Painkillers are divided into three groups: non-opioid, weak opioid and strong opioid. The approach to pain management is to start with the first group to relieve pain. If the medications and dosages in the first group are no longer sufficient, the patient moves to the next classification group, possibly up to the third group of strong opioids. This includes tramadol.
What is tramadol?
Tramadol is a centrally acting pain reliever used for moderate to severe pain. Tramadol is a centrally acting pain reliever that is used for moderate to severe pain. Tramadol falls into the middle or second group of pain medication classification here. It is a prescription medication. Few pharmaceutical companies manufacture the tablets in two layers, so it is also possible to adjust the dose here. Tramadol is one of the few opioids that can also be administered intravenously, which is particularly beneficial after surgery or as a treatment with higher doses over a longer period of time, especially here again because of the immediate onset of action.
Pharmacological action
Tramadol is a centrally acting analgesic, which means it achieves its analgesic effect by docking with nerve cells of the spinal cord and brain. It effectively turns off certain pain receptors or shuts down sensitivity, resulting in freedom from pain for a period of time because the pain is no longer perceived. But this is not the only mode of action of the substance. Tramdol ensures that the reuptake of norepinephrine is inhibited and that there is a slightly increased release of serotonin. This also leads to a slight antidepressant effect of the drug. Despite its centrally acting property, Tramdol is not suitable for all forms of pain. For example, there is low efficacy in muscle pain or certain abdominal pain. Often there are reservations about treatment with opioids and it is too late to consider such a drug. However, the drugs can be used for a long time without the development of tolerance, which would make a dose increase unavoidable. However, if a dose increase is necessary with tramadol, it is usually because the patient’s pain has actually become more severe.
Medical use and application
Opioid analgesics have a special significance in pain therapy and have an excellent effect in various forms of pain. Tramadol is frequently used in the field of tumor pain treatment and quite often for more severe back pain. Tramadol hydrochloride is administered in drop form or as a tablet – in this case usually with two levels of action. Drops must be taken frequently, but they have the advantage that the pain-relieving effect occurs very quickly. In the case of the so-called sustained-release tablets, part of the active ingredient is released immediately and the other part is only released gradually over a longer period of time in the body. This has the advantage of a long period of action, but in the overwhelming majority of cases the dosage can only be adjusted by changing the dose when the prescription is dispensed, since most of the sustained-release pain tablets cannot be divided.
Risks and side effects
Tramdol has low organ toxicity. That is, there is less stomach, intestinal, liver, and even kidney damage than with many other pain relievers. However, side effects may occur after taking the drug, mainly nausea and sometimes vomiting – especially in connection with increased physical activity – as well as dizziness and lightheadedness and blurred vision. Therefore, one should refrain from driving or operating machinery while taking tramadol, especially during the initial period of use, as the side effects may be increased. Other less common side effects include headache, changes in appetite, false sensations, slowed breathing, and coordination problems. Hypersensitivity to the active ingredient tramadol may cause allergic reactions such as itching, shortness of breath, and shock reactions. If these side effects occur, call a doctor or emergency service immediately.In some patients, a development of dependence occurs, especially after prolonged use; this has been observed especially when the drug is abruptly discontinued. The appearing manifestations of withdrawal are mainly: anxiety, nervousness, trembling and hyperactivity. Very rarely, panic attacks, hallucinations, false sensations such as tingling and muscle pain, and numbness or ringing in the ears have also been reported. These side effects after discontinuation can be largely prevented by adjusted dose reduction.
