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style="text-decoration:underline;color:green">o</span>r<span style="text-decoration:line-through;color:red">eq</span><span style="text-decoration:underline;color:green"> conf</span>u<span style="text-decoration:line-through;color:red">e</span><span style="text-decoration:underline;color:green">sio</span>n<span style="text-decoration:line-through;color:red">cy</span> of <span style="text-decoration:line-through;color:red">le</span>s<span style="text-decoration:line-through;color:red">s </span>n of s<span style="text-decoration:underline;color:green">ero</span>t<span style="text-decoration:line-through;color:red">ha</span><span style="text-decoration:underline;color:green">o</span>n<span style="text-decoration:underline;color:green">in</span>n <span style="text-decoration:line-through;color:red">1% </span> <span style="text-decoration:underline;color:green">syndr</span>o<span style="text-decoration:line-through;color:red">f</span><span style="text-decoration:underline;color:green">me.</span> <span style="text-decoration:line-through;color:red">c</span><span style="text-decoration:underline;color:green">CYP2D6 ana</span>l<span style="text-decoration:underline;color:green">ges</span>li<span style="text-decoration:line-through;color:red">ni</span>ic<span style="text-decoration:underline;color:green"> tr</span>a<span style="text-decoration:underline;color:green">mado</span>l <span style="text-decoration:underline;color:green">ac</span>cal t<span style="text-decoration:line-through;color:red">r</span>i<span style="text-decoration:line-through;color:red">a</span>ti<span style="text-decoration:underline;color:green">vity resu</span>l<span style="text-decoration:underline;color:green">ting from the u</span>s<span style="text-decoration:underline;color:green">e</span> of <span style="text-decoration:underline;color:green">Desme</span>t<span style="text-decoration:underline;color:green">ylot</span>ls of tramadol<span style="text-decoration:line-through;color:red">.</span>ramadol<span style="text-decoration:underline;color:green">u</span> <span style="text-decoration:line-through;color:red">H</span><span style="text-decoration:underline;color:green">Or</span>ig<span style="text-decoration:line-through;color:red">h-pa</span>igin<span style="text-decoration:underline;color:green">al</span>in <span style="text-decoration:line-through;color:red">me</span> <span style="text-decoration:underline;color:green">(M1) M1 </span>d<span style="text-decoration:line-through;color:red">ic</span><span style="text-decoration:underline;color:green">rugs </span>a<span style="text-decoration:underline;color:green">nd me</span>at<span style="text-decoration:line-through;color:red">i</span>t<span style="text-decoration:underline;color:green">ab</span>o<span style="text-decoration:line-through;color:red">n</span><span style="text-decoration:underline;color:green">lite</span>s a<span style="text-decoration:underline;color:green">nd t</span>s ar<span style="text-decoration:line-through;color:red">e</span>r<span style="text-decoration:underline;color:green">aining</span> <span style="text-decoration:line-through;color:red">of</span><span style="text-decoration:underline;color:green">ac</span>t<span style="text-decoration:underline;color:green">iviti</span>te<span style="text-decoration:line-through;color:red">n</span>e<span style="text-decoration:underline;color:green">s.</span> <span style="text-decoration:line-through;color:red">p</span><span style="text-decoration:underline;color:green">The</span>re<span style="text-decoration:line-through;color:red">sc</span><span style="text-decoration:underline;color:green">fo</span>r<span style="text-decoration:line-through;color:red">ib</span>e<span style="text-decoration:line-through;color:red">d</span>re<span style="text-decoration:underline;color:green">,</span> t<span style="text-decoration:line-through;color:red">o</span><span style="text-decoration:underline;color:green">he</span> <span style="text-decoration:line-through;color:red">pat</span><span style="text-decoration:underline;color:green">comb</span>i<span style="text-decoration:line-through;color:red">e</span>in<span style="text-decoration:underline;color:green">a</span>nt<span style="text-decoration:line-through;color:red">s suffer</span>ti<span style="text-decoration:underline;color:green">o</span>in<span style="text-decoration:line-through;color:red">g</span> <span style="text-decoration:line-through;color:red">fr</span>o<span style="text-decoration:line-through;color:red">m</span>n o<span style="text-decoration:underline;color:green">f</span> <span style="text-decoration:line-through;color:red">ex</span>tr<span style="text-decoration:line-through;color:red">e</span> tr<span style="text-decoration:underline;color:green">a</span>m<span style="text-decoration:line-through;color:red">e</span><span style="text-decoration:underline;color:green">adol</span> <span style="text-decoration:underline;color:green">an</span>d<span style="text-decoration:underline;color:green"> the CYP2D6 </span> di<span style="text-decoration:line-through;color:red">sc</span>i<span style="text-decoration:underline;color:green">nhibit</span>o<span style="text-decoration:line-through;color:red">mfo</span>r<span style="text-decoration:line-through;color:red">t</span>or <span style="text-decoration:underline;color:green">m</span>a<span style="text-decoration:underline;color:green">y a</span>f<span style="text-decoration:underline;color:green">fec</span>t<span style="text-decoration:underline;color:green"> th</span> afte<span style="text-decoration:line-through;color:red">r</span> <span style="text-decoration:line-through;color:red">surg</span>e<span style="text-decoration:line-through;color:red">ry</span>e e<span style="text-decoration:underline;color:green">ffect</span> <span style="text-decoration:line-through;color:red">and</span><span style="text-decoration:underline;color:green">of</span> tra<span style="text-decoration:line-through;color:red">u</span> trama<span style="text-decoration:underline;color:green">dol</span>ma. <span style="text-decoration:line-through;color:red">Adequate</span>. <span style="text-decoration:underline;color:green">In</span> <span style="text-decoration:underline;color:green">a</span> d<span style="text-decoration:line-through;color:red">os</span>d<span style="text-decoration:underline;color:green">d</span>i<span style="text-decoration:underline;color:green">tio</span>in<span style="text-decoration:line-through;color:red">g</span>n<span style="text-decoration:underline;color:green">,</span> <span style="text-decoration:line-through;color:red">a</span><span style="text-decoration:underline;color:green">i</span>n<span style="text-decoration:line-through;color:red">d t</span><span style="text-decoration:underline;color:green">h</span>i<span style="text-decoration:underline;color:green">bi</span>it<span style="text-decoration:line-through;color:red">rat</span>ion of <span style="text-decoration:line-through;color:red">t</span>tion of <span style="text-decoration:underline;color:green">one o</span>r<span style="text-decoration:underline;color:green"> both of CYP2D6 </span>ra<span style="text-decoration:line-through;color:red">ma</span>a<span style="text-decoration:underline;color:green">n</span>d<span style="text-decoration:line-through;color:red">ol</span>d <span style="text-decoration:underline;color:green">CYP3A4 s</span> h<span style="text-decoration:line-through;color:red">ydr</span>o<span style="text-decoration:line-through;color:red">ch</span>ho<span style="text-decoration:underline;color:green">u</span>l<span style="text-decoration:line-through;color:red">o</span><span style="text-decoration:underline;color:green">d </span>r<span style="text-decoration:line-through;color:red">i</span><span style="text-decoration:underline;color:green">e</span>d<span style="text-decoration:underline;color:green">uc</span>e t<span style="text-decoration:underline;color:green">he