On the part of the digestive tract: dry mouth, nausea, vomiting, flatulence, abdominal pain, consti

Tramadol activates opioid receptors (mu-, delta-and kappa) on pre-and postsynaptic membranes of nociceptive afferent fiber systems in the brain and spinal cord, as well as in the gastrointestinal tract, application of reverse osmosis promotes application of reverse osmosis the opening of potassium and calcium channels, causing

membrane application of reverse osmosis hyperpolarization and inhibits the nerve pulse. Analgesic

effect is due to decreased activity of nociceptive and zoom - antinociceptive systems. Sedative effect on the central nervous system.
Paracetamol has analgesic and antipyretic effect. Blocks cyclooxygenase predominantly in the CNS, acting on pain centers and thermoregulation. It does not cause irritation of the gastrointestinal tract, has no impact application of reverse osmosis on water-salt metabolism, because it does not affect the synthesis of prostaglandins in peripheral tissues.
When administered drugs rapidly and almost completely absorbed from the gastrointestinal tract, absorption of tramadol is slower than paracetamol. Bioavailability of tramadol - 75%, with repeated use increases to 90%. Tmax in plasma paracetamol application of reverse osmosis is 1 hour and is not changed by concomitant use with tramadol. Plasma protein binding of tramadol and paracetamol - about 20%, volume of distribution - about 0.9 liters. Tramadol is metabolized in the liver by N-and O-demethylation followed by conjugation with glucuronic acid. Found 11 metabolites, including mono-O-desmetiltramadol (M1) has pharmacological activity. Paracetamol application of reverse osmosis is metabolized primarily in the liver. T1 / 2 is tramadol 4,7-5,1 h, paracetamol - 2-3 pm Tramadol (about 30%) and its metabolites (60%) excreted primarily through the kidneys. Paracetamol and its conjugates allocated kidneys. Indications.
Pain (medium and strong intensity of various etiologies, application of reverse osmosis including inflammatory, traumatic, vascular origin). Analgesia during painful application of reverse osmosis diagnostic or therapeutic interventions manipulation. Contraindications. application of reverse osmosis
Hypersensitivity, acute intoxication with alcohol or drugs that suppress the central nervous system, hypnotics, narcotic analgesics and psychotropic drugs, the simultaneous application of reverse osmosis use of MAO inhibitors application of reverse osmosis (or period within 2 weeks after discontinuation), severe hepatic and / or renal insufficiency (Cl Kretynyn application of reverse osmosis <10 mg / l ) epilepsy application of reverse osmosis not controlled by treatment; syndrome "cancel" drugs, children's age (14 years). Restrictions apply.
Shock, head injury, intracranial hypertension, susceptibility application of reverse osmosis to seizures (in patients with epilepsy controlled by medication may be used only for health reasons), confusion of unknown etiology, respiratory failure, concomitant use of psychotropic and other painkillers central action of local anesthetics disease biliary tract, benign hyperbilirubinemia, viral hepatitis, deficiency of glucose-6-phosphate dehydrogenase, alcoholic liver disease, alcoholism, drug addiction, abdominal pain of unknown origin ("acute abdomen"), advanced age (over 75 years). Side effects.
Nervous system and sensory organs: dizziness, headache, weakness, fatigue, lethargy, paradoxical CNS stimulation (nervousness, agitation, anxiety, tremors, muscle spasms, euphoria, emotional lability, hallucinations), sleepiness, sleep disorders, confusion, impaired

coordination of movements, seizures of central origin (while prescribing antipsychotic drugs), depression, amnesia, cognitive disorders, paresthesias, unsteadiness of gait, blurred vision, taste.
On the part of the digestive tract: dry mouth, nausea, vomiting, flatulence, abdominal pain, constipation, diarrhea,

difficulty swallowing, increased liver enzymes, usually without the development of jaundice.
Since the cardiovascular system and blood (hematopoiesis, hemostasis): tachycardia, orthostatic hypotension, syncope, collapse, sulfhemohlobinemiya, chronic administration at doses much higher than recommended - aplastic anemia, pancytopenia, agranulocytosis.
Genitourinary: difficulty urinating, urinary application of reverse osmosis retention, dysuria, chronic administration at doses much higher than recommended - nephrotoxicity (interstitial nephritis, application of reverse osmosis papillary necrosis).
With prolonged use - the development application of reverse osmosis of drug dependence (irritability, phobias, anxiety, sleep disturbance, psychomotor activity, tremor, discomfort application of reverse osmosis in the stomach or intestines). With the sudden withdrawal - withdrawal. Interaction.
The combined use of opioid agonist-antagonists (buprenorphine, nalbufyn, pentazocine) is not recommended application of reverse osmosis because analgesic effect reduced by competitive interaction with receptors and the risk of withdrawal syndrome. In joint therapy with other drugs that have depressant effect on the central nervous system (such as sleeping pills or tranquilizers), and while taking alcohol side effects characteristic of tramadol may be more pronounced.
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