Cas Lek Cesk. 2001 May 24;140(10):291-4.
[Pain in elderly patients and aspects of its therapy]

[Article in Czech]

Kubesova H, Holik J, Bogrova I, Syslova D.

Klinika geriatrie, osetrovatelstvi a praktickeho lekarstvi LF MU, Brno.

Treatment of pain in elderly patients can meet with diagnostic problems, namely in those with cognitive disorders, as well as with problems concerning pharmacokinetic and pharmacodynamics brought about by the advanced age. Our article presents an overview on the basic differences in the diagnostics and treatment of pain, on the therapeutic risks, and on other interrelations, which have to be considered in the therapy of elderly patients. The review is supplemented with results of our examination on the rate of analgesic treatment, spectrum of analgesics in use in the population of patients older than 75 years. About one quarter of the population use analgesics regularly, the order of most frequently prescribed analgesics is: ibuprofen 38%, diclophenac 24%, tiaprophenic acid 14%, tramadol 8%, indometacine 4%. Included were also data concerning the quality of life of patients with pain and information about the relations among patients and the curing personnel where obtained by our own inquiry. Patients concluded that pain was better tolerated at home, administration of drugs in tablets revealed to be most satisfactory, all information, namely from medial doctors, were welcome. Treatment of pain improved the quality of life in 1/3 of patients; one half of them considered it as successful. Personnel also asked for better professional information, though they had good of knowledge on the evaluation and documentation of pain and the principles of pharmacological treatment. Failure of treatment evokes in 69% of the personnel the feeling of impotency, in 41% affection of unsatisfactoriness, in 20% a tension, in 13% feeling of failing, in 18% depression and frustration. Reconciled with failure is 6% of the curing personnel.

Tramadol reference source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11411056&dopt=Abstract tramadol Ultram




Anesteziol Reanimatol. 1999 Nov-Dec;(6):71-4.
[Ketoprofen (ketonal): a drug for preventing and treating postoperative pain]

[Article in Russian]

Osipova NA, Beresnev VA, Vetsheva MS, Dolgopolova TV.

A prophylactic approach to the management of postoperative pain is described: ketoprofen, a nonsteroid antiinflammatory drug, was used, which possesses numerous advantages and a variety of dosage forms. To cancer patients subjected to extensive radical operations on the pelvic organs, head, and neck, ketonal (ketoprofen) was injected intramuscularly or rectally in a dose of 100 mg 1 h before surgery and in a daily dose of 300 mg during the postoperative period. Adequate postoperative monoanalgesia with ketonal was attained in 47% patients. In the rest patients ketonal was combined with medium-potent opioid tramadol. A more potent opioid buprenorfin (sangesik) in the minimal daily dose of 0.3 mg was required in only 2 cases. Nonsteroid antiinflammatory drug ketoprofen (ketonal) in therapeutic doses administered preventively before surgery intramuscularly or rectally notably decreased the acuity of the postoperative pain syndrome.

Tramadol reference source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11452775&dopt=Abstract tramadol Ultram

just.edu.jo

An inert matrix to control the release of tramadol HCl was prepared using glyceryl behenate as a matrix-forming agent. The matrices were prepared by either direct compression of a physical mixture of the drug and the matrix-forming agent or by compression of granules prepared by hot fusion of the drug and the matrix-forming agent. The hot fusion method was found to be more effective than compression of physical mixtures in retarding the release of the drug from the matrix. Drug release was adjusted by using release enhancers, such as microcrystalline cellulose and lactose, and the results showed that higher release rates were obtained using lactose. However, the release of the drug was independent of the compression force and the pH of the dissolution medium. This study showed that glyceryl behenate is an appropriate waxy material that can be used as a matrix-forming agent to control the release of a water-soluble drug such as tramadol HCl.

Tramadol reference source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11522491&dopt=Abstract tramadol Ultram




Reumatizam. 2000;47(2):25-8.
[Tramadol in the treatment of pain]

[Article in Croatian]

Curkovic B.

Klinika za reumatske bolesti i rehabilitaciju Medicinskoga fakulteta Sveucilista u Zagrebu KBC Zagreb, Zagreb.

Tramadol hydrochloride is a centrally-acting, synthetic analgesic with a dual mechanism of action-weak opioid and monoaminergic effects. Tramadol is a racemic mixture and its mechanism of action via opioid and noradrenergic/serotonergic mechanisms is related to the independent effects of its two enantiomers. Interestingly, the enantiomers act synergistically to achieve better antinociceptive effect without enhancing side effects, moreover, lowering respiratory depression and tolerance/dependence. In several post-marketing surveillance studies tramadol is showed as effective as codeine, penthazocine, pethidine and morphine with good tolerability. Tramadol might be analgesic of choice for a wide variety of painful conditions.

Tramadol reference source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11552611&dopt=Abstract tramadol Ultram

klch.med.uni-muenchen.de

A novel, multidimensional SPE sample-processing platform for complex fluids, which relies on the combination of small LC columns packed with restricted access materials (RAM) and molecular imprinted polymers (MIP) is described. It is called the Six-S ProcEdure (Six-SPE). Six-SPE involves a size-selective sample-separation step followed by a solvent-switch. Six-SPE efficiently removes interfering matrix components of complex aqueous samples and creates optimal conditions for selective recognition, i.e. binding of the imprinted target analyte(s). A Six-SPE analysis cycle consists of four distinct steps: 1. separation of a given sample (e.g. plasma, urine, saliva, milk, etc.) by adsorptive extraction (e.g. reversed-phase partitioning) of low molecular weight components on to the stationary phase of a RAM column and simultaneous size-exclusion, i.e. quantitative disposal of macromolecular matrix constituents to waste; 2. desorption and transfer of the extract from the RAM column on to a series-connected MIP column using a pure organic mobile phase (e.g. acetonitrile) [solvent switch]; 3. molecular recognition, i.e. selective binding of the target analyte(s) by a tailor-made MIP column; and 4. desorption and transfer of the analyte fraction on to a series-connected separation (e.g. HPLC) and/or detection system (e.g. UV, FD, MS). As a first application we coupled the Six-SPE platform to a conventional HPLC system for on-line analysis of the analgesic drug Tramadol in human plasma using LiChrospher ADS RP-18 as a RAM precolumn for the fractionation step in the first and second chromatographic dimension and a Tramadol imprinted polymer for the molecular recognition step, i.e. third chromatographic dimension.

Tramadol reference source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11605750&dopt=Abstract tramadol Ultram