<!--
 var howMany = 9
  var quote = new Array(howMany+1)
  quote[0]="<h3>Hydrocodone: Prescription Drug Abuse & Testing</h3><p><a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Hydrocodone\">Hydrocodone</a> or dihydrocodeinone is a semi-synthetic opioid derived from two of the naturally occurring opiates, codeine and thebaine. </p> <p>   <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Hydrocodone\">Hydrocodone</a> Prescription, Dosage & Administration:</p> <p>   Hydrocodone is an orally active, narcotic analgesic and antitussive. Being a narcotic analgesic, it is prescribed for the relief of moderate to severe pain & being a antitussive, it is prescribed as a medicine used to suppress or relieve coughing.  </p> <p>   Hydrocodone comes both as a tablet and also in liquid form & thus can easily be taken orally. 5 mg of hydrocodone is equivalent to 30 mg of codeine when administered orally. Earlier hydrocodone and morphine were considered equipotent for pain control in humans. However, it is now considered that a dose of 15 mg of hydrocodone is equivalent to 10 mg of morphine. Hydrocodone is considered to be morphine-like in all respects and thus, final dosage is adjusted by physician according to the severity of the pain and the response of the patient.</p> <p>   Hydrocodone Abuse:</p> <p>Vicodin i.e. hydrocodone in combination with acetaminophen, is a commonly abused version of hydrocodone in United States and Canada. Vicodin, as with all narcotic analgesics, can be habit forming—causing dependence, tolerance, and withdrawal symptoms if not used as it is prescribed. The presence of acetaminophen in hydrocodone-containing products deters many drug users from taking excessive amounts. </p> <p>   Effects of Hydrocodone Abuse:</p> <p>   Some of the common side effects of drug abuse include dizziness, lightheadedness, nausea, drowsiness, euphoria, vomiting, and constipation. Some of the lesser common side effects are various allergic reactions, blood disorders, mood swings, mental fogginess, anxiety, lethargy, difficulty in urinating, ureter spasms, rashes and irregular or depressed respiration etc.</p> <p>   Physical Dependence on Hydrocodone:</p> <p>   Opioid analgesics such as Hydrocodone may cause psychological and physical dependence. Physical dependence results in withdrawal symptoms in patients who abruptly discontinue the drug. Physical dependence usually does not occur to a clinically significant degree until after several weeks of continued opioid usage, but it may occur after as little as a week of opioid use. </p> <p>   Commercial Status in United States:</p> <p>   There are over 200 products containing hydrocodone in the U.S. When sold commercially in the US, hydrocodone is always combined with another medication due to a separate federal regulation. In its most usual forms, hydrocodone is combined with acetaminophen. Such commercial hydrocodone products which are combined with acetaminophen are known by various trademark names such as Vicodin & Lortab. Hydrocodone also can be combined with aspirin (Trade name: Lortab ASA), ibuprofen (Trade name: Vicoprofen), & certain antihistamines (Trade name: Hycomine). </p> <p>   Pure Hydrocodone tablets or capsules are not offered currently by any USA drug company. The cough preparation Codiclear DH is the purest available US hydrocodone item, containing guaifenesin and small amounts of ethanol as active ingredients.</p> <p>   With such a huge number of Hydrocodone containing products, the possibility of misuse and addiction remains substantial. As a result, Sales and production of this drug has increased significantly in recent years & so has its diversion and illicit use. To limit abuse of opioid drugs like Dilaudid it is necessary to properly assess the patient, employ proper prescription practices, periodically re-evaluate the opioid therapy, and properly dispense and store the drugs.</p> <p>   Hydrocodone Testing:</p> <p>   Hydrocodone may not cause a positive result in a standard opiate urine test. Many opiate tests test only for morphine (which both codeine and heroin break down into). This is true for both home/business kits and laboratory testing. </p> <p>   However, there are several specialized home and laboratory testing kits available that specifically detects hydrocodone (& hydromorphone, its metabolic product). So test results usually depend on the particular type of test that is used and whether or not laboratory verification is done. If a home drug test is given and the opiate test shows a positive result (due to hydromorphone use), laboratory verification might not result in a positive test because the lab may only test for morphine.</p> "
  quote[1]="<h3>Medication Error : an Abuse for Patients</h3><p> </p> <p>Medication Error : An Abuse For Patient</p> </p> <p>Kamal Shah1*, Nagendra Singh2, Jiteendra Ku. Gupta1 and Pradeep Mishra3</p> <p> </p> <p>Lecturer, GLA Institute of Pharmaceutical Research, Mathura (U.P.)*,1</p> <p>Research scholar, Dr. H.S. Gour University, Sagar (M.P.)2</p> <p>Director, GLA Institute of Pharmaceutical Research, Mathura (U.P.)3</p> <p> </p> <p> </p> <p>A medication error is “any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer “.1 or Medication errors, defined as any error in the prescribing, dispensing or administration of a drug whether there are adverse consequences or not, are the single most preventable cause of patient injury.2,3 These errors can occur at any stage in the drug use process from prescribing to administration to the patient.</p> <p> </p> <p>A recent report by the Institute of Medicine (IOM) estimated that errors in medical management cause between 44,000 and 98,000 deaths each year in USA hospitals. In the USA it has been suggested that the rate of serious medication error is approximately 7%.4</p> <p> </p> <p>Examples 5-6</p> <p>1) Hydrocodone is the narcotic ingredient that controls cough, can cause life-threatening breathing problems when given in overdose or when the medicine is given more frequently than recommended. It should not be used in children less than 6 years old. On March 11, 2008, FDA reports indicate that health care professionals have prescribed hydrocodone for patients younger than the approved aged group of 6 years old and older, more frequently than the labeled dosing interval of every 12 hours (”extended release”), and that patients have administered the incorrect dose due to misinterpretation of the dosing directions.</p> <p>2) A physician ordered a 260-milligram preparation of Taxol for a patient, but the pharmacist prepared 260 milligrams of Taxotere instead. Both are chemotherapy drugs used for different types of cancer and with different recommended doses. The patient died several days later, though the death couldn’t be linked to the error because the patient was already severely ill.</p> <p>3) An elderly patient with rheumatoid arthritis died after receiving an overdose of methotrexate–a 10-milligram daily dose of the drug rather than the intended 10-milligram weekly dose. Some dosing mix-ups have occurred because daily dosing of methotrexate is typically used to treat people with cancer, while low weekly doses of the drug have been prescribed for other conditions, such as arthritis, asthma, and inflammatory bowel disease.</p> <p>4) One patient died because 20 units of insulin was abbreviated as “20 U,” but the “U” was mistaken for a “zero.” As a result, a dose of 200 units of insulin was accidentally injected.</p> <p>5) A man died after his wife mistakenly applied six transdermal patches to his skin at one time. The multiple patches delivered an overdose of the narcotic pain medicine fentanyl through his skin.</p> <p> </p> <p>6) A patient developed a fatal hemorrhage when given another patient’s prescription for the blood thinner warfarin.