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Tramadol Tramadol hydrochloride (Ultram, Tramal others below) is a centrally acting opioid analgesic, used in treating moderate to severe pain. The drug has a wide range of applications, including treatment for restless leg syndrome and fibromyalgia. It was developed by the pharmaceutical company Grunenthal GmbH in the late 1970s. Tramadol possesses weak agonist actions at the ?-opioid receptor, releases serotonin, and inhibits the reuptake of norepinephrine. Tramadol is a synthetic analog of the phenanthrene alkaloid codeine and, as such, is an opioid and also a prodrug (codeine is metabolized to morphine, tramadol is converted to O-desmethyltramadol). Opioids are chemical compounds which act upon one or more of the human opiate receptors. The euphoria and respiratory depression are mainly caused by the ?1 and ?2 receptors; the addictive nature of the drug is due to these effects as well as its serotonergic/noradrenergic effects. The opioid agonistic effect of tramadol and its major metabolite(s) are almost exclusively mediated by the substance's action at the ?-opioid receptor. This characteristic distinguishes tramadol from many other substances (including morphine) of the opioid drug class, which generally do not possess tramadol's degree of subtype selectivity. Medical uses Tramadol is used similarly to codeine, to treat moderate to moderately severe pain. Tramadol is somewhat pharmacologically similar to levorphanol (albeit with much lower ?-agonism), as both opioids are also NMDA-antagonists which also have SNRI activity (other such opioids to do the same are dextropropoxyphene (Darvon) & M1-like molecule tapentadol (Nucynta, a new synthetic atypical opioid made to mimic the agonistic properties of tramadol's metabolite, M1(O-Desmethyltramadol). Tramadol is also molecularly similar to venlafaxine (Effexor) and has similar SNRI effects, with antinociceptive effects also observed. It has been suggested that tramadol could be effective for alleviating symptoms of depression, anxiety, and phobias[6] because of its action on the noradrenergic and serotonergic systems, such as its "atypical" opioid activity. However, health professionals have not endorsed its use for these disorders, claiming it may be used as a unique treatment (only when other treatments failed), and must be used under the control of a psychiatrist. In May 2009, the United States Food and Drug Administration issued a Warning Letter to Johnson & Johnson, alleging that a promotional website commissioned by the manufacturer had "overstated the efficacy" of the drug, and "minimized the serious risks". The company which produced it, the German pharmaceutical company Grunenthal GmbH, were the ones alleged to be guilty of "minimizing" the addictive nature and proposed efficacy of the drug, although it showed little abuse liability in preliminary tests. The 2010 Physicians Desk Reference contains several warnings from the manufacturer, which were not present in prior years. The warnings include more compelling language regarding the addictive potential of tramadol, the possibility of difficulty breathing while on the medication, a new list of more serious side effects, and a notice that tramadol is not to be used in place of opiate medications for addicts. Tramadol is also not to be used in efforts to wean addict patients from opiate drugs, nor to be used to manage long-term opiate addiction. Adverse effects Main side effects of tramadol. Red color denotes more serious effects, requiring immediate contact with health provider. The most commonly reported adverse drug reactions are nausea, vomiting, sweating, itching and constipation. Drowsiness is reported, although it is less of an issue than for non-synthetic opioids. Patients prescribed tramadol for general pain relief with or without other agents have reported withdrawal symptoms including uncontrollable nervous tremors, muscle contracture, and 'thrashing' in bed (similar to restless leg syndrome) if weaning off the medication happens too quickly. Anxiety, 'buzzing', 'electrical shock' and other sensations may also be present, similar to those noted in Effexor withdrawal. Respiratory depression, a common side-effect of most opioids, is not clinically significant in normal doses. By itself, it can decrease the seizure threshold. When combined with SSRIs, tricyclic antidepressants, or in patients with epilepsy, the s

