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Acema (Tramadol)
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Acema

Acema is a strong painkiller used to treat moderate to severe pain. It is generally used when non-opioid painkillers don't work as well to control the pain anymore. Acema may cause drowsiness. You shouldn't drive or use heavy machinery or perform dangerous activities until you know how this drug affects you.

Other names for this medication:
Anazac, Antram, Atdol, Bludol, Bolodol, Damadol, Dolex, Gemodol, Hyperdol, Jpdol, Meridol, Muzox, Nictram, Opiran, Oshdol, Painex, Relidol, Sedate, Spasteez, Takol, Taramol, Taxidol, Tragesic, Tramabit, Tramacip, Tramadex, Tramadol, Tramaflam, Tramagesic, Tramak, Tramakind, Tramared, Tramdop, Trandol, Trasic, Trazac, Trectadol, Tridol, Trydol, Tryme, Ultracon, Urgendol, Zytram

Similar Products:
Adalat, Lamisil, Fosamax, Avapro, Minocin, Mestinon, Cenforce, Precose, Protonix

Also known as: Tramadol

Description

Ultram (tramadol) is a pain medicine similar to an opioid. It acts in the central nervous system (CNS) to relieve pain.

Ultram is used to treat moderate to severe pain in adults.

The extended-release form of tramadol (Ultram ER) is for around-the-clock treatment of pain. Ultram ER is not for use on an as-needed basis for pain.

Dosage

Usual Adult Dose for Pain:

Adults (17 years or older): 50 to 100 mg orally every 4 to 6 hours as needed for pain -For patients not requiring rapid onset of analgesic effect: Initial dose: 25 mg orally once a day; titrate in 25 mg increments every 3 days to reach a dose of 25 mg four times a day; thereafter increase by 50 mg as tolerated every 3 days Maximum dose: 400 mg per day.

Usual Adult Dose for Chronic Pain:

Extended-Release (ER): 18 years or older (tramadol-naive): 100 mg orally once a day -Individually titrate in 100 mg increments every 5 days to an effective dose that minimizes adverse reactions -Maximum Dose: 300 mg/day For patients CURRENTLY receiving Immediate-Release (IR) Ultram: Initial Dose: Calculate 24-hour IR requirement and initiate with a total daily ER dose rounded down to the next lowest 100 mg increment orally once a day Conversion from OTHER Opioids: Discontinue all other around the clock opioid drugs prior to initiating therapy -Initial dose: 100 mg ER orally once a day -Individually titrate in 100 mg increments every 5 days to an effective dose that minimizes adverse reactions -Maximum Dose: 300 mg/day.

Usual Geriatric Dose for Pain:

Dose selection should be cautious generally starting at the low end of the dose range Over 75 years: Maximum dose of Immediate-release: 300 mg per day.

Usual Geriatric Dose for Chronic Pain:

Dose selection should be cautious generally starting at the low end of the dose range Over 75 years: Maximum dose of Immediate-release: 300 mg per day.

Usual Pediatric Dose for Pain:

Ultram is not recommended for use in pediatric patients 17 years or older: See Adult Dose.

Detailed Ultram dosage information

Overdose

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include severe drowsiness, pinpoint pupils, slow breathing, or no breathing.

Your doctor may recommend you get naloxone (a medicine to reverse an opioid overdose) and keep it with you at all times. A person caring for you can give the naloxone if you stop breathing or don't wake up. Your caregiver must still get emergency medical help and may need to perform CPR (cardiopulmonary resuscitation) on you while waiting for help to arrive.

Anyone can buy naloxone from a pharmacy or local health department. Make sure any person caring for you knows where you keep naloxone and how to use it.

Storage

Store Acema at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Keep away from heat, moisture, and light. Do not store in the bathroom. Keep Acema out of the reach of children and away from pets.

Side effects

The most common side effects associated with Acema are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

You should not take Ultram ER if you are allergic to it, or if you have:

severe asthma or breathing problems; a stomach or bowel obstruction (including paralytic ileus); if you have recently used alcohol, sedatives, tranquilizers, or narcotic medications; or if you have used an MAO inhibitor in the past 14 days (such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine).

Ultram ER should not be given to a child younger than 12 years old. Ultram ER should not be given to anyone younger than 18 years old.

Do not give Ultram ER to anyone younger than 18 years old who recently had surgery to remove the tonsils or adenoids.

Seizures have occurred in some people taking Ultram ER. Your seizure risk may be higher if you have ever had:

a head injury, epilepsy or other seizure disorder; drug or alcohol addiction; or a metabolic disorder.