</p> <p>There are some other causes of medication errors i.e. poor communication, misinterpreted handwriting, drug name confusion, lack of employee knowledge, and lack of patient understanding about a drug’s directions. In most cases, medication errors can’t be blamed on a single person.</p> <p> </p> <p>Types of Medication Errors</p> <p> Medication errors can be broadly classified as prescribing, dispensing or drug administration errors :</p> <p>Prescribing Errors</p> </p> <p>Prescribing errors may be defined as an incorrect drug selection for a patient, be it the dose, the strength, the route, the quantity, the indication, the contraindications.7</p> <p>Dispensing Errors</p> <p>Dispensing errors are errors that occur at any stage during the dispensing process from the receipt of a prescription in the pharmacy through to the supply of a dispensed product to the patient. These errors include the selection of the wrong strength/product. This occurs primarily when two or more drugs have a similar appearance or similar name (look-a-like/sound-a-like errors ). Other potential dispensing errors include wrong dose, wrong drug, wrong patient.8</p> <p>Administration Errors</p> <p>The “five rights” have long been the basis for nurse education on drug administration i.e. giving the right dose of the right drug to the right patient at the right time by the right route. Drug administration errors largely involve errors of omission where administration is omitted due to a variety of factors e.g wrong patient, lack of stock. Other types of drug administration errors include wrong administration technique, administration of expired drugs and wrong preparation administered.9-10</p> <p>Additional factors to prescribing error are: 11</p> <p>Illegible      handwriting </p> <p>Inaccurate      drug history taking </p> <p>Confusion in      drug name </p> <p>Inappropriate      use of decimal points </p> <p>Use of      abbreviations </p> <p>Use of      verbal orders </p> <p> <p> </p> <p>Lack of knowledge of the prescribed drug, the recommended dose and the patient may also contribute to prescribing errors. Other factors include poor dispensing procedures with inadequate checking, unreasonable workloads and poor housekeeping standards. Studies have also supported an association between dispensing errors and lighting levels, prescription workload and noise. It is suspected that distractions and interruptions can lead to performance errors. In addition, not challenging unusual doses, dispensing unfamiliar products, dispensing before seeing a written order may lead to errors.12</p> <p>Methods of Minimizing Medication Error13 </p> <p>Medication errors can be prevented by as follows:</p> <p>- By alterations in the system for ordering, dispensing and administration of drugs.</p> <p>- The use of computerized physician order entry systems.</p> <p>- Correct knowledge of a drug before prescribing</p> <p>- Printing the drug name and patient details clearly on the prescription</p> <p>- Includes all details of drug therapy i.e. name of drug, dose, directions, duration of therapy</p> <p>- Not leaving a decimal point “naked”. A zero should always precede expression of values e.g 0.1. Ten-fold errors in dose have occurred due to the use of a trailing zero.</p> <p>- Avoiding the use of abbreviations e.g. AZT, ISMN, FeSO4, U.</p> <p>- Being aware of sound-a-like products.</p> <p>Bar code label rule: After a public meeting in July 2002, the FDA decided to propose a new rule requiring bar codes on certain drug and biological product labels. Health care professionals would use bar code scanning equipment, similar to that used in supermarkets, to make sure that the right drug in the right dose and route of administration is given to the right patient at the right time.</p> <p>Drug name confusion: To minimize confusion between drug names that look or sound alike, the FDA reviews about 300 drug names a year before they are marketed.The agency tests drug names with the help of about 120 FDA health professionals who volunteer to simulate real-life drug order situations.</p> <p>The last time the FDA changed a drug name after it was approved was in 1994 when the thyroid medicine Levoxine was being confused with the heart medicine Lanoxin (digoxin), and some people were hospitalized as a result. Now the thyroid medicine is called Levoxyl, and the agency hasn’t received reports of errors since the name change.</p> <p>Drug labeling: The label clearly lists active ingredients, uses, warnings, dosage, directions, other information, such as how to store the medicine, and inactive ingredients.14</p> <p>Reductions in dispensing errors done by:</p> <p>Use of safe      dispensing procedure.</p> <p>Using      different brands or separating products that look-a-like.</p> <p>Focusing on      the task in hand, keeping interruptions to a minimum and maintaining their      workload at a safe and manageable level.</p> <p>Being aware      of high risk drugs e.g. Potassium chloride, cytotoxic agents </p> <p>Introducing      good housekeeping practices.</p> <p> </p> <p>Drug administration errors may be reduced by:</p> <p>Checking      patient identity.</p> <p>Dosage      calculations checked independently before the drug is administered.</p> <p>Ensuring      that medication is given at the correct time.</p> <p> </p> <p>Conclusion </p> <p>When healthcare professionals gives a prescription, ask him or her to tell the name of the drug, the correct dosage, and what the drug is used for. Be sure to understand the directions for any medications including the correct dosage, storage requirements, and any special instructions. In the hospital, ask (or have a relative or friend ask) the name and purpose of each drug given. Be sure to tell the doctor the names of all the prescription and non-prescription drugs, dietary supplements, and herbal preparations you are taking every time he or she writes you a new prescription. This will help to prevent another type of medication problem, undesirable and potentially serious interactions among medications. Finally, never be afraid to ask questions. If the name of the drug on your prescription looks different than expected, if the directions appear different than the thought, or if the pills or medication itself looks different, tell your doctor or pharmacist right away. Asking questions if you have any suspicions at all is a free and easy way to ensure that you don’t become the victim of a medication error.<br /> Each healthcare professional shares a responsibility for identifying contributing factors to medication errors and for using that knowledge to reduce their occurrence. Both experienced and inexperienced staff may be responsible for medication errors. A multidisciplinary approach to solving this problem should be promoted whereby all parties address the issue of reducing medication error occurrence. Development of a multidisciplinary approach has been slow, possibly due to the reluctance or unwillingness of the doctor, pharmacist or nurse to admit to a medication error.</p> <p> </p> <p>References:</p> <p> </p> <p>1. http://www.nccmerp.org/aboutMedErrors.html</p> <p>2. Am J Health-Syst Pharm 1995; 52:379-82.</p> <p>3. BMJ 2000;320:774-7</p> <p>4. NEJM 2000; 342: 1123-5.</p> <p>5. www.fda.gov/bbs/topics/NEWS/2008/NEW01805.html</p> <p>6. www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=11623</p> <p>7. Am J Hosp Pharm 1993;50:305-14</p> <p>8. C&D 1997 (Feb);P1-P2</p> <p>9. Am J Health-Syst Pharm 1995;52:390-5</p> <p>10. Drug Safety 2000;22:321-33</p> <p>11. Am J Health-Syst Pharm 1995; 52:382-5</p> <p>12. Am J Health-Syst Pharm 1995; 52:369-416.</p> <p>13. Drug Safety 1996; 15: 303-10.</p> <p>14.  www.fda.gov/consumer/updates/medicationerrors031408.html</p> <p> </p> "
