Comparative Toxicity of Tapentadol and Tramadol Utilizing Data Reported to the National Poison Data System
Background: Tapentadol (TAP) and tramadol (TRA) provide pain relief through similar monoaminergic and opioid agonist properties. Objective: To compare clinical effects and medical outcomes between TAP and TRA exposures reported to the National Poison Data System of the American Association of Poison...
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| Veröffentlicht in: | The Annals of pharmacotherapy 2015-12, Vol.49 (12), p.1311-1316 |
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| container_title | The Annals of pharmacotherapy |
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| creator | Tsutaoka, Ben T. Ho, Raymond Y. Fung, Stacey M. Kearney, Thomas E. |
| description | Background: Tapentadol (TAP) and tramadol (TRA) provide pain relief through similar monoaminergic and opioid agonist properties. Objective: To compare clinical effects and medical outcomes between TAP and TRA exposures reported to the National Poison Data System of the American Association of Poison Control Centers. Methods: A retrospective cohort study was conducted analyzing national data for single medication TAP or TRA cases reported from June 2009 through December 2011. Case outcomes, dichotomized as severe versus mild; clinical effects; and use of naloxone were compared. Results: There were 217 TAP and 8566 TRA cases. Significantly more severe outcomes were associated with TAP exposures for an all-age comparison (relative risk [RR] = 1.24; 95% CI = 1.04-1.48), and for the |
| doi_str_mv | 10.1177/1060028015604631 |
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Objective: To compare clinical effects and medical outcomes between TAP and TRA exposures reported to the National Poison Data System of the American Association of Poison Control Centers. Methods: A retrospective cohort study was conducted analyzing national data for single medication TAP or TRA cases reported from June 2009 through December 2011. Case outcomes, dichotomized as severe versus mild; clinical effects; and use of naloxone were compared. Results: There were 217 TAP and 8566 TRA cases. Significantly more severe outcomes were associated with TAP exposures for an all-age comparison (relative risk [RR] = 1.24; 95% CI = 1.04-1.48), and for the <6-year-old age group (RR = 5.76; 95% CI = 2.20-15.11). Patients with TAP exposures had significantly greater risk of respiratory depression (RR = 5.56; 95% CI = 3.50-8.81), coma (RR = 4.16; 95% CI = 2.33-7.42), drowsiness/lethargy (RR = 1.38; 95% CI = 1.15-1.66), slurred speech (RR = 3.51; 95% CI = 1.98-6.23), hallucination/delusion (RR = 7.25; 95% CI = 3.61-14.57), confusion (RR = 2.54; 95% CI = 1.56-4.13) and use of naloxone (RR = 3.80; 95% CI = 2.96-4.88). TRA exposures had significantly greater risk of seizures (RR = 7.94; 95% CI = 2.99-20.91) and vomiting (RR = 1.96; 95% CI = 1.07-3.60). Conclusion: TAP was associated with significantly more toxic clinical effects and severe outcomes consistent with an opioid agonist. TRA was associated with significantly higher rates of seizures and vomiting.</description><identifier>ISSN: 1060-0280</identifier><identifier>EISSN: 1542-6270</identifier><identifier>DOI: 10.1177/1060028015604631</identifier><identifier>PMID: 26369569</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adolescent ; Adult ; Adverse Drug Reaction Reporting Systems ; Aged ; Aged, 80 and over ; Analgesics, Opioid - adverse effects ; Child ; Child, Preschool ; Drug Overdose - epidemiology ; Female ; Humans ; Infant ; Male ; Middle Aged ; Phenols - adverse effects ; Poison Control Centers ; Retrospective Studies ; Risk ; Seizures - chemically induced ; Tramadol - adverse effects ; Vomiting - chemically induced ; Young Adult</subject><ispartof>The Annals of pharmacotherapy, 2015-12, Vol.49 (12), p.1311-1316</ispartof><rights>The Author(s) 2015</rights><rights>The Author(s) 2015.