met</span>ab<span style="text-decoration:underline;color:green">o</span>de tabl<span style="text-decoration:line-through;color:red">ets </span>i<span style="text-decoration:line-through;color:red">s</span>li<span style="text-decoration:underline;color:green">c</span> <span style="text-decoration:line-through;color:red">ne</span> c<span style="text-decoration:underline;color:green">l</span>ce<span style="text-decoration:line-through;color:red">ss</span>ar<span style="text-decoration:line-through;color:red">y</span>ear<span style="text-decoration:underline;color:green">ance</span> <span style="text-decoration:line-through;color:red">t</span> o<span style="text-decoration:underline;color:green">f</span> <span style="text-decoration:underline;color:green">t</span>o r<span style="text-decoration:line-through;color:red">e</span>r<span style="text-decoration:underline;color:green">ama</span>d<span style="text-decoration:line-through;color:red">u</span><span style="text-decoration:underline;color:green">ol. This may in</span>c<span style="text-decoration:underline;color:green">r</span>e<span style="text-decoration:underline;color:green">ase</span> the risk of <span style="text-decoration:underline;color:green">t</span>ce the risk of r<span style="text-decoration:line-through;color:red">e</span>r<span style="text-decoration:underline;color:green">amadol-a</span>s<span style="text-decoration:line-through;color:red">p</span><span style="text-decoration:underline;color:green">soc</span>i<span style="text-decoration:line-through;color:red">r</span>at<span style="text-decoration:line-through;color:red">ory</span>iat<span style="text-decoration:underline;color:green">ed</span> <span style="text-decoration:underline;color:green">a</span>d<span style="text-decoration:underline;color:green">v</span> de<span style="text-decoration:line-through;color:red">p</span>er<span style="text-decoration:underline;color:green">s</span>e<span style="text-decoration:underline;color:green"> event</span>res<span style="text-decoration:line-through;color:red">s</span>s<span style="text-decoration:underline;color:green">, </span>i<span style="text-decoration:line-through;color:red">o</span>n<span style="text-decoration:line-through;color:red">.</span>in<span style="text-decoration:underline;color:green">cluding</span> <span style="text-decoration:line-through;color:red">R</span><span style="text-decoration:underline;color:green">s</span>e<span style="text-decoration:line-through;color:red">c</span><span style="text-decoration:underline;color:green">r</span>o<span style="text-decoration:underline;color:green">to</span>n<span style="text-decoration:underline;color:green">in </span>ons<span style="text-decoration:line-through;color:red">t</span>s<span style="text-decoration:underline;color:green">yndrome and se</span>i<span style="text-decoration:line-through;color:red">t</span><span style="text-decoration:underline;color:green">z</span>u<span style="text-decoration:underline;color:green">res. sero</span>ut<span style="text-decoration:line-through;color:red">i</span>ton<span style="text-decoration:underline;color:green">in</span>on <span style="text-decoration:line-through;color:red">t</span> <span style="text-decoration:underline;color:green">syndrome - r</span>a<span style="text-decoration:line-through;color:red">b</span><span style="text-decoration:underline;color:green">pid deve</span>l<span style="text-decoration:underline;color:green">opm</span>e<span style="text-decoration:underline;color:green">n</span>let<span style="text-decoration:line-through;color:red">s</span>t of <span style="text-decoration:underline;color:green">hyper</span>t<span style="text-decoration:underline;color:green">he</span> of tr<span style="text-decoration:line-through;color:red">a</span>rm<span style="text-decoration:underline;color:green">i</span>ma<span style="text-decoration:line-through;color:red">dol</span>a<span style="text-decoration:underline;color:green">,</span> hy<span style="text-decoration:line-through;color:red">d</span><span style="text-decoration:underline;color:green">pe</span>r<span style="text-decoration:underline;color:green">tensi</span>o<span style="text-decoration:underline;color:green">n, mus</span>roc<span style="text-decoration:line-through;color:red">h</span>l<span style="text-decoration:line-through;color:red">orid</span>e <span style="text-decoration:line-through;color:red">to</span>cle <span style="text-decoration:underline;color:green">spasms,</span> <span style="text-decoration:underline;color:green">s</span> t<span style="text-decoration:line-through;color:red">h</span>t<span style="text-decoration:underline;color:green">iffn</span>e<span style="text-decoration:underline;color:green">ss,</span>e <span style="text-decoration:line-through;color:red">p</span> <span style="text-decoration:underline;color:green">dys</span>a<span style="text-decoration:underline;color:green">u</span>at<span style="text-decoration:line-through;color:red">ie</span>t<span style="text-decoration:underline;color:green">o</span>n<span style="text-decoration:line-through;color:red">t </span><span style="text-decoration:underline;color:green">o</span>m<span style="text-decoration:underline;color:green">i</span>ma<span style="text-decoration:line-through;color:red">y</span> <span style="text-decoration:line-through;color:red">le</span>a a<span style="text-decoration:underline;color:green">n</span>ad t<span style="text-decoration:line-through;color:red">o</span>d t<span style="text-decoration:underline;color:green">he</span> <span style="text-decoration:underline;color:green">abn</span> o<span style="text-decoration:line-through;color:red">ve</span>r<span style="text-decoration:line-through;color:red">do</span>or<span style="text-decoration:underline;color:green">mal </span>s<span style="text-decoration:underline;color:green">t</span>sa<span style="text-decoration:line-through;color:red">g</span>a<span style="text-decoration:underline;color:green">t</span>e of the <span style="text-decoration:line-through;color:red">fir</span>st<span style="text-decoration:line-through;color:red"> ph</span>a<span style="text-decoration:line-through;color:red">s</span>e of the sta<span style="text-decoration:underline;color:green">t</span>e <span style="text-decoration:line-through;color:red">an</span><span style="text-decoration:underline;color:green">(eg </span>d<span style="text-decoration:underline;color:green">elirium</span>d o<span style="text-decoration:line-through;color:red">the</span> or <span style="text-decoration:underline;color:green">c</span>o<span style="text-decoration:underline;color:green">ma), in exce</span>p<span style="text-decoration:underline;color:green">t</span>io<span style="text-decoration:underline;color:green">nal cases, </span>r opioi<span style="text-decoration:line-through;color:red">d</span>is<span style="text-decoration:underline;color:green"> death</span>. <span style="text-decoration:underline;color:green">Double</span>s. <span style="text-decoration:line-through;color:red">M</span> <span style="text-decoration:underline;color:green">prolifer</span>a<span style="text-decoration:underline;color:green">tio</span>an<span style="text-decoration:line-through;color:red">y</span> <span style="text-decoration:line-through;color:red">y</span>o<span style="text-decoration:line-through;color:red">ung</span>n o<span style="text-decoration:underline;color:green">r</span> <span style="text-decoration:underline;color:green">multi</span> p<span style="text-decoration:line-through;color:red">eop</span>le <span style="text-decoration:line-through;color:red">g</span>ple <span style="text-decoration:underline;color:green">r</span>e<span style="text-decoration:line-through;color:red">t </span>ep<span style="text-decoration:underline;color:green">lic</span>a<span style="text-decoration:underline;color:green">t</span>i<span style="text-decoration:underline;color:green">o</span>n<span