Discover and read the best of Twitter Threads about #Tramadol
Most recents (6)
Je sais pas pourquoi le #Tramadol est en TT, mais c'est la pause alors quelques rappels de réduction des risques et des dommages de base pour accompagner votre déjeuner 🥪💊💉 A thread ⤵️
1- Le tramadol est un analgésique opioïde de pallier 2 (comme la codéine). Anti-douleur donc
1- Le tramadol est un analgésique opioïde de pallier 2 (comme la codéine). Anti-douleur donc
(le pallier 3 comprend la morphine et apparentée). Comme tout médoc, il convient à certaines personnes et à d'autres moins. Il reste pas mal prescrit pour des douleurs modérées à intenses non traitées par les paliers 1. Certaines personnes vont très mal y réagir, les effets
secondaires pouvant être assez importants/impressionnants (syndrome sérotoninergique entre autres).
2- Je ne sais que trop bien que la prévention des OD reste minime, mais SVP considérez avec sérieux que le tramadol est un opiacé, et que (surtout) si vous n'en avez pas l'habitude
2- Je ne sais que trop bien que la prévention des OD reste minime, mais SVP considérez avec sérieux que le tramadol est un opiacé, et que (surtout) si vous n'en avez pas l'habitude
Ett journalistiskt haveri i @SvD .
Ja, opioider kan missbrukas.
Ja, opioider kombineras med andra droger t ex cannabis i missbrukssammanhang.
MEN på vilka avgörande sätt skiljer sig #tramadol från andra opioider i detta sammanhang?
Varför kalla just tramadol för ”morddrog”?
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Ja, opioider kan missbrukas.
Ja, opioider kombineras med andra droger t ex cannabis i missbrukssammanhang.
MEN på vilka avgörande sätt skiljer sig #tramadol från andra opioider i detta sammanhang?
Varför kalla just tramadol för ”morddrog”?
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”Morddrogen”
”Mordpillren”
”Mördardrogen - tramadol”
En hel serie som börjar med bara allmänna formuleringar från nästående och andra. Vore förstås självklart för seriös journalistik att börja med ett faktaunderlag från personer kunniga i farmakologi & beroendesjd.
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”Morddrogen”
”Mordpillren”
”Mördardrogen - tramadol”
En hel serie som börjar med bara allmänna formuleringar från nästående och andra. Vore förstås självklart för seriös journalistik att börja med ett faktaunderlag från personer kunniga i farmakologi & beroendesjd.
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Istället vräker @svd på med ogrundade värdeord kring en opioid som 66 733 svenska fick behandling med någon gång under 2020.
Utan vidare ett av de sämsta reportage som jag sett under 30 år kring läkemedel.
Dubbelt dåligt. Varför då?
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Istället vräker @svd på med ogrundade värdeord kring en opioid som 66 733 svenska fick behandling med någon gång under 2020.
Utan vidare ett av de sämsta reportage som jag sett under 30 år kring läkemedel.
Dubbelt dåligt. Varför då?
->
THREAD: Trama-DO or Trama-DON'T?
What to know about #tramadol
1/7 Tramadol has multiple mechanisms of action:
- via serotonin & norepinephrine reuptake inhibition
- after metabolism to M1 metabolite, via opioid agonism
bit.ly/3t5o7jC #chronicpain #arthritis #MedEd
What to know about #tramadol
1/7 Tramadol has multiple mechanisms of action:
- via serotonin & norepinephrine reuptake inhibition
- after metabolism to M1 metabolite, via opioid agonism
bit.ly/3t5o7jC #chronicpain #arthritis #MedEd
2/7 People metabolize #tramadol variably 🤔💊
- Some who are ‘ultra rapid’ produce more M1 (opioid);
- Some ‘poor’ metabolizers (~20% with inactive CYP2D6) may have more SSRI/SNRI-like effect
Thus, analgesic & adverse effects are unpredictable
ncbi.nlm.nih.gov/books/NBK315950 #MedEd
- Some who are ‘ultra rapid’ produce more M1 (opioid);
- Some ‘poor’ metabolizers (~20% with inactive CYP2D6) may have more SSRI/SNRI-like effect
Thus, analgesic & adverse effects are unpredictable
ncbi.nlm.nih.gov/books/NBK315950 #MedEd
3/7 Tramadol, once called a ‘safer’ opioid, causes tolerance and withdrawal, and is associated with addiction, overdose, and death
Observational studies show people treated with #tramadol, vs other opioids, are ↗️ likely to engage in prolonged opiate use #chronicpain #arthritis
Observational studies show people treated with #tramadol, vs other opioids, are ↗️ likely to engage in prolonged opiate use #chronicpain #arthritis
#Tramadol, a game of analgesic roulette, will it work or won’t it? Will your patient obtain analgesic effects or will they have a seizure, respiratory depression, or various other side effects...🤷🏼♀️that’s why it’s been nicknamed #Tramadont! Its variable effects are (1/3)
attributable to hepatic enzyme CYP2D6;unless you know your pt’s CYP2D6 genetic polymorphism (which I haven’t come across anyone who does)AND a comprehensive list of all of their home meds, don’t prescribe it!🙅🏼♀️
#pharmacyeducationboard #twitterx #medtwitter #pharmacogenomics (2/3)
#pharmacyeducationboard #twitterx #medtwitter #pharmacogenomics (2/3)
Thank you to our #pharmacyresident for putting this one up, and to @DavidJuurlink & @ToxAndHound for the inspiration. 🙂💡 (3/3)
What's the deal with pain control in #cirrhosis?
A #meded #tweetorial with QI undertones
Aims:
👍Tylenol
👎NSAIDs (mostly)
🤯Pharmacokinetics in ESLD
🔪Tramadol
If this is a confusing topic for you, you are not alone!
Join me as we try 2 sort a few things out
#livertwitter
A #meded #tweetorial with QI undertones
Aims:
👍Tylenol
👎NSAIDs (mostly)
🤯Pharmacokinetics in ESLD
🔪Tramadol
If this is a confusing topic for you, you are not alone!
Join me as we try 2 sort a few things out
#livertwitter
Let's start with a real world scenario:
Your patient has cirrhosis with well controlled ascites, HE, and unfortunately comes in with MSK back pain from raucously cheering in vain 4 the Winnipeg Jets.
They ask for advice/treatment. In addition to stretching/PT, you recommend...
Your patient has cirrhosis with well controlled ascites, HE, and unfortunately comes in with MSK back pain from raucously cheering in vain 4 the Winnipeg Jets.
They ask for advice/treatment. In addition to stretching/PT, you recommend...
Although APAP OD is☠️, @ lower doses it's safest analgesic
Speed limit=2-3g/d (I use 2g)
Wouldnt push it but take solace in:
Fig1: Tylenol tox=NAPQI>Glutathione (👀CYP2E1)
Fig2: Tho ppl assume cirrhosis⬇️glutathione, normal metabolism preserved
Fig3: 1 reason:cirrhosis⬇️CYP2E1
Speed limit=2-3g/d (I use 2g)
Wouldnt push it but take solace in:
Fig1: Tylenol tox=NAPQI>Glutathione (👀CYP2E1)
Fig2: Tho ppl assume cirrhosis⬇️glutathione, normal metabolism preserved
Fig3: 1 reason:cirrhosis⬇️CYP2E1
