tramadol seminar new 2.pptx an opioid drug

We were 5 students on this seminar
i will be happy to get some feedback on it

1. TRAMADOL BY HUSSAIN SAIB NOUR AL-HUDA ARKAN MARYEM AYYED NABAA MOHAMMED MUSHTAQ ASAL Supervised by Dr.Emad Noaman

2. WHAT IS PAIN?

3. INTRODUCTION HISTORY MESOPOTOMIA EGYPT GREECE

4. PAIN RELIEF

5. OPIOIDS Opioids are a class of drugs that derive from, or mimic, natural substances found in the opium poppy plant. Opioids work in the brain to produce a variety of effects, including pain relief . They are divided into three types :

6. TRAMADOL Tramadol is an FDA-approved opioid medication for pain relief. It has specific indications for moderate to severe pain. It is considered a class IV drug by the FDA and has been since July of 2014. Due to possible misuse disorder potential, limitations to its use should be for pain that is refractory to other pain medication, such as non-opioid pain medication. There are two forms of tramadol: extended-release and immediate release. Tramadol was patented in 1972 and launched under the name " Tramal " in 1977 by the West German pharmaceutical company Grünenthal GmbH. In the mid-1990s, it was approved in the United Kingdom and the United States . GERMANY – 1977 , FDA VIVOS IN BERLIN

7. TRAMADOL TRAMADOL IS A MAN – MADE PRODUCT , BUT SOME OF INGREDIENTS ARE FOUND NATURALLY IN ROOTS AND BARK OF NAUCLEA LATIFOLIA . After frequent, prolonged Tramadol use, many people develop a tolerance to the drug. This means they have to take larger doses to feel the drug’s effects. Tolerance to and withdrawal from Tramadol are common signs that someone has a Tramadol dependence. They may also show signs of a Tramadol addiction, a chronic, neurobiological disease with genetic, psychosocial, and environmental factors .

8. TRAMADOL A MAN SUFFERS FROM TRAMADOL ADDICTION IN HIS WORK

9. TRAMADOL 28% OF PEOPLE WHO USED TRAMADOL ARE FELL IN THE HELL OF ADDICTION BASED ON STUDY ON ADDICTED PEOPLE IN LOS ANGELOS USA . 37% OF TRAMADOL TAKERS ARE SUFFERING FROM WITHDRAWAL SYMPTOMS 63%

10. TRAMADOL Tramadol is a prescription-only painkiller . This means you can't buy it legally without a prescription. People who take tramadol illegally, or abuse their prescription, sometimes crush up the tablets and snort them . IT IS ILLEAGAL IN SAUDI ARABIA , UAE AND JORDAN . BUT LEGAL IN IRAN AND INDIA . UNFORTUNATELY , IN IRAQ YOU COULD GET IT WITHOUT A PRESCRIPTION .

11. TRAMADOL RALIVIA TRIDURAL ZYTRAM ULTRAM BRAND NAMES

12. ORALLY : CAPSULE ROUTES OF ADMINSTRATION : TABLET INJECTION : I.M ,IV AND S.C THERE ARE SUPPOSITORIES AND DROPS ( ORALLY ) BUT IN FEW AMOUNTS

13. PHARMACOKINETICS Quick absorption: Peak plasma concentration in 1-2 hours (fast pain relief). High bioavailability : 70-80% reaches bloodstream, effectively delivered to target site. Moderate distribution: Crosses blood-brain barrier for CNS effects, but can be found in small amounts in placental and breast milk . Extensive metabolism: Primarily by CYP2D6 in the liver, creating the active metabolite O- desmethyltramadol (OTD). Elimination half-life : Around 6 hours, but can vary with individual factors. Excretion : Mainly through urine (50-75% within 24 hours)

14. CONTRAINDICATIONS Uncontrolled Seizures : It lowers the seizure threshold, increasing the risk of seizures, especially in those with uncontrolled epilepsy , due it affects brain chemistry, potentially triggering uncontrolled electrical activity in the brain leading to seizures. Breathing problems : Can worsen asthma or sleep apnea, leading to dangerous breathing difficulties. Recent head injury : Raises pressure inside the skull, potentially causing further brain damage. Mixing with alcohol : Doubles down on drowsiness and breathing problems, potentially fatal. Severe liver or kidney disease : Body can't properly remove the drug, leading to dangerous buildup.

15. CONTRAINDICATIONS Stomach/bowel blockage : Worsens the blockage, creating serious complications. History of opioid abuse : High risk of addiction due to similar effects to opioids. Taking certain medications : Can interact poorly with sedatives, tranquilizers, or antidepressants, increasing side effects . CHILDREN UNDER 18 BREASTFEEDING PREGNANCY

16. PAIN TRANSMISSION Pain begins at the nociceptors ( the branching ends of sensory neurons) found within the peripheral nervous system The signal is carried through the spinothalamic tract to the thalamus and then to the somatosensory cortex where pain is perceived . mu receptors present in the central and peripheral nervous system, delta , kappa ( G protein binding) found in high concentration in the dorsal horn of the spinal cord . Activation of these receptors by an agonist causes decrease in releasing neurotransmitters such as substance P , make the neurons less sensitive to excitatory inputs .

