7:10 p.m. - 2007-09-25
tramadol usa pharmacy
Patient reporting of adverse drug reactions: useful information for pain management?
The complete Freund's adjuvant (CFA)-induced arthritic rat model has extensively served as a laboratory model in the study of arthritic pain. However, the time courses of allodynia and hyperalgesia and the efficacies of different analgesics have not fully been analyzed in this model. Mechanical allodynia, thermal and joint hyperalgesia, and other disease development parameters (body weight, mobility, paw volume, and joint stiffness) were measured on postinoculation days (PIDs) 0 to 28 in rats. Acute analgesic efficacies of drugs were evaluated on PID 9 when degrees of allodynia, hyperalgesia, and joint stiffness in the ipsilateral paw reached almost the maximum, although those in the contralateral paw changed only slightly. In the ipsilateral paw, thermal hyperalgesia reached the maximum on PID 1, whereas mechanical allodynia and joint hyperalgesia progressively developed during the first 7 or 8 days, being tuned in to arthritis development. In the contralateral paw, thermal hyperalgesia never occurred, whereas mechanical allodynia and joint hyperalgesia developed after PID 11. Morphine and Tramadol ( Generic Ultram ) had full efficacies for all the pain parameters tested at sedation-inducing doses. Indomethacin and diclofenac significantly but partially improved thermal and joint hyperalgesia. Amitriptyline significantly reduced thermal and joint hyperalgesia only at sedation-inducing dose. Acetaminophen, carbamazepine, and gabapentin had, at the most, very small efficacies. In conclusion, the present study provided integrated information about the time course of pain and other disease development parameters in the CFA-induced arthritic rats, and clarified acute efficacies of different categories of analgesics for the allodynia and hyperalgesia.
Effects of Tramadol ( Generic Ultram ) on alpha2-adrenergic receptors in the rat brain.Faron-Gorecka A, Kusmider M, Inan SY, Siwanowicz J, Dziedzicka-Wasylewska M.Institute of Pharmacology, Polish Academy of Sciences, 12 Smetna Street, Cracow PL-31-343, Poland.In recent years, it has been postulated that Tramadol ( Generic Ultram ), used mainly for the treatment of moderate to severe pain, might display a potential as an antidepressant drug. The present study investigated the effects of acute and repeated Tramadol ( Generic Ultram ) administration on the binding of [3H]RX 821002, a selective alpha2-adrenergic receptor ligand, in the rat brain. Male Wistar rats were used. Tramadol ( Generic Ultram ) (20 mg/kg, i.p.) administered acutely (single dose), at 24 h after dosing, induced a significant decrease in the alpha2-adrenergic receptors in all brain regions studied. The most pronounced effects were observed in all subregions of the olfactory system, nucleus accumbens and septum, thalamus, hypothalamus, amygdala, and cerebral cortex. Repeated treatment with Tramadol ( Generic Ultram ) (20 mg/kg, i.p., once daily for 21 days) also induced statistically significant downregulation of [3H]RX 821002 binding sites in the rat brain. However, the effect--although statistically significant--was less pronounced than in the group treated acutely with the drug. Since drugs such as mianserin and mirtazapine are potent antagonists of central alpha2-adrenergic receptors and are effective antidepressants, it is tempting to suggest that, in addition to other alterations induced by Tramadol ( Generic Ultram ), downregulation of these receptors may represent a potential antidepressant efficacy. On the other hand, one should be careful to avoid the treatment of chronic pain with Tramadol ( Generic Ultram ) in patients already receiving antidepressant drugs. Tramadol ( Generic Ultram )-induced downregulation of alpha2-adrenergic receptors--when combined with ongoing antidepressant therapy with drugs, which themselves inhibit serotonin reuptake or are antagonists of alpha2-adrenergic receptors--might cause threatening complications.
