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Pain is the most common cause of seeking medical attention. Pain treatment has always occupied a significant place in the doctor’s activities, and it is probably one of the most critical activities today.
Nevertheless, pain therapy is still on the rights of a stepson in medicine (unfairly little attention is paid to the treatment of pain to this day). The primary strategy for treatment of severe and perpetual agony disorders in the current drug is fundamental pharmacotherapy. The last can be done utilizing diverse strategies for overseeing pain relieving into the body (oral, rectal, sublingual, transdermal, by infusion). Be that as it may, regardless, the medication is consumed into the foundational flow, and after that to the site of its activity (not at all like local the technique for the organization of the pain-relieving, for instance, perineural, epidural).
Engineered narcotics are delegated narcotics. Tramadol is a non-particular narcotic receptor agonist. Exceedingly compelling pain relieving impact is because of the substance in it of the active substance tramadol hydrochloride. The medication is a solid sedative like pain relieving with an articulated impact of repressing the impression of agony and the vibe of torment sensations. Tramadol does not have any particular hostile implications. You can buy tramadol online from our reliable pharmacy.
As indicated by the scientists, in the improvement of enslavement and fixation, tramadol ought to be ascribed to a gathering of robust painkillers with almost no potential for building up the dependence. In therapeutic dosages, does not cause respiratory sorrow and weakness of cardiovascular movement. The pain-relieving impact comes rapidly and goes on for a few hours. The medication is having an antitussive effect, does not abuse the motility of the gastrointestinal tract. The term of the pain-relieving impact is 4-6 h. Agony related with malignancy or other terminal conditions can and ought to be satisfactorily wiped out, and worries about resilience and reliance ought to be put aside to accomplish the objective of most extreme alleviation for the patient.
Tramadol is a medium-quality pain relieving. Its analgesic effect has a unique dual mechanism of action. A part of tramadol molecules activates the analgesic mu opioid receptors. At the same time, the affinity of tramadol to these receptors is 6 thousand times weaker than that of morphine; therefore, the carcinogenic potential of this drug is very weak. The second part of tramadol molecules simultaneously activates non-opioid analgesic systems – inhibits the reuptake of serotonin or norepinephrine in nerve synapses.
Due to the activation of non-opioid noradrenergic and serotonergic systems, tramadol inhibits the transmission of pain impulses at the spinal level. The contribution of each mechanism of action separately is rather weak, but in general, there is a multiple enhancement of general analgesia. The synergism of the two mechanisms of action of tramadol makes it highly effective. Tramadol is presented in non-invasive forms:
• capsules – 50 mg;
• drops (20 drops – 50 mg);
• suppositories – 100 mg;
• long-acting tablets (100, 150 and 200 mg);
• there are also ampoules of 50 and 100 mg.
When ingestion tramadol is characterized by high bioavailability, which is very important with long-term treatment of chronic pain syndrome when administered orally, tramadol is rapidly and 90% absorbed in the gastrointestinal tract, the maximum concentration in the blood is reached 2 hours after taking the capsules or drops. The initial dose of tramadol is 50 mg, daily doses of tramadol range from 50 to 400 mg.
Its main feature is the enhancement of sedative medications. Also, it also stimulates the opiate receptors of the nociceptive system, located in the brain, as well as in the digestive tract.
Tramadol helps to slow down the decay of catecholamines and maintains its necessary concentration in the central nervous system. At the same time, the effect of the drug, in general, is much weaker than that of Codeine. Also, it is 6,000 times less effective than morphine.
If Tramadol is used in therapeutic doses, it has no particular effect on the intensity of breathing or hemodynamics. However, it in some way reduces intestinal motility, which, however, does not lead to constipation. Even with systemic intake, the patient does not have an increase in blood pressure in the lungs. It has an unexpressed antitussive effect and an equally blurred sedative.
In the brain, the drug has a depressing effect on the respiratory center, and on the gag, on the contrary, stimulating.
