This paper is only available as a PDF. To read, Please Download here.
Abstract
Overdose of pentazocine (Talwin®), an agonist/antagonist opioid analgesic, is relatively
uncommon. Fifty-seven cases occurring over ten years are reported. Twenty-three patients
(40%) had ingested only pentazocine and did not have the classic opioid toxidrome
of CNS and respiratory depression with miosis. Most patients were awake, and no patient
had a respiratory rate below 12/minute. Other findings included: grand mal seizures,
hypertension, hypotonia, dysphoria, hallucinations, delusions, and agitation. Eleven
of 23 patients received IV naloxone (0.42–2.4 mg), but only two showed improvement.
Thirty-four patients (60%) had coingested pentazocine with one to five additional
substances. Patients who had ingested pentazocine with alcohol, a sedative/hypnotic
drug, or an antihistamine, showed increased toxicity, including apnea, deep coma,
and recurrent seizures. One patient developed opioid pulmonary edema. One patient
died. Three of five patients with coma and inadequate respirations responded to IV
naloxone in doses of 0.4 to 1.2 mg.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Emergency MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Product information.Winthrop Pharmaceutical Company, 1988
- Toxicological findings in deaths due to ingestion of pentazocine: a report of two cases.Forensic Sci Internat. 1982; 20: 89-95
- Baselt R. Disposition of toxic drugs and chemicals in man. 2nd ed. Biomedical Publications, Davis, California1982: 603-606
- Toxicological and pathological studies in psychoactive drug involved deaths.in: Biomedical Publications, Davis, California1980: 365-367
- Toxicology findings in fatal poisonings.Clin Chem. 1973; 19: 361-365
- Pentazocine overdose.Ann Emerg Med. 1983; 12: 28-31
- Seizures after pentazocine overdose.Isr J Med Sci. 1986; 22: 385-386
- Short-acting barbiturate overdosage—correlation of intoxication score with serum barbiturate concentration.JAMA. 1982; 248: 55-61
- Bioavailability and first-pass metabolism of oral pentazocine in man.Clin Pharmacol Ther. 1977; 22: 888-892
- Relationship of pentazocine plasma levels in pharmacological activity in man.Clin Pharmacol Ther. 1969; 10: 320-328
- The absorption, distribution and excretion of pentazocine in man after oral and intravenous administration.J Pharm Pharmacol. 1970; 22: 123-128
- Opioid analgesics and antagonists.in: Gilman A.G. Goodman L.S. Rall T.W. Murad F. The pharmacological basis of therapeutics. 7th ed. MacMillan, New York1985
- Naloxone.Ann Intern Med. 1976; 85: 765-768
- The hallucinatory effect of pentazocine (Talwin).JAMA. 1969; 210: 502
- The effects of morphine and nalorphine like drugs in the nondependent and morphine-dependent chronic spinal dog.J Pharmacol Exp Ther. 1976; 197: 517-732
- Effect of pentazocine and pethidine on plasma catecholamine levels.Ann Clin Res. 1971; 3: 22-29
- Increase of cortical excitability induced by pentazocine.J Pharm Pharmacol. 1980; 32: 599-600
- Some actions of pentazocine on behavior and brain monamines in the rat.J Pharmacol Exp Ther. 1972; 181: 346-356
- Severe hypertension and multiple atrial premature contractions following naloxone administration.Anesth Analg. 1979; 58: 524-525
- Hypertensive reaction to naloxone.JAMA. 1974; 228: 25-26
- Sudden death following naloxone administration.Anesth Analg. 1980; 59: 782-784
- Naloxone administration releases catecholamines [letter].N Engl J Med. 1983; 308: 654-655
- Cardiovascular response following naloxone administration during Enflurane anesthesia.Anesth Analg. 1981; 60: 237-238
- Pharmacology of opioids.Pharmacol Rev. 1984; 35: 283-323
Article info
Publication history
Accepted:
August 8,
1989
Received in revised form:
August 7,
1989
Received:
November 1,
1988
Identification
Copyright
© 1990 Published by Elsevier Inc.