The withdrawal syndrome

Posted on August 8, 2018  in Medical news

The withdrawal syndrome is always the same. This applies to absolutely all cases, regardless of what was caused by addiction. Exception can be considered only those situations when the abstinence is not so bright. The main symptoms of withdrawal syndrome are:
deterioration of well-being, constant depression, decrease in working capacity;
increased irritability, aggressiveness, apathy, depression;
disruption of normal operation of internal organs, accompanied by shortness of breath, increased palpitations, nausea, digestive system disorders, tremor in the muscles, increased sweating;

a constant desire to accept a substance that has become addictive. Throughout the symptom of withdrawal, the patient is almost nothing else to think about. All of the above manifestations indicate that the patient has developed a withdrawal syndrome. The signs can be both pronounced and less obvious.

When does abstinence begin to manifest?

The manifestations of abstinence can occur at different times and depend on a variety of factors, the main ones being the degree of dependence caused by certain substances. In most cases, abstinence makes itself felt in such terms as: in the case of nicotine addiction, the desire to smoke can occur only one hour after the last smoke break; about whether there is a withdrawal syndrome for alcohol abuse, you can find out in a few hours; Abstinence caused by taking antidepressants is manifested 1-2 days after refusal; when using narcotic substances, the breakdown occurs about a day after the last dose. It is worth noting that when the onset of withdrawal symptoms are manifested not immediately, but gradually.

The withdrawal syndrome is what?

After the completion of taking medications intended to arrest various conditions, the symptoms may return to the patient. In this case, they are manifested with greater force. As a result, the patient’s condition deteriorates significantly, and he may fall into a coma. A similar manifestation is called withdrawal syndrome. This phenomenon was first discovered by doctors when using hormone therapy.
Causes
The withdrawal syndrome is an acute manifestation, caused by the way it happens, if you refused to take medication, we did not receive any substances necessary for normal functioning. This is due to the fact that any hormonal drugs have a negative effect on the nervous system, violating the normal psychological and emotional background. If you take such drugs for a long period of time, then the patient may develop a feeling of constant discomfort and depression. Therefore, do not use medication without the advice of a qualified specialist.
The most common drugs and substances that cause dependence and can lead to the development of withdrawal syndrome in refusing to take them are: narcotic substances, for example, cocaine, opium, etc.; psychostimulants and antidepressants; alcohol; nicotine. Each provocateur listed in the list has a different degree of addiction. Therefore, dependence on them develops in a person for a different period of time. For example, addiction develops much more quickly to narcotic substances than to nicotine or alcohol. The most dangerous thing is that such dependence has a detrimental effect on the body. In some cases, there may even be a lethal outcome. A frequent picture is the syndrome of hormonal ointment withdrawal, which are widely used in gynecology for the treatment of various diseases. The abolition of their application leads to hormonal failure, and consequently, to abstinence.

Treatment of dependence on Tramadol

Drug dependence on Tramadol is treated by the same methods as opium addiction. The patient needs rehabilitation in the medical center.

Regardless of the condition of a person, he is hospitalized. However, this requires personal consent of the patient.

Treatment is carried out in several stages:

Detoxification.
General strengthening therapy.
Active drug treatment.
Antiretroviral therapy.
Detoxification lasts 3-4 weeks, during which the patient takes glucose, vitamin-mineral complexes, blood substitutes, nootropics and other drugs. In parallel, symptomatic treatment is performed. If necessary, prescribe analeptics for the normalization of respiratory functions, medications to restore the work of the heart and blood vessels.

An important condition of treatment – a sharp and final refusal to use Tramadol. The withdrawal syndrome, which causes this drug, is removed with clonidine and pyrroxane. To eliminate psychoses, tranquilizers and haloperidol are usually prescribed.

As part of the antinarcotic treatment, the body functions that are damaged as a result of Tramadol’s administration are restored, the behavior of the patient is corrected and the cravings in the drug are suppressed. At this stage, antidepressants and antipsychotics are used, in parallel treatment continues with nootropic drugs.

Also, the patient is affected by psychotherapeutic methods. Individual and collective classes are held in different centers. Hypnosis can be used with the development of aversion to the drug at the subconscious level, acupuncture, electrostimulation.
The longest stage is maintenance therapy, aimed at maintaining the achieved result and preventing breakdowns. After discharge from the medical institution, the patient should continue to attend psychotherapy sessions and take fortified preparations. The duration of anti-relapse treatment can be up to five years.

