Tramadol

You Should Know Before Buy

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Thursday, August 16, 2012

Kindle Fire review: Yes, it's that good

   This won't be one of those long technical reviews. You're reading this to make sure that the Amazon Kindle Fire you already know you want is up to snuff, and well, it is. I've had it since Thursday — reading, watching video, listening to music, checking email, even playing some games — and I can say it's tight. Turn it on and you know what to do, like with an Apple product. So much like an Apple product that Apple should be scared.

   It's a 7-inch tablet, which means that it's half as big as an iPad, and way closer in size to a paperback book. It could be a little easier to grip, but Amazon went minimalist here, rather than opting for some weird-looking ergonomics. Because of the size, reading is easier than on an iPad, though kids' entertainment and other engrossing interactive content isn't as fun. And because the Fire is widescreen, unlike the more 4x3 iPad, videos look almost as big as they do on Apple's much larger device. As far as screen quality goes, it's on par with the iPad. In other words, as an opening move, hardware-wise, Amazon's getting it right.

   If you buy the Fire from Amazon's website, it comes with your login information already onboard, so you just confirm that you are you, and you're off. The top of the home screen has labeled categories: Newsstand, Books, Music, Video, Docs, Apps and Web. Any Kindle e-books you ever bought show up in the library archive, any music you bought or uploaded to Amazon's Cloud Player shows up in music, and any video in your locker is there, too. There's a gallery of apps that you may have purchased from Amazon's app store (excuse me, "Appstore"). And by design, each page of stuff you own is just a click away from a store where you can get a ton more.

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John Brecher / msnbc.com 

   The Silk browser on the Kindle Fire is nearly as smooth as its namesake.
Amazon's Appstore is a huge asset. Because it is tied to Amazon's own purchasing system, it's easier for you to buy apps from a trusted source. And because Amazon went with quality over quantity, it lacks the feel of Google's Android Market, which can get so slimy that it could use a hosing down from time to time. Not every app you want is in the Amazon Appstore, but the company is already getting some of the best stuff out there — including apps from competitors like Netflix and Hulu — and developers who see the Kindle Fire will work just as hard to get their "A" material in front of Fire buyers.

  The rest of the home screen is a combination of two well-known Apple design elements. Up top, there's a "cover flow" of all recent items, be they book, app, movie or Web page. Underneath is an iBooks-like shelving system, where you can pin and rearrange your favorite media items. Rip-off or not, the interface works well enough. The Fire is certainly more fluid than the Kindle e-reader, which succeeds in spite of its user interface.

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John Brecher / msnbc.com 

   Amazon Prime lets you borrow a book a month at no extra cost, and some of the titles are bestsellers.
Speaking of fluid, the Fire's Silk browser is nice and quick, and only gets faster as it wises up to your browsing patterns. If you always hit the msnbc.com home page then jump to Tech/Sci, it will start caching Tech/Sci in anticipation of your click. And though it tends to trigger the mobile versions of websites, it has few problems with the full versions, including embedded video and other features. I did encounter a broken page once, apparently caused by an ad loading funny, but troubles have been minor to date.

   It's easy to see that Amazon Prime will be a requirement for most Fire buyers, and not only because it's the best way to get Julia Child's original series "The French Chef" instantly on demand. Prime videos, movies and books could account for a huge chunk of your media diet, and represent the best value. It's a shame Amazon doesn't have a Spotify-like component for on-demand music, but I suspect that would eat too much into its MP3 sales.

   The biggest downside to Prime video is that it's like Netflix, and only works when you're connected to the Internet. That means that, in an airplane or a car, you are likely in trouble. You can connect the Kindle Fire to your PC or Mac and easily copy over home videos and movies you rip from DVD (DVDs you own, hopefully). Still, the main way to take videos with you into a no-bandwidth zone is to rent or buy them, so you can download them to the Fire. Beware, because with a total of 8GB on board, you only have enough storage for 10 movies or 800 songs, but certainly not both. There's no step-up model, like there is with the iPad, and there's no SD card slot, like on the Barnes & Noble Nook Tablet.
 
    As you wander through the Kindle Fire interface, it's not easy to get lost, partly because the categories are so cut-and-dry, and partly because you can nearly always see a home button to take you back when things get muddy. But I say "nearly" because in some apps, you have to click a few times to even see the home button. This inconsistency made me miss the physical home button found on the iPad and many Android devices. While we're on the subject, I also missed volume up/down buttons, and wish that the on/off button wasn't located on the bottom, where it's so easily pressed on accident.

