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

My Dr. currently changed my meds because they were’nt helping my pain, and what he gave me doesn’t seem to be helping much either. I go to a pain management dr., and I have been to the same one for almost 2 years. What do I say or do to not make myself look like a drug addict? I take my pills like i’m suppose to, and do not abuse them. I just want to be pain free. Please help. Thank you.

Chosen Answer:

just talk to your doctor. i mean, doctors know more than anyone about pain medication, and that those kinds of medications dont have a very long lasting effect (thats why he did decide to switch you, because he knows its only suppose to work for a few months or less). just schedule an appointment with them, and when you go in and they ask how youre doing or what can they do for you, just let it out. do seem like desperate or anything, like omg theyre not working what should i do. no, lol, just tell them, its really hard because the medication isnt working as well as they were before. and now your life is put on hold just to deal with the pain, and you dont know what to do know. most doctors will/can understand where your coming from, and may switch you again/up your dose. only a few doctors will get suspecious like you said, and to prove that youre not abusing them or selling them, tell your doctor to give you a blood/drug test. that why, they can see you have the right amount of that medication in your system (youre not taking more than directed or not enough in your system-selling them). but good luck!!! and just be open to your doctor, thats why you chose them to be your doctor, so you can feel comfortable AND safe talking to your doctor about everything and anything:)
by: iloveu2_21
on: 6th November 08

I delivered my beautiful son Connor this past Thursday.

My OB gave me a painkiller prescription, sanitary wipes, and hemorrhoid cream. They are not helping. I cannot sit on any surface (no matter how soft). I cannot walk without pain, and the swelling is honestly hard to believe.

Any advice on pain relief and/or your story about what you went through (and for how long) is appreciated.

Chosen Answer:

First baby- huh? Delivery is just hard on the perineum, no matter what they say. Your episiotomy has healed enough for the nerves to be really screaming now, I bet. Until healing is complete, you are just going to be sore. Real sore, to be frank. The best thing to do in the meantime is soak your tush in a warm bath with witch hazel added in. You can that several times a day, too. In between that, every time you go to the bathroom, you can use a witch hazel pad on the spot to help as well. The most famous brand is called Tucks, but you can also use a plain cotton pad and witch hazel from a bottle if you prefer. So far as sitting, well- you are right, there is no surface made that will be comfy for a bit yet. Try sitting slid forward onto your talebone, top portion of the buttocks, with your legs up. That takes the strain off the region involved. Normally you would add in some airflow, and possibly sunlight- but of course at the moment that’s just not practical or possible. Fortunately witch hazel is naturally soothing to the tissues, and will help with the swelling. For the episiotomy site itself, you can also try Vitamin E oil, from a gel cap or a bottle. Dab that on as often as you like. It helps moisturize and heal as well. I can empathize. I didn’t have a forceps delivery, but I also opted not to have an episiotomy either. The tissues were so sore I think I didn’t sit down comfy for nearly 10 days. In fact, I laid on the couch, rather than to sit- and nursed the baby in that position as well. It wasn’t near so bad with each of the babies afterward, as the tissues seem to learn to give a bit easier. Hopefully some of my suggestions will help you as well. Otherwise, it is really just a matter of time for the healing. Congratulations on the baby well born, at least it’s payback for the current misery, eh?
by: The mom
on: 24th November 09

I am curious, as a dear friend passed away from cancer two years ago, and I fear that she may not have had/wanted adequate pain relief due to her religious beliefs.
Mike: Thank you. It’s good to know that the discomfort would not have hastened her passing.

Chosen Answer:

Well, s/he could not have died from the pain, so that’s irrelevant. If s/he had refused other medical help, then that could be an issue.

Krishnas usually prefer natural alternatives, so i’m sure s/he might have been taking Wild Kratom or Salvia Herb for pain. Just as good as morph.
by:
on: 6th June 09

I want to have a natural birth with my baby. I’m due in about 11 weeks and I want to learn how to meditate and breathe through the pain and let my body relax and experience birth like it was meant to. I’ve heard of a lot of women who have wonderful birth experiences and are able to release the tension in their bodies and be connected to their baby during birth.

Where can I learn more about pain management of this kind? Any one have any advice or book suggestions?

Chosen Answer:

Google Jon Kabbat Zinn. He wrote a book on pain management using meditation.
by: Mike
on: 3rd March 09

I’m on a surgical waiting list and am looking for other types of pain relief besides surgical stockings and elevating my legs–any tip would help.

Chosen Answer:

Kinesiology is great for all kinds of pain relief, and is very complimentary to whatever your doctor is doing. A good kinesiologist can show you simple techniques to minimise your pain that don’t require painkillers, so you don’t need to worry about interactions with anything your doctor may have given you. Couple of good websites to give you more info re kinesiology: www.luminouslife.com.au – www.kinesiology.com.au – www.icpkp.com These sites also list practitioners so that you can find someone in your area. Good luck!
by: SL
on: 31st May 06

ive taken tramadol for 2 years now and the percocets for about a month now. i was wanting to know why its doing this and how. please my job is at serious risk.

