Specialist Palliative Care Pharmacist, Independent Prescriber @SouthTees @teessidehospice Views are my own. Mam to 2 humans & 1 wolf, lover of ๐๐ชด๐โจ๐๏ธ
With respect to their opioid action both codeine and tramadol can be considered pro-drugs which are hepatically metabolised into their pharmacologically active forms. This biotransformation shows significant genetic polymorphism, resulting in variable patient response, which at the extremes can range from lack of efficacy to toxicity. As a result, many guidelines (including palliative care, surgical and emergency medicine) advocate for the initiation of small doses of strong opioids in preference to weak opioids, as the former have been shown to provide more predictable and superior pain relief without an increase in adverse effect burden.
As a result, the initiation of tramadol is rarely appropriate and often goes against current evidence and guidance. ย This is all the more true in situations where tramadol may pose a unique risk, such as bleeding with warfarin. Exploration of other analgesic options is likely the best option..
Would you or anyone you know like to work in a growing and progressive pharmacy team with amazing opportunities for development?! If so hit the link and come work at @steespharmacy
Accepting full and part time for the right candidate ๐
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Docusate aimed high, constipation's foe, But the stubborn blockade refused to go. Movicol stepped in with a confident grin, Breaking the chains, letting relief begin.
@suzieedge It's called birthing 2 kids and having the mental load of being their mum and it doesn't get easier getting back into it, Mr Edge! ๐ซ ๐คฆ๐ผโโ๏ธ
heard that a friend of mine died in October. I call her a friend though we hadn't spoken in years, we started the very same day in our first job as a qualified pharmacists. She was quieter than me, but she had plenty to say. She had the most beautiful smile, it lit up the room.
We went in different directions and lost touch over the years other than the odd well wishing social media interaction. She leaves a young son behind, I hope he learns what a wonderful person his mum was โจ
She was kind, warm and caring. She'd listen and give her opinion gently. We went through the perculier once in a lifetime experience of started a new career in a new hospital together.
@DonnaWakefield_ ๐คฃ honestly i get so frustrated. Doesn't help i have an independent-I-can-fix-everything-myself personality as you defo need a masters in fixing printers which I do not have!