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Contents: This chapter deals mainly with the pharmacology of opioid analgesic agents. For more information on the clinical application of these drugs you might like to check out these other related chapters of the Virtual Anaesthesia Textbook: The information (eg trade names and dosage schedules) supplied in some of these pages may be very specific to a particular country (for example Fiorinal contains completely different agents in the USA and Australia). Please keep this in mind and consult local information guides if in doubt.
Patrick Woster from Wayne State University, Detroit, has a fine page on the Chemistry of Opioid Analgesics. as part of a number of pages on Neurology Pharmacotherapeutics. The University Of Iowa Department of Anesthesia has some general information on Opioids used for Procedural Sedation. Haratio F. Olivo has (had) an absolutely crackerjack page on Opioid Analgesics as part of the Medicinal Neurochemistry course at the University of Iowa. It seems to be offline at the moment but I'll keep an eye on it and link it again when (if) it's available. The Hypermedia Assistant for Cancer Pain Management (HACPM - used to be called the Talarian Index) has an enormous amount of information pertaining to pain management including a table of equivalent doses for a substantial number of opioids with a second table for folks less than 50kg. They also have some General comments and cautions regarding the use of opioid analgesics. I'll let this one speak for itself..."The Oxford Pain Internet Site is for anyone with a professional or personal interest in pain and analgesia. It is firmly based in the principles of evidence-based medicine and has pulled together systematic reviews with pain as an outcome." This is a fantastic resource including information on a large number of opioid and non-opioid analgesics. Well worth a visit.
The Australian Medicines Handbook (AHM) and MIMS Online are resources delivered by Health Communtications Network (HCN) Australia but require subscription. They both have sections on Analgesics and seperate sections on Opioids covering all those currently available in Australia (ie most of them). Both resources are available (free to staff/students) within many Australian university and health care organisations, for example via CIAP in New South Wales (passwords required). In the USA, NursesPDR and Gold Standard Multimedia also provide drug information that used to be free but now requires subscription. :-( RxMed, fortunately, still has a lot of drug monograph information free of charge. Drugs are listed only by trade name, unfortunately, and their search facility is not currently working.
This drug is a peculiar beast. It has a weak opioid action and also inhibits noradrenaline and serotonin reuptake (similar to a number of antidepressant agents). Monographs may be available via the links above. Ortho-McNeil, the company that makes Ultram brand tramadol, has a pdf file of their own prescribing information available. You are visitor number This page is one chapter of many in the Virtual Anaesthesia Textbook. Please direct all comments about the organisation of this chapter, corrections to links, and suggestions for additions to: John Loadsman, Questions about the Virtual Anaesthetic Textbook project itself should be sent to Dr. Thompson on this form.
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