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A Case of Altered Mental Status and Acute Renal Failure Due to Tramadol and Alprazolam Usage

Year 2014, Volume: 5 Issue: 6, 168 - 170, 01.06.2014

Abstract

Introduction: Tramadol, as a centrally acting synthetic analgesic agent, shows its effects by multiple transmitter systems. Tramadol usage may cause respiratory depression, seizures, renal failure. Alprazolam is a triazolobenzodiazepin derivative agent that has anxiolytic and antidepressant effects. High dose usage can cause side effects such as light-headedness, drowsiness, respiratory depression, delirium, coma, and death.Case Report: In this case report, we represent a 58-year-old male patient admitted to Emergency Department with altered mental status and acute renal failure after co-ingestion of tramadol and alprazolam. With supportive mechanical ventilation and hemodialysis he was discharged with fully remission on the ninth day of follow-up.Conclusion: Clinicians should be aware of cases presented with altered mental status and kidney failure associated with tramadol and alprazolam usage

References

  • Grond S, Sablotzki A. Clinical pharmacology of tramadol. Clin Pharmacokinet 2004; 43: 879–923. [CrossRef]
  • Schulz M, Schmoldt A. Therapeutic and toxic blood concentrations of more than 500 drugs. Pharmazie 1997; 52: 895-910.
  • Manocha A, Sharma KK, Mediratta PK. On the mechanism of anticonvulsant effect of tramadol in mice. Pharmacol Biochem Behav 2005; 82: 74-81. [CrossRef]
  • Keskinbora K, Aydınlı I. Atipik Opioid Analjezik: Tramadol. Agri 2006; 18: 5-19.
  • Barnung SK, Treschow M, Borgbjerg FM. Respiratory depression following oral tramadol in a patient with impaired renal function. Pain 1997; 71: 111-2. [CrossRef]
  • Guadreault P, Guay J, Thivierge RL, Verdy L. Benzodiazepine poisoning: Clinical and pharmacologic considerations and treatment. Drug Safety 1991; 6: 297.
  • De Decker K, Cordonnier J, Jacobs W, Coucke V, Schepens P, Jorens PG. Fatal intoxication due to tramadol alone: case report and review of the literature. Forensic Sci Int 2008; 175: 79-82. [CrossRef]
  • Michaud K, Augsburger M, Romain N, Giroud C, Mangin P. Fatal overdose of tramadol and alprazolam. Forensic Sci Int 1999; 105: 185-9. [CrossRef]
  • Agrawal A, Diwan SK, Mahajan R. Severe delirium following single dose of tramadol. Indian J Med Sci 2009; 63: 80-1. [CrossRef]
  • Zalsman G, Hermesh H, Munitz H. Alprazolam withdrawal delirium: a case report. Clin Neuropharmacol 1998; 21: 201-2.

Tramadol ve Alprazolam Kullanımına Bağlı Bilinç Değişikliği ve Böbrek Yetmezliği

Year 2014, Volume: 5 Issue: 6, 168 - 170, 01.06.2014

Abstract

Giriş: Tramadol santral etkili sentetik analjezik bir ajan olup;
çoklu transmitter sistemleri üzerinden etkilerini göstermektedir.
Tramadol kullanımı solunum depresyonu, nöbet, böbrek
yetmezliği gibi durumlara neden olabilir. Alprazolam ise
triazolobenzodiazepin türevi anksiyolitik ve antidepresif etkili bir
ajandır. Yüksek dozlarda alprazolam kullanımı sersemlik, uyku hali,
solunum depresyonu, deliryum, koma ve ölüm gibi yan etkilere
neden olabilir.
Olgu Sunumu: Biz bu vaka sunumunda acil servise tramadol ve
alprazolamın birlikte alımı sonrası gelişen bilinç bozukluğu ve
akut böbrek yetmezliği olan 58 yaşında bir erkek hasta sunuyoruz.
Destekleyici mekanik ventilasyon ve hemodiyaliz tedavisi sonrası
durumunda belirgin düzelme olan hasta yatışının dokuzuncu
gününde taburcu edildi.
Sonuç: Klinisyenler tramadol ve alprazolam kullanımı olan
hastalarda bilinç değişikliği ve böbrek yetmezliği gibi durumların
olabileceği konusunda dikkatli olmalıdır.