Effects

Consequences of prolonged use of TramadolAfter one year of misuse of Tramadol in humans, bone tissue is significantly weakened. This increases the risk of fractures and related injuries. Loss of teeth and hair can also occur.

If the patient does not throw Tramadol, then, as a rule, he dies within 3-4 years. However, even after a successful rehabilitation, people have the consequences of dependence that they will have to struggle with for the rest of their lives.

After two years of continuous use of the drug, severe consequences develop:

  • epilepsy;
  • toxic hepatitis;
  • dementia;
  • cirrhosis of the liver.

Among other consequences of long-term use of Tramadol, mental abnormalities are noted:

  • alternation of euphoria and depression;
  • bouts of irritability;
  • obsessions;
  • paranoids.

Only a quarter of tramadol addicts survive after undergoing rehabilitation. The rest die from causes that are directly or indirectly related to the consequences of dependence.

According to statistics, most patients die as a result of overdoses that occur during breakdowns. Up to 9% of all those who use this drug commit suicide during withdrawal, slightly less people die from diseases of internal organs. With 3% of patients in a state of drug intoxication, accidents occur that lead to death.

Signs and symptoms of consumption

Signs and symptoms of consumption
Tramadol is a psychoactive drug, so its use primarily causes behavioral abnormalities. They can be different and depend on the personality characteristics of the patient.
In different cases:

  • excessive motor activity or lethargy;
  • drowsiness or insomnia;
  • inability to concentrate;
  • self-isolation and indifference to everything;
  • reluctance to communicate with loved ones;
  • decreased memory and attention;
  • absenteeism of study or work without a clear explanation;
  • acute reaction to criticism;
  • sharp mood swings;
  • falsity and avoidance of direct answers to questions;
  • untidy appearance;
  • the appearance of suspicious acquaintances, jargon;
  • interest in specific music and films;
  • constant requests to borrow money;
  • loss of values.

The dependence on Tramadol can also be recognized by physiological signs. They can also vary depending on the characteristics of the body.

Most often in people who take the drug, there are:

  • enlarged or narrowed pupils;
  • red squirrel eyes;
  • clouded look;
  • pale or reddened skin;
  • rash;
  • slow and incoherent or simply accelerated speech;
  • lack of appetite or gluttony;
  • strong weight loss or a large weight gain;
  • digestive disorders;
  • excessive gesticulation;
  • unstable gait.

Within a month on the background of the reception of Tramadol, the patient’s appetite gradually comes to naught. At the same time, an unquenchable thirst develops.

Within three months of regular use of the drug develops physical, emotional and mental exhaustion. The person becomes more and more sluggish. He is often in a good mood, but laughter can suddenly turn into tears or a flash of aggression.

Because of the increased pressure in the patient, there are more intense headaches, with him there are fainting. Opportunities to learn and work are reduced, because memory worsens, absent-mindedness grows. As a result, a person has to exert more effort to perform the usual actions.

The development of dependence

How does dependence on Tramadol develop? Therapeutic doses of Tramadol are generally not addictive. However, even with a slight excess of it, even after the first use of the drug, both physical and psychological dependence develops.

During three months of regular use, Tramadol is the only or the main drug for a person. If the patient wants to be treated and gets rid of physical dependence, the psychological craving for the drug will still remain. It persists to 10-15 years, so very often failures occur.

Even with the help of detoxification in the hospital it is impossible to completely purify the body of Tramadol. The products of its decay are deduced within 20-25 years.

The process of inpatient treatment itself occurs quite quickly and takes from a week to a month. However, in practice, 75% of people who at least once tried Tramadol, go back to taking the drug for 4-5 years. This in most cases ends with death.

After a dramatic withdrawal of Tramadol, the drug addict experiences the most severe of all possible abstinence symptoms. The break takes 20-25 days.

Hallucinations in the period of the abstinence syndrome do not vanish, but, on the contrary, become more frequent and realistic, the gloominess of their plots increases.

In parallel, the patient manifests other mental disorders:

  • severe depression with suicidal tendencies;
  • aggressiveness;
  • hysteria;
  • irritability.

The effect of Tramadol

Effect
The effect of Tramadol begins one to two minutes after ingestion. There comes a euphoria, which lasts 12-36 hours, but as it gets used to the drug its duration gradually decreases. After a while, narcotic intoxication becomes weak, passes through 1-5 minutes.

Drug addicts usually use Tramadol in capsules, less often they use injectable solutions for the home-made drug production. After taking the drug develops an empathic state, similar to what causes “ecstasy.”