Tell your doctor if you have ever had:

breathing problems, sleep apnea; liver or kidney disease; urination problems; problems with your gallbladder, pancreas, or thyroid; a stomach disorder; or mental illness, or suicide attempt.

If you use Ultram ER during pregnancy, your baby could be born with life-threatening withdrawal symptoms, and may need medical treatment for several weeks.

Ask a doctor before using Ultram ER if you are breastfeeding. Tell your doctor if you notice severe drowsiness or slow breathing in the nursing baby.

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It has been reported that in some patients with MS who develop neutralizing antibodies (NAbs) against interferon beta (IFNbeta), antibody levels can initially increase and then decrease thereafter even when treatment is continued. Aggregation of the platelets was induced by adrenaline or ADP and the first and second waves of aggregation were evaluated. On the application and significance of a series of investigations of speech development in aphasic patients. Cross-correlation of the spike trains of two adjacent neurons was found in the range of minus 10 msec to plus 10 msec (which is probably an expression of direct interaction or of a common input) in 6 of 50 pairs analyzed in the unanesthetized state. The integrin alpha9beta1 is expressed on migrating cells, such as leukocytes, and binds to multiple ligands that are present at sites of tissue injury and inflammation. The Facet Orientation of the Subaxial Cervical Spine and the Implications for Cervical Movements and Clinical Conditions. Non-random appearance of Y-chromatin-like fluorescence in the nuclei of thyroid and brain and its chromosomal background. Radiotherapists and chemotherapists are now investigating the feasibility of a nonsurgical treatment for cancer of the esophagus. In enteric bacteria, proteins of the Hha/YmoA family play a role in the regulation of gene expression in response to environmental factors.

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Motilin-antimotilin reaction reveals two antigenic determinants in motilin. Orthotopic neobladder following cystectomy: indications, management, and outcomes. At the end of each semester, each student of the 6 consecutive classes was asked to evaluate the same bitewing radiograph, which had been demonstrated at the start of the semester. The P alpha H is converted into alpha H, which expresses alpha determinants, by passage through molecular sieving columns or by treatment with low levels of Nonidet P-40 or urea. The sexual development of female mice is accelerated by exposure to an adult male or to male urine. Ultrasonography was the most sensitive method for picking up small liver tumors even when compared with angiography, but the findings were non-specific (an echogenic mass was noted in 14 of the 19 lesions). When new quinolone antimicrobial agents (such as OFLX) and aminoglycosides (such as ISP) that possess PAE against both the gram-positive and negative organisms were used there was no difference between ERT of the gram-negative rods and gram-positive coccus. Seven major proteins appear to have age-dependent patterns of synthesis and accumulation in the prostatic fluid.

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The extensive worldwide disease burden attributable to tobacco smoking is reviewed, with particular attention to the epidemiologic and clinical aspects, molecular and cellular mechanisms, and pathophysiology of a variety of smoking-related pulmonary diseases, and the epidemiology and clinical presentation of smoking-related atherosclerotic disease as it affects the cardiovascular system cerebral circulation, the aorta, and the peripheral arterial tree. The information describes service issues, which are predominantly locally determined, and clinical implications, which may be local, national, governmental and international. Vascular endothelial growth factor (VEGF), a factor that is critical for development of the vascular system in mouse embryos, exists as at least three isoforms, VEGF120, VEGF164, and VEGF188. Verbal responding under a fixed-interval schedule: effects of D-amphetamine. Loss of co-linearity by modular polyketide synthases: a mechanism for the evolution of chemical diversity. We studied in vitro the effects of fluvastatin on Th1/Th2 cytokine release in relation to caspase-1 activation, in human peripheral-blood mononuclear cells (PBMC) stimulated or not with Mycobacterium tuberculosis. Predatory behavior of Gambusia affinis in relation to different light colors. This suggests that there is a block in vesicular transport from RER to the Golgi complex, or in fusion of the vesicles with Golgi membranes. The method developed offers a quick, simple and reproducible cellular-based assay for hTERT expression. Optoelectronic markers are placed on a surgical drill, involved bone fragments, the femoral nail, and the fluoroscope to track their positions.

