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

I took about 9 pills of 50 mlg last night at 10 pm and i’m still feel dazing and can’t feel my body. Should I drink a lot of water or sleep?

Chosen Answer:

Drink a lot of water AND sleep. Also eat some food. You have to let your body run it’s natural cycle, so get comfy.
by:
on: 13th October 11

I have osteo arthritis. I was on morphine based pain killers but suffered serious side effects. My GP took me off the tablets but i am in terrible pain. I have a tens machine which helps during the day but the problem is lack of sleep at night.
My mattress is not a problem as i sleep ok sometimes. But when i get a flare up the pain wakes me and keeps me awake..
I have regular injections in my spine and hips and am having knee surgery on Wednesday.
Can anyone suggest alternative ways to help with the pain?
I attend a pain clinic.
I would rather not take any more pills.Thanks to those that suggested that, but it is not what i want.

Chosen Answer:

If tens or morphine aren’t working then you really are on the technology edge. Try alchohol if it’s allowed. There’s more than one flavour electric pain management machine and some of them are programmable. Worth hassling you GP for more details.
by: Del Piero 10
on: 7th February 07

and I mean the strongest over the counter pain relief..
Motrin and Midol don’t do anything for me!

Chosen Answer:

Try Aleve (Naproxen) , will work when Motrin doesn’t.
by:
on: 1st February 09

How long can I keep on taking pain relief for toothache?

Chosen Answer:

Until the pain is gone. Or until your dentist or doctor has recommended that you stop it.
by: mtwaites
on: 9th November 08

I heard when haveing a drug screening it comes up as an illegal subsatance, is this true?
It slipped my mind to say that I do take it so i’m worried they may think I may be taking an illegal substance.
The last time I took it was about 2 or 3 days ago.

Chosen Answer:

3 days (which would be 72 hours after taking 50-100 milligrams). And it shows up as an opioid, and that’s not illegal if you have a prescription.
by:
on: 10th August 12

Urine analysis test and need to know if i will pass?

Chosen Answer:

Tramadol is a centrally acting analgesic.

It has a half life of between 6.3 to 7.4 hours (of tramadol and its active metabolite). It takes 5.5 half lives for a drug to totally leave the system, therefore it would take about 40.7 hours (5.5 x 7.4) for tramadol to be totally eliminated.

by: Kate from Drugs.com
on: 12th November 08

I have a horrible case of strep throat and my doctor didn’t prescribe any pain medicine. So, I took 50 mg Tramadol (Ultram) that I had already to help with the throat pain. I have a fever now and need to know, does Tramadol have any fever reducing effects or should I go ahead and take some Tylenol in conjunction with it?

Chosen Answer:

Be sure that it’s not Ultracet, but if it’s truly Tramadol 50 mg, then yeah, by all means take tylenol with it as the tramadol will not help your fever.
by: Crouching Doggie
on: 6th June 08

I have been taking Ultram/Tramadol now for several months and when I stopped taking the medication I have very serious withdrawl symptoms. The doctors say that it isn’t a narcotic, but I am beginning to wonder if that’s true or not. They say it works on the opioids in the brain just like a narcotic, so I am confused. Is anyone else having a hard time coming off of this pain medication? Or does anyone have more info on it?

Chosen Answer:

A doctor told me it isn’t habit forming. I sure like it though, it makes me feel a little drunk, and a little numb. It has the same painful with drawl as opiates. Doctors used to believe cocaine wasn’t habit forming either.
by: ghost
on: 4th July 08

I have chronic back pain, and my regular doctor is sending me to one, since physical therapy isn’t working. (He doesn’t like to prescribe narcotic pain medication more than once). So what can I expect at the Pain Clinic?

Chosen Answer:

The very first thing that they do is ask you to take a Urine Test. If you are clean of any up prescribed or illegal drugs then they will start to work with you.
They will have already read your chart that your doctor sent to refer you, but they will ask you lots of questions about your condition and they will work with you to determine the best medication regime to start you on. For instance if you work, or have daily responsibilities that would keep you from taking certain narcotics then they will find what is right for you during the day, or if you have any nerve damage with your back pain they will maybe try you on some medication that helps with the nerve. (sciatic, usually)

Their primary objective is to determine how much medication you will be requiring to help you with quality of life. If you are on other medications they will make sure there isn’t any drug interaction. You usually see them 1 time a month, on those visits, you discuss how your meds are working for you and then they will decide if anything needs to change that would maybe work better.
Pain Management Clinics are being used alot more now because there is such a problem with drug seeking patients out there that regular GP’s don’t like to get involved with long term pain patients. They are watched closely about the # of prescriptions they write and these Clinic employees and doctors are trained to detect deception and drug abuse. They are great for those who are truely in pain as well because of their extensive training.

I am so grateful for my Pain Clinic, my quality of life has improved at least 50% since they have been working with me.
Just be completely honest with them and thing will go well!!
They do usually make you sign a contract with them though, stating that you don’t use illegal drugs and you won’t sell you medications. They reserve the right to give you a drug test at any visit, and at my clinic they say that they can call you in for a “pill count” at any time if they think you are abusing them.
I don’t know if they really do that or not, they have never called me, but I still signed that they could if need be.

Good Luck to You, I hope you get the relief that you are looking for!
by: DeltaQueen
on: 14th November 07

I have sciatica and I was wondering if anybody else knew what to do that didn’t involve any pain medications other than Advil.Thanks!

Chosen Answer:

Dear

I understand ur problem as i am suffering from the same.

To be very honest.. all pills have side effects and i am suffering heavy weight gain due to these pain killers…

please try TENS or get a physiotherapy done.. its ur life & ur health should be ur topmost priority…

i suffer cause i neglected,, i am now on a verge to get a surgery done which i dont want to..

please dont take pills but go in for physiotherapy instead..
Take Care
by: navriti g
on: 27th October 08