Tramadol is one of the most potent analgesics available today to treat moderately severe pain; however, like all pharmacological medications, tramadol is also harmful in large doses (or even in normal dosage in some genetically susceptible individuals). Analgesics are the traditional pain medications that we all consume for different types of aches and pains. Common over-the-counter pain medications such as Aspirin and Tylenol are classified as NSAIDs (Non-steroidal anti-inflammatory drugs) and can treat most trivial muscular pains. However, moderate to severe pain (for example pain as a result of surgery or a fracture) is normally not responsive to over-the-counter pain medications.
For these situations, opioids are normally prescribed by healthcare professionals. tramadol is considered superior to most opioids in terms of its clinical effectiveness and comparatively lower addiction potential when compared to other opioids such as morphine or codeine. It is indeed a top choice for the short-term management of post-operative or acute pain.
Tramadol is a potent drug and the risk of developing reactions or side effects is a fair concern for clinicians as well as patients. tramadol exerts its action by affecting opioid receptors and although the mechanism of action is pretty similar to morphine and other opioids, tramadol also inhibits the uptake of serotonin and norepinephrine (neurochemicals in the brain) which are in part responsible for superior therapeutic efficacy when compared to morphine and codeine.
The most common side effects observed with tramadol include nausea, vomiting, dizziness, dry mouth, and sedation. These are generally well-tolerated and do not require any dose modification. However, the severity can be minimized by dose adjustment. For example, M. Cossmann suggested in his report that the overall risk of developing nausea and vomiting are 17.8% and 7.0% respectively when the drug is administered intravenously. However, with oral intake the risk is only 4.2% and 0.5% respectively. He further suggested that the overall risk of complications with tramadol is only 1% to 6% (depending upon the dosage and manner of administration).
Tramadol During Pregnancy
Despite the fact that tramadol is one of the potent analgesics with a lower risk of psychological or physical dependence, there is concern surrounding its consumption by pregnant mothers. Since fetuses have under-developed systems, tramadol is a topic of huge debate regarding its safety during pregnancy.
Why do most women require pain medication during pregnancy?
Pregnancy is a physiological state of hormonal irregularities that produce a variety of symptoms. Most pregnant mothers battle a variety of pain symptoms during pregnancy that may be trivial (not requiring any pain medication) or severe (requiring pain medication and other forms of pain management).
Headaches and migraine due to changes in the hormonal concentration. Pregnancy hormones produce changes in the caliber of blood vessels.
Backache due to the pressure on the spine of the expanding uterus
Lower pelvic pain caused by changes in the strength and stability of ligaments as a result of the pregnancy hormone (in an attempt to prepare the pelvis for delivery)
Pain involving lower limbs as a result of maternal weight gain that press upon nerves, muscles, and ligaments leading to edema and pain.
Codeine and tramadol are analgesics used to treat moderate to moderately severe pain. The two drugs do not interact with each other, but they should not be taken together. Taking these substances at the same time increases the risk of respiratory depression. The use of both drugs at the same time also increases the risk of seizures, particularly in people already disposed to seizure activity.
Codeine is an opiate drug. It can be derived directly from the opium poppy or synthesized from morphine. tramadol is a synthetic compound that is not chemically related to drugs in the opiate class. Neither drug has anti-inflammatory properties. Codeine and tramadol have similar pain-relieving properties and can usually be used interchangeably.
Tramadol’s analgesic action is not fully understood, although studies have revealed some of the ways the drug can control pain. Tramadol does not contain opioids, but it works similar to codeine in mimicking the body’s natural endorphins. Endorphins bind to the opoid receptors in the brain, blocking the transmission of pain signals from nerves to the brain. Tramadol also enhances the effects of serotonin, thereby moderating pain.
Both codeine and tramadol tramadol cause the same constellation of side effects related to opioids. Dizziness, nausea, and constipation are common when using either drug. Taking the two drugs together can increase their severity. There is also a higher incidence of serious side effects when codeine is taken with tramadol.
Tramadol and Alcohol
The practicality of prescribing strong painkillers such as morphine and codeine is limited by their significant risk of addiction in chronic users. Therefore, for long-term pain relief, clinicians often advise tramadol, as it has a partial opioid action with little dependence potential. However, there is considerable concern for those who consume alcohol regularly and are, at the same time, prescribed tramadol by physicians for pain relief and/or other ailments.
(Opioids are strong painkillers that are given during or after surgery to relieve pain and induce a much needed “calming effect” in the brain by changing the biochemical environment.)
What happens if tramadol is consumed with alcohol?
Tramadol exerts its action directly by interacting with the brain biochemical environment. Since alcohol and alcohol metabolic products are also released in the circulation acting as CNS (Central Nervous system or brain) depressant, concurrent consumption of alcohol and tramadol may lead to deleterious side effects. There could be an abnormal slowing of CNS (Central Nervous system or brain) activity with symptoms as trivial as drowsiness to as severe as depression of brain activity, coma, pinpoint pupils, and ultimately death.
Moderate alcohol consumption with tramadol may produce the following symptoms:
High risk of depression, mood disorders, agitation
Nausea, vomiting, gastrointestinal upset
Significant changes in nervous functioning like lack of coordination, permanent changes in behavior and memory
Sedation, vertigo and recurrent episodes of troubling headache
Elevated risk of enhanced liver damage, higher than either of the agents alone
Acute alcohol syndrome (marked by toxic reaction to moderate alcohol consumption that may prove life-threatening)
Moderate increase in intracranial pressure
Acute abdomen marked by severe pain and discomfort
Renal dysfunction (that may deteriorate to renal failure)
Decrease in the seizure threshold, especially in susceptible individuals
Various research studies indicate that co-ingestion of alcohol and tramadol increases the potential of substance abuse and is directly associated with a higher mortality.
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