   But these are design issues that don't really interfere with the overall potency of the product, especially since much of the potency comes from that $199 price tag. What does matter is battery life. Amazon says it's "up to 8 hours of continuous reading, or 7.5 hours of video playback, with wireless off." That's not as good as an iPad, which is rated for up to 10 hours of continuous use. I didn't run it into the ground in one sitting, but I managed to go several days of regular use between charges. Again, an iPad can go longer — mine lasts nearly a week between charges. Still, the Fire's battery life ought to be satisfactory for most people.

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John Brecher / msnbc.com 

   So while we're on the subject of iPad, let's have the talk. No, the Kindle Fire is not anywhere close to being the precision machine that the iPad 2 is. There are no cameras and no microphone. The Fire's screen is half the size of the iPad's, and the Fire's battery life isn't as good, yet the Fire is still a hair thicker. The Fire interface, while seductively simple, lacks the nuances — the futuristic animations and fades — that keep Apple on top.

   But for Apple, this still spells trouble. The Kindle Fire can handle about 80 percent of what I want to do on an iPad, for 40 percent of the price. And much of what's missing won't be missing for long. Even if you can justify buying one iPad, you may look to the Fire as a second device in your high-tech home. And if you can't justify an iPad this holiday season, you might consider Amazon's alternative.

  Later this week, we'll be looking at the Barnes & Noble Nook Tablet, the closest thing to competition that the Kindle Fire will see in its class and price range. Though Barnes & Noble already has momentum from selling the Nook Color, it's hard to see how the book retailer could outsell Amazon in this space, especially since Amazon is a digital media powerhouse, and these tablets are about more than reading. We keep an open mind, though, not least of all because the Nook specs are impressive. But for the moment, and perhaps for the time being, Kindle Fire is well worth its amazingly low price.

Friday, August 10, 2012

Tramadol

Why is this medication prescribed?

 

Tramadol is used to relieve moderate to moderately severe pain. Tramadol extended-release tablets are only used by people who are expected to need medication to relieve pain around-the-clock for a long time. Tramadol is in a class of medications called opiate agonists. It works by changing the way the body senses pain.

How should this medicine be used?

 

Tramadol comes as a tablet and an extended-release (long-acting) tablet to take by mouth. The regular tablet is usually taken with or without food every 4-6 hours as needed. The extended-release tablet should be taken once a day. Take the extended-release tablet at about the same time of day every day, and either always take it with food or always take it without food. Take tramadol exactly as directed. Do not take more medication as a single dose or take more doses per day than prescribed by your doctor. Taking more tramadol than prescribed by your doctor may cause serious side effects or death.
Your doctor may start you on a low dose of tramadol and gradually increase the amount of medication you take, not more often than every 3 days if you are taking the regular tablets or every 5 days if you are taking the extended-release tablets.
Swallow the extended-release tablets whole; do not split, chew, or crush them. Do not snort (inhale powder from crushed tablet) or inject the dissolved extended-release tablets. Taking this medication in a way that is not recommended may cause serious side effects or death.
Tramadol can be habit-forming. Do not take a larger dose, take it more often, or take it for a longer period of time than prescribed by your doctor. Call your doctor if you find that you want to take extra medication or if you notice any other unusual changes in your behavior or mood.
Do not stop taking tramadol without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop taking tramadol you may experience withdrawal symptoms such as nervousness; panic; sweating; difficulty falling asleep or staying asleep; runny nose, sneezing, or cough; numbness, pain, burning, or tingling in your hands or feet; hair standing on end; chills; nausea; uncontrollable shaking of a part of your body; diarrhea; or rarely, hallucinations (seeing things or hearing voices that do not exist).

Other uses for this medicine

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.


What special precautions should I follow?