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c437t-cff0643c77412cc971a786963836096af5555766c80b1f779d642fa39df8ca3e3</citedby><cites>FETCH-LOGICAL-c437t-cff0643c77412cc971a786963836096af5555766c80b1f779d642fa39df8ca3e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1060028015604631$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1060028015604631$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26369569$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tsutaoka, Ben T.</creatorcontrib><creatorcontrib>Ho, Raymond Y.</creatorcontrib><creatorcontrib>Fung, Stacey M.</creatorcontrib><creatorcontrib>Kearney, Thomas E.</creatorcontrib><title>Comparative Toxicity of Tapentadol and Tramadol Utilizing Data Reported to the National Poison Data System</title><title>The Annals of pharmacotherapy</title><addtitle>Ann Pharmacother</addtitle><description>Background: Tapentadol (TAP) and tramadol (TRA) provide pain relief through similar monoaminergic and opioid agonist properties. Objective: To compare clinical effects and medical outcomes between TAP and TRA exposures reported to the National Poison Data System of the American Association of Poison Control Centers. Methods: A retrospective cohort study was conducted analyzing national data for single medication TAP or TRA cases reported from June 2009 through December 2011. Case outcomes, dichotomized as severe versus mild; clinical effects; and use of naloxone were compared. Results: There were 217 TAP and 8566 TRA cases. Significantly more severe outcomes were associated with TAP exposures for an all-age comparison (relative risk [RR] = 1.24; 95% CI = 1.04-1.48), and for the <6-year-old age group (RR = 5.76; 95% CI = 2.20-15.11). Patients with TAP exposures had significantly greater risk of respiratory depression (RR = 5.56; 95% CI = 3.50-8.81), coma (RR = 4.16; 95% CI = 2.33-7.42), drowsiness/lethargy (RR = 1.38; 95% CI = 1.15-1.66), slurred speech (RR = 3.51; 95% CI = 1.98-6.23), hallucination/delusion (RR = 7.25; 95% CI = 3.61-14.57), confusion (RR = 2.54; 95% CI = 1.56-4.13) and use of naloxone (RR = 3.80; 95% CI = 2.96-4.88). TRA exposures had significantly greater risk of seizures (RR = 7.94; 95% CI = 2.99-20.91) and vomiting (RR = 1.96; 95% CI = 1.07-3.60). Conclusion: TAP was associated with significantly more toxic clinical effects and severe outcomes consistent with an opioid agonist. TRA was associated with significantly higher rates of seizures and vomiting.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Adverse Drug Reaction Reporting Systems</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analgesics, Opioid - adverse effects</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Drug Overdose - epidemiology</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Phenols - adverse effects</subject><subject>Poison Control Centers</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Seizures - chemically induced</subject><subject>Tramadol - adverse effects</subject><subject>Vomiting - chemically induced</subject><subject>Young Adult</subject><issn>1060-0280</issn><issn>1542-6270</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kM1P3DAQxS1UxPedU-VjL6HjODuOj2j5qoRKVZZzNDg2eJXEwfZWLH89gaUcKnUuM6P3e-_wGDsWcCKEUt8FIEBZg5ghVCjFFtsTs6ossFTwZbonuXjTd9l-SksA0KLUO2y3RIl6hnqPLeehHylS9n8sX4Rnb3xe8-D4gkY7ZGpDx2lo-SJS__7cZd_5Fz888DPKxH_bMcRsW54Dz4-W_5ySwkAd_xV8CsMGul2nbPtDtu2oS_boYx-wu4vzxfyquL65_DE_vS5MJVUujHOAlTRKVaI0RitBqkaNspYIGsnNplGIpoZ74ZTSLValI6lbVxuSVh6wb5vcMYanlU256X0ytutosGGVGqGwlCighgmFDWpiSCla14zR9xTXjYDmreHm34Yny9eP9NV9b9tPw99KJ6DYAIkebLMMqzjVkf4f-ApIpYJ0</recordid><startdate>20151201</startdate><enddate>20151201</enddate><creator>Tsutaoka, Ben T.</creator><creator>Ho, Raymond Y.</creator><creator>Fung, Stacey M.</creator><creator>Kearney, Thomas E.