Enantiomeric separation of Tramadol ( Generic Ultram ) hydrochloride and its metabolites by cyclodextrin-mediated capillary zone electrophoresis.

The enantiomeric separation of Tramadol ( Generic Ultram ) hydrochloride and its major metabolites, O-demethylTramadol ( Generic Ultram ) (M1) and N-demethylTramadol ( Generic Ultram ) (M2) was studied using cyclodextrin (CD)-mediated capillary zone electrophoresis (CZE). Influence of the choice of type and concentration of CD, capillary temperature, length of capillaries, buffer pH and the addition of polymer modifier on the chiral separation of Tramadol ( Generic Ultram ) and its metabolites was evaluated. It was found that the drug and the metabolites can be baseline-separated simultaneously by using 50 mM phosphate buffer (pH 2.5) containing 75 mM methyl-beta-CD, 220 mM urea and 0.05% (w/v) hydroxypropylmethyl cellulose.

Pain in elderly patients and aspects of its therapy

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 ( Generic Ultram ) 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.

Palliative care in a national cancer center: results in 1987 vs. 1993 vs. 2000.

BACKGROUND AND OBJECTIVE: In recent human and animal studies, intrathecal administration of various doses of neostigmine produces analgesia without neurotoxicity. The aim was to examine the effects of intrathecal neostigmine and bupivacaine in patients undergoing perianal surgery under spinal anaesthesia. METHODS: The patients were randomly allocated into three groups of 15: Group 1 (controls) received hyperbaric bupivacaine 10 mg + dextrose 5%, 1 mL, to a total volume of 3 mL; Group 2 received hyperbaric bupivacaine 10 mg + neostigmine 25 microg in dextrose 5%, 1 mL, to a total volume of 3 mL; and Group 3 received hyperbaric bupivacaine 10 mg + neostigmine 50 microg in dextrose 5%, 1 mL, to a total volume of 3 mL. RESULTS: The onset of sensory block was significantly earlier for Group 2 and 3 patients compared with Group 1 patients (P < 0.05). The full time to recovery of motor block and sensory block was significantly longer in Group 3 compared with Group 1 (P < 0.05). In Group 3, the average time until the first dose of Tramadol ( Generic Ultram ) was longer than Group 1 (P < 0.05). The incidence rate of nausea and vomiting was significantly higher in Groups 2 and 3 than in Group 1 (P < 0.05). CONCLUSIONS: The use of intrathecal neostigmine as an analgesic drug in perianal surgery is unsatisfactory because of prolonged motor blockade and nausea.

Postoperative analgesia with epidural administration of a combination of Tramadol ( Generic Ultram ) and clonidine

Postoperative analgesia inhibits the stress cascade with negative effects on whole organism. Therefore the spectrum of drugs used for soothing postoperative pain quickly widens. The epidural route appears as being logical, since due to the direct effect in the transmission and processing of pain it suffices with a lower dosage. The authors refer to a group of 30 patients postoperatively treated by a combination of Tramadol ( Generic Ultram ) and Clonidine administrated by means of an epidural catheter. 26 patients evaluated the induced analgesia as excellent or sufficient. (Tab. 3, Ref. 4).

Withdrawal characteristics following frequent intravenous administration of several opioids in rats

Characteristics of withdrawal signs of several opioids were compared in rats after short-term frequent intravenous infusions. Male Sprague-Dawley rats with catheters implanted in the jugular veins were infused with a fixed dose of a drug hourly for 72 hrs. Thirty min after the final infusion, naloxone 4 mg/kg, s.c. was administered and withdrawal signs were observed for 1 hr and the severity of the withdrawal signs was scored, classified into a behavioral sign score, autonomic sign score, and body weight loss score. As a result, total withdrawal scores of morphine, methadone, d-propoxyphene, loperamide, Tramadol ( Generic Ultram ), and pentazocine were significantly higher than that of saline, with the highest score being observed for 4 mg/kg or more of morphine. The total score of ethylketocyclazocine was slightly but significantly higher than that of saline. Buprenorphine and thebaine produced no observable withdrawal signs. The behavioral sign score tended to be higher than the other 2 scores in the drugs showing relatively low but significant total scores such as Tramadol ( Generic Ultram ), pentazocine, and ethylketocyclazocine, while the score of autonomic signs or the body weight loss tended to be higher in drugs showing high total scores. Thus, in the case of opioids, it is considered that the severity of withdrawal signs was mainly derived from the autonomic signs including diarrhea which may result in body weight loss.


Direct determination of Tramadol ( Generic Ultram ) glucuronides in human urine by high-performance liquid chromatography with fluorescence detection.

A sensitive and selective reversed-phase high-performance liquid chromatography method has been developed for the direct determination of three glucuronides of the centrally acting analgesic Tramadol ( Generic Ultram ) (1). Separation of these glucuronides into their diastereomers was achieved by HPLC using ion pair chromatography with nonanesulfonic acid sodium salt and LiChrospher 100 RP 18 as stationary phase. Quantification of O-demethylTramadol ( Generic Ultram ) glucuronide and N,O-didemethylTramadol ( Generic Ultram ) glucuronide in human urine was performed by fluorescence detection. The urine samples were purified by a two-step solid-phase extraction. The glucuronides were found to be highly enriched in the 1S,2S-diastereomers. The results of a study with three healthy volunteers are presented.