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Fate mapping analysis using a multifunctional Chx10 BAC reporter mouse revealed this process to be direct transdifferentiation of retinal cells into pigmented cells. Most of the major proteins which are phosphorylated in response to insulin or EGF migrated with pH 4.6-6.5 and MW 20000-130000. Reality orientation, a therapy for psychogeriatric patient: a controlled study. Enhanced interleukin-1beta and interleukin-18 release in a patient with chronic infantile neurologic, cutaneous, articular syndrome. Single particle analysis of filamentous and highly elongated macromolecular assemblies. Erythrophagocytosis in the human bone marrow as disclosed by iliacal bone biopsies. A benzodioxanhydroxyethylpiperidine derivative with an acute central hypotensive action, different from that of clonidine.

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Amine synthesis directly from nitroarenes is attractive due to improved step economy and functional group compatibility. Carrageenan administration after BU treatment had no effect on enhancement by BU, which indicated that macrophages were not playing a major role in the observed enhancement. Each risk-management file was analyzed to identify potential causes of adverse outcomes. In contrast, when F9 cells are transfected with a plasmid expressing Myc under control of the SV40 early promoter, resulting cell clones are resistant to differentiation by retinoic acid as shown by the lack of induction of plasminogen activator. Phorbol ester modulation of cyclic AMP accumulation in a primary culture of rat aortic smooth muscle cells. Survey of attitudes of Chinese perinatologists and obstetricians toward non-invasive prenatal genetic testing. Characterizing abnormal mitochondrial structural features may thus provide insight into the underlying pathogenesis of inherited and acquired mitochondrial diseases. Development of epileptic seizures through brain stimulation at low intensity.

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Multiplication of bacteria and bacteriophages in a magnetic field. To determine the cellular basis of the Foxb1 lactation defect we have inserted a tau-lacZ lineage marker into the locus to follow the fate of Foxb1 expressing cells. Diffuse brainstem glioma in a patient with Laurence-Moon-(Bardet-)Biedl syndrome. Flank pain, hematuria, and allergy to intravenous pyelogram dye. Neurogranin expression in stably transfected N2A cell line affects cytosolic calcium level by nitric oxide stimulation.

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In addition, immunohistochemical staining was done to test for the presence of proliferating cell nuclear antigen (PCNA), p53, hMSH2, and hMLH1 in the mucosal tissues. They pay much attention to vascular density which is significantly changed in the uterine tumors. Induction of major histocompatibility complex class I molecules on human neuroblastoma line cells by a flavoid antioxidant. Single injection of quinine in a maximum tolerable dose to BALB/c mice caused morphological changes in the testes and suppressed spermatogenesis. We studied the relationship between osteoprotegerin (OPG)/osteoclastogenesis inhibitory factor (OCIF) concentration in synovial fluid from individuals with osteoarthritis (OA) of the knee and the severity of this condition. ovatus strains examined did not form a distinct group, and their rRNA fragment patterns displayed a marked heterogeneity. Agrippa and Boerhaave: 2 positions in the struggle for certitudo medicinae (medical certainty). In the normal human gastric antrum, the G-cell secretory granules were found to contain both gastrin and the C-terminal progastrin determinants (progastrin 87-93, 87-95 and 93-101). Such categorization would be helpful in identifying illnesses due to sedentary life in special groups of people. Specificity of adoptive chemoimmunotherapy of established syngeneic tumors.

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The effect of ethanol on the concentration of gamma-aminobutyric acid in the rat brain. Amino acid PET allows a sensitive monitoring of a response to various treatment options, the early detection of tumor recurrence, and an improved differentiation of tumor recurrence from posttherapeutic effects. Hand eczema and steroid-refractory chronic hand eczema in general practice: prevalence and initial treatment. Pretreatment of rats with the human recombinant soluble complement receptor-1 resulted in marked attenuation of IgA immune complex-induced lung injury. The myotonolytic activity of a new muscle-relaxant, DS 103-282, was compared with that of diazepam in a randomized double-blind study on thirty patients suffering from acute muscular spasm due to disorders of the cervical and lumbar segments of the spine. No contact inhibition was observed, and the cells proliferated in multi-layer fashion.

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Effect of Gradual Heating and Fat/Oil Type on Fat Stability, Texture, Color, and Microstructure of Meat Batters. Its population is known to be at a high risk of cystic fibrosis (CF). The method allows detection of C1q in human sera diluted 1/20--1/40 and in 5--10 micrograms/ml concentrations of isolated C1q. Sp14A, Sp14D1, and Sp14D2 are clip domain serine proteases that are similar to enzymes with presumed roles in melanization or antimicrobial peptide synthesis. The study suggests the effectiveness of this outpatient tinnitus therapy concept. The key illumination changed every 2 min during daily 1-hr sessions.