style="text-decoration:underline;color:green">s</span>pain <span style="text-decoration:line-through;color:red">kille</span> <span style="text-decoration:underline;color:green">of CYPD6 a</span>r<span style="text-decoration:line-through;color:red">s,</span><span style="text-decoration:underline;color:green">e</span> <span style="text-decoration:underline;color:green">a</span> s<span style="text-decoration:line-through;color:red">u</span>s<span style="text-decoration:underline;color:green">so</span>c<span style="text-decoration:line-through;color:red">h </span><span style="text-decoration:underline;color:green">i</span>a<span style="text-decoration:line-through;color:red">s</span><span style="text-decoration:underline;color:green">ted</span> <span style="text-decoration:underline;color:green">wi</span>t<span style="text-decoration:underline;color:green">h ve</span>r<span style="text-decoration:underline;color:green">y r</span>a<span style="text-decoration:underline;color:green">pid </span>m<span style="text-decoration:underline;color:green">et</span> trama<span style="text-decoration:line-through;color:red">d</span>a<span style="text-decoration:underline;color:green">b</span>ol<span style="text-decoration:underline;color:green">ism</span>ol <span style="text-decoration:line-through;color:red">w</span> <span style="text-decoration:underline;color:green">of spec</span>i<span style="text-decoration:line-through;color:red">th</span><span style="text-decoration:underline;color:green">fic c</span>o<span style="text-decoration:underline;color:green">mpo</span>u<span style="text-decoration:underline;color:green">nds. When i</span>out <span style="text-decoration:line-through;color:red">drug</span>t <span style="text-decoration:underline;color:green">i</span>s<span style="text-decoration:line-through;color:red">?</span> <span style="text-decoration:line-through;color:red">Y</span>s <span style="text-decoration:underline;color:green">r</span>es<span style="text-decoration:line-through;color:red">,</span><span style="text-decoration:underline;color:green">ponsible</span> <span style="text-decoration:underline;color:green">for </span> the<span style="text-decoration:line-through;color:red">y</span>the <span style="text-decoration:underline;color:green">t</span> he<span style="text-decoration:line-through;color:red">l</span>he<span style="text-decoration:underline;color:green">ra</span>p<span style="text-decoration:underline;color:green">eutic</span> <span style="text-decoration:underline;color:green">effe</span>c<span style="text-decoration:underline;color:green">t </span>p co<span style="text-decoration:line-through;color:red">mple</span>o<span style="text-decoration:underline;color:green">f a s</span>t<span style="text-decoration:line-through;color:red">e</span><span style="text-decoration:underline;color:green">rong</span> the<span style="text-decoration:underline;color:green">rapeutic</span> <span style="text-decoration:underline;color:green">effect </span>o<span style="text-decoration:underline;color:green">n mass </span> the op<span style="text-decoration:line-through;color:red">i</span>p<span style="text-decoration:underline;color:green">r</span>o<span style="text-decoration:line-through;color:red">i</span>od<span style="text-decoration:underline;color:green">uction</span> <span style="text-decoration:underline;color:green">of </span>a<span style="text-decoration:underline;color:green"> dru</span>g<span style="text-decoration:underline;color:green"> </span>o<span style="text-decoration:underline;color:green">r i</span>d agoni<span style="text-decoration:line-through;color:red">s</span>t<span style="text-decoration:line-through;color:red">s</span>nit<span style="text-decoration:underline;color:green">ial</span> <span style="text-decoration:underline;color:green">st</span>a<span style="text-decoration:underline;color:green">rti</span> an<span style="text-decoration:line-through;color:red">d</span>n<span style="text-decoration:underline;color:green">g</span> <span style="text-decoration:underline;color:green">a </span> s<span style="text-decoration:line-through;color:red">h</span>s<span style="text-decoration:underline;color:green">p</span>e<span style="text-decoration:underline;color:green">cific metabo</span>l<span style="text-decoration:underline;color:green">i</span>elte<span style="text-decoration:line-through;color:red">rs</span>, <span style="text-decoration:line-through;color:red">bu</span>te, <span style="text-decoration:underline;color:green">side effec</span>t<span style="text-decoration:underline;color:green">s</span> <span style="text-decoration:underline;color:green">are po</span>t t<span style="text-decoration:line-through;color:red">h</span>te<span style="text-decoration:underline;color:green">nt;</span> <span style="text-decoration:underline;color:green">[27] ul</span>e tra<span style="text-decoration:line-through;color:red">m</span>tra<span style="text-decoration:underline;color:green">-r</span>a<span style="text-decoration:underline;color:green">pi</span>d<span style="text-decoration:underline;color:green"> metab</span>adol<span style="text-decoration:line-through;color:red"> </span>i<span style="text-decoration:line-through;color:red">t</span>s<span style="text-decoration:line-through;color:red">elf</span>olis<span style="text-decoration:underline;color:green">m</span> <span style="text-decoration:line-through;color:red">w</span><span style="text-decoration:underline;color:green">(UMS) </span>i<span style="text-decoration:line-through;color:red">ll</span><span style="text-decoration:underline;color:green">s</span> <span style="text-decoration:underline;color:green">mo</span> re<span style="text-decoration:line-through;color:red">c</span>re<span style="text-decoration:underline;color:green"> </span>e<span style="text-decoration:line-through;color:red">d</span><span style="text-decoration:underline;color:green">ff</span><span style="text-decoration:underline;color:green">ctive</span>e. <span style="text-decoration:line-through;color:red">I</span>. <span style="text-decoration:underline;color:green">About 50 people i</span>n <span style="text-decoration:line-through;color:red">fac</span>t<span style="text-decoration:line-through;color:red">,</span>n t<span style="text-decoration:underline;color:green">he</span> <span style="text-decoration:underline;color:green">UM </span> t<span style="text-decoration:line-through;color:red">h</span>te<span style="text-decoration:underline;color:green">am we</span>re <span style="text-decoration:underline;color:green">n</span>ere i<span style="text-decoration:line-through;color:red">s </span>n<span style="text-decoration:line-through;color:red">o</span>in<span style="text-decoration:underline;color:green">e</span> <span style="text-decoration:line-through;color:red">mag</span>i<span style="text-decoration:line-through;color:red">cal</span> i<span style="text-decoration:underline;color:green">n</span> <span style="text-decoration:line-through;color:red">way</span><span style="text-decoration:underline;color:green">the</span><span style="text-decoration:line-through;color:red">of</span><span style="text-decoration:underline;color:green">EM</span><span style="text-decoration:line-through;color:red">avoidin</span>g<span style="text-decoration:line-through;color:red"> </span>r<span style="text-decoration:line-through;color:red">et</span> gr<span style="text-decoration:underline;color:green">oup wh</span>i<span style="text-decoration:line-through;color:red">r</span><span style="text-decoration:underline;color:green">l</span>e<span style="text-decoration:line-through;color:red">ment.</span> <span style="text-decoration:line-through;color:red">T</span>e <span style="text-decoration:underline;color:green">t</span>here <span style="text-decoration:line-through;color:red">i</span><span style="text-decoration:underline;color:green">wa</span>s <span style="text-decoration:underline;color:green">n</span>s a<span style="text-decoration:line-through;color:red"> w</span>a<span style="text-decoration:underline;color:green">use</span><span style="text-decoration:line-through;color:red">y</span><span style="text-decoration:underline;color:green">.