Danielle Church provides an easy-to-read guide discussing the facts about synthetic pain reliever tramadol. She also provides common-sense tips for safe use of this medication. Tramadol hydrochloride (hcl) was developed by the German pharmaceutical house Grünenthal GmbH in the late 1970s. It's a synthetic drug with analgesic actions similar to codeine and antidepressant properties similar to SSRI drugs like Prozac. As such, it relieves pain and elevates mood at the same time, . Although not an anti-inflammatory like ibuprofen, false positive tramadol, tramadol does have unique anti-inflammatory properties. It's usually prescribed for short or long-term moderate to moderately-severe pain. Marketed under the brand name Ultram in the US and trade name Tramacet in Canada, the medication also comes in generic form, false positive tramadol. What Is Tramadol Used For? In addition to its analgesic and mood-elevating qualities, , tramadol may be especially effective for relief from nerve pain and diabetic neuropathy that's unresponsive to opiate drugs like morphine, oxycodone and hydrocodone. It's also been used to treat restless leg syndrome, treatment-resistant depression, high blood pressure, fibromyalgia and migraine headaches. Tramadol and acetaminophen taken together may be more effective for pain than either drug alone. The combination of the two can mean that lower doses of both medications are required. How It Works Tramadol causes a shift in the body's perception of pain. Pain may still be present, but there's less discomfort because the pain signal is significantly reduced. The mood-elevating component adds a mildly stimulating and euphoric aspect to the mix, false positive tramadol, while the anti-inflammatory property reduces swelling. The combined effect increases one's ability to function and helps patients to carry on with daily life. Side Effects The most common side effects of tramadol are: what is the drug tramadol used for, Dizziness
Constipation
Nausea
Headache
Drowsiness
Vomiting
Sweating Drug Interactions Do not take tramadol with carbamazepine (Tegretol, Equetro, Carbatrol); false positive tramadol; these drugs reduce the concentration of tramadol in the bloodstream by inactivating it. Avoid mixing tramadol with quinidine (Quinaglute, false positive tramadol, Quinidex); these medications can increase the concentration of tramadol in the body by as much as 50-60%. Patients on tramadol hcl should not take MAO Inhibitors (Parnate, Nardil), SSRIs (Prozac, , Zoloft), anti-psychotics (Haldol, Thorazine), or medications for nausea and vomiting, . Combining any of these with tramadol can cause seizures. Tramadol should not be taken with other opiate drugs, alcohol, false positive tramadol, anesthetics, , tranquilizers, muscle relaxers, , or sleeping pills. Respiratory failure, coma, and death could result. Tramadol Cautions Seizures can result from large single oral doses of 700 mg or more, false positive tramadol. Tramadol can cause seizures in those with epilepsy or other seizure disorders, head injuries, or metabolic disorders. Tramadol should be avoided by anyone with a history of addiction to alcohol or drugs, kidney disease, cirrhosis or other liver diseases, stomach disorders, mental illness or suicidal tendencies. Do not take Tramadol if you are a dialysis patient. Tramadol should not be taken by anyone under age 16, and daily doses of more than 30 mg are not recommended for anyone over 75. Is Tramadol Addictive? This drug can produce psychological and physical dependence similar to morphine. As such, , it's highly addictive, especially in conjunction with its antidepressant effect. To avoid withdrawal symptoms, patients are advised to strictly limit their usage to the frequency and duration prescribed by a doctor. For short-term pain, the usual treatment course is no longer than five days, . Withdrawal Effects Although tramadol was considered minimally addictive when it was introduced, false positive tramadol, it's apparently more addictive than originally thought. The 2010 Physicians Desk Reference (PDR) contains several warnings to this effect, false positive tramadol. Patients have experienced physical withdrawal symptoms like nervous tremors, , palpitations, sweating, , muscle contractions, headache, insomnia and sensations similar to electrical shock. Psychological symptoms like anxiety, panic, depression, anguish, false positive tramadol, mood swings, aggression and anger have also been reported, false positive tramadol. The longer a patient has used tramadol hcl before withdrawing, the more severe the withdrawal syndrome can be. Long-term users with chronic pain have said that because the drug has both pain relieving and stimulating effects, , it is one of the most difficult analgesics to stop taking. Withdrawal symptoms can develop within 12-20 hours after the last dose, . The withdrawal process is said to last longer and be more uncomfortable than withdrawing from opiate drugs like morphine. Tramadol hcl should not be used to manage opiate addiction or to wean addicts from opiate dependency. Given that the drug's stimulating properties make it doubly addictive, using it to treat opiate addiction can only worsen an existing condition. Due to the unpleasant nature of the withdrawal process, long-term tramadol users should be weaned from the drug gradually while under a doctor's care. Discontinuing the medication suddenly can result in seizures. Dosage The usual dose of tramadol is 50-100 mg every 4-6 hours with a maximum of 400 mg per day. Used as directed, the drug is generally effective for up to 24 hours. Users are advised not to exceed the recommended dosage; overdose can be fatal. For moderate pain, false positive tramadol, tramadol comes in 50 mg oral tablets that dissolve in the mouth, . For those with chronic, severe pain, the long-acting time-release tablet comes in 100, 200, and 300 mg formulations and can be taken once per day, false positive tramadol. Buying Tramadol Online Although tramadol hcl requires a doctor's prescription, , you can still purchase it on the Internet from reputable pharmacies. Check with the National Association of Boards of Pharmacy to find out if a web pharmacy is licensed and in good standing. Buying prescription drugs and other medications online is safe, convenient and considerably cheaper than shopping the local drugstore.