  quote[2]="<h3>What to Know About <b>Tramadol</b></h3><p>We all know that not all people are aware of what <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a> is. Upon hearing the name, several questions may come to mind. Questions such as, “What is <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a>?”, “Do I need <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a>?”, and “Will <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a> be of importance to me in any way?” Also, one may think whether <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a> is harmful or not, who should be asked for more information about it, and what benefits can be derived from it? Several considerations must indeed be taken first prior to any action.</p> <p>   For the sake of added knowledge as well as for the benefit of those who really have no idea what <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a> is, I made a simple research about it. Based on the sources I have obtained, <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a> is simply a medicine. However, unlike its simple description, the reputation of this medication as a pain reliever is widely-known. One contributing factor to its being recognized must be because it is currently one of the most prescribed pain relievers available. If by any chance you are experiencing mild to severe pain right now and you have difficulty in finding an appropriate medicine as treatment, I just provided you one of the best possible solutions. Tramadol is most appropriately used for treatment of moderate to severe pain which may be concomitant to other health problems. Moreover, aside from being used as a pain reliever, Tramadol is also said to be possibly effective for alleviating symptoms of depression and anxiety. It is even sometimes used after surgery and for muscoskeletal injuries among other things. Just another interesting information about this medication, Tramadol is actually the chemical name of medicine brands Ultracet or Ultram. </p> <p>   In terms of usage, before taking Tramadol, you must see your doctor first to determine how to avoid certain complications. If you had previously experienced allergic reactions toward this type of medicine, never attempt to make use of this anymore. If you are wondering where this type of medication can be found, Tramadol is now available at certain online drugstores as well as in several drugstores in your area. If purchasing online is more convenient and more advantageous for you, then choose that mode of obtaining the medication. However, you must always review first the reputation and operations of each online drugstore site you visit to differentiate which among those will you be able to trust. </p> <p>   Finally, after obtaining the medication and after already using it, always observe for possible symptoms of Tramadol overdose such as insomnia, restlessness, tremor, nausea, vomiting, diarrhea, abdominal pains, sweating, seizures, drowsiness, decreased breathing, dizziness or fainting, confusion, and irregular heartbeats. This is just for precautionary purposes and to avoid further complications. Instances of overdosage are rare when a doctor’s prescription is strictly adhered to. However, when placed in this kind of situation where you or a person you know is experiencing the symptoms, the best possible action is to proceed immediately to a medical facility or to at least report the incident to a knowledgeable professional to obtain proper treatment.</p> "
  quote[3]="<h3>A Study On The Natural Remedies For Your Common Health Problems</h3><p>Let take a look on what conventional medicine has to offer, suppose you are sick and suffered from migraine headaches. Every time when you approach your physicians, they will certainly be helpful by giving you a diagnosis of your condition. Most likely, you’ll also walk out of the physician’s office with a prescription medications like Maxalt,  <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Imitrex\">Imitrex</a>, and the other “triptan-class” formulations that help you relieve the pain. The prescription medications may not work well for you, what worse some has side effects that make you just as unpleasant as having the headache.  So do you have another choice of treatment?</p> <p>  The answer is definitely YES, perhaps it is time for you to consider trying a natural remedy.   What is natural remedy? Natural Remedy is a form of unconventional medicine or alternative medicine, which is not inside the “mainstream” of Western health care.  Natural remedy has been practiced in ancient civilizations for many, many years. The healers today still collect herbs, roots, plants, minerals, and other naturally-occurring substances to relieve pain, to prevent illness and even cure some diseases. On top of this,  Natural Remedy also includes acupuncture, homeopathy, hypnotherapy, acupressure and biofeedback.</p> <p>  Are Natural Remedies Safe?</p> <p>  This depends on the skill of the healers that prepares or administers it and the natural of herbal substances used.  The herbal substances usually used by healers are not regulated by the FDA, and healers of the art are not licensed,  no qualification or held to particular standards of practice. Most healers learn their skill by word of mouth, demonstration and well-researched books on the herbal substances.</p> <p>  If you follow the FDA, natural remedies or herbal substances should never be apply on serious diseases and conditions, especially if the diseases exit for a period of time.  It is also must be careful when used to treat children, by nursing or pregnant mothers, or with pets.  It is very important that you inform your doctors if you are using herbal substances because they may negatively interact with laboratory tests and prescription medications.  If you develop unusual side effects while using nature herbal substances, stop taking them and inform your doctor.  </p> <p>  All herbal substances should be purchased from a good reputation stores or well-known sources.  Likewise, for acupuncture it should be provided by a licensed doctor, legitimate expert by the professional references from exiting patient or who can prove his or her success through personal.</p> <p>  Before you are using any herbal substance, do some study and ask what it contains and probably know how the ingredients work.  Be especially careful when using tinctures, as it contain alcohol. So patients who have problems on chemical dependency should avoid using tinctures to treat.</p> <p>  It is highly not recommended to use the natural remedies for self-treating without consult an expert, doctor or done your homework. Many trustworthy companies provide instruction, CD and consultation about how to safely use their herbs products. It is beneficial for you if you can read some book on herbal medicine and natural remedies, as some of these herbs, plants and berries may be poisonous when consumed it. If you have horrible side effects from any of these forms of alternative medicine, you need to stop it and consult your doctors.  </p> <p>  Many Useful Herbs Aid in Healing Process</p> <p>  Let take a look on some of this useful nature herbs that the healers always use for some treatments.</p> <p>  Ginger<br />  It is being used for against vomiting, nausea, and quieting irritated bowels. It is also well know as a highly touted herb for muscle and joint pain relief, and Aid in relief the pain of migraine headaches. Please take note when using ginger, if you already suffer from high blood pressure or hypertension, you should consult the doctor first as the nature of ginger also tends to raise blood pressure.