Manouchehri Aliasghar, Nekoukar Zahra, Malakian Abdollah, Zakariaei Zakaria
Department of Internal Medicine, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol.
Department of Clinical Pharmacy, Faculty of Pharmacy.
Ann Med Surg (Lond). 2023 Jul 7;85(8):3982-3989. doi: 10.1097/MS9.0000000000001075. eCollection 2023 Aug.
Tramadol (TR) is an opioid agonist (μ-opioid receptors) that also affects the noradrenergic and serotonergic systems. TR is a synthetic analgesic substance with opioid agonist properties that has been approved for pain management by affecting the central nervous system.
The primary objective of this scoping review was to determine the poisoning consequences of TR and its associated symptom management techniques, as well as its effect on opioid and non-opioid receptors, metabolism, and complications on various organ systems.
Typically, acute overdose of TR is not considered life threatening, and most fatalities are attributed to polysubstance overdose. TR can cause drowsiness, headaches, seizures, respiratory depression, low heart rate, coma, and even death. Additionally, the prolonged use of TR can lead to addiction, with withdrawal resulting in both common and atypical symptoms.
Therefore, it is recommended that patients with TR poisoning receive close monitoring of their cardiovascular system, along with a comprehensive management plan for their levels of consciousness and respiratory function.
曲马多(TR)是一种阿片类激动剂(μ-阿片受体),同时也影响去甲肾上腺素能和5-羟色胺能系统。TR是一种具有阿片类激动剂特性的合成镇痛物质,已被批准用于通过影响中枢神经系统来进行疼痛管理。
本范围综述的主要目的是确定TR的中毒后果及其相关症状管理技术,以及其对阿片类和非阿片类受体、代谢以及对各种器官系统并发症的影响。
通常,TR急性过量摄入不被认为会危及生命,大多数死亡归因于多药过量。TR可导致嗜睡、头痛、癫痫发作、呼吸抑制、心率降低、昏迷甚至死亡。此外,长期使用TR可导致成瘾,戒断会出现常见和非典型症状。
因此,建议对TR中毒患者密切监测其心血管系统,并针对其意识水平和呼吸功能制定全面的管理计划。