Ulcetra Overdosage

Ulcetra is a combination product. Clinical presentation of an overdose may include signs and symptoms of Tramadol toxicity, Paracetamol toxicity or both. Early symptoms seen in the first 24 hours after Paracetamol overdose may include: gastrointestinal irritation, anorexia, nausea, vomiting, malaise, pallor, and diaphoresis.
Human experience: Tramadol: Potential and serious consequences of an overdose of the Tramadol component are respiratory depression, lethargy, coma, convulsions, cardiac arrest and death.
Paracetamol: Severe overdose of Paracetamol can cause liver toxicity in some patients. Initial symptoms following potential overdose resulting in hepatotoxicity may include: gastrointestinal irritation, anorexia, nausea, vomiting, malaise, pallor, and diaphoresis. Clinical and laboratory evidence of liver toxicity may not be apparent until 48-72 hours after consumption.
Treatment: Single or multiple overdoses with Ulcetra may potentially lead to a deadly multi-drug overdose and it is recommended to consult an expert. Although naloxone can overcome some of the poisoning symptoms, but not all of the symptoms caused by Tramadol overdose can be managed. The risk of seizures also increases with the administration of naloxone. Based on experience, hemodialysis did not gave result as expected because it can only eliminate less than 7% dose of Tramadol taken in the dialysis period of 4 hours. In treating Ulcetra overdose, a major concern should be given to maintaining adequate ventilation (breathing) along with supportive therapy. Steps should be taken to reduce drug absorption. Vomiting should be mechanically induced, or with ipecac syrup, if the patient is conscious (adequate pharyngeal and laryngeal reflexes). The activated charcoal orally (1 g/kg) should be given after the gastric emptying action. The first dose should be accompanied by proper catharsis. If repeated doses are used, catharsis may be included with the necessary alternative dosage. Hypotension is usually caused by hypovolemic conditions and should be treated with fluids. Vasopressors and other support measures should be used as indicated. A balloon endotracheal tube should be inserted before gastric rinse in unconscious patient and, when necessary, to provide respiratory relief.
In adult and pediatric patients, any individual who presents with Paracetamol ingestion but unknown amount or history or timing, it should be attempted to determine plasma Paracetamol level and treated with acetylcysteine. If a measurement can not be obtained and the estimated consumption of Paracetamol exceeds 7.5-10 grams for adults and adolescents or 150 mg/kg for children, then dosing with N-acetylcysteine should be started and continued with overall therapy.