</p> <p>  Aloe Vera plant<br />  This is a unique plant from Africa, it has 25 pointed leaves on its body, each leaves containing a gel, which has been well known to aid in healing abrasions, burns and cuts. It is considered one of the best nature herbal for healing.</p> <p>  Ginkgo Biloba<br />  Many study reported that Ginkgo Biloba has help to ease breast soreness and mood swings during episodes of PMS. It also has benefits of increasing memory, improving libido and working to treat erectile dysfunction. Ginkgo Biloba is often used as a natural healing remedy by healers.</p> <p>  Dandelion <br />  It is a wonderful herb for your liver. If your hormones are imbalance, then your liver is over stress, and dandelion root will be beneficial for this.</p> <p>  Kava<br />  This Plant is from the south Pacific. It is a member of the peppercorn family and is highly regarded as a mood enhancer. It has been found to aid in anxiety and fatigue and produce a positive feeling bordering on intoxication.</p> <p>  Ginseng<br />  It strengthens the adrenal glands, increases energy, enhances immune function, and normalizes blood pressure. It is useful for symptoms of both physical fatigue and mental. Avoid it if you have very high hypertension (over 180/100). </p> <p>  Is Time To Study And Make Use Of Nature Herbs</p> <p>  Many of us are fed up with risky, costly and ineffective conventional medicine.</p> <p>  More and more people made more visits to alternative practitioners than to primary care physicians. Furthermore, preventing disease is less costly than curing. Many of us can’t afford the conventional medical system anymore. We need a new healing paradigm, which promotes health rather than curing disease.</p> "
  quote[4]="<h3>Pain Killer Addiction Guide</h3><p>If pain killers are taken exactly as prescribed, they are safe and will rarely cause addiction.  And yet addiction to prescription pain killers is growing.  The most common medications that can cause this are opiods (sometimes called narcotics) and include morphine, codeine and others in the same group. </p> <p>  Research shows that every year, almost 2 million Americans use prescription opiod painkillers.  In some communities, addiction to painkillers has now overtaken the use of cocaine and marijuana.  9% of the population admit to having used pain killers illegally. </p> <p>  Morphine is often used after surgery for the control and alleviation of severe pain.  Codeine is more common and can deal with milder pain.  Opiods work by attaching to proteins in the brain, spine and digestive tract.  These proteins are called opiod receptors.  When an opiod attaches to a receptor, they can change the way a person feels pain.   </p> <p>  SO HOW DO PEOPLE GET ADDICTED TO THEM?</p> <p>  They can also affect how pleasure is experienced and this is why many opiods give a feeling of euphoria when they are taken. </p> <p>  People who become addicted start out by taking pain killers for longer than they should do, to get this intial euphoria. The problem is that if pain killers are used for a long time, the body can become tolerant to that medication.  This means that higher and higher doses must be taken to get the same effect.  It also means that the body has adjusted to operating normally with that level of pain killers, and so if the pain killers are stopped, or reduced, withdrawal symptoms can occur. </p> <p>  COLD TURKEY</p> <p>  Symptoms of drug withdrawal ae extremely unpleasant and can involve restlessness, pain in the bones and muscles, insomnia, diarhea, vomiting and involuntary leg movements.  Withdrawal is called ‘cold turkey’ because another major symptom is cold flashes with goose bumps on the skin. </p> <p>  WHY DO PEOPLE NEED HELP TO QUIT - CAN’T THEY JUST STOP?</p> <p>  If these drugs are used for a long time, they will eventually change the brain in fundamental ways.  They take over the normal pleasure and motivational systems of the brain - pushing the need for drugs up to the highest priority.  The need for drugs therefore overrides all of the person’s previous motivations, behaviours and drives.  This is the domineering compulsion to find and use drugs, and what is called addiction.   </p> <p>  Once addicted to drugs, people feign illness and visit different doctors to obtain prescriptions, buy drugs on the street, steal and lie to obtain their ‘fix’.  It is not a personality choice - it’s a medical need or craving, generated by the affect that the chemical has imposed on the brain. </p> <p>  WHAT HAPPENS IN REHAB?</p> <p>  Celebrities seem to go into rehabilitation {rehab) with alarming frequency.  Rehab is a place where people are medically supervised to come off their addiction, in an effort to reduce or avoid withdrawal symptoms.  The addiction can be to pain killers, recreational drugs or alcohol. </p> <p>  The client is medically detoxified - which means that medications may be given to help them through the withdrawal phase.  Detoxification is not a treatment for addiction - it simply removes the addictive substance from the person’s system so that they can start thinking clearly again.  Detox is usually followed by counselling and behavioural therapy to try and help the client to avoid returning to the addiction. </p> <p>  Celebrities and their alleged pain killer addictions:</p> <p>  * Kathleen Turner - pain killers and alcohol.</p> <p>  * Daniel Baldwin - pain killers originally for a back problem. </p> <p>  * Anna Nicole Smith - vicodin.</p> <p>  * Matthew Perry - vicodin.</p> <p>  * Jerry Lewis - allegedly went into rehab for prednisone addiction at the age of 77!</p> "
  quote[5]="<h3>Common Medications for Dental Pain (Part 2)</h3><p>In part 1, nonnarcotic pain medications for dental pain are discussed.  Dentists use these medications for relieving mild to moderate oral pain.  This article describes the narcotic medications. For moderate to severe dental pain, the typical medications are:</p> <p>• <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a> (Ultram), 50mg every 6 hours as needed for pain.  • <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a> with acetaminophen (Ultracet, containing 37.5 mg <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a> hydrochloride and 325 mg acetaminophen), one table every 6 hours as needed for pain. • Acetaminophen (Tylenol#4, containing 60 mg Codeine Phosphate and 300 mg Acetaminophen), one table every 4-6 hours as needed for pain. </p> <p>For severe pain, opioid combinations are advised.  For example, one Vicodin ES (10 mg hydrocodone and 750 mg acetaminophen), can be taken every 4-6 hours as needed for pain.</p> <p>Opioids: Opioids are narcotic agents that act on the central nervous system. Side effects—including nausea, constipation, dizziness, sedation and respiratory depression—are common with opioid therapy. However, the relative risk of opioidlike side effects varies.  </p> <p>Although opioids as a class are effective dental pain reliever, some commonly used formulas show poor efficacy for dental pain.   Other drugs with fewer severe side effects can have similar results. For examples, codeine alone has not been found as effective as other common analgesics (acetaminophen and NSAIDs) for relief of dental pain. Oxycodone, hydrocodone and propoxyphene are about as effective as codeine.   Dihydrocodeine, penta-zocine and meperidine show no advantages over codeine orally and can even be less effective. Their effectiveness in combination therapy (combining opiods with acetaminophen and NSADs) is better than that in monotherapy. </p> <p>Tramadol: Tramadol is a synthetic, centrally acting pain reliever.  It is indicated for moderate to moderately severe oral pain. Its analgesic action affects both opioid receptor and serotonin uptake. This suggests that tramadol’s effect is not mainly through narcotic mechanism.  