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Patient satisfaction with overdentures supported by one-stage TPS implants. Prevalence of antibodies to some viral pathogens, Brucella abortus and Toxoplasma gondii in serum from camels (Camelus dromedarius) in Sudan. Peroxy acid as a partial structure of neocarzinostatin (NCS) chromophore. RWJ 67657 inhibits major proinflammatory mediator production in stimulated RSF at pharmacologically relevant concentrations. Criteria associated with benign lesions, are: regular, trabecular matrix, osteoplastic matrix, exostotic growth, location in the posterior elements, absent soft tissue mass, and bulging of the vertebra.

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Treatment of bronchial obstruction in patients with pulmonary tuberculosis. BES1 regulates the localization of the brassinosteroid receptor BRL3 within the provascular tissue of the Arabidopsis primary root. Selective Gas-Phase Ion/Ion Reactions: Enabling Disulfide Mapping via Oxidation and Cleavage of Disulfide Bonds in Intermolecularly-Linked Polypeptide Ions. Patients were randomized hydroxyurea 500 mg uses to receive one COH cycle with ganirelix or the reference treatment, a long protocol of leuprolide acetate in conjunction with follitropin-beta for injection. Simulation of the opening and closure dynamics of a mechanical valve through a moving deforming mesh algorithm presents a challenge because of the large rotations of the leaflet and of the small gaps between the housing and the leaflets, which make remeshing a critical issue. Geographical information systems (GISs) have made spatiotemporal understanding of geographical patterns possible and have contributed to the identification and analysis of factors relating to health care behaviours and outcomes.

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Genetic and physiological characterization of ciprofloxacin resistance in Pseudomonas aeruginosa PAO. Comparison of the cardiovascular actions of N,N-di-n-propyl dopamine and sodium nitroprusside in conscious and chloralose-anaesthetised dogs. Progressive intrapartum respiratory insufficiency due to pulmonary alveolar proteinosis. The results of the fluorescence indicated that bisphenol A interacted with candida rugose lipase and made tryptophan be exposed to a hydrophobic environment. No evidence was obtained to indicate that the ARDS had been caused by either cytokine release or tumor lysis, and serum human antichimeric antibody was not detected. Biosynthesis of averufin from acetate by Aspergillus parasiticus. We conclude that while oxidative processes may cause toxicity, the arylation of intracellular thiols or nucleophiles also contributes significantly to the cytotoxicity of compounds such as menadione. Improvement of Anaemia in Patients with Primary Myelofibrosis by Low-Dose Thalidomide and Prednisone. The gastrointestinal tract is characterized by a self-renewing epithelium fueled by adult stem cells residing at the glucophage 500 dosage bottom of the intestinal crypt and gastric glands.

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Transfection of constructs carrying the four most frequent haplotypes relative to variants at -66, -156, and -443 fused to the luciferase reporter gene in a panel of different cell lines showed that one haplotype conferred a significantly reduced level of reporter gene expression in all tested cell lines. Two variants of Loma salmonae occur in net-pen reared chinook salmon, Oncorhynchus tshawytscha. Action of stychnine on frog single myelinic nerve fibers studied with the electrophysiological method. However, the role of nucleosomes in transcription is not well understood. Anatomy, histology, and pathology of coronary arteries: a review relevant to new interventional and imaging techniques--Part IV.

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A study of SGPT levels in individuals with and without (HBsAG) was conducted in the village of Plati, Greece. They have been performed using specific antibodies prepared against two distinct synthetic fragments of 7B2 comprising amino acids 23-39 and 117-128 of the native human molecule isolated from pituitary gland. One-year follow-up on the safety and efficacy of isoprinosine for human immunodeficiency virus infection. The advent of transesophageal echocardiography (TEE) has provided a new method for the assessment of aortic valve area (AVA) using planimetry by two-dimensional imaging. Toxicological research on the toxic substances of Penicillium tardum. Bile flow and composition and the biliary clearance of erythritol were observed during secretin, glucagon, or sodium taurocholate choleresis and were compared with control studies. The purpose of this study was to determine if the effects of the DBA/2J derived isa and ipd loci are modified in strain AKXD-28/Ty. Combined application of desensitizing varnish and self-etch adhesives seems to increase microleakage in composite restorations. By systematically varying ingredients of defined and semidefined media, an xanax overdose icd 10 improved medium was found that not only gave polysaccharide preparations of increased viscosity, but also increased yield.

