Tramadol - a synthetic opioid analgesic central action, which is used to suppress chronic or acute post-operative pain. Since Tramadol belongs to a class of narcotic pain medications, this drug a lot of side effects and contraindications. For these reasons, tramadol for suppressing slight or moderate pain, usually not applicable.

The main indications for receiving tramadol - moderate or severe pain, different in origin (tramadol suitable for suppression of postoperative pain, neuropathic pain, pain caused by injury or tumors). In addition, tramadol may be appointed as an anesthetic when performing certain diagnostic procedures that cause pain.

How to take tramadol

The recommended dosage of tramadol depend on the form of the drug and the health status of a person. Depending on the intensity of the analgesic effect of tramadol pain may persist for four to eight hours. Typically, tramadol suppresses pain very fast, but in the absence of analgesic effect within half an hour after administration permitted to adopt a similar dose of the drug again.

• Tramadol is in the form of tablets or capsules: for adults and children under the age of fourteen years and over - fifty milligrams once or one hundred milligrams once (with the powerful pain). For children under the age of fourteen, the optimal dose is calculated from the ratio of one to two milligrams of tramadol per kilogram of body weight. Tramadol tablets can be taken both fasting and postprandial - its effect does not depend on the contents of the stomach, drinking a quantity of liquid.
• Tramadol is in the form of drops: for adults and children under the age of fourteen years, the recommended dose is twenty drops once (drops need to stir in a small amount of liquid). For children under fourteen years of age the dose is calculated from the ratio of one to two milligrams of tramadol per kilogram of body weight.
• Tramadol is in the form of suppositories: adults only - a hundred milligrams of the drug up to four times a day.
• Tramadol shaped ampules for intravenous or intramuscular injection: assigned physician. Recommended dosage - from fifty to one hundred milligrams intravenously or intramuscularly. The daily rate of tramadol should not exceed chetyrhsot milligrams.

Contraindications

It is forbidden to take tramadol intoxicated with alcohol or drugs by the following:

• Other narcotic analgesics (opioids)
• Sedatives or tranquilizers
• Antidepressants and other drugs to relieve the symptoms of depression Depression - a little more than a bad mood   and panic disorders
• Drugs for the treatment of psychiatric disorders (such as medications for bipolar disorder, schizophrenia)

Since Tramadol belongs to a class of narcotic pain medications, prolonged his likely reception of dependence - so taking tramadol should be strictly in accordance with the instructions of the physician or the manufacturer, or in any way increase the dose or frequency of administration of the drug on their own, without consulting a doctor. Separate discontinuation of tramadol is also not recommended because in that case may have symptoms so-called "withdrawal". Treatment with tramadol is not recommended during pregnancy and lactation Breast-feeding: feed - and no nails! .

Possible consequences

When the following side effects after taking the drug should stop taking tramadol and seek medical help:

• Hallucinations, fever, rapid heartbeat, nausea, vomiting, loss of coordination, fainting, diarrhea
• Twitching, convulsions
• Rash, redness of the skin
• Rapid shallow breathing, weak pulse

Less serious side effects that can cause tramadol include dizziness Dizziness - if the ground is slipping from under his feet , Headache, constipation, indigestion, increased nervousness, anxiety Anxiety - how to distinguish normal from disease? , Drowsiness and lethargy.

  Fluoxetine belongs to a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). Antidepressants - are drugs that affect brain cells. SSRIs also affect neurotransmitters which transmit signals between nerve cells. Serotonin - a neurotransmitter that performs many functions, including, improve emotional state. It is believed that one cause of depression is that the brain serotonin produce less than normal, but one that is produced, rapidly absorbed back into neural cells - that is there is a serotonin reuptake.

SOIZS block (inhibit) the reuptake of serotonin and the person taking them for longer stays in a good mood. Thus fluoxetine helps relieve the symptoms of depression Depression - a little more than a bad mood . Fluoxetine is also used to treat bulimia and obsessive-compulsive disorder in adults. It is used for treatment of severe episodes of major depressive disorder in children, if after 4-6 sessions of psychotherapy fail to achieve improvements.

Attention!

Depression and other mental disorders are associated with an increased risk of suicidal thoughts, self harm and suicide. If you or your loved one taking antidepressants, it is important to contact your doctor if any signs of worsening symptoms - for example, if the anxiety is amplified Anxiety - how to distinguish normal from disease?   and / or popping suicidal thoughts Suicide in terms of the psychiatrist - can it be prevented? .

Children should only take fluoxetine with moderate to severe depression. At the beginning of antidepressant treatment children and teenagers may be more prone to suicidal behavior than extending similar treatment of adult patients. It is imperative that their relatives treated them with understanding, easy to go on contact, giving children the opportunity to express all my thoughts and feelings. It should tell your doctor about any disturbing changes in the behavior of children taking antidepressants.

Effect of fluoxetine has been little studied, but there are as minor, reason to believe that this drug can affect the growth, as well as sexual, mental, emotional and behavioral development of children. Before you assign fluoxetine, your doctor must tell in detail the child's parents about the risks and benefits associated with the medication. After the treatment for a time necessary to follow the further development of the child.

If fluoxetine does not give a positive effect for nine weeks, should reconsider the advisability of taking this medication.

• Under the influence of fluoxetine may worsen the patient's ability to drive a vehicle.
• During the course of treatment should refrain from drinking alcohol.

Contraindications

Fluoxetine should not be taken at uncontrolled seizure disorders (eg, associated with brain damage), while those suffering from manic episodes of manic-depressive disorder, uncontrolled epilepsy when Epilepsy - a sacred disease And during reception of MAO inhibitors and for 14 days after the end of their reception.

This medication should be taken with extreme care the elderly, children and adolescents; people who have ever been observed suicidal thoughts or behavior, and patients who have had any manic and / or bipolar disorder. In addition, increased attention during fluoxetine is required for patients who are undergoing treatment electroconvulsive therapy (ECT), take anti-psychotic drugs, as well as those who are taking anticoagulants, who has heart disease, diabetes, epilepsy, seizures, and blood diseases in history.