Before taking tramadol,

 

  • tell your doctor and pharmacist if you are allergic to tramadol or other opiate pain or cough medications such as meperidine (Demerol), morphine (Avinza, Kadian, MS Contin), codeine (in some pain medications and cough syrups), hydrocodone (in Vicodin), hydromorphone (Dilaudid), oxycodone (OxyContin, in Percocet), propoxyphene (Darvon, Darvon N, in Darvocet), any other medications, or any of the ingredients in tramadol tablets or extended-release tablets. Ask your pharmacist for a list of ingredients in tramadol tablets or extended release tablets.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, and nutritional supplements you are taking. Be sure to mention any of the following: antifungal medications such as ketoconazole (Nizoral); digoxin (Lanoxin); erythromycin (E.E.S., E-Mycin, Erythrocin); monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate); medications for anxiety, mental illness, nausea, and pain; medications for seizures, such as carbamazepine (Tegretol); muscle relaxants such as cyclobenzaprine (Flexeril); promethazine (Phenergan); quinidine; rifampin (Rifadin, Rifamate, Rimactane, others); sedatives; sleeping pills; selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft); tranquilizers; tricyclic antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil);and warfarin (Coumadin). Many other medications may also interact with tramadol, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor what herbal products you are taking, especially St. John's wort.
  • tell your doctor if you have or have ever had seizures; an infection in your brain or spine; a head injury, a brain tumor, a stroke, or any other condition that caused high pressure inside your skull; depression or thoughts about harming or killing yourself or planning or trying to do so; diabetes; breathing problems or lung disease; or kidney or liver disease. Also tell your doctor if you drink or have ever drunk large amounts of alcohol, use or have ever used street drugs, or have overused prescription medications.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking tramadol, call your doctor.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking tramadol.
  • you should know that this medication may make you drowsy and may affect your coordination. Do not drive a car or operate machinery until you know how this medication affects you.
  • talk to your doctor about the safe use of alcohol while you are taking this medication. Alcohol can make the side effects from tramadol worse.
  • you should know that tramadol may cause dizziness, lightheadedness, and fainting when you get up from a lying position. To avoid this, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.
 

What special dietary instructions should I follow?

Talk to your doctor about drinking grapefruit juice while you are taking this medication.


What should I do if I forget a dose?

If your doctor has told you to take tramadol regularly, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Tramadol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: 
  1. dizziness
  2. weakness
  3. sleepiness
  4. difficulty falling asleep or staying asleep
  5. headache
  6. nervousness
  7. agitation
  8. uncontrollable shaking of a part of the body
  9. muscle tightness
  10. changes in mood
  11. drowsiness
  12. heartburn or indigestion
  13. nausea
  14. vomiting
  15. diarrhea
  16. constipation
  17. itching
  18. sweating
  19. chills
  20. dry mouth
Some side effects can be serious. If you experience any of these symptoms or those listed in the SPECIAL PRECAUTIONS section , call your doctor immediately: 
  1. seizures
  2. sores on the inside of your mouth, nose, eyes, or throat
  3. flu-like symptoms
  4. hives
  5. rash
  6. difficulty swallowing or breathing
  7. swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
  8. hoarseness
  9. hallucinations (seeing things or hearing voices that do not exist)
     
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
Tramadol may cause other side effects. Tell your doctor if you have any unusual problems while you are taking this medication.


What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.


In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

  • decreased size of the pupil (the black circle in the center of the eye)
  • difficulty breathing
  • extreme drowsiness
  • unconsciousness
  • coma
  • seizure
  • heart attack

What other information should I know?

Keep all appointments with your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements.

You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Some basics on Tramadol

    Treating any kind of physical pain is an absolute priority for whoever is experiencing it. This is purely logical, as pain inhibits one’s ability to focus on anything else and as such should be treated as soon as possible. There are more painkillers out there than can fit in a simple article, but in this one we will discuss Tramadol, one of the most popular painkillers in the world.

    Tramadal hydrochloride, or simply Tramadol, is a drug similar to Codeine. It is a synthetic analgesic used to treat mostly more ‘serious’ pain, and is not to be used by people who have a simple headache. Some of the conditions for which Tramadol is used are arthritis, bone fractures and as a postoperative drug. It was first launched as Tramal in 1977 and has since gained popularity worldwide.

    Classified as a central nervous system drug, it comes in numerous forms and mostly in its standard dose of 50mg. Some of the ways in which you can use Tramadol are: capsules, tablets, suppositories, powders, ampoules, and solutions. Other than this, Tramadol is frequently used as an ingredient of many gels and creams that are applied on the skin for treatment of injuries.

    For those taking it as a tablet, Tramadol has an unpleasant taste, but some drops and solutions come in different flavors, many of which taste good (like strawberry flavor). While the maximum daily varies from one manufacturer to another, the standard maximum is about 400mg. In any case, before using Tramadol, make sure you consult your doctor and undergo a medical exam, just so there are no negative surprises afterward.

