Pain killers

Discussion in 'Professionally Qualified, RAMC and QARANC' started by armourer, Aug 2, 2005.

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  1. I was on Pethadine for about 6 months then my Doc changed it to Burenorphine now he has changed it to Tramadol.

    In laymans (or Armourer speak) terms whats the difference between them, I have to say I found the Pethadine good kit.

    Seriously any help appreciated and obviously I'd check with my Doc if I wanted to take any advice offered here. ( I think thats called a disclaimer for any ARRSE user giving advice :wink: )

    Thanks.
     
  2. Try whisky........................
     
  3. Q
    uite right - been on Lagavulin and Brufen for the last twenty years, never felt a thing.
     
  4. A lot of g.p `s have been advised to stop giving patients strong pain killers because of the risks involved .

    e.g. sucide , heart attacks etc .

    L.S was on dia morphine but now only uses mild pain killers because of the risks.

    check the http://bmj.bmjjournals.com/
     
  5. Buprenorphine. Opioid painkiller for moderate to severe pain. Can cause some dependence.

    Pethidine. Another opioid painkiller that is going out of fashion somewhat. Can cause real problems with dependence and is not suitable for severe continuing pain.

    Tramadol. Again, opioid painkiller that has less in the way of side effects than other opioids.

    In my experience (I am a nurse) tramadol is one of the drugs of choice for moderate to severe pain and works well in conjunction with other painkillers like paracetamol/voltorol etc where appropriate and prescribed. One thing to remember about all of these drugs is that they slow down the action of the gut thus leading to a high risk of constipation. Being well hydrated and having a healthy diet can help here.

    Hope your pain management is effective. If it is not then go back to the quack and tell him/her. PM me if you need more info.
     
  6. ..that explains a lot.........
     
  7. BUPRENORPHINE..... is that the posh name for methadone?? Armourer do you have a bad habit by any chance?
     
  8. One of its trade names is Temgesic. I suspect Armourer to be more of a crack addict than methadone freak
     
  9. Tramadol is actually a "synthetic" opioid which is why its less addictive, much better for long term use than the others.

    Any analgesic always works better if taken with regular paracetamol in the normal safe doses.

    (I'm a Nursie Handbag & Mrs TomB was part of an "Acute Pain Team" till recently).

    Mrs TomB reckons that simple paracetamol should always used as a basis for any other Analgesic because it enhances the effect hugely...........So sayeth the "pain team bible".

    Obviously the above advice depends on what your medical problem is & whether you are on any other paracetamol based drug.
     
    • Like Like x 1
  10. Literature in the BMJ sudjests the numbers needed to treat for Tramadol are more than paracetamol and Diclofenac. Surprisingly enough our good old friend Ibuprofen came up tops!

    The sooner you can get off the hard stuff the better. less Pills combined with intensive physiotherapy is the answer (in my opinion).
     
  11. There are lots of very good answers already on here from the nurses and their other halves but I think Tomb has made a particularly imortant point. Ultimately the choice of painkiller will depend on the problem being treated and the individual involved. What suits one person may not be appropriate for another not least because the different classes of painkillers work in different ways. Doctors were also encouraged to use what is called the 'Step Ladder' approach (Mrs TomB - is this approach still current?) to pain which calls for them to choose a type of drug depending on how severe the pain is and to drop to least 'strong' painkiller as soon as that is sufficient to handle the pain or up to stronger drug if pain not controlled.

    ie: Severe pain = Strong opiate (eg morphine)
    Moderate pain = Weak opiates (eg codeine)
    Mild pain = Simple analgesia (eg paracetamol, aspirin, ibuprofen)

    Also, the way the medicine is given is very important. Pethidine may be very useful when injected but the tablets are not very effective at all by comparison. This is due to the availability of the drug when it is swallowed. Tramadol controls pain in a similar way to pethidine, but the body can absorb and use it much better than oral pethidine.

    There was a post some time back ( http://www.arrse.co.uk/cpgn2/Forums/viewtopic/p=83508.html#83508 ) where I gave a bit of a spiel on Non-steroidal Anti Inflammatory drugs (eg Brufen) and Paracetamol. If you want I could do the same for the Opiate drugs which include Pethidine, Morphine, Diamorphine, Buprenorphine and Tramadol. Let me know.

    By the way the use of buprenorphine (Temgesic as P&B explained) is strongly discouraged in most circles as it is not terribly effective and can partially block the effects of other opiod medicines if they are needed.

    Jez
     
  12. That would be physeptone.. Heroin replacement treatment. Doesn't get you high, but stops the craving and stops the heroin working. Ketamine and Subutex are worth enquiring about :lol: :wink:
     
  13. Just to clarify Operators post..... Physeptone is the Trade name for methadone.

    BTW - did you know that the street name for diamorphine is 'heroin'......?
     
  14. i would suggest that if you are going to be using subutex or ketamine a controlled detox program would be worthwhile, rather than going it 'alone'as they will only give you so many on a 'script' at a time
     
  15. So sayeth the voice of experience?