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Interestingly, while several past approaches extract fiber-bundles by can i take prevacid while breastfeeding grouping available fibers on the basis of provided atlases (and, therefore, cannot capture possibly existing fiber-bundles nor represented in the atlases), our approach first clusters available fibers once and for all, and then tries to associate obtained clusters with models provided directly and dynamically by users. Results show that 18 oxidation is inhibited by compounds blocking electron transport (antimycin A, cyanide, rotenone, amytal). Treatment of the neuromuscular complications of human immunodeficiency virus infection. These results suggest a regulatory role for enkephalinergic, GABAergic and glutamatergic afferents onto the basal forebrain cholinergic system within the SI. The hormonal activities of interferon were neutralized by specific rabbit anti-interferon sera. On the successful administration of higher doses of segontin in the treatment of the angina pectoris symptom complex. Change of leukocytic index of intoxication in the pre- and postoperative period in patients with cholecystitis.

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Removal or disruption of this repressor element revealed the presence of elements within the mu enhancer that activate transcription in fibroblasts. The role of the stapedius reflex in poststimulatory auditory fatigue. Dispersion was found to be a dominating attractive force, largest for the stacked structures, and smallest for the coplanar dimers. Gastric emptying of cold beverages in humans: effect of transportable carbohydrates. Although the pathogenesis remains unclear, endothelial dysfunction may be a key factor. Pretreatment with either antihypertensive agent (5 or 10 micrograms/kg, i.v.) significantly potentiated both the degree and duration of the initial elevation in arterial pressure and cardiac contractility promoted by the other compound (10 micrograms/kg, i.v.). Speed of pilocarpine decomposition in humans with clinical symptoms of arteriosclerosis and in experimental hyperlipemia. Post-tetanic twitch potentiation is shown to be ankle joint dependent as well.

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Effect of microgrooved poly-l-lactic (PLA) surfaces on proliferation, cytoskeletal organization, and mineralized matrix formation of rat bone marrow cells. Carbohydrate receptor depletion as an antimicrobial strategy for prevention of urinary tract infection. The comparative study between gadobenate dimeglumine and gadodiamide was performed at 2.0 mmol/kg. A comparison between protein-RNA and protein-DNA complexes showed that whilst base and backbone contacts (both hydrogen bonding and van der Waals) were observed with equal frequency in the protein-RNA complexes, backbone contacts were more dominant in the protein-DNA complexes. In contrast, levels of Cat2 transcript and protein decreased, while Cat3 transcript levels were not affected. Bromocriptine effect on the adrenal cortex was antagonized by sulpiride, whereas its effect on the liver was not changed. Occurrence of heterogenous forms of the subunits of creatine kinase in various muscle and nonmuscle tissues and their behaviour during myogenesis.

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A proposed blind routine quality control system for multichannel analyzers. Antibody engineering includes the introduction of the antibody combining site (variable regions) into a host of architectures including bi and multi-specific formats that further impact the therapeutic properties leading to further advantages and successes in patient treatment. In an attempt to more correctly model in vivo conditions, a method for the isolation and culture of synovial microvascular endothelial cells (SMEC) has been developed. There was a significant increase in Coxsackie B1 and B6 viral titers by complement fixation test, suggesting Coxsackie virus-induced pancreatitis. Ultrasound efficiency rose linearly with input power in sludge at small distances from the transducer. Unusual stereospecificity of the potential antidepressant rolipram on the cyclic AMP generating system from rat brain cortex. Evaluation of medical treatment errors at the Institute of Forensic Medicine Heidelberg 1978 to 1980. It is concluded that the relation of diet to AHD is still controversial, and that the development and severity of the disease cannot be confidently attributed to any single dietary factor nor to blood cholesterol.

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Advanced practice psychiatric nursing education in the United States. To obtain uniform, comparable closing volumes, it is suggested that the subject inspire slowly, control expiratory flow (preferably voluntarily), and not pause between inspiration and expiration. Following up from previous studies, we investigate changes in the base composition of all 12 H-strand proteins and find that variability in proportions of C and T is correlated with location on the genome. At rest there were statistically significant dose-response trends, linear or quadratic, between the cumulative doses of oxprenolol and reductions in systolic pressure, heart rate, and cardiac output and increases in stroke volume and pulmonary wedge pressure. However, the ideal intervention for a preferential functional outcome is not known. Poly I:C-induced interferon production shows quantitative differences in various mouse strains depending on multiple interactions among genes located both inside and outside the major histocompatibility complex. Based on the history and the other findings coronary sclerosis or/and congenital malformations had to be assumed. In eight patients, segmental duplication of 1q12-21 and adjacent bands occurred on nonhomologous chromosomes.

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