PDR MED
ULTRAM®
(tramadol hydrochloride) Tablets
http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/020281s032s033lbl.pdf
INDICATIONS AND USAGE
ULTRAM® is indicated for the management of moderate to moderately severe pain in
adults.
http://www.deadiversion.usdoj.gov/drug_chem_info/tramadol.pdf
Controlled Status:
On July 2, 2014, the DEA published in the Federal
Register the final rule placing tramadol into schedule IV of
the Controlled Substances Act. This rule will become
effective on August 18, 2014. All regulatory requirements
applicable to schedule IV controlled substances will apply
to tramadol beginning August 18, 2014.
http://www.deadiversion.usdoj.gov/schedules/
Schedule IV Controlled Substances
Substances in this schedule have a low potential for abuse relative to substances in Schedule III.
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http://agencymeddirectors.wa.gov/mobile.html
http://www.nyc.gov/html/doh/html/mental/MME.html
Tramadol 50
Morphine Equivalent Dose (MED) = 10
OxyContin Description
OxyContin (oxycodone) 80 mg
Morphine Equivalent Dose (MED) = 120
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http://www.ncbi.nlm.nih.gov/pubmed/18472996
Ther Clin Risk Manag. 2007 Oct;3(5):717-23.
The role of tramadol in current treatment strategies for musculoskeletal pain.
Schug SA1.
Author information
Abstract
Non-selective and cyclooxygenase-2 (COX-2) selective non-steroidal anti-inflammatory drugs (NSAIDs) have been the mainstay of treatment for musculoskeletal pain of moderate intensity. However, in addition to gastrointestinal and renal toxicity, an increased cardiovascular risk may be a class effect for all NSAIDs. Despite these safety risks and the acknowledged ceiling effect of NSAIDs, many doctors still use them to treat moderate, mostly musculoskeletal pain. Recent guidelines for treating osteoarthritis and low back pain, issued by numerous professional medical societies, recommend NSAIDs and COX-2 inhibitors only in strictly defined circumstances, at the lowest effective dose and for the shortest possible period of time. These recent guidelines bring more focus to the usage of paracetamol and opioids. But opioids still remain under-utilized, although they are effective with minimal organ toxicity. In this setting, the atypical, centrally acting analgesic tramadol offers important benefits. Its multi-modal effect results from a dual mode of action, ie, opioid and monoaminergic mechanisms, with efficacy in both nociceptive and neuropathic pain. Moreover, fewer instances of side effects such as constipation, respiratory depression, and sedation occur than with traditional opioids, and tramadol has been prescribed for 30 years for a broad range of indications. Tramadol is now regarded as the first-line analgesic for many musculoskeletal indications. In conclusion, it is recommended to better implement the more recent guidelines focusing on pain management and consider the role of tramadol in musculoskeletal pain treatment strategies.
https://www.dovepress.com/articles.php?article_id=1258
Full Article PDF
https://www.dovepress.com/articles.php?article_id=1258
Full Article
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2376082/
http://www.iasp-pain.org/Taxonomy
http://www.merriam-webster.com/medical/pain
1
a : a state of physical, emotional, or mental lack of well-being or physical, emotional, or mental uneasiness that ranges from mild discomfort or dull distress to acute often unbearable agony, may be generalized or localized, and is the consequence of being injured or hurt physically or mentally or of some derangement of or lack of equilibrium in the physical or mental functions (as through disease), and that usually produces a reaction of wanting to avoid, escape, or destroy the causative factor and its effects <was in constant pain>
b : a basic bodily sensation that is induced by a noxious stimulus, is received by naked nerve endings, is characterized by physical discomfort (as pricking, throbbing, or aching), and typically leads to evasive action
http://www.merriam-webster.com/thesaurus/pain
http://www.oxforddictionaries.com/us/definition/american_english/pain
see definition AND SYNONYMS
open SYNONYMS window
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http://www.drugs.com/pro/carisoprodol.html
Indications and Usage for Carisoprodol
Carisoprodol Tablets, USP are indicated for the relief of discomfort associated with acute, painful musculoskeletal conditions in adults.
Carisoprodol Tablets, USP should only be used for short periods (up to two or three weeks) because adequate evidence of effectiveness for more prolonged use has not been established and because acute, painful musculoskeletal conditions are generally of short duration.
http://www.deadiversion.usdoj.gov/drug_chem_info/carisoprodol/carisoprodol.pdf
Control status:
As of January 11, 2012, Carisoprodol is a schedule IV
controlled substance under the Controlled Substances Act.
Introduction:
Carisoprodol is a prescription drug marketed since
1959. It is a centrally acting muscle relaxant. The diversion
and abuse of carisoprodol have increased in the last
decade.
Licit Uses:
Carisoprodol is used as an adjunct to rest, physical
therapy and other measures for relief of acute, painful
musculoskeletal conditions. It is available as single-entity
tablets containing 250 mg or 350 mg carisoprodol, and as
combination tablets containing 200 mg carisoprodol, 325
mg aspirin and 16 mg codeine phosphate. The standard
dosage for adults is 250 mg to 350 mg three times daily and
at bed-time. Use in patients under age 12 is not
recommended. According to IMS Health™, there were
approximately 8.5 million carisoprodol products dispensed
in the U.S in 2013
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http://www.ncbi.nlm.nih.gov/pubmed/15276195
J Pain Symptom Manage. 2004 Aug;28(2):140-75.
Comparative efficacy and safety of skeletal muscle relaxants for spasticity and musculoskeletal conditions: a systematic review.
Skeletal muscle relaxants are a heterogeneous group of medications used to treat two different types of underlying conditions: spasticity from upper motor neuron syndromes and muscular pain or spasms from peripheral musculoskeletal conditions
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The DEA overpays informants without oversight
July 26, 2015 12:00 AM
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http://www.thaicrc.com/collect/MIS/index/assoc/D5673.dir/5673.pdf
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