A suicidal poisoning due to tramadol. A metabolic approach to death investigation

Barbera, Nunziata; Fisichella, Marco; Bosco, Andrea; Indorato, Francesca; Spadaro, Giorgio; Romano, Guido

doi:10.1016/j.jflm.2013.03.006

Cited by 31 publications

(38 citation statements)

References 26 publications

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“…Few cases of fatal poisoning due to tramadol alone have been reported in the literature. [9][10][11] More frequent are intoxications with coingestion of other drugs or alcohol. 12,13 Symptoms following tramadol intoxication are similar to those of other opioids analgesics.…”

Section: Introductionmentioning

confidence: 99%

Histological changes of the adult albino rats entorhinal cortex under the effect of tramadol administration: Histological and morphometric study

Ragab

Mohamed

2017

Alexandria Journal of Medicine

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Background: Tramadol is a centrally acting synthetic analgesic agent with opioid activity. Tramadol is used to treat moderate to severe pain. The entorhinal cortex has initially attracted attention because of its strong reciprocal connections with the hippocampal formation and its involvement in certain brain disorders. Aim of work: The present study was designed to assess the deleterious effects of tramadol on the entorhinal cortex of the adult male albino rats. Materials and methods: The study was carried out on 40 adult male rats. The rats were divided equally into two groups: control group, received 1 ml normal saline 0.9% intraperitoneally for 4 weeks. Treated group received 50 mg/kg/day of tramadol intraperitoneally for 4 weeks. All animals were anaesthetized by ether inhalation and perfused by normal saline. The brains were extracted from the skulls. For light microscopy, the brains of 10 animals in each group were processed for paraffin sections and stained by Gallocyanine stain. For electron microscopy, the entorhinal cortex was dissected in 10 brains of each group and processed. Semithin sections were prepared and stained with toluidine blue. Morphometric and statistical studies were performed. Results: By light microscopy, the treated groups showed neuronal cells disorganization. Apoptotic cells were detected. In addition, diffuse chromatolysis of nuclear chromatin, absence of nucleoli, multinuclear cells, intercellular edema and a congested blood capillary were noticed. By electron microscopy, the treated groups of both lateral and medial entorhinal areas showed granular and pyramidal apoptotic cells. The morphometric and statistical studies showed significant increase of apoptotic index % in treated group as compared with control group.

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Section: Introductionmentioning

confidence: 99%

Histological changes of the adult albino rats entorhinal cortex under the effect of tramadol administration: Histological and morphometric study

Ragab

Mohamed

2017

Alexandria Journal of Medicine

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“…Metabolization of tramadol is performed by cytochrome P450 enzymes. CYP2D6 is responsible for O-demethylation while N-demethylation is done by CY2B6 and CY3A4 [6,31,32]. Tramadol can be used in renal failure although decreased doses are recommended in renal problems and liver cirrhosis [33].…”

Section: Pharmacologymentioning

confidence: 99%

“…However, death due to tramadol overdose is rare and consists up to 1% of the hospitalized cases [1,10,44,88]. Blood levels of tramadol have been between 0.03 to 134 mg/L in different fatal cases [26,32,109,110].…”

Section: Tramadol-related Mortalitiesmentioning

confidence: 99%

“…Fatal toxicity of tramadol has been reported after co-administration of other medications including propranolol, trazodone, ethanol, and especially CNS depressants including benzodiazepines, barbiturates, and serotonergic drugs [88]. M1/M2 (ODT/NDT) metabolite ratio of higher than one in biologic liquids and organs represents more sudden deaths while M1/M2 < 1 shows that death will occur at later stages after the tramadol use [32,112]. In fatal cases of tramadol, femoral blood samples are the best since they have the least redistribution changes after death [113].…”

Section: Tramadol-related Mortalitiesmentioning

confidence: 99%

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Tramadol Poisoning

Mehrpour¹,

Sharifi²,

Zamani³

2015

Toxicology Studies - Cells, Drugs and Environment

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“…Previous animal studies have not revealed a carcinogenic effect of tramadol as reproductive and developmental toxicity studies were negative [12]. However, [13] and [14] have reported few cases of fatal poisoning due to tramadol. This has been attributed to more frequent intoxication with co-ingestion of other drugs or alcohol.…”

Section: Introductionmentioning

confidence: 99%

Some Marker Enzymes and Histological Alteration on the Administration of Tramadol Hydrochloride on Rat Liver

Simeon¹,

Abbey²

2018

MRI

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The ease of availability and potential tendency to abuse tramadol hydrochloride prompted this research. Making use of biochemical and histological techniques, concentrations of marker enzymes were monitored along with alterations in the liver architecture of wistar albino rats in graded doses of tramadol hydrochloride for 28 days. Specifically, levels of gammaglutamyltransferase (Ɣ-GT), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were determined. Statistical evaluation of the results at a p < 0.05 elucidated significantly elevated values of these enzymes when compared with controls that were not on tramadol hydrochloride. The variations were time and dose dependent. Histological evaluation presented various degrees of inflammatory cells of the liver, cytolysis in hepatocytes and some portal tract hypertrophy. These findings support the need for caution in administration of tramadol particularly for long term administration.

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A suicidal poisoning due to tramadol. A metabolic approach to death investigation

Cited by 31 publications

References 26 publications

Histological changes of the adult albino rats entorhinal cortex under the effect of tramadol administration: Histological and morphometric study

Histological changes of the adult albino rats entorhinal cortex under the effect of tramadol administration: Histological and morphometric study

Tramadol Poisoning

Some Marker Enzymes and Histological Alteration on the Administration of Tramadol Hydrochloride on Rat Liver

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