Paracetamol is readily absorbed from the gastrointestinal tract with peak plasma concentrations occurring about 10 to 60 minutes after oral administration. Paracetamol is distributed into most body tissues. The elimination half-life of Paracetamol varies from about 1 to 3 hours. Paracetamol is metabolized predominantly in the liver and excreted in the urine.
Paracetamol, a para-aminophenol derivative, has analgesic and antipyretic properties and weak anti-inflammatory activity. Paracetamol is often the analgesic or antipyretic of choice especially in patients in whom salicylates or other NSAIDS are contraindicated. Such patients include asthmatics or those with a history of peptic ulcer. Its use is generally preferred in elderly patients. Paracetamol is used in the management of mild to moderate pain. Paracetamol may also be used as an adjunct to opioids in the management of severe pain such as cancer pain.
Tramadol is readily absorbed following oral administration but is subject to first pass metabolism. Tramadol is metabolized in the liver. Tramadol is excreted mainly in the urine predominantly as metabolites. Tramadol is widely distributed. The elimination half life following oral administration is about 6 hours.
Tramadol is a synthetic centrally acting analgesic. Tramadol is used orally as an analgesic for the relief of moderate to moderately severe pain. Comparative and non-comparative clinical studies have shown that tramadol is an effective analgesic agent in the treatment of moderately severe acute or chronic pain including post-operative gynaecologic and obstetric pain, as well as pain of various other origins including cancer. The drug acts as an opiate agonist apparently by selective activity at µ opioid receptors. Tramadol inhibits reuptake of certain monoamines (norepinephrine, serotonin) which appears to contribute to the drug’s analgesic effect.
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Ruoff GE, Rosenthal N, Jordan D, et al. Tramadol/acetaminophen combination tablets for the treatment of chronic lower back pain: a multicenter, randomized, double-blind, placebo-controlled outpatient study. Clin Ther 2003;23:1123–41. |
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McClellan K and Scott L.J., Tramadol/Paracetamol. Drugs 2003; 63 (11): 1079-86 |
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Bennett R.M. et al., Tramadol and acetaminophen combination tablets in the treatment of fibromyalgia pain: a double-blind, randomized, placebo-controlled study. The American journal of medicine (2003); 114 (7): 537–45 |
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Fricke J.R. Jr. et al., A double-blind, single-dose comparison of the analgesic efficacy of tramadol/acetaminophen combination tablets, hydrocodone/acetaminophen combination tablets, and placebo after oral surgery. Clin Ther. 2002; 24 (6): 953-968 |
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Silverfield J.C. et al., Tramadol/acetaminophen combination tablets for the treatment of osteoarthritis flare pain: A multicenter, outpatient, randomized, double-blind, placebo-controlled, parallel-group, add-on study. Clin Ther. 2002; 24 (2): 282-297. |
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Edwards J.E. et al., Combination analgesic efficacy: individual patient data meta-analysis of single-dose oral tramadol plus acetaminophen in acute postoperative pain. J Pain Symptom Manage. 2002; 23(2):121–130. |
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Edwards J.E. and McQuay H., Meta-analysis of single dose oral tramadol plus acetaminophen in acute postoperative pain. Eur J Anaesthesiol Suppl. 2003; 28: 19-22 |
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Fricke J.R. Jr. et al., A double-blind placebo-controlled comparison of tramadol/acetaminophen and tramadol in patients with postoperative dental pain. Pain. 2004; 109(3): 250-257 |
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Schug S.A., Combination analgesia in 2005 – a rational approach: focus on paracetamol-tramadol. Clin Rheumatol. 2006;25 Suppl 1: S16-21 |
Taurine is derivative of the sulfur containing amino acid, Cysteine. Taurine is one of the few known naturally occurring sulfonic acids. It is often called an amino acid but as it lacks a carboxyl group it is not strictly an amino acid. It acts as an anti-oxidant and protects against toxicity of various substances. Supplementation with taurine has been shown to prevent oxidative stress induced by exercise. Taurine aids the movement of potassium, sodium, calcium and magnesium in and out of cells and helps generate nerve impulse and activate the body. The action of taurine on the cardiovascular system is highly complex and has not yet been fully investigated. There is proof however that taurine both inhibits cardiac arrhythmias and lowers blood pressure. Taurine contributes to the maintenance of the electrolytic balance. It has been shown to have a protective effect on cells especially on leucocytes and neurons. Based on its anti-oxidative role, its effect on inflammation, connective tissue generation, and taurine has recently been proposed as a wound healing agent. Taurine has a positive effect on patients with cardiac disorders.
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“Taurine”, Modern Nutrition in Health and Disease, Williams and Wilkins, Ninth edition. 1998: 545-56. |
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“Contemporary review of therapeutic benefits of the amino acid taurine”, The Magnesium website online library, Richard smayda, D.O., June 2002 |
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Kendler B.S., Taurine: an overview of its role in preventive medicine, Prev. Med. (1989) Jan; 18(1) 79-100 |
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Birdsall T.C., Therapeutic applications of taurine, Altern Med Rev. (1998) Apr; 3(2): 128-36 |
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R. Lourenço and M. E. Camilo, Taurine: a conditionally essential amino acid in humans? An overview in health and disease, Nutr. Hosp. (2002) XVII (6) 262-270 |
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Oja S.S and Saransaari P., Pharmacology of Taurine, Proc West Pharmac Soc., (2007); 50: 8-15 |
Caffeine is absorbed readily after oral administration and is widely distributed throughout the body. Caffeine passes readily into CNS and saliva. In adults Caffeine is metabolized almost completely in the liver and is excreted 1% unchanged in the urine. Elimination half lives are approximately 3 to 7 hours in adults.
Caffeine is a methylxanthine which like theophylline inhibits the enzyme phosphodiesterase and has an antagonistic effect at central adenosine receptors. It is a stimulant of CNS particularly the higher centres and it can produce a condition of wakefulness and increased mental activity. It may also stimulate the respiratory centre increasing the rate and depth of respiration. Caffeine facilitates the performance of muscular work and increases the total work which can be performed by a muscle.
FUNCTIONS OF CAFFEINE IN THE BODY
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Caffeine consumption is known for its stimulating effect of psychological and physiological functions – concentration, reaction speed and alertness are improved. |
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Caffeine stimulates fat burning during endurance activities and thereby helps to use fat stores in the body to provide energy and to preserve the glycogen. This means that Caffeine intake during endurance activities results in a more efficient supply of energy and especially in extended exertion it leads to a significant improvement in performance and endurance. |
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Chawla Jasvinder and Amer Suleman, “Neurologic Effects of Caffeine.” emedicine.com, June 7, 2006. |
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Mobbs C., Caffeine and the adenosine receptor: Genetics trumps pharmacology in understanding pharmacology, Cellscience (2005); Vol. 2 No.1 |