17. MECHANISM OF ACTION Tramadol works by changing the way our brain and nerves system respond to pain . it act centrally as analgesic and it is structurally related to Morphine and Codeine , less potent than Morphine , it has a dual mechanism Opioid receptor binding: act as mu-opioid receptor in the central nervous system producing pain relief by reducing the perception of pain signals and altering the brain response to pain ( moderate affinity for mu receptor but weak for delta and kappa ) . inhibition of serotonin and norepinephrine reuptake both involved in mood regulation and pain perception thus enhancing inhibitory effects on pain transmission.

18. TOXICITY OF TRAMADOL The toxic dose of tramadol, like with any medication, varies depending on individual factors such as age, weight, medical history, and tolerance to opioids. Exceeding the recommended dose of tramadol can lead to serious side effects and even overdose. For adults, ingesting a single dose of tramadol greater than 400 milligrams can increase the risk of severe adverse effects, including respiratory depression, seizures, coma, and death. However, toxicity can occur at lower doses in individuals who are not tolerant to opioids or who have certain medical conditions. Administration of naloxone can reverse tramadol toxicity .

19. INDICATIONS OF TRAMADOL -It’s used to treat moderate to severe pain both acute and chronic pain by acting on central nervous system It is commonly prescribed to manage : POSTOPERATIVE AND LOWER BACK PAIN DENTAL PAIN MALIGNANT PAIN OA AND RH PAIN DIABETIC NEUROPATHY FIBROMYALGIA

20. WITHDRAWAL SYNDROME Long term use of high dose of Tramadol causes Tolerance, physical dependence and withdrawal syndrome . What is Withdrawal Syndrome? Withdrawal syndrome: is defined as the unpleasant symptoms that are experienced when a person with physical dependence discontinues the use of an abused drug abruptly. Withdrawal is the result of the body becoming chemically addicted, or altered, from taking Tramadol on a continuous basis—even after only a few weeks . In most cases withdrawal symptoms begin in 8-24 hours After the last dose and they generally last for 5-7 days .

21. WITHDRAWAL SYMPTOMS Tramadol withdrawal symptoms vary from individual to individual. It is best to taper off the drug over time in order to minimize negative withdrawal symptoms. FLU – LIKE SYMPTOMS PSYCHO PROBLEMS AGRESSION ITCHING NUMBNESS HEADACHE

22. ADVERSE EFFECTS OF TRAMADOL ADDICTION CONSTIPATION DEPRESSION FATIGUE DROWSINESS DRY MOUTH NAUSEA , VOMITING SEIZURES SWEATING

23. DOSAGE OF TRAMADOL treatment of moderate pain 50 - 100 mg administered every four to six hours . Initial dose 50 mg. Treatment For severe pain, 50- 100 mg , every four to six hours may be administered. 100mg is usually more effective as the initial dose. Tramadol is not typically recommended for pediatric patients under 12 years old, and its use in adolescents (12 to 18 years old) is subject to specific dosing considerations and caution due to safety concerns.

24. INTERACTIONS OF TRAMADOL Tramadol & Opioid Analgesics  Tramadol & Benzodiazepines Tramadol & Alcohol Selective Serotonin Reuptake Inhibitors (SSRIs) Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) Tricyclic Antidepressants (TCAs) Monoamine Oxidase Inhibitors (MAOIs) Triptans Dextromethorphan

25. HOW TO ADVISE A PATIENT OR AN ADDICTED TO TAKE OFF TRAMADOL REMEMBER , THAT LIFE IS JUST – DAY ONE & ONE DAY – SO YOU SHOULD LIVE EVERY MOMENT AND NEVER MISS THIS GREAT GRANT FROM GOD THERE IS ALWAYS MORE TO LIVE THAN TO COMPLAIN OR BEING UNCONCIOUS THE EARTH IS SO HUGE AND THE SKY IS SO BEAUTIFUL AND THE GRASS IS GORGEOUS AND PEOPLE STILL GOOD AND HAVE A MERCY , SO YOU HAVE THE CHANCE TO BELIEVE , TO LOVE , TO WALK , TO EAT , TO LAUGH , TO RUN , TO PLAY , TO DRINK , TO FEEL PAIN! FEELING PAIN GIVES A MEANING TO THIS LIFE REMEMBER “ OUR HEARTS AND OUR BODIES ARE GIVEN TO US ONLY ONCE “ LIFE IS A CHANCE SO YOU SHOULD EXPRESS YOUR SINCERE FEELINGS .

26. REFERENCES 1-"Tramadol". MedlinePlus. American Society of Health-System Pharmacists 2-"Tramadol". (https://www.drugs.com/international/tramadol.html) Drugs.com. archived(https://web.archive.org/web/20180723182517/https://www.drugs.com/international/tramadol.html) from the original on 23 July 2018. Retrieved 22 December 2018. 3- "Tramadol Use During Pregnancy". (https://www.drugs.com/pregnancy/tramadol.html) Drugs.com. 14 October 2019. Archived 4- 6- "Ultram, Ultram ER (tramadol) dosing, indications, interactions, adverse effects, and more". (http://reference.medscape.com/drug/ultram-er-tramadol-343324#showall) Medscape Reference. WebMD. 5- Anvisa (https://en.m.wikipedia.org/wiki/Brazilian_Health_Regulatory_Agency) (31 March 2023). 6- 11 Dayer P, Desmeules J, Collart L (1997). "[Pharmacology of tramadol]". Drugs. 53 7- Diário Oficial da União (https://en.m.wikipedia.org/wiki/Di%C3%A1rio_Oficial_da_Uni%C3%A3o) (published 4 April 2023).

27. THANK YOU