Assessment of cases of acute tramadol toxicity as regards clinical, laboratory and management procedures in some university hospitals in Cairo

ABSTRACT

Tramadol, a widely used opioid in recent years, is a centrally acting analgesic drug that has been used clinically for the last two decades to treat pain in humans. Tramadol also has antitussive activity. Tramadol is a centrally acting analgesic which is extensively used in the management of moderate to severe pain. It slightly affects opioid receptors and inhibits the reuptake of norepinephrine and serotonin in the CNS. The aim of this study was to evaluate the clinical manifestations, the laboratory findings, the different lines of treatment and the outcome of cases presented with acute toxicity by tramadol overdoses. This study was carried out at Al-Azhar University Emergency Hospitals in Cairo [El-Hussein and Bab El-Shaaria University Hospitals] and Ain Shams University Hospitals on one hundred subjects in the period from July 2016 to February 2018. Toxicological screening was done for every patient by rapid lateral flow chromatographic immunoassay for detection of tramadol and its principal metabolites in human urine by special kits at a cut off level of 1000 ng/ml. In this study, 95% of studied cases fully recovered and 5% died