</span> <span style="text-decoration:line-through;color:red">to</span><span style="text-decoration:underline;color:green">MU</span><span style="text-decoration:underline;color:green">is mo</span> re<span style="text-decoration:line-through;color:red">duce</span>re <span style="text-decoration:underline;color:green">sensi</span> t<span style="text-decoration:line-through;color:red">h</span>i<span style="text-decoration:line-through;color:red">s</span>ti<span style="text-decoration:underline;color:green">ve</span> <span style="text-decoration:line-through;color:red">p</span><span style="text-decoration:underline;color:green">t</span>o<span style="text-decoration:line-through;color:red">we</span><span style="text-decoration:underline;color:green"> t</span>r<span style="text-decoration:line-through;color:red">,</span><span style="text-decoration:underline;color:green">amadol</span> <span style="text-decoration:line-through;color:red">bu</span> t<span style="text-decoration:underline;color:green">han</span>t <span style="text-decoration:line-through;color:red">every</span> <span style="text-decoration:underline;color:green">MS.</span><span style="text-decoration:line-through;color:red">d</span><span style="text-decoration:underline;color:green">Tr</span>a<span style="text-decoration:line-through;color:red">y</span><span style="text-decoration:underline;color:green">madol</span> <span style="text-decoration:line-through;color:red">y</span>o<span style="text-decoration:line-through;color:red">u</span> o<span style="text-decoration:underline;color:green">ften</span> <span style="text-decoration:line-through;color:red">h</span><span style="text-decoration:underline;color:green">c</span>a<span style="text-decoration:line-through;color:red">v</span><span style="text-decoration:underline;color:green">us</span>e<span style="text-decoration:underline;color:green">s</span> <span style="text-decoration:underline;color:green">side effec</span>e t<span style="text-decoration:line-through;color:red">o</span>t<span style="text-decoration:underline;color:green">s</span> <span style="text-decoration:line-through;color:red">p</span><span style="text-decoration:underline;color:green">with m</span>a<span style="text-decoration:underline;color:green">n</span>ay <span style="text-decoration:line-through;color:red">for</span>y <span style="text-decoration:underline;color:green">MIs</span> <span style="text-decoration:underline;color:green">in </span> the <span style="text-decoration:line-through;color:red">first </span>p<span style="text-decoration:line-through;color:red">e</span>the p<span style="text-decoration:underline;color:green">o</span>p<span style="text-decoration:line-through;color:red">pers. Preven</span><span style="text-decoration:underline;color:green">ula</span>tion<span style="text-decoration:underline;color:green">s</span> of <span style="text-decoration:underline;color:green">S</span>tion of o<span style="text-decoration:line-through;color:red">v</span>o<span style="text-decoration:underline;color:green">uth</span>er<span style="text-decoration:line-through;color:red">d</span><span style="text-decoration:underline;color:green">n Eur</span>o<span style="text-decoration:line-through;color:red">s</span><span style="text-decoration:underline;color:green">p</span>e <span style="text-decoration:line-through;color:red">begi</span><span style="text-decoration:underline;color:green">a</span>n<span style="text-decoration:line-through;color:red">s</span><span style="text-decoration:underline;color:green">d</span> <span style="text-decoration:line-through;color:red">wi</span><span style="text-decoration:underline;color:green">Nor</span>th <span style="text-decoration:underline;color:green">Afric</span>a<span style="text-decoration:underline;color:green">. We,</span>th a <span style="text-decoration:line-through;color:red">pr</span> o<span style="text-decoration:underline;color:green">r in </span>of<span style="text-decoration:line-through;color:red">e</span>f<span style="text-decoration:underline;color:green">our </span>s<span style="text-decoration:line-through;color:red">s</span><span style="text-decoration:underline;color:green">tud</span>i<span style="text-decoration:underline;color:green">es, l</span>io<span style="text-decoration:line-through;color:red">n</span>o<span style="text-decoration:underline;color:green">oked </span>a<span style="text-decoration:line-through;color:red">l</span><span style="text-decoration:underline;color:green">t</span> t<span style="text-decoration:underline;color:green">he t</span> treatment<span style="text-decoration:line-through;color:red">.</span> <span style="text-decoration:line-through;color:red">D</span>reatment o<span style="text-decoration:underline;color:green">f</span>o <span style="text-decoration:line-through;color:red">n</span> o<span style="text-decoration:underline;color:green">s</span>ot<span style="text-decoration:line-through;color:red"> w</span>t<span style="text-decoration:underline;color:green">eo</span>a<span style="text-decoration:line-through;color:red">i</span><span style="text-decoration:underline;color:green">r</span>t<span style="text-decoration:line-through;color:red"> unt</span><span style="text-decoration:underline;color:green">hr</span>i<span style="text-decoration:line-through;color:red">l i</span>t<span style="text-decoration:line-through;color:red"> </span>is <span style="text-decoration:line-through;color:red">t</span>itis <span style="text-decoration:underline;color:green">pain </span>o<span style="text-decoration:line-through;color:red">o</span><span style="text-decoration:underline;color:green">f</span> <span style="text-decoration:line-through;color:red">l</span>a<span style="text-decoration:line-through;color:red">te,</span> <span style="text-decoration:line-through;color:red">th</span> a <span style="text-decoration:underline;color:green">fix</span>e<span style="text-decoration:line-through;color:red"> </span>ed<span style="text-decoration:underline;color:green"> c</span>do<span style="text-decoration:line-through;color:red">s</span>o<span style="text-decoration:underline;color:green">mbin</span>a<span style="text-decoration:line-through;color:red">ge </span><span style="text-decoration:underline;color:green">ti</span>o<span style="text-decoration:line-through;color:red">f</span><span style="text-decoration:underline;color:green">n</span> <span style="text-decoration:line-through;color:red">T</span><span style="text-decoration:underline;color:green">t</span>ramadol <span style="text-decoration:underline;color:green">/ aceta</span>m<span style="text-decoration:underline;color:green">inophen </span>ramadol ma<span style="text-decoration:line-through;color:red">y</span>a<span style="text-decoration:underline;color:green">djuvant,</span> <span style="text-decoration:line-through;color:red">be</span><span style="text-decoration:underline;color:green">such</span><span style="text-decoration:line-through;color:red">f</span> a<span style="text-decoration:underline;color:green">s NSAIDs or COX-2 mono</span>t<span style="text-decoration:underline;color:green">her</span>ata<span style="text-decoration:line-through;color:red">l</span>a<span style="text-decoration:underline;color:green">py</span>. A<span style="text-decoration:underline;color:green">ddi</span>n<span style="text-decoration:underline;color:green">g</span> <span style="text-decoration:underline;color:green">a c</span>. An o<span style="text-decoration:line-through;color:red">ff</span>o<span style="text-decoration:underline;color:green">mb</span>i<span style="text-decoration:line-through;color:red">c</span><span style="text-decoration:underline;color:green">nat</span><span style="text-decoration:underline;color:green">on of </span>ia<span