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10 Questions about TRAMADOL for pain: uses, dosages, and risks by Andrea Furlan MD PhD

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In this video, Doctor Andrea Furlan answers 10 questions about tramadol for chronic pain:

Tramadol is an opioid. it is different from  other opioids due to its unusual characteristics.   some of these characteristics offer an advantage  for tramadol over other opioids, but on the other   tramadol is the generic drug name, and there  today, i will answer 10 common questions   question #1. how does tramadol work? before i

Continue, let me remind you that   this video is not intended to replace medical  advice. it is for educational purposes only.   doctor. in case of emergency, go to the   tramadol is a synthetic opioid. this means   it is done in laboratory as opposed to naturally  occurring opioids such as codeine and morphine  

Which are found in the opium poppy. when a person  takes tramadol, a pill, a tablet, suppository,   or even by injection, tramadol will need to be  converted in the liver to a more potent substance   called o-desmetyl-tramadol or m1. some people  do not have the ability to transform tramadol   into m1 and will not produce the more

Potent form  of tramadol. approximately 5% of caucasian people   to m1, so they will not respond to tramadol,   but tramadol will have an additional effect  in the pain system, which is very helpful for   people who have chronic pain. tramadol will block  the reabsorption of serotonin and noradrenaline,   two substances

That are needed in the central  nerve system in people who have chronic pain. in   chronic pain, we use antidepressants called snris  or serotonin-noradernalin reuptake inhibitors   noradrenaline. but tramadol is like taking 3 pills   for one. or 3 in one. however, it is hard to treat  depression with tramadol because the effects

Will   be unpredictable, so it is safer to prescribe one  medication for pain and another for depression.  for people with chronic pain and depression   dangerous. people with chronic pain who take   also increase serotonin in their brain, like   antidepressants, anti-migraine, other opioids,  anti-nausea and even some

Herbal supplements.   brain, there is the risk of “serotonin syndrome”,   one of the first symptoms is mental confusion,  and if this condition is not recognized quickly,   question #2. is tramadol a good painkiller? tramadol and m1 will activate opioid receptors in   the brain, spinal cord and the peripheral nerves, 

And will stop the pain, this is called analgesia.   codeine, and for this reason is commonly referred   as a weak opioid. however, the concept of weak  and strong opioid is relative. what this really   means is that you need a high dose of tramadol to  get the same effects of a low dose morphine. so,   morphine is strong. in

This case, fentanyl is   super strong because you would need micrograms  of fentanyl to have the same analgesic effects   there are various systematic reviews of   showed moderate quality evidence that tramadol  alone or in combination with acetaminophen   intensity and physical function over placebo   a cochrane

Review published in 2017 showed   low or very low-quality evidence that tramadol  could have some benefit for neuropathic pain.  very low quality evidence that tramadol   a systematic review published in 2020 showed low  quality evidence that tramadol as a single agent   question #3. what is the proper dose of  tramadol? how

Do i know if i need a higher dose?  we usually start tramadol with the lowest possible  dose. tramadol can be found as a short-acting or   long-acting medication. the short-acting usually  starts in 30 minutes and last about 4 hours. the   long-acting tramadol takes longer to start but  lasts about 8 to 12 hours. in some parts of

The   that is taken once a day as the effects last   contain a mix of short and long-acting tramadol.   pharmacist and find out what type of tramadol   because of the risks of serotonin syndrome that  i explained before, tramadol has maximum dose   for short-acting tramadol pills, if the pill   if the short

Acting tramadol pill contains 50  mg, then we recommend no more than 8 per day.  for the long-acting tramadol, they come in pills  of 50, 100, 150, 200 and 225 mg, depending on the   brand. the maximum dose is 400 mg per day. the  dose limit is mainly because of the risks of   question #4. can i take tramadol with other  

Mixed with acetaminophen. for example,  tramacet, the pill contains tramadol plus   you take additional doses of acetaminophen   tolerate is around 4,000 mg a day. acetaminophen   is the type of drug that is hidden in a lot of  other medications, like cold, cough, headaches,   etc. it is very important that you don’t

Take  more than 4,000 to preserve your liver function.  tramadol, but you need to be very careful   because the two medications can cause sedation,  sleepiness and poor concentration. and combining   question #5. is tramadol a risky pain medication?  death because it is an opioid, and opioids can   cause the person to stop

Breathing while they are  sleeping. this is even more common when tramadol   antidepressants, anti-psychotics, alcohol and  even when the person is taking other opioids.  opioid overdose. however, overdose by tramadol   the other risk of tramadol, that we already  mentioned is serotonin syndrome, and this is   if you want

To read the script of this video,  question #6. is tramadol safe  during pregnancy and breastfeeding?  tramadol crosses the placenta. we do not have  any evidence that it causes any malformation   pregnancy can result in withdrawal symptoms   opioid withdrawal can be life-threatening. so,   we recommend that pregnant woman

To discontinue  opioid as soon as they know they are pregnant,   and under medical supervision to avoid uterine   for breastfeeding women, tramadol is found in   serious overdose to the baby leading to brain  question #7. will tramadol  help me sleep or keep me awake?  they produce a state of stupor, paralysis,  

Sleepiness and relaxation. morphine, which has  been used for thousands of years was named after   characteristics that i mentioned before,  increasing serotonin and noradrenaline,   question #8. can i drive if i use tramadol? when the person is starting treatment with   operating heavy machinery until the dose is  

Stable and no more adjustments are being made  in the dose. once the person is on a stable   drowsiness and dizziness are the two most common  adverse effects of tramadol. but most people will   when the person is not feeling sleepy or  drowsy anymore, then they can resume driving.  both alcohol and tramadol inhibit the brain 

Function and cause the same effects of sleepiness,   breathing, which may lead to overdose and death.  yes, tramadol is a drug that can be abused.   euphoria similar to other opioids like oxycodone,   regularly will have withdrawal symptoms   withdrawal symptoms are very unpleasant.   even when the pain condition has

Resolved   a small proportion of people will develop  an opioid use disorder, which is basically   taking. this is a serious mental health disease,   and it has to be treated as soon as possible.  opioid use disorder or oud occurs in about   if you like this video press the thumbs up   button here, don’t forget

To subscribe to this  channel and turn on the notifications button.  thank you for watching. god bless you. good bye!

Transcribed from video
10 Questions about TRAMADOL for pain: uses, dosages, and risks by Andrea Furlan MD PhD By Dr. Andrea Furlan