It is accompanied by:

  • emotional susceptibility;
  • desire to help others;
  • sympathy and sympathy for all, even for the enemies;
  • the tide of vivacity;
  • looseness.

After one or two days intoxication comes to naught. A person has a fear of being alone, nightmares begin to haunt him. As you get accustomed to the drug, euphoria and empathy practically disappear, but paranoia and mania develop, as well as as a result of prolonged use of heroin.

By the end of the first week of taking Tramadol against the background of euphoria, the first hallucinations appear. The patient can hear or see certain creatures. He talks to them, watches them from outside in extreme situations, perceiving what is happening as an exciting adventure.

Mechanism of action Tramadol

Posted on July 11, 2018  in Medical news

The mechanism of action of the drug Tramadol after penetration into the bloodstream Tramadol begins to affect the activity of the nervous system. It inhibits pain impulses and stimulates opioid receptors in the brain and spinal cord. As a result, a person has pain relief.

The use of the drug for its intended purpose and compliance with the recommendations of the doctor, rarely leads to side effects.

However, exceeding the therapeutic dose causes drug intoxication and related side effects:

  • retardation;
  • hallucinations;
  • cardiopalmus;
  • dizziness.

Properties

As a narcotic analgesic, Tramadol has a powerful analgesic effect. The effect of the drug begins almost immediately after administration inward or parenterally and lasts a long time. By activity inferior to morphine, so it is used in higher doses.

Tramadol as a drug

Tramadol as a drug

Tramadol belongs to the group of narcotic opioid analgesicsEarlier it could be bought in a drugstorethough with difficultybut now the drug is everywhere withdrawn from circulation.

Tramadol is available in capsules for oral administrationampoules for injections and rectal suppositoriesIn most countriesit is prescribed only to a fatal patient who experiences unbearable pain in the late stages of illness.

In the pastthe drug was used in the treatment of drug addictionDue to the fact that it has an effect on the central nervous systemit alleviates the pain in the withdrawal syndromebut other manifestations of withdrawal only aggravateThereforenow restrictions are imposed on the use of the medication.

Currentlyhalf of the patients in the narco-dispensaries are people who are dependent on TramadolAccording to statisticsthe drug is consumed by thousands of schoolchildren.

As a synthetic heroin opiateTramadol often causes an overdoseIt leads to paralysislimb amputationserious CNS lesions and deathBut is he a drugIndeedmany drug addicts use the drug as a single drug or use it at a time when they can not find heroin.

Composition

The composition of Tramadol differs slightly depending on the form of releaseThe active substance of the drug is tramadol hydrochlorideAs auxiliary components in the capsulesmagnesium stearate and milk sugar are containedand in injection solutionssodium acetate and distilled water are contained.

Ciprofloxacin

Posted on April 17, 2018  in Medical news

A synthetic antibacterial preparation of a broad spectrum of action from the group of fluoroquinolones.

Pharmacological properties

Ciprofloxacin is a broad-spectrum antimicrobial agent of the fluoroquinolones group. Has a bactericidal effect, the mechanism of which is due to the inhibition of DNA-gyrase of bacteria with a violation of DNA synthesis, growth and division of microorganisms.

Has antimicrobial effect with the highest activity against aerobic gram-negative and gram-positive bacteria: Pseudomonas aeruginosa, Haemophilus influenzae, Escherichia coli, Shigella spp., Salmonella spp., Neisseria meningitidis, N. gonorrhoeae. It is active against many strains of Staphylococcus spp. (producing and non-producing penicillinase), some strains of Enterococcus spp., as well as Campylobacter spp., Legionella spp., Mycoplasma spp., Chlamidia spp., Mycobacterium spp. Ciprofloxacin is active against bacteria that produce beta-lactamase. Resistant to ciprofloxacin Streptococcus faecium, Ureaplasma urealyticum, Nocardia asteroides, Treponema pallidum. Resistance of bacteria to ciprofloxacin develops slowly.

When ingested quickly and completely absorbed in the digestive tract. Cmax in blood plasma is achieved 1-2 hours after admission, bioavailability is 70%, T1 is 4 hours. Approximately 20-40% of ciprofloxacin binds to plasma proteins. Ciprofloxacin is well distributed in tissues and body fluids, and its concentration can significantly exceed the concentration in the blood plasma. Penetrates into the CSF through the placenta, excreted in breast milk, high concentrations are determined in the bile. It is excreted from the body up to 40% with urine (unchanged) for 24 hours, in part – with bile.