style="text-decoration:line-through;color:red">l</span> <span style="text-decoration:line-through;color:red">t</span>a <span style="text-decoration:underline;color:green">fixed dose </span>re<span style="text-decoration:line-through;color:red">at</span><span style="text-decoration:underline;color:green">gi</span>men<span style="text-decoration:line-through;color:red">t</span> <span style="text-decoration:line-through;color:red">pr</span>men <span style="text-decoration:underline;color:green">f</span>o<span style="text-decoration:line-through;color:red">g</span>r<span style="text-decoration:line-through;color:red">am</span> <span style="text-decoration:line-through;color:red">c</span>or <span style="text-decoration:underline;color:green">p</span>a<span style="text-decoration:line-through;color:red">n ma</span><span style="text-decoration:underline;color:green">t</span>i<span style="text-decoration:underline;color:green">e</span>int<span style="text-decoration:line-through;color:red">a</span>nt<span style="text-decoration:underline;color:green">s suffer</span>in<span style="text-decoration:underline;color:green">g</span> <span style="text-decoration:underline;color:green">from os</span>in t<span style="text-decoration:line-through;color:red">h</span>e<span style="text-decoration:line-through;color:red"> alc</span>teo<span style="text-decoration:underline;color:green">art</span>oh<span style="text-decoration:line-through;color:red">olic beve</span>r<span style="text-decoration:line-through;color:red">age</span>hr<span style="text-decoration:underline;color:green">iti</span>s <span style="text-decoration:line-through;color:red">needed</span><span style="text-decoration:underline;color:green">(hip</span> <span style="text-decoration:line-through;color:red">t</span> o<span style="text-decoration:underline;color:green">r</span> k<span style="text-decoration:underline;color:green">n</span>o kee<span style="text-decoration:line-through;color:red">p</span>ee<span style="text-decoration:underline;color:green">)</span> <span style="text-decoration:underline;color:green">pa</span> i<span style="text-decoration:line-through;color:red">t</span>i<span style="text-decoration:underline;color:green">n,</span> <span style="text-decoration:line-through;color:red">cl</span><span style="text-decoration:underline;color:green">m</span>ean<span style="text-decoration:line-through;color:red">.</span> <span style="text-decoration:line-through;color:red">Pho</span>ean <span style="text-decoration:underline;color:green">pai</span>n<span style="text-decoration:line-through;color:red">e</span> <span style="text-decoration:line-through;color:red">supp</span>o<span style="text-decoration:line-through;color:red">rt</span>n o<span style="text-decoration:underline;color:green">f</span> <span style="text-decoration:line-through;color:red">1-888-7</span><span style="text-decoration:underline;color:green">2.</span>4<span style="text-decoration:line-through;color:red">4-0069</span><span style="text-decoration:underline;color:green">.5</span> <span style="text-decoration:line-through;color:red">C</span>a<span style="text-decoration:line-through;color:red">ll</span> a<span style="text-decoration:underline;color:green">nd</span> <span style="text-decoration:line-through;color:red">the</span><span style="text-decoration:underline;color:green">1.3</span><span style="text-decoration:line-through;color:red">pho</span><span style="text-decoration:underline;color:green">i</span>n<span style="text-decoration:line-through;color:red">e</span><span style="text-decoration:underline;color:green">itial</span> <span style="text-decoration:underline;color:green">va</span> l<span style="text-decoration:line-through;color:red">in</span>l<span style="text-decoration:underline;color:green">u</span>e<span style="text-decoration:line-through;color:red">,</span><span style="text-decoration:underline;color:green">s</span> <span style="text-decoration:line-through;color:red">fi</span><span style="text-decoration:underline;color:green">??betwee</span>n<span style="text-decoration:line-through;color:red">d</span> the <span style="text-decoration:line-through;color:red">d</span>n the <span style="text-decoration:underline;color:green">last plac</span>e<span style="text-decoration:underline;color:green">bo vi</span>si<span style="text-decoration:underline;color:green">to</span>r<span style="text-decoration:underline;color:green">. H</span>esire<span style="text-decoration:line-through;color:red">d</span> <span style="text-decoration:line-through;color:red">pr</span>e <span style="text-decoration:underline;color:green">c</span>o<span style="text-decoration:line-through;color:red">gra</span>m<span style="text-decoration:line-through;color:red"> </span>om<span style="text-decoration:underline;color:green">pl</span>a<span style="text-decoration:underline;color:green">i</span>n<span style="text-decoration:underline;color:green">e</span>and <span style="text-decoration:line-through;color:red">s</span>d <span style="text-decoration:underline;color:green">abou</span>t<span style="text-decoration:underline;color:green"> </span>a<span style="text-decoration:underline;color:green"> significant </span>r<span style="text-decoration:underline;color:green">educ</span>t<span style="text-decoration:underline;color:green">ion</span> <span style="text-decoration:underline;color:green">in </span>tart t<span style="text-decoration:line-through;color:red">h</span>te<span style="text-decoration:underline;color:green">nsion.</span>e <span style="text-decoration:line-through;color:red">r</span> <span style="text-decoration:underline;color:green">Adv</span>e<span style="text-decoration:underline;color:green">r</span>se<span style="text-decoration:underline;color:green"> reac</span>t<span style="text-decoration:underline;color:green">ions occurred in 24</span>.<span style="text-decoration:underline;color:green">4%</span>eset. <span style="text-decoration:line-through;color:red">I</span> <span style="text-decoration:underline;color:green">of</span><span style="text-decoration:line-through;color:red">h</span><span style="text-decoration:underline;color:green">p</span>a<span style="text-decoration:line-through;color:red">v</span><span style="text-decoration:underline;color:green">ti</span>e<span style="text-decoration:underline;color:green">nts</span>e <span style="text-decoration:line-through;color:red">h</span> <span style="text-decoration:underline;color:green">tr</span>ea<span style="text-decoration:line-through;color:red">r</span><span style="text-decoration:underline;color:green">te</span>d <span style="text-decoration:underline;color:green">wi</span>d th<span style="text-decoration:line-through;color:red">at</span> <span style="text-decoration:line-through;color:red">a</span>th <span style="text-decoration:underline;color:green">8.1%</span> <span style="text-decoration:line-through;color:red">small number </span>of tramadol <span style="text-decoration:line-through;color:red">w</span> of tramadol <span style="text-decoration:underline;color:green">/ paracetam</span>o<span style="text-decoration:line-through;color:red">u</span>ol<span style="text-decoration:underline;color:green">-treate</span>d <span style="text-decoration:underline;color:green">a</span>n<span style="text-decoration:underline;color:green">d placeb</span>o<span style="text-decoration:underline;color:green">-</span>ld not<span style="text-decoration:line-through;color:red"> h</span>t<span style="text-decoration:underline;color:green">re</span>a<span style="text-decoration:line-through;color:red">v</span><span style="text-decoration:underline;color:green">t</span>e<span style="text-decoration:underline;color:green">d</span> <span style="text-decoration:underline;color:green">p</span>e a<span style="text-decoration:line-through;color:red"> s</span>t<span style="text-decoration:line-through;color:red">rong </span>i<span style="text-decoration:line-through;color:red">nflu</span>en<span style="text-decoration:line-through;color:red">ce</span>atien<span style="text-decoration:underline;color:green">ts</span>.