Chosen Answer:

After your drug screen you have a chance to present any medications that you take to the doctor, if the combinations of all the meds you are taking could possibly be giving the result you have seen, then that will be noted and the test should be considered a false positive. This is only valid if the prescriptions are current and in your name and can be verified by the doctor who prescribed them to you.
You can also request a split test (done by two different labs) to see if they will have a different result.
I don’t see how that combo is showing up as pcp, as a narcotic yes, as flat out pcp… i don’t think so.
by: evil_streak_78
on: 22nd April 08

I was seeing an orthopedic because i have very bad pain in my back due to scoliosis in my back and neck and when muscle relaxers, physical therapy, and stretches were not helping he told me to make an app. with a pain management doctor. My mom goes to pain management so i made an app. with her doctor. What do you think he will do for me when i go? I already want a breast reduction, can he help me find a surgeon?
PS- Back surgery is not an option

Chosen Answer:

Your first appointment with a pain medicine (or pain management) specialist is much like other doctor visits. Although there are many similarities, the focus is on your pain, the cause or contributing factors, and quickly managing it!

Pain medicine doctors perform a physical and neurological examination, and review your medical history paying particular attention to pain history. You may be asked many questions about your pain, including:

1. On a scale from zero to 10, with 10 being the worse pain imaginable, rate your pain.
2. When did pain start?
3. What were you doing when pain started?
4. Does pain spread into other areas of the body?
5. Is its intensity constant, or is it worse at different times of the day or night?
6. What helps to relieve the pain?
7. What makes pain worse?
8. What treatments have you tried? What worked? What failed?
9. Do you take over-the-counter medications, vitamins, or herbal supplements?
10. Do you take prescription medication? If so, what, how much, and how often?

Most pain medicine specialists use a standardized drawing of the front/back of the body to enable you to mark where pain is felt, as well as indicate pain spread and type. You may be asked to complete the form each time you visit the pain doctor. The completed drawing helps to evaluate your treatment progress.

The proper diagnosis may involve obtaining an X-ray, CT scan, or MRI study to confirm the cause of spine-related pain. When treating spine-related pain, other tests, such as discography, bone scans, nerve studies (electromyography, nerve conduction study), and myelography may be performed. The correct diagnosis is essential to a successful treatment plan.

Some spinal disorders and treatment considerations require involvement by other specialists. Other specialists who may become involved in pain care include your primary care physician, neurosurgeon, orthopaedic surgeon, and other specialists in radiology, psychiatry, psychology, oncology, nursing, physical therapy, complimentary alternative medicine, and other fields. In the case of spine-related pain, the pain medicine specialist may consult with and/or refer you to a neurosurgeon or orthopaedic spine surgeon to determine if your pain problem requires spine surgery.
by: I <3 the Holidays
on: 5th May 09

100 mg of unisom
150 mg of tramadol
Is this okay? Or will i become sick?

Chosen Answer:

call your pharmacist, walgreens are usually 24 hours.
by:
on: 28th November 09

Hi,

I need to know if anyone knows or recommends a pain management doctor, it has to be from the Baltimore VA Medical Center(at Greene ST).

Thanks,

VET

Chosen Answer:

I saw Dr. Kiratsoawee after a tree crushed my ankle. He was very polite and did a great job of helping with the pain.
by: Dusty H
on: 23rd August 11

I have been taking Tramadol for a while now and want to know what are the side-effects
How about Liver or Kidney damage?

Chosen Answer:

Tell your doctor if you notice any of the following and they worry you.

Common side effects:

dizziness
sedation, fatigue
headache
constipation
nausea or vomiting
sweating
dry mouth

Less common side effects:

indigestion
changes in appetite
skin reactions
sudden onset of low blood pressure, collapse
muscle weakness
tremor
seizures
respiratory depression
improvement in mood
confusion
sleep disturbance
blurred vision
difficulty in passing urine

Serotonin Syndrome: signs of this vary and are not specific: they may include fever, sweating, confusion, agitation, diarrhoea, muscle twitching, difficulty with walking and balance. Serotonin Syndrome may result from interaction of tramadol with other medicines which increase serotonin effects, for example, the SSRI antidepressants.

Tell your doctor immediately if you experience any of the following side-effects, as urgent medical treatment may be required:

skin rash (red spots or patches), itching, hives, skin lumps
swelling or puffiness of the eyelids, face or lips
chest tightness, wheezing or pain in the chest
heart palpitations, faintness or collapse
hallucinations
convulsions.

Other side effects not listed above may also occur in some patients.

Tell your doctor if you notice anything else that is making you feel unwell.

Do not be alarmed by this list of possible side effects. You may not experience any of them.
by: ♥
on: 5th June 09