title: Hypo and hyperglycemia among tramadol overdose patients in Loghman Hakim Hospital, Tehran, Iran.
abstract: Tramadol is a synthetic and centrally active analgesic. Hypoglycemia as another possible major side effect among abusers has not been known well. Our objective is evaluation of the Blood Glucose Level (BGL) among tramadol-overdosed patients. This prospective cross-sectional study was performed from Feb to June 2013; BGL was measured at the time of admission, 8 and 12 hours later. All patients with hypoglycemia received infusion of 0.5-1 gr/kg of hypertonic dextrose and their BGL was checked every hour until normal BGL. Patients' demographic, clinical and paraclinical data were collected. Totally, 128 patients with a mean (SD) age of 24.5 (6.9) years were recruited; 127 (99.2%) were male. Seizure occurred in 59.4% cases. Mean ± SD admission BGL was 94.88 ± 21.5mg/dL. Fourteen patients experienced hypoglycemia within 12 hours period. Hyperglycemia was experienced in 8 patients (6.25%) on admission day. There was no significant relation between the dose of tramadol and BGL. In conclusion, hypoglycemia must be considered as an important side effect of tramadol-overdose. It is suggested that serial BGL monitoring in cases of Tramadol-overdose should be done for early recognition of hypoglycemia and its timely management. Also hyperglycemia may be revealed.
authors.affiliation: Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Soheil
authors.initials: S
authors.lastname: Nasouhi
authors.affiliation: Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Haleh
authors.initials: H
authors.lastname: Talaie
authors.affiliation: Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Abdolkarim
authors.initials: A
authors.lastname: Pajoumand
authors.affiliation: Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Sevil
authors.initials: S
authors.lastname: Aghapour
authors.affiliation: Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mitra
authors.initials: M
authors.lastname: Rahimi
authors.affiliation: Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Ahmad Ghochani
authors.initials: AG
authors.lastname: Khorasani
authors.affiliation: Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Mashayekhian
authors.affiliation: Forensic Medicine and Toxicology Department, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Aghabiklooei
authors.affiliation: Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Parmis
authors.initials: P
authors.lastname: Razi
authors.affiliation: Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Arezou
authors.initials: A
authors.lastname: Mahdavinejad
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000506:poisoning*; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D003430:Cross-Sectional Studies; D062787:Drug Overdose; D005260:Female; D005950:Glucose Solution, Hypertonic / Q000008:administration & dosage; D006761:Hospitals; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis; D007003:Hypoglycemia / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D007262:Infusions, Intravenous; D007492:Iran; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013997:Time Factors; D014147:Tramadol / Q000506:poisoning*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D001786:Blood Glucose; D005950:Glucose Solution, Hypertonic; D014147:Tramadol