Tramadol ( Generic Ultram ) (Ultram) concentrations in death investigation and impaired driving cases and their significance.Clarkson JE, Lacy JM, Fligner CL, Thiersch N, Howard J, Harruff RC, Logan BK.Washington State Toxicology Laboratory, Forensic Laboratory Services Bureau, Washington State Patrol, 2203 Airport Way South, Seattle, WA 98134, USA. We reviewed a series of 66 deaths in Washington State between 1995-2000 in which Tramadol ( Generic Ultram ) (Ultram and Ultracet, Ortho-McNeil) was detected in the decedent's blood, in order to assess the role Tramadol ( Generic Ultram ) was determined to have played. Additionally, we reviewed a series of 83 impaired driving cases in which Tramadol ( Generic Ultram ) was detected in order to establish a non-lethal blood Tramadol ( Generic Ultram ) concentration reference range. In both populations, Tramadol ( Generic Ultram ) was consistently found together with other analgesic, muscle relaxant, and CNS depressant drugs. Death was rarely attributable to Tramadol ( Generic Ultram ) alone. However, Tramadol ( Generic Ultram ) may be a significant contributor to lethal intoxication when taken in excess with other drugs, via the potential interaction with serotonergic antidepressant medications, as well as the potential for increased CNS depression. Although the incidence of Tramadol ( Generic Ultram ) detection has increased consistently over the last eight years, there is no evidence of a corresponding increase in the number of cases in which death was attributed solely to Tramadol ( Generic Ultram ). Blood drug concentrations in many deaths exceeded the therapeutic serum range of 0.28-0.61 mg/L; however, the concentrations overlapped almost completely with the range identified in living subjects arrested for impaired driving. These findings suggest caution in the interpretation of blood Tramadol ( Generic Ultram ) concentrations outside of the recognized therapeutic range. It also suggests that the drug, even when used in moderate excess, is not a principle cause of death in suicidal or accidental deaths.
Effects of opioid analgesics on potential-gated ion channels in the pond snail neurons
The effects of opioid analgesics morphine, promedol, Tramadol ( Generic Ultram ), and butorphanol on the transmembrane calcium, sodium, and potassium (fast and slow) ion currents in pond snail (Lymnaea stagnalis) neurons were studied by intracellular dialysis and membrane potential (voltage-clamp) measurements. It was established that all these drugs produce a dose-dependent reversible inhibition of the ion currents (sodium calcium potassium) and reduce nonspecific leak currents, thus producing a stabilizing action upon the sample membrane. The current-inhibiting effect of morphine was not eliminated by naloxone (500 microM); moreover, the latter drug significantly inhibited the ion currents as well.
Enantiomeric separation of Tramadol ( Generic Ultram ) hydrochloride and its metabolites by cyclodextrin-mediated capillary zone electrophoresis.
The enantiomeric separation of Tramadol ( Generic Ultram ) hydrochloride and its major metabolites, O-demethylTramadol ( Generic Ultram ) (M1) and N-demethylTramadol ( Generic Ultram ) (M2) was studied using cyclodextrin (CD)-mediated capillary zone electrophoresis (CZE). Influence of the choice of type and concentration of CD, capillary temperature, length of capillaries, buffer pH and the addition of polymer modifier on the chiral separation of Tramadol ( Generic Ultram ) and its metabolites was evaluated. It was found that the drug and the metabolites can be baseline-separated simultaneously by using 50 mM phosphate buffer (pH 2.5) containing 75 mM methyl-beta-CD, 220 mM urea and 0.05% (w/v) hydroxypropylmethyl cellulose.
A clinical-experimental study of narcotic properties of opiate receptor agonists-antagonists and experience in their use in drug addiction practice
Narcogenic characteristics of opiate agonists-antagonists were studied in drug abusers. It is shown that buprenorphine, butorphanol, nalbuphine hydrochloride, but not Tramadol ( Generic Ultram ), have high narcogenic potential. Opportunities for these drugs in narcological practice are outlined.
Palliative care in a national cancer center: results in 1987 vs. 1993 vs. 2000.