   Like with most other strong analgesics, Tramadol cannot be recommended to everyone. People who take antidepressants such as Prozac or Zoloft, or any kind of strong opioids should not be using Tramadol. Also, people over 70 years of age and children, as well as adults with a reduced kidney and liver function should do several tests and consult the doctor about the using Tramadol.
 
   While being extremely convenient and efficient, Tramadol isn’t without side effects. Some of the commonly reported negative consequences of using Tramadol are nausea and vomiting, sweating, itching, even constipation. Many patients also report tiredness and drowsiness, however, this is common with most opioids. Unlike with other opioids, Tramadol is not likely to cause respiratory depression, but could cause several withdrawal symptoms. Should the patient stop taking the medicine abruptly, it is possible to experience, nervous tremor, muscle contracting and bodily convulsions in bed, similar to the restless leg
syndrome.

Some studies suggest that using Tramadol over an extended period could cause physical dependence, which is why it is best to use it with continual medical supervision and not in excessive amounts. Most withdrawal symptoms are similar to those of other opiate-like drugs, and can be anxiety, depression, mood swings, sweating, palpitations, insomnia, night terrors, etc.

What you need to know about Tramadol

      The title of this article is somewhat misleading as it is actually quite difficult to say everything that needs to be said about a certain medication in an article as short as this one, especially when that medication is as efficient and as popular as Tramadol. However, there are some basic facts that can be covered in an article like this one and that is actually the goal of this article, to provide you with the basic facts that will give you a general picture of Tramadol and allow you to have a basis on which you can later build by learning more about it.
 
     Tramadol is, basically, a painkiller. To be more precise and more technical, Tramadol is a synthetic analgesic (a fancy word for painkillers) that is similar in is action to a few other painkillers and other types of drugs. For instance, it works on the same opioid receptors that opioid painkillers do, even though it is completely different in its chemical and pharmacological structure. It also has additional beneficial effects, such as stimulation of serotonin release as well as inhibition of norepinephrine reuptake. Because of these various effects, Tramadol not only eases the pain but also does away with anxiety, relaxes the muscles and calms the person.
 
        There are numerous possible uses for Tramadol and most of them have to do with the need to alleviate certain pain that ranges from moderate to moderately severe pain. For instance, Tramadol can be used after surgery and after certain more serious injuries that leave the person in significant amount of pain. It can also be used in alleviating pain caused by certain chronic conditions, such as fibromyalgia, rheumatoid arthritis as well as some other conditions that are associated with significant amounts of pain.

      As you can guess, Tramadol is a very powerful medication which means that it should never be used without consulting a doctor. In fact, if you decide to take Tramadol on your own, you might experience severe side effects and you might even risk your own life. There are some people who should not be taking Tramadol in the first place due to their medical history as well as people who should not be taking the usual doses as they might put their health in danger.


It s also extremely important that you only take Tramadol as prescribed as larger doses can easily lead to overdoses, especially in combination with some other drugs. It is also extremely dangerous not to continue to use Tramadol once your regimen is complete as this increases the chances of developing dependence to the drug. Since certain dependence, both physical and psychological can occur even in those people who use Tramadol as recommended (usually those who take it for longer periods of time), the discontinuation of the medication needs to be done in consultation with your doctor who will gradually lower your dosage so as to avoid withdrawal effects.


     Remember to take Tramadol exactly as you are prescribed and never to make any changes to your Tramadol treatment on your own, and you will soon discover why it is still one of the most popular painkillers on the market.

Why is Tramadol so good at what it can do?

      Tramadol is certainly one of the most widely used painkillers available on the market today. It is a synthetic analgesic and it works quite similarly to other painkillers that you can find. Although Tramadol has a completely different chemical structure from most other drugs of this type it still works on the same opioid receptors as opioid painkillers.
      There are also additional positive effects to using this medication. Some of them are that it stimulates the release of serotonin and it can also inhibits the  norepinephrine reuptake. Thanks to these, Tramadol can help not only with the pain, but it can also work as a muscle relaxant and it can alleviate anxiety.
This drug is quite potent and for that reason it has to be taken only after you’ve consulted with your doctor. Taking it on your own can cause to overdosing or, at best, to some side effects, which you may not find pleasant at all if you manage to avoid those that can be life-threatening. After consulting with your doctor, you will be able to determine if you should be taking this drug in the first place. There are people with a medical history that can have serious health problems if they decide to use Tramadol.
     Like I already mentioned, although it is primarily a painkiller, Tramadol has other medical uses as well. This is mainly due to the fact that it can be successfully used for almost any sort of pain form moderate to moderately severe. It can be used after some cases when a person is severely injured and is in a lot of pain or it can be used after surgery for the same reason.
 
