Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Tramadol is a man-made (synthetic) analgesic (pain
reliever). Its exact mechanism of action is unknown but similar morphine. Like
morphine, tramadol binds to receptors in the brain (opioid receptors) that are
important for transmitting the sensation of pain from throughout the body to.
Tramadol, like other narcotics used for the treatment of pain, may be abused.
Tramadol is not a nonsteroidal antiinflammatory drug (NSAID) and does not have
the increased risk of stomach ulceration and internal
bleeding that can occur
with NSAIDs.
STORAGE: Store at room temperature, 15-30 C (59-86 F). Store in a sealed
container.
PRESCRIBED FOR: Tramadol is used in the management of moderate to moderately
severe pain. Extended release tablets are used for moderate to moderately severe
chronic pain in adults who require continuous treatment for an extended period.
DOSING: The recommended dose of tramadol is 50-100 mg (immediate release
tablets) every 4-6 hours as needed for pain. The maximum dose is 400 mg/day. To
improve tolerance patients should be started at 25 mg/day, and doses may be
increased by 25 mg every 3 days to reach 100 mg/day (25 mg 4 times daily).
Thereafter, doses can be increased by 50 mg every 3 days to reach 200 mg day (50
mg 4 times daily). Tramadol may be taken with or without food.
Recommended dose for extended release tablets is 100 mg daily which may be
increased by 100 mg every 5 days but not to exceed 300 mg /day. Extended release
tablets should be swallowed whole and not crushed or chewed.
DRUG INTERACTIONS:Carbamazepine
(Tegretol, Tegretol XR , Equetro, Carbatrol) reduces the effect of tramadol by increasing
its inactivation in the body. Quinidine
(Quinaglute, Quinidex) reduces the inactivation of tramadol,
thereby increasing the concentration of tramadol by 50%-60%. Combining tramadol
with monoamine oxidase inhibitors (for example, Parnate) or selective serotonin
inhibitors ((SSRIs, for example, fluoxetine Prozac]) may result in severe side effects such as
seizures or a condition called serotonin syndrome.
Tramadol may increase central nervous system and respiratory depression when
combined with alcohol, anesthetics, narcotics, tranquilizers or sedative
hypnotics.
PREGNANCY: The safety of tramadol during
pregnancy has not been established.
NURSING MOTHERS: The safety of tramadol in
nursing mothers has not been
established.
SIDE EFFECTS: Tramadol is generally well tolerated, and side effects are
usually transient. Commonly reported side effects include
nausea,
constipation,
dizziness, headache, drowsiness, and
vomiting. Less commonly reported side
effects include itching, sweating, dry mouth, diarrhea, rash, visual
disturbances, and vertigo. Some patients who received tramadol have reported
seizures. Abrupt withdrawal of tramadol may result in anxiety, sweating,
insomnia, rigors, pain, nausea,
diarrhea, tremors, and hallucinations.
Fibromyalgia, formerly
known as fibrositis, causes chronic pain, stiffness, and
tenderness of muscles, tendons, and joints without detectable inflammation. Fibromyalgia patients have an unusually low pain threshold. Symptoms of fibromyalgia include fatigue, abnormal sleep, mental/emotional disturbances, abdominal pain, migraine and tension headaches, and irritable bladder. Treatment of fibromyalgia involves patient education, medication, exercise, and stress reduction.
Pain management and treatment can be simple or complex, according to its cause. There are two basic types of pain, nociceptive pain and neuropathic pain. Some causes of neuropathic pain includes: complex regional pain syndrome, interstitial cystitis, and irritable bowel syndrome. There are a variety of methods to treat chronic pain, which are dependant on the type of pain experienced.
Chronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
Fibromyalgia causes pain, stiffness, and tenderness
of muscles, tendons, and joints without detectable inflammation.
Fibromyalgia does not cause body damage or deformity.
Fatigue occurs in 90% of patients with fibromyalgia.
Irritable bowel syndrome can occur with fibromyalgia.
Sleep disorder is common in patients with
fibromyalgia.
There is no test for the diagnosis of fibromyalgia.
Fibromyalgia can be associated with other rheumatic
conditions.
Fibromyalgia treatment is most effective with
combinations of education, stress reduction,
exercise, and medications.
What is fibromyalgia?
Fibromyalgia is a chronic condition that causes pain, stiffness, and tenderness of the muscles, tendons, and
joints. Fibromyalgia is also characterized by restless sleep, awakening feeling tired, chronic fatigue, anxiety...
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