Tramadol, thus, is a nonscheduled drug.  The serious side effects typically associated with opioids—such as dependence, sedation, respiratory depression and constipation—occur less often with this medication.  Tramadol also has a low rate of abuse, about one per 100,000 persons.  The side effects commonly seen with tramadol include nausea, dizziness, drowsiness and tiredness. </p> <p>Tramadol’s lack of sedation is particularly important for same-day dental surgery. Tramadol does not have the same side-effects like NSAIDs or traditional opioids. Adverse side effects generally are mild and transient. Importantly, tramadol does not have the ceiling dose effect common to many other analgesics. Recent studies show that tramadol is a good postsurgical and dental pain killer. They also show that tramadol has a dose-response effect. For instance, in one study they reviewed, tramadol 200 mg was more effective than 100 mg after third-molar extraction.  Unlike aspirin and acetaminophen with codeine, which have an analgesic duration of about four hours, tramadol provides analgesia for five to six hours after dental surgery. </p> <p>Benzodiazepines are increasingly being used to decrease patient’s anxiety. Their sedative, “anxiety-reducing” and “forgetful” properties, along with their mild respiratory depression, are especially helpful for lowering the “view” of dental pain. By reducing the dental fear, the patient becomes less sensitive to painful stimuli. </p> <p>Midazolam: Midazolam has the ability to decrease postoperative anxiety. It provides complete surgical amnesia (memory blockage) that lasts about 25 minutes.  A multidrug combination of fentanyl, midazolam and metho-hexital (commonly used in intraveous sedation for wisdom teeth removals) gives better pain control but produced deeper sedation. </p> <p>Treatment of anxiety related to dental procedures is most worthwhile for children. Extreme preoperative apprehension may need more anesthesia and lead to postoperative negative effects. Oral midazolam has been shown to produce significant amnesia in children when it is given10 minutes before a surgical procedure. Recent clinical trial of oral tramadol mixed with midazolam provides effective pain relief during and after surgical procedures for kids.</p> <p>Diazepam:  Diazepam is another useful benzodiazepine that treats oral pain associated with muscle spasm. However, its use is limited by long-term sedation, abuse potential and dependence potential. Diazepam may have additive side effects with other central nervous system depressants. Combinations of benzodiazepine and opioids are used widely for conscious sedation but are associated with significant risks. These combinations may be safely used only under adequate cardiopulmonary monitoring.</p> "
  quote[6]="<h3>Arthritis Pain Relief With Liquid Glucosamine</h3><p> </p> <p> <p>Arthritis is one of those conditions that can really foul up your day. For anyone having to deal with chronic pain, even simple everyday tasks can be excruciating. As most sufferers know arthritis is a degenerative bone disease that causes the bones and of your body to slowly deteriorate over time. This often leads to swelling and inflammation in your joints. This can lead to a severe loss of mobility. I imagine it would be easy to get depressed if you’ve always led an active life. This is what leads many people to look for some sort of natural arthritis pain relief.</p> <p> <p> </p> <p> <p>There are literally millions of people who experience arthritis pain and a lot of them are looking for a way to get pain relief without using prescription drugs. While these medications can be effective many of them come with harsh side effects. There is a lot to be said for alternative exercises such as Tai Chi and Yoga, and many folks have found relief with water aerobics.</p> <p> <p> </p> <p> <p>Liquid glucosamine is a natural treatment that has helped thousands of people deal with arthritis pain. With an effective dosage of 1500 mg, liquid glucosamine can relieve the pain of arthritis, stop its progress and is said to even help repair the damage caused by the disease. Often combined with chondroitin, liquid glucosamine is a safe and effective change from using prescription drugs.</p> <p> <p> </p> <p> <p>Liquid glucosamine products such as the popular Syn-Flex are easier for your body to absorb than tablets and this can give you faster arthritis pain relief. The New England Journal of Medicine reported that glucosamine when combined with chondroitin actually reduced moderate to severe joint pain even better then Celebrex.</p> <p> <p> </p> <p> <p>Syn-Flex products have been available for years online and they even have one specifically for your pets. If you’ve decided you’re not going to let arthritis pain ruin your active life, do yourself a favor and check out liquid glucosamine.</p> <p> <p> </p> "
  quote[7]="<h3>“me-too” Drugs: Good or Bad?</h3><p>Introduction</p> <p>   A drug that is structurally very similar to already known drugs, with only minor differences. The term “me-too” carries a negative connotation. However, me-too products may create competition and drive prices down1.</p> <p>   The majority of the new products the industry puts out, are “me-too” drugs, which are almost identical to current treatments but “no better than drugs already on the market to treat the same condition.” Around 75 percent of new drugs approved by the FDA are me-too drugs. They can be less effective than current drugs, but as long as they’re more effective than a placebo, they can get the regulatory green light2. </p> <p>   This isn’t surprising at all, as someone who works in the field, but these so-called “me-too” drugs, which are reportedly better than their forebears, is driving costs. A “me-too” drug is a drug that has its origins in another drug. Probably the most famous example of this is Prilosec (“The Purple Pill”) and Nexium (“Today’s Purple Pill”). Prilosec’s active ingredient is omeprazole. Nexium’s active ingredient is called esomeprazole. The difference is that Nexium is the left-handed version of omeprazole. In chemistry, S stands for sinister, which means the molecular conformation has a left-handed orientation. (D would be right handed.) So this S-omeprazole is one half of the mixture that comprises its predecessor. By specifically picking only the S conformation, the drug is made more potent. This sounds great, but its efficacy is only marginally better than Prilosec-, which has a generic version, and costs about a third less than Nexium. Some other “me-too” drugs are: Claritin (loratidine) and Clarinex (desloratidine), Celexa (citalopram) and Lexapro (escitalopram)3. </p> <p>   What are “Me-Too” drugs?</p> <p>   Ever since the advent of modern chemotherapy, when drugs were discovered and developed through the process of screening thousands of molecules for a variety of disease conditions, using animal models, there has been a growing criticism that too many molecules were developed with similar chemical structure and the same pharmacological profile, with very little to distinguish them from each other in terms of their therapeutic utility. In other words, once the first breakthrough discovery is made of a new pharmacological activity for a new molecule, subsequent years saw the emergence of a host of new molecules or “me-too” drugs from the same chemical class and possessing the same pharmacological profile. </p> <p>   Such follow-up drugs have been termed molecular modifications, molecular roulettes or copycats, the development of which are alleged to be motivated by purely commercial considerations. They are also deemed to involve lower levels of innovation, compared to the original molecule. It is important to analyze in a historical perspective the end results of such efforts in different therapeutic areas of developing new molecular entities, as later generation products, after an initial breakthrough discovery has been made and the technical, medical and commercial merits of developing such drugs.