BACKGROUND AND OBJECTIVE: In recent human and animal studies, intrathecal administration of various doses of neostigmine produces analgesia without neurotoxicity. The aim was to examine the effects of intrathecal neostigmine and bupivacaine in patients undergoing perianal surgery under spinal anaesthesia. METHODS: The patients were randomly allocated into three groups of 15: Group 1 (controls) received hyperbaric bupivacaine 10 mg + dextrose 5%, 1 mL, to a total volume of 3 mL; Group 2 received hyperbaric bupivacaine 10 mg + neostigmine 25 microg in dextrose 5%, 1 mL, to a total volume of 3 mL; and Group 3 received hyperbaric bupivacaine 10 mg + neostigmine 50 microg in dextrose 5%, 1 mL, to a total volume of 3 mL. RESULTS: The onset of sensory block was significantly earlier for Group 2 and 3 patients compared with Group 1 patients (P < 0.05). The full time to recovery of motor block and sensory block was significantly longer in Group 3 compared with Group 1 (P < 0.05). In Group 3, the average time until the first dose of Tramadol ( Generic Ultram ) was longer than Group 1 (P < 0.05). The incidence rate of nausea and vomiting was significantly higher in Groups 2 and 3 than in Group 1 (P < 0.05). CONCLUSIONS: The use of intrathecal neostigmine as an analgesic drug in perianal surgery is unsatisfactory because of prolonged motor blockade and nausea.
Arousal in various analgosedation schedules
The patterns of recovery of patients who received seven different analgesic and sedative treatments were investigated with regard to the time at which the subjects awoke. For observations of the neurologic status, we developed a special score. The analgesic and sedative therapies were given at three various doses. The combination of fentanyl/midazolam, alfentanil/midazolam and ketamine/flunitrazepam showed the best results. Piritramid/promethazine, pethidine/flunitrazepam, pethidine/promethazine and Tramadol ( Generic Ultram )/methohexital required more time for awakening. On the basis of these results, we prefer to use the combination of fentanyl/midazolam, alfentanil/midazolam and ketamine/flunitrazepam to judge all patients' neurologic scores.
Postoperative analgesia with epidural administration of a combination of Tramadol ( Generic Ultram ) and clonidine
Postoperative analgesia inhibits the stress cascade with negative effects on whole organism. Therefore the spectrum of drugs used for soothing postoperative pain quickly widens. The epidural route appears as being logical, since due to the direct effect in the transmission and processing of pain it suffices with a lower dosage. The authors refer to a group of 30 patients postoperatively treated by a combination of Tramadol ( Generic Ultram ) and Clonidine administrated by means of an epidural catheter. 26 patients evaluated the induced analgesia as excellent or sufficient. (Tab. 3, Ref. 4).
The antinociceptive effect of Tramadol ( Generic Ultram ) on a model of neuropathic pain in rats.
BACKGROUND: The introduction of the laparoscopic approach to bariatric surgery has brought similar advantages as those seen in general surgery. There have been no trials assessing postoperative pain after laparoscopic adjustable silicone gastric banding (LASGB). We compared prospectively postoperative pain and outcome in LASGB and laparoscopic cholecystectomy (LC), to determine if morbidly obese patients can expect the same benefits from a laparoscopic approach in gastric banding as those which are known for LC in non-obese and obese patients. METHODS: In a prospectively collected database of 80 patients undergoing LASGB, information including a survey assessing the postoperative pain, the amount of analgetic drugs used, operative reports, laboratory data, and follow-up data was collected. This was compared to an equal number of patients undergoing LC. Postoperatively, all patients received standardized pain medication of 150 mg Tramadol ( Generic Ultram ) per day. Pain was assessed twice on postoperative days 1-3 using a patient questionnaire. RESULTS: Patient characteristics and duration of hospital stay were similar in the two groups. Although there was no significant difference in type and intensity of pain experienced by the patients in either group, the gastric banding patients reported less postoperative pain overall.
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