Application:

Infections caused by drug-susceptible microorganisms:

infections of the lower respiratory tract caused by gram-negative bacteria (pneumonia, except pneumococcal, bronchopulmonary infection in chronic obstructive pulmonary disease, cystic fibrosis, bronchiectasis);
infections of the middle ear and paranasal sinuses caused by gram-negative bacteria;
infections of the kidneys and urinary tract;
skin and soft tissue infections caused by gram-negative bacteria;
infection of bones and joints;
infections of the pelvic organs (including adnexitis and prostatitis), gonorrhea;
infections of the gastrointestinal tract (including diarrhea, caused by enterotoxigenic strains of Escherichia coli, Campylobacter jejuni);
intra-abdominal infections;
infection in patients with reduced immunity (with neutropenia).

Do not take Ciprofloxacin in the following cases:

hypersensitivity to ciprofloxacin, other quinolones or excipients of the drug;
pregnancy, the period of breastfeeding;
children and adolescents under 18;
simultaneous use with tizanidine.

Possible side effects: Like all medicines, ciprofloxacin can cause side effects with varying frequency, regardless of whether it was previously taken.

Often (1 to 10 – 100 cases): nausea, diarrhea.

Infrequently (1 per 100 to 1,000 cases): fungal superinfections, eosinophilia, lack of appetite, hyperactivity, agitation, headaches, dizziness, sleep disorders, taste disorders, vomiting, stomach and bowel pain, dyspepsia, flatulence, increased hepatic activity enzymes, increased bilirubin, rash, itching, urticaria, musculoskeletal pain (in the extremities, back, chest), joint pain, impaired renal function, fatigue, fever.

Rarely (1 per 1,000 – 10,000 cases): inflammation of the colon, changes in the number of leukocytes, anemia, a decrease in the number of platelets, allergic reactions, increased blood sugar, confusion, pathological dreams, depression with the appearance of suicidal thoughts, changes in sensitivity, trembling , convulsions, dizziness, visual impairment, hearing disorders, tachycardia, decreased blood pressure, fainting, choking, liver function disorders, jaundice, hepatitis, photosensitivity, muscle pain, joint inflammation, increased muscle -screw tone, muscle spasms, renal failure, blood / crystals in the urine, nephritis, increased amylase activity.

Very rarely (less than 1 in 10 000 cases): hemolytic anemia, decreased number of blood cells, suppression of bone marrow function, anaphylactic reaction, anaphylactic shock, mental reactions with possible suicidal attempts, migraine, impaired coordination, unstable gait, odor perception disorder, increased intracranial pressure, changes in color perception, vasculitis, pancreatitis, liver necrosis, petechiae, erythema, Stevens-Johnson syndrome, toxic epidermal necrolysis, muscle weakness, inflammation and tearing of tendons (mainly Achilles), swelling, increased sweating.

The frequency is unknown (can not be estimated from the available data): peripheral neuropathy, ventricular tachycardia, arrhythmia, acute generalized pustular exanthema, increased prothrombin time.

If you took a dose of ciprofloxacin more than the doctor recommended: If the number of tablets a day you took exceeds the amount that your doctor recommended, or your child swallowed the tablets, consult a doctor or call an ambulance! Stop taking medication! Overdosing can be manifested by dizziness, headache, fatigue, convulsions, hallucinations, confusion, a feeling of discomfort in the abdomen, a violation of kidney and liver function, the presence of crystals and blood in the urine. As a first aid it is recommended to wash the stomach and take antacids.

Precautions and special instructions for taking Ciprofloxacin:

Severe infectious diseases and mixed infectious processes. In these conditions, ciprofloxacin is administered in combination with other antimicrobial agents.

Streptococcal infection (including Streptococcus pneumoniae). Ciprofloxacin is not recommended for treatment due to inadequate efficacy.

Urogenital infections. These infections can be caused by fluoroquinolone resistant Neisseria gonorrhoeae. In these cases, ciprofloxacin should be administered along with other antimicrobials. If no improvement is observed within 3 days of treatment, then treatment is recommended to be reviewed.

Intra-abdominal infectious diseases. Data on the effectiveness of ciprofloxacin for the treatment of postoperative intra-abdominal infectious diseases are limited.

Diarrhea of ​​the “traveler”. When choosing ciprofloxacin, the available information on drug resistance of the relevant microorganisms in the visited country is taken into account.

Infectious diseases of bones and joints. Ciprofloxacin is administered in combination with other antimicrobials after a microbiological examination.