</p> <p>   Development of “Me-Too” drugs</p> <p>   The success rate in the discovery of new chemical entities with fundamentally new chemical and biological profiles of activity are very low. In fact, even chemical entities within the same structural class of an approved drug are becoming rare now, compared to the period of sixties to eighties. In 2001, $ 26 billion was spent on developing new drugs and the U.S. FDA approved only 9 new chemical entities. At the same time, two thirds of the drugs approved from 1989 to 2000 were modified versions of existing drugs or even identical to those, in newer forms and formulations4. </p> <p>   Of the 1,035 drugs approved by FDA during 1989 to 2000, only 361 or 35% contained new active ingredients. Of these, only fewer than half were granted priority review status by the FDA. One impression is that these drugs are slightly altered versions of existing drugs, with little to offer in terms of better activity or tolerance, let alone new pharmacological profiles. The implication is that such drugs are developed, as patents on top-selling original drugs run out and not many truly new medicines are discovered. The indication that many of these drugs do not offer any major advantages over existing drugs is given by FDA’s unwillingness to grant priority review for most of them. </p> <p>   On the other hand, conventionally, the Regulatory Agencies, including the FDA, are not obliged to consider better efficacy over existing drugs as a criterion for approval; rather, they require only the establishment of efficacy and safety of the new drug over a placebo.</p> <p>    How good are they?</p> <p>   Notwithstanding such perceptions, historically, many “me-too” drugs have proved to be considerably better than their original counterparts. Examples are a series of generations of beta-blockers, which came up after the original drug Propanalol was discovered by ICI, with most of them having merits in terms of better efficacy, cardio-selectivity and safety. Ranitidine, the first follow-up drug after the introduction of the first H-2 receptor antagonist, Cimetidine, was followed by Famotidine and in each case these “me-too” drugs had notable merits over the original drug.</p> <p>   Apart from the major breakthrough in the development of orally active beta lactam antibiotics of the Penicillin and Cephalosporin class, within the same oral derivatives, there have been considerable improvements brought about by change in the side chains incorporated by condensation of specific agents with 6-APA, 7-ADCA and 7-ACA. A whole new range of broad-spectrum antibiotics of these structural classes could thus be developed. In each of the major classes of antibiotics, classified according to the mechanisms of their action, namely inhibition of cell wall synthesis (Beta Lactams, Vancomycin), inhibition of bacterial protein synthesis (Erythromycin, Tetracycline, Streptomycin), inhibitors of DNA or RNA replication (Quinolones, Rifamycins), inhibition of Folate Coenzyme biosynthesis (Sulfa drugs, Trimethoprim), there have been several “me-too” drugs marketed. </p> <p>   An important recent example to show that ‘me-too” drugs need to be developed is the case of the oral hypoglycemic drug Troglitazone, approved as an anti-diabetic drug in 1997. The drug was withdrawn from the market following reports of unacceptable hepato-toxicity. The follow-up “me-too” drugs, Rosiglitazone and Pioglitazone are much less toxic and are today widely used. If these drugs were not developed, the withdrawal of Troglitazone would have left a major therapeutic gap in anti-diabetic therapy.</p> <p>   “Me-Too” drugs: Strategies for New Drug Research for Indian Companies</p> <p>   Breakthrough innovations in pharmaceutical industry, of new drugs, such as the first beta blocker, the first NSAID, the first of each class of Antibiotics, Calcium Channel blockers, ACE inhibitors, Sulfonyl Ureas, Biguanides, Insulin, Glitazones, Glinides, Tricyclic Anti Depressants,major and minor Traquillisers, Selective Serotonin Receptor inhibitors, H-1 and H-2 Receptor antagonists, Proton Pump inhibitors etc are relatively rare and even though a few of the original drugs under these classes are still very much in use, they have been superceded in most cases, by later generation products, many of them “me-too”. The newer drugs are discovered both through incremental innovations on the original drugs as well as through new research. </p> <p>   Generally the original discovery leads to feverish activity both within the innovator company as well as in Competitors’ laboratories, to develop better products in the same therapeutic category. The essential caveat for commercial success, however, is that the newly discovered molecules should meet the minimum standards of patentability. For example within three years of the discovery of the highly successful Sildinafil Citrate (<a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=14&q=Viagra\">Viagra</a>), three more new versions for the same indications have been patented and developed5.</p> <p>   Me-too drugs also provide therapeutic advantage6. For the practicing physicians, there’s the benefit of established drug MoA with a “me-too” medication, coupled with clinical studies that - hopefully - show patient-centered benefits such as better adverse events profiles, less frequent dosing, less bothersome potential for drug/drug interactions, and so forth.  A “me-too” drug is a helluva lot easier to incorporate in practice than a totally novel medication7.  </p> <p>   “Me-Too” drugs: The hidden dynamics </p> <p>   The most common criticism of drug development centers on the so-called “me-too” drugs that employ the same biological mechanism as pioneer brands. This involves a lot more than such high-profile targets as the anti-ulcer drug Nexium. We should be thinking about antidepressants, cholesterol-reducing drugs, diabetes treatments, anti-psychotics, and other therapeutic categories that have seen both blockbuster sales and rapid innovation. There is quite a bit of evidence that follow-on drugs do a lot of patients a lot of good. The newer statins, for example, often out-perform the older ones in clinical trials where the endpoints are the number of heart attacks and deaths prevented.</p> <p>   Me-too drugs are also a powerful tool for cutting health care costs. We should be glad that our research industry does not target only brand new biological mechanisms. That would be a very expensive business model indeed. Fortunately, the industry also works on marginal improvements, exploiting opportunities to make drug therapy better and sometimes opening the door to really radical improvements that happen to lie more or less next-door, scientifically speaking. In the meantime, we get price competition as a by-product. Me-too’s almost always undercut the prices of the pioneer drugs. </p> <p>   Another part of the me-too story gets almost completely ignored even though it is extraordinary important. For me-too manufacturers, advancing the science is a way to gain a competitive advantage. The classic example is the statin class of cholesterol drugs. Research on one of the follow-on drugs (Pravachol) demonstrated for the first time that using a statin to reduce cholesterol would actually prevent deaths from heart attacks, something that had previously been assumed without proof. Additional trials for several statins, including Lipitor, the formidable challenger to Zocor and Pravachol, have demonstrated that serum cholesterol is far more important than almost anyone thought (for preventing strokes, for example). </p> <p>   There are lots of other stories about the benefits of new research from me-too drugs, but they are part of a larger story: new uses for old drugs. The data showing a slowdown in new drug approvals exclude essential information: discoveries of new uses for old drugs. This kind of discovery has become so common that it amounts to a “new-use” revolution. One of the scientific ironies of the new era of pharmaceutical research is that as drugs become more tightly targeted on biological mechanisms, their uses actually become more diverse. This is because the body typically uses specific mechanisms over and over again, sometimes in what appear to be completely unrelated ways.