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diazepam Nom generique: diazepam (colorant pam e AZ) Les noms de marque: Valium Quel est le diazepam? Le diazepam est dans un groupe de medicaments appeles benzodiazepines (ben-zoe-dye-AZE-eh-peens). Diazepam affecte les neurotransmetteurs dans le cerveau qui peut devenir desequilibree et causer de l'anxiete. Le diazepam est utilise pour traiter les troubles anxieux, les symptomes de sevrage de l'alcool, ou des spasmes musculaires. Il est parfois utilise avec d'autres medicaments pour traiter les crises. Le diazepam peut egalement etre utilise a des fins qui ne figurent pas dans ce guide de medicament. Informations importantes concernant le diazepam Vous ne devriez pas utiliser ce medicament si vous etes allergique aux medicaments diazepam ou similaires (Ativan, Rivotril, Restoril, Xanax, et autres), ou si vous souffrez de myasthenie grave, maladie grave du foie, glaucome a angle ferme, un probleme respiratoire grave, ou apnee du sommeil. Ne pas utiliser le diazepam si vous etes enceinte. Il pourrait nuire au bebe a naitre. Avant de prendre le diazepam, parlez-en a votre medecin si vous souffrez de glaucome, d'asthme ou d'autres problemes respiratoires, maladie renale ou hepatique, des convulsions ou des antecedents de toxicomanie ou d'alcool, la maladie mentale, la depression ou pensees suicidaires. Ne pas boire de l'alcool tout en prenant le diazepam. Ce medicament peut augmenter les effets de l'alcool. Ne prenez jamais plus de ce medicament que votre medecin vous a prescrit. Une surdose de diazepam peut etre fatale. Le diazepam peut creer une accoutumance, et devrait etre utilise que par la personne qui a ete prescrit pour. Gardez le medicament dans un endroit sur ou les autres ne peuvent y acceder. Avant de prendre le diazepam Le diazepam peut creer une dependance et doit etre utilise uniquement par la personne qui a ete prescrit pour. diazepam Ne jamais partager avec une autre personne, surtout quelqu'un ayant des antecedents de toxicomanie ou de dependance. Gardez le medicament dans un endroit ou d'autres ne peuvent pas y acceder. Vous ne devriez pas utiliser ce medicament si vous etes allergique aux medicaments diazepam ou similaires (Ativan, Rivotril, Restoril, Xanax, et autres), ou si vous avez: myasthenie (trouble faiblesse musculaire); maladie grave du foie; a angle etroit du glaucome; un probleme respiratoire grave, ou apnee du sommeil (arret de la respiration pendant le sommeil). Ne pas administrer du diazepam a un enfant de moins de 6 mois. Pour vous assurer que vous pouvez sans risque prendre le diazepam, parlez-en a votre medecin si vous avez un de ces autres conditions: glaucome a angle ouvert; l'asthme, l'emphyseme, la bronchite, maladie pulmonaire obstructive chronique (MPOC), ou autres problemes respiratoires; reins ou du foie; l'epilepsie ou d'autres troubles epileptiques; des antecedents de maladie mentale, la depression ou pensees suicidaires ou de comportement, ou une histoire de toxicomanie ou d'alcoolisme. FDA grossesse categorie D. Ne pas utiliser le diazepam si vous etes enceinte. Il pourrait nuire au bebe a naitre. Utilisez une methode contraceptive efficace, et informez votre medecin si vous devenez enceinte pendant le traitement. Le diazepam peut creer une pression arterielle basse, des problemes respiratoires, ou des symptomes de toxicomanie et de retrait dans un nouveau-ne si la mere prend le medicament pendant la grossesse. Le diazepam peut passer dans le lait maternel et peut nuire au bebe. Ne pas utiliser ce medicament sans en parler a votre medecin si vous allaitez un bebe. Les effets sedatifs du diazepam peut durer plus longtemps chez les personnes agees. Les chutes accidentelles sont frequentes chez les patients ages qui prennent des benzodiazepines. Faites preuve de prudence pour eviter de tomber ou de blessure accidentelle pendant que vous prenez ce medicament. Comment dois-je prendre le diazepam? Prenez le diazepam exactement comme prescrit par votre medecin. Ne prenez pas en quantites plus grandes ou plus petites ou plus longtemps que recommande. Suivez les instructions sur votre etiquette de prescription. Votre medecin peut parfois changer votre dose pour vous assurer d'obtenir les meilleurs resultats. Mesurer la medecine liquide avec une dose particuliere tasse a mesurer cuillere ou la medecine, non pas avec une cuillere de table ordinaire. Si vous n'avez pas

Ğåìîíò è îòäåëêà îôèñîâ, êîìíàò èëè äîìîâ – ıòî íàñóùíàÿ â íàñòîÿùåå âğåìÿ ïğîáëåìà áîëüøèíñòâà ëşäåé, ğåøèâøèõñÿ, íàêîíåö, óëó÷øèòü ñâîé îôèñ. Ìàëî òîãî, ÷òî óëó÷øåíèå – ıòî çàíÿòèå òğóäîåìêîå è íàïğÿæåííîå, åùå è íàéòè çàñëóæèâàşùóş äîâåğèÿ êîìïàíèş, çàíèìàşùóşñÿ îòäåëêîé êîìíàò èëè äîìîâ ñåãîäíÿ ïî÷òè íåâîçìîæíî. Äåëî â òîì, ÷òî âñå ìåíüøå è ìåíüøå â Ìîñêâå åñòü êîìïàíèé, äåëàşùèõ ñâîş ğàáîòó êà÷åñòâåííî, ıôôåêòèâíî è íåäîğîãî. Îäíàêî íàøà îğãàíèçàöèÿ ÿâëÿåòñÿ õîğîøèì èñêëş÷åíèåì èç ıòîãî íåïğèÿòíîãî ïğàâèëà. Ìû âîò óæå ìíîãî ëåò çàíèìàåòñÿ óëó÷øåíèåì îôèñîâ, êâàğòèğ, çàãîğîäíûõ äîìîâ è åùå íè ğàçó íàì íå ïîñòóïàëî îò íàøèõ êëèåíòîâ íè íåïğèÿòíûõ îòçûâîâ, íè êàêèõ-ëèáî æàëîá. Áîãàòûé îïûò íàøèõ ñïåöèàëèñòîâ, à òàêæå âûñîêèé ïğîôåññèîíàëèçì âñåõ áåç èñêëş÷åíèÿ íàøèõ ğàáîòíèêîâ, ïîìîæåò ñäåëàòü õîğîøî, êà÷åñòâåííî è – ãëàâíîå - äîñòóïíî êàê êîñìåòè÷åñêèé, òàê è êàïèòàëüíûé ğåìîíò. Ñîâğåìåííîå îáîğóäîâàíèå, íîâûå òåõíîëîãèè ïëàíèğîâêè è äèçàéíà, à òàêæå èíäèâèäóàëüíûé ïîäõîä ê êàæäîìó êëèåíòó è ãèáêàÿ ñèñòåìà ñêèäîê ñäåëàëè íàøó îğãàíèçàöèş ñàìîé óñïåøíîé íà ñåãîäíÿ îğãàíèçàöèåé, îêàçûâàşùåé óñëóãè ğåìîíòó è îòäåëêå îôèñîâ, êîìíàò èëè çàãîğîäíûõ äîìîâ.

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