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Pentazocine (Talwin) intoxication: report of 57 cases.
K R Challoner1, M M McCarron, E J Newton
1Department of Emergency Medicine, Los Angeles County/University of Southern California Medical Center 90033.
The Journal of Emergency Medicine
|January 1, 1990
Summary
Pentazocine (Talwin) overdose is uncommon. Many patients lack typical opioid symptoms, experiencing seizures and agitation, with limited response to naloxone, especially when combined with other substances.
Area of Science:
- Toxicology
- Pharmacology
- Emergency Medicine
Background:
- Pentazocine (Talwin), an agonist/antagonist opioid analgesic, presents unique overdose challenges.
- Overdose cases are relatively infrequent, necessitating a review of clinical presentations and management.
Purpose of the Study:
- To analyze the clinical features and outcomes of pentazocine overdose.
- To evaluate the efficacy of naloxone in pentazocine overdose management.
Main Methods:
- Retrospective case series of 57 pentazocine overdose incidents over ten years.
- Analysis of patient demographics, coingested substances, clinical signs, and treatment responses.
Main Results:
- Forty percent of patients ingested pentazocine alone, often without classic opioid toxidrome (CNS/respiratory depression, miosis).
- Reported symptoms included seizures, hypertension, agitation, and altered mental status.
- Naloxone was variably effective, particularly in patients with coingestions and severe respiratory depression.
Conclusions:
- Pentazocine overdose can manifest atypically, differing from pure opioid overdoses.
- Coingestion significantly increases toxicity and complicates management, with naloxone showing limited efficacy in some cases.
- Further research into optimal management strategies for pentazocine overdose, especially with coingestions, is warranted.