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Background: Regarding increasing tramadol toxicity in recent years due to usage of tramadol as a drug for suppression of withdrawal symptoms and high availability of this drug, we did a survey on the frequency of tramadol intoxication symptoms, duration of admission, therapeutic measurements, tramadol dosage, and prognosis of the patients. Methods: We conducted a cross sectional study, in which information of every patient with tramadol toxicity admitted in Noor hospital ward of toxicology (Isfahan, Iran) were gathered and analyzed. Finding: From 184 cases, 141 (76.6%) were men. The mean age of the patients was 24 ± 7 years. Forty percent of patient had positive history of substance abuse. Eighty four cases (45.6%) were with coingestion. Thirty four percent of patients had chronic ingestion of tramadol. The most common chief complaint was central nervous system (CNS) depression (57%) followed by seizure (25%), bradypnea (18%), tachycardia (25%), and hypertension (7%). Active charcol (89%), gastric lavage (81%), naloxane (25%), anti convulsants (11%), and intubation and ventilation (5%) were done as therapeutic acts. The most common complication in patients was aspiration pneumonia. Two (1.1%) patients died. There were significant relationships between tramadol dose and seizure (P = 0.036), ataxia (P = 0.002), and outcome (P < 0.001). Conclusion: Tramadol overdose frequently cause CNS depression, respiratory depression, tachycardia, hypertension, and seizure; these symptoms could be from both effects of tramadol either on mu receptor or inhibition of monoamine reuptake. [ABSTRACT FROM AUTHOR]

Background: Poisoning is one of the medical emergencies. Poisoning with new Anticonvulsant drugs such as lamotrigine, sodium valproate, topiramate and gabapentin has been observed alone or in combination with other drugs in the last few years. Therefore this study was performed regarding the poisoning with new anticonvulsant drugs with respect to demographic, clinical manifestations, length of hospital stay, outcome and correlation between the outcome and different variables. Methods: This study was a descriptive-analytical and cross-sectional study. Simple sampling method was performed in the Noor and AliAsghar Hospital on poisoning cases with new anticonvulsant drugs. Need to intubation, connected to ventilator and aspiration pneumonia were considered as outcome Statisticial analysis was done by SPSS17 using ANOVA, Student t-test and logistic regression. Findings: Poisoning with Sodium valproate was more common than Lamotrigine, Topiramate and Gabapentin. The Mean (SD) age of study population was 27.67 (9.74) years old. The most important prediciting factors in outcome incidence were sex (male), seizure, cardiovascular and respiratory symptoms in poisoning with Sodium valproate and seizure in poisoning with Lamotrigine. One death occurred in poisoning with Sodium valproate. Conclusion: Average age of patient was about 27.67 years which may be due to the use of these drugs in the younger age groups. The higher length of hospital stay in patients with respiratory symptoms in Sodium valproate and Lamotrigine poisoning would be because of more complications (intubation, ventilation and aspiration penumonia) observed with these two drugs. [ABSTRACT FROM AUTHOR]