Anthrax: Information on the use of the drug in humans is limited. It is recommended to be guided by national and / or international documents on the treatment of this disease.

Other specific severe infectious diseases: Ciprofloxacin is used according to treatment protocols or after careful assessment of the “risk-benefit” ratio and microbiological analysis in cases where other treatment is not possible or after an adverse outcome of previous therapy.

Hypersensitivity. After taking a single dose of the drug, hypersensitivity reactions are possible, including anaphylactic and anaphylactoid reactions, which are life-threatening conditions. Take the medicine immediately and immediately inform the doctor or call an ambulance!

The musculoskeletal system. Ciprofloxacin should not be given to patients with tendon disorders or disorders in the administration of quinolones in the past. If necessary, treatment of severe infectious diseases in such patients for the treatment of severe infectious diseases, a microbiological study and an assessment of the ratio of “risk-benefit.” Perhaps the occurrence of inflammation or rupture of tendons, mainly in elderly patients or concomitantly taking corticosteroids. With any signs of this disease (swelling, inflammation), the drug is taken to stop and immobilize the affected limb. It is used with caution in patients with myasthenia gravis.

Photosensitivity. Patients taking ciprofloxacin should avoid direct exposure to sunlight and UV radiation.

Central nervous system. It is known that quinolones can lower the convulsive threshold and initiate convulsions. It is used with caution by patients with CNS diseases, provoking convulsive seizures. There were reports of cases of polyneuropathy (pain, burning, feeling of excitement, tinnitus, muscle weakness, sensitivity disorders, including tactile, pain, temperature, vibration, and musculo-articular). When these phenomena occur, stop taking the drug! Immediately inform the doctor.

The cardiovascular system. Since the use of ciprofloxacin is associated with cases of prolongation of the QT interval on the ECG, care must be taken when treating patients at risk of arrhythmia: congenital lengthening of the QT interval; simultaneous reception of antiarrhythmic drugs of class IA and III, antidepressants, macrolides, antipsychotics; electrolyte disturbances; women and elderly patients are more sensitive; heart disease.

Pseudomembranous colitis: If you suspect a pseudomembranous colitis (loose stool for a long time, possibly with an admixture of blood or mucus in it), stop taking it immediately and call a doctor immediately for the appropriate treatment! Do not use drugs that depress intestinal motility. Immediately inform the doctor.

Renal and urinary systems: Sufficient fluid should be taken.

Hepatobiliary system: There were reports of cases of liver necrosis and life-threatening liver failure (jaundice, dark urine, itching, lack of appetite). When these phenomena occur, stop taking the drug! Immediately inform the doctor.

Deficiency of glucose-6-phosphate dehydrogenase. Possible development of hemolytic reactions. The drug is not assigned to such patients, except when the potential benefit exceeds the possible risk.

Resistance. During long-term therapy and in cases of treatment of some infections, ciprofloxacin-resistant bacteria can be released.

Eating and dairy products. You should avoid simultaneous reception with dairy products or beverages enriched with minerals (milk, yogurt, calcium fortified, orange juice), since the absorption of ciprofloxacin may decrease.

Contraindications

Hypersensitivity to ciprofloxacin or other quinolones, pregnancy and lactation, age 12 years, severe liver and kidney dysfunction, history of tendonitis caused by the use of quinolones.

Side effects

As a rule, it is well tolerated, but the following side effects are possible: dizziness, headache, fatigue, agitation, tremor; in isolated cases – peripheral disorders of sensitivity, sweating, hot flashes, gait disturbance, increased intracranial pressure, a sense of fear, depression, visual disturbances; nausea, vomiting, diarrhea, digestive disorders, abdominal pain, flatulence, hepatitis, necrosis of liver cells; tachycardia, rarely – AH; skin itching, rash; extremely rare – edema Quincke, bronchospasm, arthralgia; anaphylactic shock, petechiae, vasculitis, Stevens-Johnson syndrome, Lyell’s syndrome; eosinophilia, leukopenia, anemia, thrombocytopenia; leukocytosis, thrombocytosis, hemolytic anemia; increase in plasma creatinine, hepatic transaminases, alkaline phosphatase, LDH, bilirubin.

Special instructions

With caution appoint patients with epilepsy and patients with other organic diseases of the central nervous system, as well as with cerebral atherosclerosis.

With simultaneous treatment with ciprofloxacin and barbiturates, it is necessary to monitor heart rate, blood pressure, and ECG. During the treatment should monitor the concentration in the blood of urea, creatinine, liver transaminases.