</p> <p>   Consider the SSRI antidepressants. A recent Science article on the diverse and unexpected applications of drugs that fiddle with serotonin reuptake which is what the SSRIs do concluded that the very term “antidepressant” is misleading because there is no scientific reason to think of this drug as being just for depression. Fighting depression just happened to be the first really useful condition that was explored for this very interesting class of drugs.</p> <p>   Another example is the Cox-2 inhibitors like Celebrex (and Vioxx, which is important in this story and may return to the market partly for this reason). These were invented to relieve arthritis pain. But the Cox-2 enzyme turns out to be important for lots of things including cancer and Alzheimer’s. Clinical trials to exploit these leads have been underway for years. Celebrex has already been approved for reducing the risk of colorectal cancer, and Vioxx has also achieved promising results. Of course, the big news recently has been that these drugs may cause heart attacks. But even here, me-too economics is of surpassing importance. The traditional NSAIDS (non-steroidal anti-inflammatory drugs) like Alleve and Advil may have the same heart attack risks. The potential risk has been there for decades, but only the new drugs-the Cox-2s-have been put through large-scale long-term clinical trials because those are the only ones still under patent. This is an example of how me-too drug development adds importantly to the research base. Thanks to the me-too’s, we are learning about NSAIDs, heart attacks, cancer and probably much more.</p> <p>   Also dominated by new uses are the new-targeted cancer drugs, which attack such specific biological mechanisms that they avoid killing every fast-growing cell in sight (as traditional chemotherapy tends to do).</p> <p>   The implications are clear. The annual count of new drug approvals will only show a tick when a new cancer drug or a new statin gets its very first approval. But a new use for an old drug can be as valuable as an entirely new drug, or even more valuable when you consider that we know more about the safety profile of old drugs and one drug will sometimes do the work of two (preventing both heart attacks and strokes, for example)8.</p> <p>   Me-too products can sometimes have important advantages on tolerability or dosing. It could help create more competition and lower the price. If you have five me-toos, possibly the sixth is something that is a little better. That is for the plans to decide on behalf of their patients. And even if it has the same mechanism of action, more competition could help drive down the price of the entire class. That’s an important influence, with potentially an improvement in health from greater access.</p> <p>   How bad are they?</p> <p>   Even though the major problem of antibiotic therapy, namely drug resistance cannot be addressed by the development of “me-too” drugs, due to the propensity of the same class to develop cross resistance; in most cases, the new semi-synthetic derivatives had distinct advantages over the earlier ones. Thus, for example, the first generation Cephalosporins are useful for gram-positive infections, while the second-generation drugs cover a broader spectrum including gram-negative organisms. The third generation drugs provide resistance against the beta lactamase enzyme, as well as acting against some of the most intractable infections, such as those caused by Pseudomonas and Klebsiella strains. </p> <p>   Even while the pharmaceutical industry turns out families of me-too drugs for relatively mild conditions in affluent people, it pays almost no attention to serious diseases, such as malaria, affecting impoverished people. It also gives short shrift to less profitable drugs, so there now are shortages of some vaccines and life-saving drugs9.</p> <p>   The big problem with me-too drugs is that they are chemically very similar to other drugs already available, yet they are marketed as if they were important new breakthroughs, with very high prices. Many new, expensive me-too drugs are not necessarily better than older and less expensive drugs. Most of the time they are compared with placebos and not older drug comparisons.</p> <p>    “Me-too” drugs are responsible for 80% of increased spending in recent years, and on average they are four times more expensive than the comparable, older alternatives10. By Patented Medicines Pricing Review Board’s (PMPRB) definitions, at the time of their introduction “me-too” drugs were judged to provide moderate, little or no improvement - in terms of effectiveness and safety - compared to older alternatives. However, on average, “me-too” drugs cost about 2.5 times as much per prescription as comparable older drugs. The question is whether the perceived or real differences justify the increased costs. New drugs do have a role in some situations and for some patients. However, it makes sense to use the older equally effective drugs whenever possible11.</p> <p>   Changing FDA rules to discourage me-too drug approvals would make R&D far more expensive, would discourage competition and therefore raise healthcare costs, and would forestall the wave of new research that has revolutionized our scientific understanding of the therapeutic categories where competition has been most intense.</p> <p>   Conclusion</p> <p>   New drugs are not required to improve on old ones, and there’s usually no way to know whether they do. Although the FDA must test drugs before they are marketed, they don’t need to be compared with similar drugs already on the market. The FDA only requires they be reasonably safe and better than nothing-a low standard indeed. This loophole in FDA regulations opens the door for an unlimited number of me-too drugs, which are easier to develop than innovative drugs.  </p> <p>   Given everything, it should come as no surprise that these more expensive “me-too” drugs cost the medical industry money. The prevalence of the me-too’s really says an awful lot about the lack of innovation within the pharmaceutical industry. If you look at the new drugs marketed over the last six years, 78 percent weren’t even new chemical compounds. They were just new combinations or different formulations of old drugs. And 68 percent were classified by the F.D.A. as unlikely to be improvements over drugs already on pharmacy shelves. </p> <p>   At the same time, there are shortages of some important drugs that the pharmaceutical companies aren’t much interested in making because they are not as profitable as the me-too’s. But the companies don’t have to turn out needed drugs, if they are not lucrative. And they don’t. </p> <p>   References</p> <p>   1. http://www.medterms.com/script/main/art.asp?articlekey=33748</p> <p>   2. http://www.motherjones.com/news/qa/2004/09/09_401.html</p> <p>   3. http://polyscience.org/2005/09/me-too-drugs</p> <p>   4. http://www.shvoong.com/books/465475-me-too-drugs</p> <p>   5. http://www.pharmabiz.com/article/detnews.asp?SecArch=&articleid=14604&sectionid=46</p> <p>   6. http://direct.bl.uk/bld/PlaceOrder.do?UIN=162532605&ETOC=RN&from=searchengine</p> <p>   7. http://www.archivum.info/sci.med/2005-09/msg00257.html</p> <p>   8. http://www.aei.org/publications/filter.all,pubID.27443/pub_detail.asp</p> <p>   9. http://blogs.wsj.com/health/2007/05/17/in-praise-of-me-too-drugs</p> <p>   10. http://www.chepa.org/KnowledgeExchange/LabelleLectureship/tabid/84/Default.aspx</p> <p>   11. http://www.ti.ubc.ca/pages/letter59.html</p> "