     Some conditions, such as rheumatoid arthritis and fibromyalga can cause chronic pain and a good medication is needed in order to help people deal with it. That is where Tramadol comes in very handy as well as it can alleviate almost the worst kind of pain that they you can feel if you are suffering from these conditions.

It is necessary to strictly follow the doctor’s prescription, no matter how much you think that just a little more can help you deal with the pain. Instead of taking more Tramadol per one dose or increasing the number of doses, you should first consult your doctor. Failing to do that and changing the dosage on your own can lead to serious overdose effects and you can also find yourself to be dependent on this painkiller. Speaking of dependency,which can be physical and/or psychological and it is usually caused by taking this medication for a prolonged period of time.

     If you were taking Tramadol for a long, you should not try to stop taking it all of a sudden. Instead, consult with your doctor and work out a plan that will gradually release your organism from it’s effects and thus prevent any possible withdrawal effects.

Tramadol - 10 Things You Should Know

      Tramadol, the generic version of Ultram, is a synthetic analgesic medication. The exact mode of action of tramadol is unknown but it is said to work like morphine. Tramadol binds to opioid receptors in the brain -- receptors that transmit the sensation of pain throughout the body. Here are 10 things you should know about tramadol to ensure its safe use.

1 - Tramadol is prescribed to treat moderate to moderately severe pain.

Tramadol belongs to the class of drugs known as opiate agonists. Primarily, tramadol works by changing the way the body senses pain. Some people mistakenly believe that tramadol is an NSAID (nonsteroidal anti-inflammatory drug), but it is not.

2 - Tramadol is available in immediate release and extended release formulations.

Tramadol may be prescribed as an immediate release tablet (50 mg.) or as an extended release tablet (100, 200, or 300 mg.). The extended release tablets are usually reserved for patients with chronic pain who require continuous, long-term treatment. Your doctor will determine the appropriate dosage schedule for you.

3 - Tramadol extended release tablets must be taken whole, not split, chewed or crushed.

It is important to take tramadol properly and to follow prescribing instructions. If taken improperly or in a way that is not recommended, serious side effects and even death can result.

4 - Tramadol can be habit-forming for some people.

Do not take more tramadol than has been prescribed for you. Taking more tramadol or taking it more often can cause dependency on it. You should also not stop taking tramadol without first consulting your doctor. You may experience withdrawal symptoms if you stopped it suddenly. You doctor will likely decrease your dose of tramadol gradually.

5 - Drug interactions are possible with tramadol.

Be aware of the following possible drug interactions:
  • Carbamazepine reduces the effect of tramadol
  • Quinidine increases the concentration of tramadol by 50% to 60%
  • Combining tramadol with an MAO (monoamine oxidase inhibitor) inhibitor or SSRI (selective serotonin reuptake inhibitors) can lead to seizures or other serious side effects.
Be sure to tell your doctor about all medications you are taking.

6 - Tramadol, when combined with certain other substances, can increase central nervous system and respiratory depression.

In other words, breathing may be affected or even stop if tramadol is combined with alcohol, narcotic drugs, anesthetics, tranquilizers, or sedatives.

7 - The use of tramadol during pregnancy should be avoided.

Because the safety of tramadol use during pregnancy has not been established, the medication should not be used during pregnancy. The safe use of tramadol in nursing mothers has also not been established.

8 - Tramadol is usually well-tolerated. Any side effects are usually temporary.

Some of the common side effects associated with tramadol include:
  • nausea
  • constipation
  • dizziness
  • headache
  • drowsiness
  • vomiting
Less common side effects include: itching, sweating, diarrhea, rash, dry mouth, and vertigo. There have been patients who developed seizures after taking tramadol.

9 - A Cochrane Review of tramadol to treat osteoarthritis revealed some small benefit.

The Cochrane Review stated that when tramadol is taken for up to 3 months, there may be decreased pain, improvements in function and stiffness and overall well-being. However, tramadol can cause side effects that are significant enough to require that the patient must stop taking the medication. Risks outweigh benefits for many people who have tried tramadol.

10 - If an overdose of tramadol has occurred, call your local poison control center, or call 911 if it appears to be an emergency situation.

Symptoms of an overdose include decreased pupil size, difficulty breathing or staying awake, unconscious, coma, heart attack, or seizure. Call for help, even if you are unsure about what to do.