Long-term use of Tramadol often leads to the development of tolerance to it. The anesthetic effect occurs no earlier than 15 minutes. It is stored for 6 hours.
About efficiency
Quite often, patients complain that the medication is not very good. As a result, they increase the doses, and the weekly amount of drugs is not enough. What is the reason for this?
For many, the suspicion creeps in that the doctors miscalculate. In reality, there is no mistake here. The doctor prescribes precisely the amount that is given in the current instructions.
But the patients themselves often incorrectly take Tramadol. The main mistake here is unsystematic.
As medical practice shows, one category of people suffering from oncological pathologies prefers to endure to the end and agrees to injection only when the pain becomes unbearable. In this situation, a relatively large amount of the drug is needed.
At the same time, others, even with comparatively minor sufferings, immediately inject themselves with the maximum allowable dose. In both cases, there is an overuse of medication.
For the given Tramadol to suffice and act as effectively as possible for a long time, we should begin to take it at the first sign of pain and only in the amount prescribed by the doctor.
How to apply
In the early stages, capsules containing 50 milligrams of Tramadol are commonly prescribed. If this amount is not enough, then in an hour later the patient drinks another one. The maximum allowable daily rate for cancer patients is 400 mg or 8 pills.
Patients of retirement age who have liver or kidney disease must take it very carefully and at long intervals.
Drops of Tramadol in the amount of 20 should be dissolved with water or moistened with a piece of sugar. If relief does not come, then after 30 minutes it is allowed to repeat the reception. The instructions indicate that after this the next dose is permissible to drink only after 6 hours. During the day, the patient can use 160 drops.
There was a test with a group of patients from 30 people who received pain therapy with tramadol for a long time on an outpatient basis. Twenty-one people had average pains, and nine people had severe pains. The median scale of illness ranged from 3.2 to 4 points. The duration of the pain syndrome remained within 6–8 months. Evaluation of the effectiveness of analgesia was performed on a 4-point scale (0 – no pain and 4 – severe pain). According to the localization of the tumor process, the patients were distributed as follows:
• head and neck – 5 people;
• mammary gland – 10;
• female genitalia – 7;
• prostate gland – 8 people.
All patients suffered pains of varying intensity against the background of disease recurrence or progression of the tumor process and were in the stage of stabilization. With persistent pains of excruciating nature, the so-called neuropathic, opioids are ineffective. In the treatment of depression, this group of patients successfully used tramadol in various forms and dosages in combination with adjuvant drugs as the pain was relieved. Doses of tramadol reached 900–1200 mg per day.
For long-term therapy, the tablets are the most convenient, which must be taken twice a day: 100 150 200 mg every 12 hours. Treatment duration ranged from 3 to 6 months. The analgesic effect was observed in 60% of patients, which reduced the trauma dose to 400–600 mg per day (anesthesia score was 2.4 ± 0) Treatment of chronic pain based on tramadol is usually well tolerated by patients. When analgesia is achieved, the quality of life night sleep, mood, and physical activity are improved.
Tolerance to tramadol
It should be said that the nature of its side properties does not differ in principle from that of morphine and its derivatives, but the frequency and degree of their severity are much less. It is a much softer opioid than the morphine by side effects. Thus, the following conclusions can be made:
1. Tramadol hydrochloride adequately relieves the pain of moderate to moderate intensity in cancer patients.
2. The strict hourly dosage regimen relieves anxiety, which improves the patient’s quality of life.
3. It does not cause tolerance, physical, psychological dependence during long-term therapy and is an alternative to narcotic analgesics in the second stage of the treatment of pain syndrome of the WHO scheme.
4. The simultaneous use of adjuvant therapy prolongs the analgesic effect, contributing to the relief of pain of vigorous intensity.
Initially, it should be limited only to Tramadol tablets, while the pain is not too sharp. It is important to remember that no medicine gives an instant effect. If the overall condition is stable and there is no sharp deterioration, then it is recommended to drink the product in the initially selected volume for several days.