  quote[8]="<h3>Pill Addiction; 3 Ways to Beat an <b>Ultram</b> Addiction</h3><p><a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Ultram\">Ultram</a> (<a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a> hydrochloride) is a synthetic codeine type of non narcotic pain killer, and although touted as a far less addictive alternative to drugs like <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Vicodin\">Vicodin</a>, oxycontin and morphine, tens of thousands of Americans have developed serious dependencies on the drug, and have found that the drug they were prescribed as a safer alternative has a syndrome of detox as severe as many of the more potent pain killers.</p> <p>Symptoms of detox</p> <p>   Some symptoms of detox are nausea, vomiting, tremors, sweating, chills, anxiety, depression, hallucinations, leg restlessness and even seizures; and the risk of seizures increases when people make an attempt at a cold turkey detox.</p> <p>   Withdrawal pains will begin within a day of cessation of use, and will continue with intensity for three or four days before gradually subsiding over a period of months.</p> <p>3 ways to get off Ultram</p> <p>   1) Cold Turkey</p> <p>   Some people, with enormous will and a determination to endure the pains of detox, can get through withdrawal after quitting without any attempts to first wean down the dosage. Most people cannot endure these detox pains, and since the risks of seizures increase with a dramatic cessation of use, detoxing without medical supervision is unadvised.</p> <p>2 Wean yourself off</p> <p>   The most commonly attempted method is to gradually wean yourself off of the pills, reducing the dosage slowly over a period of month, or even years. By slowly tapering down, you minimize the intensity of the detox pains, and you also reduce the risks of seizures. Experts advise cutting down by 50 mg’s and waiting for the sensations of slight detox to subside before making another reduction in daily dose. It’s not at all uncommon to wait weeks between reductions in daily dosage.</p> <p>   As you get closer to your goal of complete abstinence, each 50 mg reduction represents a greater percentage of your total daily dose, and the difficulties in the tapering process intensify. If you find that detox symptoms are too severe, you may wish to reduce the doses by only 25 mgs as you get closer to abstinence.</p> <p>3 Detox under supervision</p> <p>   You really should not attempt to detox cold turkey on your own. You are unlikely to be successful and the risks of seizures are real. If you do not wish to send months of gradual and uncomfortable detox, you may wish to accelerate the process through a brief but intense medically supervised detox. </p> <p>   Certain pharmaceuticals can minimize the risks of seizures inherent in a complete cessation of use, and by detoxing under medical observation; you may safely end a physical addiction in a mater of days. The long term withdrawal symptoms will endure for months, but the immediate and intense symptoms will have ended with the end of detox.</p> <p>Recovery is possible</p> <p>   Many people also benefit from a period of drug treatment therapy, whether in or outpatient, after a successful detox off of Ultram.</p> <p>   Whichever method you decide on, consulting with your doctor before attempting the process may increase the safety of withdrawal, and your doctor may also prescribe certain medications to reduce withdrawal discomforts.</p> <p>   If you are using Ultram, but are not yet addicted, be very careful with the seductive temptations of Ultram, and spare yourself a long and uncomfortable period of addiction and then withdrawal.</p> "
  quote[9]="<h3>An Introduction to an Effective Painkiller</h3><p>It is quite natural that every person must not be aware of what <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a> is. If you do not know about <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a>, this information could be of great use for you. Various questions may come to your mind upon hearing its name. What is <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a>? What are its uses and how could it be beneficial for me? One may wish to know about its side effects also. Considering all these questions, the article below contains answers to all the questions. </p> <p><a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a> is a pain reliever medication used to treat moderate to severe phases of pain. It is its simple description. <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a> acts in a different way on the body. It blocks the pain receptors to reach the brain. By this, people do not feel the pain but it actually lies in the originating point. It is an effective medication and popularly prescribed medicine by the physicians. If you are passing through the moderate or severe phases of pain, <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a> may prove to be an instant reliever. <a target=\"_blank\" href=\"http://top.darkss.info/out.php?s_id=5&q=Tramadol\">Tramadol</a> is a synthetic agent and an atypical opioid, which is a centrally acting analgesic. </p> <p>Tramadol is marketed under the name of Tramal as hydrochloride salt. It is available in both inject-able and oral preparations. It is recommended to the user to take the medicine as it is prescribed by the doctor. Any changes in the dosage and intake manner should only be changed after consulting the doctor. Tramadol is known as an effective medication to treat moderate to severe pain but it is equally effective to alleviate depression and anxiety. It is even used after surgeries and muscoskeletal injuries. This medication is used to treat all types of pain. However, it is recommended to not to use the medicine in the mild or light pain stages. Another interesting fact about Tramadol is that it is the chemical name for Ultracet or Ultram.</p> <p>In terms of usage of Tramadol, it would be better to see the doctor first to avoid any kind complications later. If you ever had experienced any kind of adverse reaction from Tramadol or any such type of medicine, consider to consult your doctor about your allergic symptoms and side effects. Some major side effects notified in the research are nausea, dizziness, drowsiness, vomiting, constipation and sweating. If you face any of these side effects after taking Tramadol, stop taking the medicine immediately and consult your doctor as soon as possible. Though the medicine is effective to treat all types of pain but the user must not forget to observe the symptoms of withdrawal or any side effect in the body. </p> <p>Tramadol is popularly prescribed medicine to relieve the patient from pains. Everyone knows how much life becomes difficult during the phases of pain; it could be either severe pain or the mild one. Tramadol is an easy and affordable way to treat the problem.</p> "
  
function rndnumber(){
        var randscript = -1
        while (randscript < 0 || randscript > howMany || isNaN(randscript)){
                randscript = parseInt(Math.random()*(howMany+1))
        }
        return randscript
}
     quo = rndnumber()
     quox = quote[quo]
document.write(quox)
window.onFocus = rndnumber()
//-->