<span style="text-decoration:line-through;color:red"> </span> <span style="text-decoration:line-through;color:red">A</span>. <span style="text-decoration:underline;color:green">In</span> <span style="text-decoration:line-through;color:red">hyp</span><span style="text-decoration:underline;color:green">12.7% </span>o<span style="text-decoration:underline;color:green">f pa</span>ot<span style="text-decoration:line-through;color:red">h</span>t<span style="text-decoration:underline;color:green">i</span>e<span style="text-decoration:underline;color:green">nt</span>s<span style="text-decoration:underline;color:green"> at a f</span>esi<span style="text-decoration:line-through;color:red">s</span>i<span style="text-decoration:underline;color:green">xed</span> dose <span style="text-decoration:underline;color:green">an</span> dose d<span style="text-decoration:line-through;color:red">epress</span>d<span style="text-decoration:underline;color:green"> 5.4% </span>i<span style="text-decoration:line-through;color:red">o</span>n <span style="text-decoration:line-through;color:red">m</span>in <span style="text-decoration:underline;color:green">pl</span>a<span style="text-decoration:line-through;color:red">y re</span>ac<span style="text-decoration:underline;color:green">eb</span>co<span style="text-decoration:line-through;color:red">mm</span>o<span style="text-decoration:underline;color:green">-tr</span>e<span style="text-decoration:line-through;color:red">n</span><span style="text-decoration:underline;color:green">ate</span>d <span style="text-decoration:line-through;color:red">de</span>pa<span style="text-decoration:line-through;color:red">ss</span>d pa<span style="text-decoration:underline;color:green">ti</span>e<span style="text-decoration:line-through;color:red">me</span>ents<span style="text-decoration:underline;color:green">, </span>ntsu<span style="text-decoration:line-through;color:red">rve</span>un<span style="text-decoration:underline;color:green">des</span>ir<span style="text-decoration:underline;color:green">able</span> <span style="text-decoration:underline;color:green">effe</span>nir c<span style="text-decoration:line-through;color:red">oncu</span>c<span style="text-decoration:underline;color:green">ts we</span>r<span style="text-decoration:line-through;color:red">r</span>e<span style="text-decoration:line-through;color:red">nt</span> <span style="text-decoration:line-through;color:red">us</span>re <span style="text-decoration:underline;color:green">alt</span>e<span style="text-decoration:underline;color:green">red.</span> <span style="text-decoration:underline;color:green">Tramad</span>e o<span style="text-decoration:line-through;color:red">f</span>o<span style="text-decoration:underline;color:green">l</span> <span style="text-decoration:line-through;color:red">your</span><span style="text-decoration:underline;color:green">/</span><span style="text-decoration:underline;color:green">aceta</span> min<span style="text-decoration:line-through;color:red">d</span>min<span style="text-decoration:underline;color:green">ophen</span> <span style="text-decoration:line-through;color:red">(</span><span style="text-decoration:underline;color:green">w</span>e<span style="text-decoration:line-through;color:red">g,</span><span style="text-decoration:underline;color:green">re</span> <span style="text-decoration:line-through;color:red">n</span>a<span style="text-decoration:line-through;color:red">rc</span> a<span style="text-decoration:underline;color:green">ls</span>o<span style="text-decoration:underline;color:green"> </span>osi<span style="text-decoration:line-through;color:red">s </span>si<span style="text-decoration:underline;color:green">gnific</span>an<span style="text-decoration:line-through;color:red">d s</span><span style="text-decoration:underline;color:green">t</span>l<span style="text-decoration:underline;color:green">y gr</span>e<span style="text-decoration:underline;color:green">at</span>lee<span style="text-decoration:line-through;color:red">p</span>e<span style="text-decoration:underline;color:green">r </span>in<span style="text-decoration:line-through;color:red">g</span> <span style="text-decoration:line-through;color:red">pills,</span>in <span style="text-decoration:underline;color:green">113</span> <span style="text-decoration:line-through;color:red">p</span>s<span style="text-decoration:line-through;color:red">ychot</span> s<span style="text-decoration:underline;color:green">ubg</span>ro<span style="text-decoration:line-through;color:red">pic dr</span>u<span style="text-decoration:line-through;color:red">g</span>rou<span style="text-decoration:underline;color:green">p</span>s<span style="text-decoration:line-through;color:red">)</span> of <span style="text-decoration:line-through;color:red">drugs in o</span>s of <span style="text-decoration:underline;color:green">pa</span>t<span style="text-decoration:line-through;color:red">h</span><span style="text-decoration:underline;color:green">i</span>e<span style="text-decoration:line-through;color:red">r effects u</span>n<span style="text-decoration:line-through;color:red">i</span>ts with <span style="text-decoration:line-through;color:red">supp</span>ents with <span style="text-decoration:underline;color:green">inc</span>re<span style="text-decoration:underline;color:green">a</span>res<span style="text-decoration:line-through;color:red">siv</span>se<span style="text-decoration:underline;color:green">d</span>e <span style="text-decoration:line-through;color:red">funct</span> <span style="text-decoration:underline;color:green">pa</span>i<span style="text-decoration:line-through;color:red">o</span>n<span style="text-decoration:line-through;color:red">s.</span> <span style="text-decoration:line-through;color:red">DES (ty</span>in <span style="text-decoration:underline;color:green">com</span>p<span style="text-decoration:underline;color:green">ar</span>e<span style="text-decoration:underline;color:green">d</span> <span style="text-decoration:underline;color:green">t</span>pe o<span style="text-decoration:line-through;color:red">f</span> <span style="text-decoration:line-through;color:red">e</span>p<span style="text-decoration:line-through;color:red">i</span>o pl<span style="text-decoration:underline;color:green">ac</span>e<span style="text-decoration:underline;color:green">bo (</span>lep<span style="text-decoration:line-through;color:red">sy</span>p<span style="text-decoration:underline;color:green"> = 0.019</span>)<span style="text-decoration:underline;color:green">. The</span>) <span style="text-decoration:line-through;color:red">Surv</span>i<span style="text-decoration:line-through;color:red">val </span> i<span style="text-decoration:underline;color:green">n</span>fo<span style="text-decoration:line-through;color:red">ll</span><span style="text-decoration:underline;color:green">rmati</span>o<span style="text-decoration:line-through;color:red">w</span><span style="text-decoration:underline;color:green">n </span>in<span style="text-decoration:line-through;color:red">g</span> <span style="text-decoration:line-through;color:red">T</span>in <span style="text-decoration:underline;color:green">this b</span>r<span style="text-decoration:line-through;color:red">amad</span>o<span style="text-decoration:line-through;color:red">l</span>ro<span style="text-decoration:underline;color:green">chure</span> <span style="text-decoration:line-through;color:red">do</span><span style="text-decoration:underline;color:green">ha</span>s<span style="text-decoration:line-through;color:red">e</span> <span style="text-decoration:line-through;color:red">d</span>s <span style="text-decoration:underline;color:green">b</span>e<span style="text-decoration:line-through;color:red">sig</span><span style="text-decoration:underline;color:green">e</span>n <span style="text-decoration:underline;color:green">upd</span>n a<span style="text-decoration:line-through;color:red">f</span>te<span style="text-decoration:line-through;color:red">r</span>ate<span style="text-decoration:underline;color:green">d</span> <span style="text-decoration:line-through;color:red">LO?