@article{ref1,
title="Characteristics of fatal tapentadol-related toxicity in Australia",
journal="Drug and alcohol review",
year="2022",
author="Darke, Shane and Duflou, Johan and Peacock, Amy and Farrell, Michael and Lappin, Julia",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="INTRODUCTION: Tapentadol is a centrally acting opioid analgesic prescribed for the treatment of moderate to severe pain. The study aimed to determine the characteristics of Australian toxicity deaths related to tapentadol. <br><br>METHODS: All cases in which tapentadol use was coded contributory to death (n = 159) were retrieved from the National Coronial Information System (1 July 2000-31 December 2020). <br><br>RESULTS: The mean age was 48.5 (18-81) and 56% were female. Documented histories of problems with chronic pain (66%), mental health (60.4%), substance use (44%) and injecting drug use (23.3%) were common. The majority of deaths were deemed unintentional (76.1%) and in 18.9% pre-existing disease was co-contributory. The median peripheral blood tapentadol concentration was 1.00 mg L(-1) (0.02-47.00), and the median aortic concentration was 2.05 mg L(-1) (0.10-30.00). In all cases, psychoactive drugs other than tapentadol were also detected, most commonly antidepressants (72.3%), opioids (66.7%), hypnosedatives (64.2%) and gabapentinoids (43.4%). Of cases where autopsies were conducted, 27.7% were diagnosed with cardiomegaly and 18.5% with severe coronary artery stenosis. Pulmonary oedema (68.1%), aspiration of vomitus (39.5%) and acute pneumonia (26.9%) were common. <br><br>DISCUSSION AND CONCLUSIONS: The typical tapentadol-related toxicity death involved unintentional death in the presence of multiple drugs, although a notable minority were intentional self-harm. Multiple morbidities were common. The identification and characteristics of these cases indicate that the adverse event profile of tapentadol needs to be considered in the setting of polypharmacy.<p /> <p>Language: en</p>",
language="en",
issn="0959-5236",
doi="10.1111/dar.13462",
url="http://dx.doi.org/10.1111/dar.13462"
}