We previously showed, in mice, that morphine and tramadol exerted different effects on immune responses. Indeed, although morphine decreased lymphocyte proliferation and NK activity (2), the same variables were significantly enhanced by tramadol (13), . The current study was undertaken to evaluate whether similar effects could be described in humans. The postoperative period represents an interesting opportunity to address this problem, because it is known that surgical stress results in activation of the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system, false positive tramadol, leading to an alteration of immune responses (8–10). Indeed, we observed a clear-cut decrease in T lymphocyte proliferation immediately after the end of surgery. Cancer patients enrolled in the study were not immunosuppressed, and before the surgical procedure, immune responses were comparable to those described in healthy people (16,17). The impaired response of T lymphocytes persisted two hours after the administration of morphine, , whereby after the administration of tramadol the lymphoproliferation was not different in comparison with presurgery values. Immunosuppression induced by surgical stress has generally been shown to last longer than two hours (18); however, from our study, it is difficult to hypothesize whether the lymphoproliferation levels would have returned to normal values in the absence of treatment with morphine. We cannot say whether the apparently reestablished levels of lymphoproliferation observed after tramadol administration are caused by the immunostimulant properties of this drug, as was observed in mice (13), or the immune function was slowly returning to basal levels and no interference by tramadol was present, . In any case, these findings indicate that tramadol does not exert immunosuppressive actions. In contrast to what was observed with lymphocyte proliferation, surgery did not affect the cytotoxic activity of NK cells. These two immune variables seem, therefore, to show a different sensitivity to the stress induced by this type of surgical procedure. Although NK activity has generally been observed to be decreased after surgical stress (19,20), , increased (21), as well as unchanged (22), NK activity in the perioperative period has also been reported, false positive tramadol. It is reasonable to suggest that different surgical procedures can produce different modifications of this variable. At two hours after morphine administration, no significant alteration of NK activity was present. Because it has been shown that the immunosuppressive effects of morphine are evident at doses larger than those needed for controlling pain (2), false positive tramadol, it is likely that doses larger than 10 mg of morphine are required to fully evidentiate the suppression of NK activity in humans. Whereas two hours after morphine administration there was no significant modification of NK activity in the group of patients treated with tramadol, a clear and significant increase of this immune variable was evident. These observations lead us to hypothesize a stimulatory effect of tramadol on NK activity, false positive tramadol. Taken together, these results confirm the pharmacological properties of tramadol observed in the experimental animal (13), false positive tramadol. Morphine and tramadol share the opioid mechanism of action, although the affinity of tramadol for μ-opioid receptors is significantly lower than that of morphine. However, the antinociceptive effects of tramadol are mediated also via a separate, nonopioid mechanism, caused by the inhibition of neuronal uptake of noradrenaline and serotonin (11,12). These differences can account for the diverse pharmacodynamic profile of morphine and tramadol on immune functions. The involvement of the noradrenergic and serotoninergic systems in neural-immune interactions has been studied by using different experimental models. Although both enhancement and reduction of immune responses have been related to the activation of the noradrenergic system (23), the increase of serotoninergic tone has usually been associated with stimulation of NK activity and lymphocyte pro- liferation (24,25). Consistent with these observations, , drugs which increase serotoninergic tone, such as D-fenfluramine and fluoxetine, stimulate immune function in rodents (24) and our unpublished results. Moreover, , in the mouse, we observed that the immune effects of tramadol on lymphoproliferation and NK activity were prevented by the administration of the nonspecific serotoninergic antagonist metergoline (25), , indicating an involvement of the serotoninergic system in the immune effects of this drug. Interestingly, we have observed (our unpublished results) that tramadol, when added in vitro to splenocyte cultures, was not able to modulate either proliferation or NK activity, thus eliminating a direct effect of the drug on immune cells. Therefore, it can be suggested that activation of the serotoninergic system might be involved in the immune effects of tramadol in experimental and clinical conditions. In conclusion, we have confirmed in humans that the immune function is differently affected by morphine and tramadol. Analgesic drugs devoid of immunosuppressive effects might offer a good alternative to morphine for the treatment of postoperative pain.
|
