Thursday, 8 December 2011
"On the Internet you get everything you want to get," says Gerd Glaeske drug researchers from the University of Bremen. Prescription drugs could be purchased there without problems. According Glaeske there are drug addicts in Germany up to 1.9 million. He expected a much higher number of unreported cases. "We must investigate the dangers of the Internet specifically," calls the pharmaceutical scientists.
For years, the Federal Criminal Police Office (BKA) to a recent study found that a constant increase in crime after the Medicines Act. According to the BKA is "a trend toward a growing phenomenon," which can be substantiated with detailed data difficult. There was a lack of information, law enforcement authorities and the pharmaceutical industry. Also be the clues that they had often not meaningful.
The central industrial property office of Customs faced in recent years, certain claims to increasingly more medicines. In 2006, the value of the drugs was 2.5 million euros for the first time and was listed by the extra inches. Particularly on the Internet according to estimates by the BKA took to the offenses. This was due to the simple relation of the desired drug, the existing market demand and the high profit potential. Therefore it is necessary, according to BKA study, to accompany the trade in prescription drugs over the Internet with controls and trade restrictions to consider.
A high dependence potential involves the opiate Tilidine. According to the Berlin police say, 80 percent of all prescription counterfeiting concern in the capital Tilidine. The State Criminal Police Office has in the past year, about 1,800 fake prescriptions safe in Berlin. Tilidine leads, according to a police spokesman, among other things to spiritual indifference. It lower the threshold for violence and had been in some cases the injury was detected on the perpetrators. "The pharmacists are now very critical, and the recipes look very closely," says the head of the Drug Commission of the German pharmacist in Eschborn, Thomas Beck. But on the Internet, could easily obtain drugs and medications.
The Federal Chamber of Physicians has published a guide for physicians in the summer. This provides practical help to control their behavior and how to deal with prescription drug addicts.
I think it's nice to read (please do not incorrectly) that there are
others suffering like this and I'm not the only one.
At the moment I take tramadol what is actually a pain reliever. I've
alwaysapproached my doctor on it until he has finally approved. Now I
take every morning30Tropfen.
Tramadol greatly slowed the bowel movements, and this saves me at the moment.
max. 2x a day diarrhea.
Depression is gone (as long as it works)
- For the duration task is quite difficult to pee
- Possibly addictive.
On the 19th I had an appointment at the hospital with a gastro. I will
then discuss withhim this "therapy" until next time.
Let's see what he thinks.
Before I forget, in a psychotherapy TCM, etc. I hold and am still in
search of a doctorhere in my close.
that's good, when you look at tramadol only a temporary solution. You
are still veryyoung and when did you first become accustomed to
Viagra, it will first be necessary to increase the dosage on and on
until even that does not help more, andthen stands at the end of
Your underlying condition is unfortunately not so resolved. But you
know that - so usethe relatively symptom-free period, you have now and
look for other solutions.
Reports then please us know what you negotiates with your gastro.
07th October 2008 09:34
Retired lung doctor should have killed gravely ill friend with syringes - accused pleaded not guilty of murder - to 16 process October postponed
Salzburg - At the Salzburg Regional Court had since today, Tuesday, responsibility, a retired physician assisted suicide into hours. The earlier lung doctor Helmut W. (67) stood on suspicion of murder before the jury. The indictment accuses him of having injected a severely depressed 70-year-old woman from the Flachgau in June 2006, three injections in the feet, which led to death. W. himself dismissed the murder charge and said instead of "euthanasia out of compassion."
The incident has taken place in a house in Obertrum Flachgau. According to the indictment W. has put his longtime good friend of three injections tramadol and methadone in the legs. After a psychiatric report but the doctor would have to be clear that the suffering from depression, hypomania, epilepsy and dementia woman who also fond of the alcoholic and chain smoker, was formed have no free will of killing anymore. The prosecution therefore does not put the facts "killing on demand", which is threatened with a punishment of six months to five years, but "murder" (ten to 20 years or life imprisonment).
"No, I'm not guilty," W. said at the beginning of the process. In the past five years of her life the woman had repeatedly expressed a desire death because he had yet to persuade her, "you are rich, enjoying life." But last year it was with the woman went downhill fast. She had a heart operation, "severe circulatory problems, calcifications and softening in the brain." A suicide attempt by the woman by a drug cocktail around four months before her death on 13 June 2006 had failed.
"In the end she was quite haggard and white in the face, like a ghost you said to me. 'Now you must help me now is the final moment, where I still have all the senses together to decide.' When she. I have not done so sorry if it was not her gone so bad, I would not have helped her, "said the doctor, who had known the woman as 50 years.
Stood third injection
The woman had two injections of morphine injected himself, then he had her put a third injection. "I stand by it, even if you lock me up, it does not matter if I sleep here or there, that great freedom is at home either. You can send me to Siberia," he swore an appraiser and called him a "monkey "as" soulless ". Of tramadol and methadone injections, as stated in the indictment, he knew nothing. Punctures are also not known him in the feet.
