Internal Medicine and Medical Investigation Journal

ISSN: 2474-7750

Tramadol Toxicity Induced Neurological and Renal Complications Accompanied by an Alteration in Electrocardiographic Parameters


Author(s): Reza Afshari, Maryam Hosseinzadeh, Yalda Fallah Rastegar, Ferial Lombard

Introduction: In recent years, Tramadols’ consumption has increased and is often as-sociated with many serious complications which in some cases can also lead to death. In this study, we aimed to assess neurological and renal complications, and also as-sessed electrocardiographic changes linked to tramadol overdose. Materials and Methods: In this descriptive study, the data required was gathered from the patients history that had been admitted to the medical toxicology ward of Imam Reza hospital in 2006-2007. Data had being included sociodemographic data and other medical information by a self-designed form, including data such as patients’ age, sex, co-in-gestion of other drugs, habitual history of drug addiction, electrocardiogram (ECG) changes including duration of QRS, QT, QTC and PR Interval, pulse rate, respiratory rate, systolic and diastolic blood pressure (SBP and DBP), consciousness and seizure occurrence. Laboratory findings including blood sugar, blood urea nitrogen (BUN), creatinine (Cr) and creatine phosphokinase (CPK) along with therapeutic interven-tions such as dialysis admission and whether patients were referred to the nephrology ward were retrieved from patients’ medical records. After the collection of data, it was registered and analyzed in SPSS software v 21. Results: 150 patients (64.70% male) with a mean age of 22.57 years qualified to be selected in our study. Out of these, 66% were drug addicts and 23.30% suffered from seizures. Additionally, 44% displayed an increased BUN, 4% showed Cr increase, 3.3% were hypertensive and 36.70% had tachycardia.Electrocardiographic parameters such as PR Interval, QRS, QT, and QTC were prolonged in 3.30%, 5.30%, 32%, and 17% of the patients, respec-tively. Furthermore, an elevated creatine phosphokinase (CPK) was noted in 38% of them, and 4% suffered from bradypnea and respiratory depression. Also, an impaired consciousness was recorded from 56.70% of the patients. Death due to cardiopulmo-nary arrest took place in a young addict male who had ingested 5000 mg of tramadol. Conclusion: Tramadol intoxication is generally common among youth and can result in seizure, tachycardia, hypertension; central nervous system and respiratory depres-sion; increasing of BUN, Cr and CPK. A regulated marketing control of tramadol can help to prevent its side-effects and the numerous complications associated with it

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