</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>C1K</scope></search><sort><creationdate>20151201</creationdate><title>Comparative Toxicity of Tapentadol and Tramadol Utilizing Data Reported to the National Poison Data System</title><author>Tsutaoka, Ben T. ; Ho, Raymond Y. ; Fung, Stacey M. ; Kearney, Thomas E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c437t-cff0643c77412cc971a786963836096af5555766c80b1f779d642fa39df8ca3e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Adverse Drug Reaction Reporting Systems</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analgesics, Opioid - adverse effects</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Drug Overdose - epidemiology</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Phenols - adverse effects</topic><topic>Poison Control Centers</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>Seizures - chemically induced</topic><topic>Tramadol - adverse effects</topic><topic>Vomiting - chemically induced</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tsutaoka, Ben T.</creatorcontrib><creatorcontrib>Ho, Raymond Y.</creatorcontrib><creatorcontrib>Fung, Stacey M.</creatorcontrib><creatorcontrib>Kearney, Thomas E.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>The Annals of pharmacotherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tsutaoka, Ben T.</au><au>Ho, Raymond Y.</au><au>Fung, Stacey M.</au><au>Kearney, Thomas E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparative Toxicity of Tapentadol and Tramadol Utilizing Data Reported to the National Poison Data System</atitle><jtitle>The Annals of pharmacotherapy</jtitle><addtitle>Ann Pharmacother</addtitle><date>2015-12-01</date><risdate>2015</risdate><volume>49</volume><issue>12</issue><spage>1311</spage><epage>1316</epage><pages>1311-1316</pages><issn>1060-0280</issn><eissn>1542-6270</eissn><abstract>Background: Tapentadol (TAP) and tramadol (TRA) provide pain relief through similar monoaminergic and opioid agonist properties. Objective: To compare clinical effects and medical outcomes between TAP and TRA exposures reported to the National Poison Data System of the American Association of Poison Control Centers. Methods: A retrospective cohort study was conducted analyzing national data for single medication TAP or TRA cases reported from June 2009 through December 2011. Case outcomes, dichotomized as severe versus mild; clinical effects; and use of naloxone were compared. Results: There were 217 TAP and 8566 TRA cases. Significantly more severe outcomes were associated with TAP exposures for an all-age comparison (relative risk [RR] = 1.24; 95% CI = 1.04-1.48), and for the <6-year-old age group (RR = 5.76; 95% CI = 2.20-15.11). Patients with TAP exposures had significantly greater risk of respiratory depression (RR = 5.56; 95% CI = 3.50-8.81), coma (RR = 4.16; 95% CI = 2.33-7.42), drowsiness/lethargy (RR = 1.38; 95% CI = 1.15-1.66), slurred speech (RR = 3.51; 95% CI = 1.98-6.23), hallucination/delusion (RR = 7.25; 95% CI = 3.61-14.57), confusion (RR = 2.54; 95% CI = 1.56-4.13) and use of naloxone (RR = 3.80; 95% CI = 2.96-4.88). TRA exposures had significantly greater risk of seizures (RR = 7.94; 95% CI = 2.99-20.91) and vomiting (RR = 1.96; 95% CI = 1.07-3.60). Conclusion: TAP was associated with significantly more toxic clinical effects and severe outcomes consistent with an opioid agonist. TRA was associated with significantly higher rates of seizures and vomiting.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>26369569</pmid><doi>10.1177/1060028015604631</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Adverse Drug Reaction Reporting Systems Aged Aged, 80 and over Analgesics, Opioid - adverse effects Child Child, Preschool Drug Overdose - epidemiology Female Humans Infant Male Middle Aged Phenols - adverse effects Poison Control Centers Retrospective Studies Risk Seizures - chemically induced Tramadol - adverse effects Vomiting - chemically induced Young Adult |
| title | Comparative Toxicity of Tapentadol and Tramadol Utilizing Data Reported to the National Poison Data System |
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