Senin, 06 Juni 2011

Pharmacy: TRAMADOL

Introduction
Tramadol is a centrally acting, synthetic analgesic of the aminocyclohexanol group, which has opioid-like effects. It has been in clinical use in Europe since the late 1970. Its mode of action is not completely understood but it appears to have a dual mechanism of action, which involves inhibition of re-uptake of serotonin (5-HT) and/or noradrenaline as well as weak affinity for opioid (mu) receptors. Since tramadol does not affect prostaglandin synthesis, it does not have antipyreticor anti-inflammatory effects.  

# Intra-operative and Post-operative Analgesia 
- Comparison with placebo
A pooled analysis of 9 single-dose, double-blind, randomised, placebo-controlled studies 18 included a total of 1594 patients with post-operative pain following caesarean section or general surgical procedures. Analysis showed that analgesic efficacy of tramadol at doses equal to or greater than 50mg was superior to that of placebo (statistical value not reported). Likewise, pooled analysis of 9  double-blind, randomized studies involving 1859 patients with dental extraction pain evaluated single oral doses of tramadol ranging from 50mg to 200mg. Analysis demonstrated a significantly greater efficacy for tramadol than for placebo at all doses evaluated. (The majority of these studies have not been published.)  A subsequent meta-analysis of these 18 studies confirmed the effectiveness of tramadol in comparison with placebo and demonstrated a significant dose response. Multi-dose studies have also demonstrated a superior effect of oral tramadol over placebo in both pain after dental extraction and pain after orthopaedic surgery.
- Comparison with morphine
- Comparison with pethidine
-  Comparison with NSAIDs
- Comparison with oral analgesics: single-dose studies

# Paediatric Surgery
# Other Acute Pain Syndromes
# Chronic Pain
# Indications other than analgesia  
#  ADVERSE EFFECTS
# Drug Interactions [More...]: 

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