References

  • Grond S, Sablotzki A. Clinical pharmacology of tramadol. Clin Pharmacokinet 2004; 43: 879–923. [CrossRef]
  • Schulz M, Schmoldt A. Therapeutic and toxic blood concentrations of more than 500 drugs. Pharmazie 1997; 52: 895-910.
  • Manocha A, Sharma KK, Mediratta PK. On the mechanism of anticonvulsant effect of tramadol in mice. Pharmacol Biochem Behav 2005; 82: 74-81. [CrossRef]
  • Keskinbora K, Aydınlı I. Atipik Opioid Analjezik: Tramadol. Agri 2006; 18: 5-19.
  • Barnung SK, Treschow M, Borgbjerg FM. Respiratory depression following oral tramadol in a patient with impaired renal function. Pain 1997; 71: 111-2. [CrossRef]
  • Guadreault P, Guay J, Thivierge RL, Verdy L. Benzodiazepine poisoning: Clinical and pharmacologic considerations and treatment. Drug Safety 1991; 6: 297.
  • De Decker K, Cordonnier J, Jacobs W, Coucke V, Schepens P, Jorens PG. Fatal intoxication due to tramadol alone: case report and review of the literature. Forensic Sci Int 2008; 175: 79-82. [CrossRef]
  • Michaud K, Augsburger M, Romain N, Giroud C, Mangin P. Fatal overdose of tramadol and alprazolam. Forensic Sci Int 1999; 105: 185-9. [CrossRef]
  • Agrawal A, Diwan SK, Mahajan R. Severe delirium following single dose of tramadol. Indian J Med Sci 2009; 63: 80-1. [CrossRef]
  • Zalsman G, Hermesh H, Munitz H. Alprazolam withdrawal delirium: a case report. Clin Neuropharmacol 1998; 21: 201-2.
There are 10 citations in total.

Details

Other ID JA48JB37KG
Journal Section Case Report
Authors

Burak Subaşı This is me

Publication Date June 1, 2014
Submission Date June 1, 2014
Published in Issue Year 2014 Volume: 5 Issue: 6

Cite

APA Subaşı, B. (2014). A Case of Altered Mental Status and Acute Renal Failure Due to Tramadol and Alprazolam Usage. Journal of Emergency Medicine Case Reports, 5(6), 168-170.
AMA Subaşı B. A Case of Altered Mental Status and Acute Renal Failure Due to Tramadol and Alprazolam Usage. Journal of Emergency Medicine Case Reports. June 2014;5(6):168-170.
Chicago Subaşı, Burak. “A Case of Altered Mental Status and Acute Renal Failure Due to Tramadol and Alprazolam Usage”. Journal of Emergency Medicine Case Reports 5, no. 6 (June 2014): 168-70.
EndNote Subaşı B (June 1, 2014) A Case of Altered Mental Status and Acute Renal Failure Due to Tramadol and Alprazolam Usage. Journal of Emergency Medicine Case Reports 5 6 168–170.
IEEE B. Subaşı, “A Case of Altered Mental Status and Acute Renal Failure Due to Tramadol and Alprazolam Usage”, Journal of Emergency Medicine Case Reports, vol. 5, no. 6, pp. 168–170, 2014.
ISNAD Subaşı, Burak. “A Case of Altered Mental Status and Acute Renal Failure Due to Tramadol and Alprazolam Usage”. Journal of Emergency Medicine Case Reports 5/6 (June 2014), 168-170.
JAMA Subaşı B. A Case of Altered Mental Status and Acute Renal Failure Due to Tramadol and Alprazolam Usage. Journal of Emergency Medicine Case Reports. 2014;5:168–170.
MLA Subaşı, Burak. “A Case of Altered Mental Status and Acute Renal Failure Due to Tramadol and Alprazolam Usage”. Journal of Emergency Medicine Case Reports, vol. 5, no. 6, 2014, pp. 168-70.
Vancouver Subaşı B. A Case of Altered Mental Status and Acute Renal Failure Due to Tramadol and Alprazolam Usage. Journal of Emergency Medicine Case Reports. 2014;5(6):168-70.