The expert testimony substantiated Was not in all respects. Medical examiner was able to find Edith Tutsch-Bauer at the corpse of the woman no puncture marks on his arms, as the doctor had said. And the found of their injection sites on the feet are very unusual for a layman, because it was difficult to meet there the veins above individual exactly as was the case. In addition, the 70-year-old was not terminally ill. The toxicologist repeated his statement that the woman had died from a Poly-drug intoxication from methadone and tramadol, and not to morphine. This one was not found in the body.
Not a mental illness
Since the accused had refused to undergo psychiatric examination in the investigation, today issued the renowned court psychiatrist Reinhard Haller, a result of his observations and video recordings during the trial an opinion. A mental illness, he could exclude with reasonable certainty, Haller, W., however, as a striking personality: "He is emotionally unstable and prone to exaggeration." The personality disorder but was not so heavy that they lift up the sanity.
Friday, 11 November 2011
- ATC code: N02AX02 opioids / other opioids / tramadol
Mechanism of Action
Opioid analgesics mimic the effect of endogenous opioid peptides (endorphins, enkephalins, dynorphins) after. On the one hand, the transmission of pain impulses is inhibited and the other changed the perception of pain in the thalamus and the limbic system.
Tramadol has opioiderge effect and also inhibits the norepinephrine uptake and release of serotonin.
The analgesic potency of tramadol is about one tenth that of morphine. The effect can also be improved by increasing the dose does not.
Austria Adamon long retard, retard Contramal, Cromatodol, Noax uno, Tradolan, Tramabene, tramadol, tramadol hydrochloride "1 A Pharma," tramadol hydrochloride "Actavis" Tramadolor, Tramal, Tramal retard Tramastad, Tramundal
Types of applications
- Oral (capsules, tablets, drops)
- Vials and solutions
- Moderate to severe pain
- Medium and, unlike acute and chronic pain pethidine
- For painful diagnostic and therapeutic procedures
- Post-operative and post-traumatic pain
- In oncology phase II of the WHO recommendations
known hypersensitivity to active or excipient
central respiratory depression, significant obstruction of the airways
Coadministration with MAO inhibitors, lactation
severe impairment of liver function, circulatory shock, traumatic brain injury and increased intracranial pressure, acute abdomen, prostatic hypertrophy, myasthenia gravis, impaired renal function the dose should be reduced in pregnancy
Dosage must be individualized, as with all centrally acting analgesics.
Oral: 50-100 mg
Supp: 100 mg
sustained-release tablets: initially 50 mg 12-hourly
up to 100 mg 8-hourly
Dose interval: 4-6h
maximum daily dose: 400 mg (= 8 x 20 drops)
Mg/kg/4h 0.5 to 1.5; retard: 0.5-2mg / kg/8h
S.C. and i.m.:
Single dose: 50-100 mg maximum daily dose of 400 mg
Single dose: 50-100 mg (10 mg diluted in slow careful titration)
for continuous infusion: initially 1.5 mg / kg / slow up-titration period, followed in order to maintain approximately 15 mg / h
General: allergic reactions of any kind (rare), sweating, dizziness
CNS: sedation up to the anesthesia, euphoria (especially during rapid influx), miosis
Cardiovascular: hypotension, orthostasis
Respiratory: respiratory depression (especially during rapid influx), cough attenuation
Stomach: central bed. Nausea and vomiting, due to contraction of smooth muscle leads to constipation
Liver and pancreas and gall bladder contraction of inputs
Kidney and bladder: Ureterkontraktion, inhibition of Miktionsreflexes
Skin: itching, skin redness
all drugs with action on the CNS: CNS dysfunction is reinforced
high serum progesterone concentration: analgesic. Effect increases
Naloxonempfindlichkeit: at long-term opiate medication increases
MAO inhibitors: central dysfunction
Warfarin: possible potentiation of warfarin
Tricycl. Antidepressants: a central serotonin activity increases
SSRIs: central serotonin activity increases
- Acute and chronic mild to moderate pain with entzündl. Component
- Pain, which respond to weaker painkillers
- Perioperative Analgesieführung
Colic (gall bladder, kidney ,....) can be effectively treated with opiates, the underlying cause (spasm) give, however. Therefore, opiates for the treatment of colic in connection with an antispasmodic apply.
The road to drive is restricted as with all centrally acting analgesics.
Absorption: p.o. to about 65% to about rectal. 78% bioavailable
First-pass effect is relatively small.
Protein binding: 4%
maximum plasma concentration after 2h
β-terminal half-life: parent compound 6h,
analgesic and antitussive active metabolite M1 approximately 9h
In inflammatory pain, a combination with NSAIDs or metamizol is useful.
Increasing the dose above 400 mg / day to avoid. A switch to a potent opioid is to be preferred.