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Tramadol
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Weak opioid agonist
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Acts on noradrenaline and 5HT uptake in spinal cord
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Single dose efficacy 150mg = 60mg codeine
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Chronic use = codeine
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Similar side -effect profile to codeine/DHC
?less constipating
NB epileptogenic with phenothiazines
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Max dose 100mg 6hrly = morphine 10mg 4 hourly