (87.3%), gastric lavage (59.3%), oxygen therapy with mask (46.6%), naloxone (11.6%), anticonvulsants (13.2%), and intubation and ventilation (5.3%) were done as first-line therapeutic measures.
Our results suggest that the trend of acute tramadol poisoning among children is decreasing, mostly accidental in adolescents and commonly intentional among young children. Proper education to improve emotional intelligence for young adults and to keep drugs out of reach of the children and safer packaging is recommended to reduce tramadol poisoning incidence in the pediatric population.
我们旨在找出儿童曲马多中毒的毒理流行病学指标，以及这些指标（如人口统计学特征和转诊时间）与最终治疗结果之间的关系。
在这项具有回顾性数据收集的横断面研究中，我们纳入了2010年至2015年间因曲马多中毒而入住位于伊斯法罕的努尔和阿里 - 阿斯加尔（愿主福安之）大学医院的所有18岁以下患者的记录。该医院是伊朗中部急性中毒管理的转诊医疗中心。记录并描述性分析了所有儿科患者的人口统计学特征、摄入剂量、剂型、临床表现、合并摄入的药物以及治疗结果。
共提取了189例患者的人口统计学和临床数据，其中包括101名男性（53.4%），平均年龄为16.66 ± 2.64岁，并纳入本研究。曲马多摄入至入院的平均时间为3.39 ± 3.23小时。平均住院时间为12.3 ± 10.7小时。在所有病例中，药物暴露途径均为口服，最常见的药物剂型为100毫克片剂（n = 122），其次是200毫克片剂（n = 32）。摄入曲马多的平均估计剂量为1126 ± 1061毫克（中位数，900；范围，50 - 7000毫克）。43.9%的中毒患者为高中生，23.3%拥有高中文凭。93.1%的病例报告为故意中毒，42.9%合并有其他物质摄入。作为一线治疗措施，进行了活性炭治疗（87.3%）、洗胃（59.3%）、面罩吸氧治疗（46.6%）、纳洛酮治疗（11.6%）、抗惊厥治疗（13.2%）以及插管和通气治疗（5.3%）。
我们的结果表明，儿童急性曲马多中毒的趋势正在下降，青少年中毒多为意外，幼儿中毒多为故意。建议对年轻人进行适当教育以提高情商，将药物放置在儿童无法触及的地方并采用更安全的包装，以降低儿科人群中曲马多中毒的发生率。
