Pain Relief Daily

I also have to write a report on the pharmacology of Tramadol, could someone help me out? Preferably the guy who answered my codeine question.

Chosen Answer:

Tramadol Hydrochloride
(Zydol, Tramacip, Ultram, (Ultracet, Tramacet – when combined with APAP)

Effects
Tramadol causes instant inhibition of serotonin and norepenephrine reuptake. This leads to increased feeling of wellbeing and happiness.
Tramadol itself acts weakly on the μ-opioid (μ is the greek letter Mu) receptors (the ones responsible for euphoria and analgesia).
Now, once the Tramadol has been metabolised in the liver, it’s M1 metabolite (odesmethyltramadol) then binds to the aforementioned opioid receptors causing a much more powerful euphoria (200x more potent than that of morphine), however, the amount of odesmethyltramadol is quite small, so the potency is relative.
The metabolisation must be considered, because not everyone metabolises Tramadol in the same manner, some barely metabolise any into odesmeth… hence many complain that Tramadol is ineffectual. This is the reason why usually.
Also, the high from Tramadol lasts longer than that of most other opioids, sometimes up to 16 hours.

Forms
Capsules (regular and extended release) (Doses usually ranging from 50mg IR (Instant release), 100mg SR (sustained release) to 200mg SR)

Tablets (regular, extended release, chewable, low-residue and/or uncoated tablets that can be taken by the sublingual and buccal routes)

Suppositories (bypasses hepatic demethylation)

Tablets and capsules containing (acetaminophen/APAP), aspirin and other agents. (for analgesic synergy)

Effervescent tablets and powders

Ampules of sterile solution for SC, IM, and IV injection (bypasses hepatic demethylation)

Preservative-free solutions for injection by the various spinal routes (epidural etc) (bypasses hepatic demethylation)

Powders

Liquids with and without alcohol for oral and/or sub-lingual use, available in regular phials and bottles, dropper bottles, bottles with a pump similar to those used with liquid soap and phials with droppers built into the cap.

Pharmacokinetic Information
Bioavailability = 68 – 72% (this increases with repeated dosing due to increasing amounts of o-desmethyltramadol)

Half life = ~5-7 hours

Metabolism = Hepatic demethylation (to odesmethyltramadol) & glucuronidation

Side Effects
Drowsiness
Fatigue
Constipation
Dizziness
Nausea
Vomiting
Dry Mouth
Headache
Indigestion
Seizure (Usually only with overdose)

Serious contraindications – Important!
SSRI medications can cause too much serotonin to build up in the brain and cause the deadly Serotonin Syndrome! AKA Serotonin Storm!

DXM (Dextromethorphan Hydrobromide), because it has Serotonin inhibiting properties and can cause the same syndrome as above.

Atypical antipsychotics are also at great risk of causing dangerous interactions when combined with tramadol.

Other notable information
Any other route except oral bypasses the hepatic demethylation, weakening the opioid effects of the drug.

Although not often warned or mentioned by prescribing doctors, Tramadol DOES have an addiction profile and should be considered an addictive substance if abused.

I’m Jacob, who advised you on your codeine question. I’ve put all the info you’d need on here. Good luck!
by: Jacob
on: 14th March 10

looking to quit and have realized it is not easy and heard that tramadol can provide ease during more acute withdrawal symptoms. Just looking for honest, knowledgabe feedback…thank you in advance.

Chosen Answer:

Tramadol is a synthetic morphine. And some say it is addictive,too. You need to be in some type of treatment program.
by:
on: 22nd January 12

My partner has just had a spinal op and is on tramadol and paracetamol (separately) – which one is it that causing his constipation? I know that both are capable, which one is likely to be more of the culprit? Thank you.

Chosen Answer:

by:
on: 1st January 70

for your pain meds? I have arthritis and severe knee problems and after seeing me for a few months my dr has referred me to a pain clinic. What exactly do they do there that is so different?

Chosen Answer:

Many of these so called pain management clinics are also very good at getting you addicted to high dose narcotics and then dropping you like a fly after you’ve been going every month for a year or two and are physically addicted to the pills. Be very careful. I would get on-line and do some research on which pain clinics in your area are good places to go for someone who wants help with their pain.
by: Soozie Q
on: 9th April 08

When someone complains of constant pain in a knee what do they mean by pain management

Chosen Answer:

by:
on: 1st January 70

Can anyone recommend a good pain management Dr in Washington state (King or Snohomish Counties)?
I get chronic Migraines and take oxycontin 40mg 4 times a day. I want to switch doctor because I am moving near these counties. what is the name of your doctor? what kind of pain do you have ? and what are you prescribed for it?

Chosen Answer:

Look into Wild Kratom and Salvia. Both help pain, both natural and both legal, no prescription required.
by:
on: 26th May 09

Is there any way to know?

If marijuana is used for pain relief (as people say), has there been any drop in the number of prescriptions written for opiates like hydrocodone, vicoden, etc.?

Chosen Answer:

Unfortunately, no it hasn’t, at least where I live! I live in California, where marijuana for pain is legal, but the use of Vicodin and Oxycodone (Percocet) is at an all-time high! They’re having so much trouble with overuse of these drugs that they’re starting to prosecute the doctors writing the scripts.

I have chronic pain myself, and find mj extremely ineffective, so I don’t use it. I think many people feel the same – I know several people on mj that also take other narcotics with it (vicodin, etc.) but don’t know too many people who have said it reduced their reliance on other pain meds.
by: Julzz33
on: 19th February 10

I am in pain management for a back surgery. I am at the point where I am weaning off of the strong post-surgical meds with the goal of getting off completely. HOWEVER, my husband just lost his job and now we have no insurance. I cant pay full price for a visit-(hence, no job) what are they going to do just let me go through withdrawls or is there some kind of policy they have for when this stuff happens?

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by:
on: 1st January 70

I took 5 tramadol at like 9ish today. Its almost 3:30 now. About an hour ago I started to get really itch and i have some very strange body feelings. I cant think straight and my visions slightly messed up. What does this mean to me?
and now im starting to feel like im going to puke

Chosen Answer:

5 Tramadol is 250mg of a rather potent opioid. The usual dose is never more then 50-100mg in a single dose and never more then 300-400mg maximum daily dose. You took 5x50mg pills which is way too much. The itchy feeling is what some people who abuse opiates/opioids desire for some reason. As long as you don’t have a seizure you will be fine but there is never a reason to take 250mg of Tramadol at once. It does cause seizures and regardless of what people say it will get you messed up just as bad as the more common pain meds.
by:
on: 26th January 10

Which is a better choice for pain management, codeine or hydrocodone?

Chosen Answer:

Well…if your having severe pain..then the hydrocodone of course.
by:
on: 4th January 11

I saw that there is “Doans” for back pain relief, but I can’t understand how it targets the back pain.

Can someone explain how that happens?

Chosen Answer:

It isn’t really relief for it only blocks the pain messages to the brain. The pains are still happening and can be doing more damage in your back. If you suffer from back pain you want to free up the pinched muscles causing the pain by doing this:
Back:
(do from a sitting position)
Place your left hand on your left leg next to your body. Place your right hand over your left shoulder, fingers over the back and the palm in the front and firmly pull down on them and hold. After 30 seconds slowly lower your body forward and to the outside of your left leg, keeping your left arm fairly straight as you do. When you reach your lap remain there for another 10 seconds, release the pressure but rest there for another 30 seconds. Then reverse your hand positions and do your right side.
For best results relax your body first by taking a deep breath and exhaling then remain this relaxed.
by: Douglas B
on: 22nd November 10