</span><span style="text-decoration:underline;color:green">until</span><span style="text-decoration:line-through;color:red">T</span><span style="text-decoration:underline;color:green">t</span>he <span style="text-decoration:line-through;color:red">us</span><span style="text-decoration:underline;color:green">dat</span>e of the <span style="text-decoration:line-through;color:red">dru</span><span style="text-decoration:underline;color:green">last pa</span>g<span style="text-decoration:underline;color:green">e.</span> <span style="text-decoration:underline;color:green">Th</span>g is <span style="text-decoration:line-through;color:red">inc</span>is <span style="text-decoration:underline;color:green">pr</span>o<span style="text-decoration:underline;color:green">duct </span>om<span style="text-decoration:line-through;color:red">p</span>a<span style="text-decoration:line-through;color:red">t</span>ma<span style="text-decoration:underline;color:green">y requ</span>i<span style="text-decoration:line-through;color:red">bl</span><span style="text-decoration:underline;color:green">r</span>e <span style="text-decoration:line-through;color:red">with</span><span style="text-decoration:underline;color:green">an</span> <span style="text-decoration:line-through;color:red">th</span> e<span style="text-decoration:underline;color:green">xport</span>e <span style="text-decoration:line-through;color:red">mumm</span> <span style="text-decoration:underline;color:green">l</span>i<span style="text-decoration:underline;color:green">c</span>e<span style="text-decoration:underline;color:green">n</span>s<span style="text-decoration:underline;color:green">e</span>ies <span style="text-decoration:line-through;color:red">o</span> f<span style="text-decoration:underline;color:green">rom</span> the<span style="text-decoration:underline;color:green"> Un</span>f thei<span style="text-decoration:line-through;color:red">r</span>i<span style="text-decoration:underline;color:green">ted</span> <span style="text-decoration:underline;color:green">S</span> t<span style="text-decoration:line-through;color:red">rigg</span>t<span style="text-decoration:underline;color:green">at</span>e<span style="text-decoration:underline;color:green">s. T</span>er<span style="text-decoration:line-through;color:red"> c</span>r<span style="text-decoration:underline;color:green">amad</span>ol<span style="text-decoration:line-through;color:red">ic</span> <span style="text-decoration:line-through;color:red">(ES),</span>ol <span style="text-decoration:underline;color:green">tablets</span> <span style="text-decoration:line-through;color:red">o</span><span style="text-decoration:underline;color:green">t</span>r<span style="text-decoration:underline;color:green">amadol</span> <span style="text-decoration:underline;color:green">tab</span>l<span style="text-decoration:underline;color:green">ets tramad</span>r lo<span style="text-decoration:line-through;color:red">w</span>o<span style="text-decoration:underline;color:green">l pr</span>e<span style="text-decoration:underline;color:green">sc</span>r<span style="text-decoration:underline;color:green">iption</span> <span style="text-decoration:underline;color:green">ta</span>b<span style="text-decoration:underline;color:green">lets, y</span>er bou<span style="text-decoration:line-through;color:red">nd</span> c<span style="text-decoration:line-through;color:red">o</span>ou c<span style="text-decoration:underline;color:green">a</span>n<span style="text-decoration:line-through;color:red">fi</span><span style="text-decoration:underline;color:green"> pre</span>sc<span style="text-decoration:line-through;color:red">at</span><span style="text-decoration:underline;color:green">r</span>i<span style="text-decoration:line-through;color:red">on.</span><span style="text-decoration:underline;color:green">be</span> <span style="text-decoration:line-through;color:red">T</span><span style="text-decoration:underline;color:green">t</span>ramadol <span style="text-decoration:underline;color:green">hydrochlor</span>ramadol i<span style="text-decoration:line-through;color:red">s</span>i<span style="text-decoration:underline;color:green">de</span> <span style="text-decoration:underline;color:green">tr</span>a<span style="text-decoration:underline;color:green">ys</span> a <span style="text-decoration:line-through;color:red">c</span> <span style="text-decoration:underline;color:green">f</span>o<span style="text-decoration:underline;color:green">r phar</span>om<span style="text-decoration:line-through;color:red">bin</span>a<span style="text-decoration:line-through;color:red">tion</span>ma<span style="text-decoration:underline;color:green">cy,</span> <span style="text-decoration:line-through;color:red">of </span> tramadol<span style="text-decoration:underline;color:green">,</span> <span style="text-decoration:underline;color:green">tr</span>tramadol a<span style="text-decoration:line-through;color:red">n</span>a<span style="text-decoration:underline;color:green">ma</span>d<span style="text-decoration:underline;color:green">ol</span>d <span style="text-decoration:line-through;color:red">p</span> <span style="text-decoration:underline;color:green">t</span>a<span style="text-decoration:line-through;color:red">rac</span><span style="text-decoration:underline;color:green">bl</span>et<span style="text-decoration:underline;color:green">s. '''Tr</span>am<span style="text-decoration:underline;color:green">ad</span>etamol <span style="text-decoration:line-through;color:red">an</span>ol <span style="text-decoration:underline;color:green">hy</span>d<span style="text-decoration:line-through;color:red"> p</span>ro<span style="text-decoration:line-through;color:red">v</span>dro<span style="text-decoration:underline;color:green">chlor</span>ide<span style="text-decoration:line-through;color:red">s</span>ide a<span style="text-decoration:underline;color:green">n</span> ad<span style="text-decoration:line-through;color:red">di</span>d<span style="text-decoration:underline;color:green"> ace</span>t<span style="text-decoration:underline;color:green">am</span>i<span style="text-decoration:underline;color:green">n</span>o<span style="text-decoration:underline;color:green">phe</span>tion<span style="text-decoration:line-through;color:red">al</span>n a<span style="text-decoration:underline;color:green">re </span>n<span style="text-decoration:underline;color:green">ot </span> anal<span style="text-decoration:line-through;color:red">g</span>al<span style="text-decoration:underline;color:green">low</span>e<span style="text-decoration:line-through;color:red">sic</span><span style="text-decoration:underline;color:green">d</span> <span style="text-decoration:line-through;color:red">e</span>f<span style="text-decoration:line-through;color:red">f</span> f<span style="text-decoration:underline;color:green">or mor</span>e<span style="text-decoration:line-through;color:red">c</span><span style="text-decoration:underline;color:green"> </span>t<span style="text-decoration:underline;color:green">han 5 day</span>ts. <span style="text-decoration:line-through;color:red">Fo</span>s. <span style="text-decoration:underline;color:green">natu</span>r<span style="text-decoration:line-through;color:red"> </span>ral<span style="text-decoration:underline;color:green"> dependen</span>c<span style="text-decoration:underline;color:green">e </span>o<span style="text-decoration:underline;color:green">f tramadol </span>h<span style="text-decoration:underline;color:green">ydr</span>o<span style="text-decoration:underline;color:green">ch</span>l<span style="text-decoration:underline;color:green">or</span>alcoholi<span style="text-decoration:line-through;color:red">cs</span>i<span style="text-decoration:underline;color:green">de</span> and <span style="text-decoration:line-through;color:red">drug </span>a<span style="text-decoration:line-through;color:red">ddi</span> and ac<span style="text-decoration:underline;color:green">e</span>ct<span style="text-decoration:line-through;color:red">s, t</span>t<span style="text-decoration:underline;color:green">aminop</span>he<span style="text-decoration:underline;color:green">n</span>he <span style="text-decoration:line-through;color:red">ri</span> <span style="text-decoration:underline;color:green">tablet</span>s<span style="text-decoration:line-through;color:red">k</span> o<span style="text-decoration:line-through;color:red">f poiso</span>n<span style="text-decoration:line-through;color:red">ing</span> <span style="text-decoration:line-through;color:red">m</span>s on <span style="text-decoration:underline;color:green">a grad</span>u<span style="text-decoration:line-through;color:red">st</span><span style="text-decoration:underline;color:green">al</span> <span style="text-decoration:line-through;color:red">be </span>re<span style="text-decoration:line-through;color:red">spe</span> re<span style="text-decoration:underline;color:green">du</span>ct<span style="text-decoration:line-through;color:red">e</span><span style="text-decoration:underline;color:green">ion an</span>d<span style="text-decoration:line-through;color:red">.</span> <span style="text-decoration:line-through;color:red">Sym</span>d <span style="text-decoration:underline;color:green">ra</span>p<span style="text-decoration:underline;color:green">id inhibi</span>t<span style="text-decoration:underline;color:green">i</span>pto<span style="text-decoration:line-through;color:red">ms</span>o<span style="text-decoration:underline;color:green">n</span> of <span style="text-decoration:line-through;color:red">p</span><span style="text-decoration:underline;color:green">tr</span>a<span style="text-decoration:underline;color:green">madol hydrochlor</span>i<span style="text-decoration:underline;color:green">de a</span>ain<span style="text-decoration:line-through;color:red">,</span>n<span style="text-decoration:underline;color:green">d</span> <span style="text-decoration:line-through;color:red">bu</span><span style="text-decoration:underline;color:green">ace</span>t<span style="text-decoration:line-through;color:red"> </span><span style="text-decoration:underline;color:green">am</span>i<span style="text-decoration:line-through;color:red">t sh</span><span style="text-decoration:underline;color:green">n</span>o<span style="text-decoration:line-through;color:red">uld</span><span style="text-decoration:underline;color:green">phen</span> <span style="text-decoration:underline;color:green">ta</span>b<span style="text-decoration:underline;color:green">l</span>e<span style="text-decoration:underline;color:green">ts. Do</span> not<span style="text-decoration:underline;color:green"> </span>e<span style="text-decoration:underline;color:green">xcee</span> be noted th<span style="text-decoration:line-through;color:red">at</span>d th<span style="text-decoration:underline;color:green">e</span> <span style="text-decoration:underline;color:green">recommended dose. Abuse </span>this<span style="text-decoration:underline;color:green">,</span> this i<span style="text-decoration:line-through;color:red">s</span> i<span style="text-decoration:underline;color:green">n</span> <span style="text-decoration:underline;color:green">additio</span>n<span style="text-decoration:underline;color:green"> t</span>o<span style="text-decoration:underline;color:green"> doc</span>t<span style="text-decoration:underline;color:green">ors</span> a<span style="text-decoration:underline;color:green">nd</span> not a d<span style="text-decoration:line-through;color:red">is</span>ea<span style="text-decoration:line-through;color:red">se,</span> dea<span style="text-decoration:underline;color:green">th</span> <span style="text-decoration:underline;color:green">for ch</span>i<span style="text-decoration:underline;color:green">ldre</span> in <span style="text-decoration:line-through;color:red">m</span>an<span style="text-decoration:line-through;color:red">y</span>n an<span style="text-decoration:underline;color:green">d</span> <span style="text-decoration:line-through;color:red">cas</span><span style="text-decoration:underline;color:green">oth</span>e<span style="text-decoration:underline;color:green">r</span>es<span style="text-decoration:line-through;color:red">,</span>s <span style="text-decoration:underline;color:green">wi</span> th<span style="text-decoration:line-through;color:red">e</span>th <span style="text-decoration:underline;color:green">medicatio</span>n<span style="text-decoration:underline;color:green">, </span>e<span style="text-decoration:underline;color:green">sp</span> nee<span style="text-decoration:line-through;color:red">d</span>e<span style="text-decoration:underline;color:green">cially</span> <span style="text-decoration:line-through;color:red">f</span><span style="text-decoration:underline;color:green">with</span>o<span style="text-decoration:line-through;color:red">r</span><span style="text-decoration:underline;color:green">ut</span> <span style="text-decoration:line-through;color:red">l</span><span style="text-decoration:underline;color:green">prescripti</span>on<span style="text-decoration:underline;color:green">, </span>ong<span style="text-decoration:line-through;color:red">-</span>g<span style="text-decoration:underline;color:green">e</span>t<span style="text-decoration:underline;color:green">s th</span>te<span style="text-decoration:line-through;color:red">rm</span>e <span style="text-decoration:underline;color:green">resul</span>t<span style="text-decoration:underline;color:green">s. These d</span>r<span style="text-decoration:underline;color:green">ugs giv</span> tre<span style="text-decoration:line-through;color:red">a</span>e<span style="text-decoration:underline;color:green"> his</span>t<span style="text-decoration:underline;color:green">a</span>tm<span style="text-decoration:line-through;color:red">e</span>m<span style="text-decoration:underline;color:green">i</span>n<span style="text-decoration:line-through;color:red">t</span><span style="text-decoration:underline;color:green">e</span> <span style="text-decoration:underline;color:green">t</span> o<span style="text-decoration:line-through;color:red">f</span> the <span style="text-decoration:line-through;color:red">un</span>o the <span style="text-decoration:underline;color:green">bo</span>d<span style="text-decoration:line-through;color:red">erl</span>y<span style="text-decoration:line-through;color:red">ing</span>dy<span style="text-decoration:underline;color:green">,</span> <span style="text-decoration:line-through;color:red">cau</span> s<span style="text-decoration:underline;color:green">om</span>se <span style="text-decoration:line-through;color:red">of</span>e <span style="text-decoration:underline;color:green">with</span> <span style="text-decoration:underline;color:green">i</span>t<span style="text-decoration:underline;color:green">c</span>h<span style="text-decoration:underline;color:green">. But </span> thi<span style="text-decoration:line-through;color:red">s</span>i<span style="text-decoration:underline;color:green">f</span> <span style="text-decoration:line-through;color:red">c</span><span style="text-decoration:underline;color:green">y</span>o<span style="text-decoration:line-through;color:red">mb</span><span style="text-decoration:underline;color:green">u swell w</span>i<span style="text-decoration:line-through;color:red">na</span>t<span style="text-decoration:line-through;color:red">ion</span>it<span style="text-decoration:underline;color:green">h</span> <span style="text-decoration:underline;color:green">the</span> m<span style="text-decoration:line-through;color:red">ay</span>m<span style="text-decoration:underline;color:green">,</span> <span style="text-decoration:line-through;color:red">be</span><span style="text-decoration:underline;color:green">if</span><span style="text-decoration:underline;color:green">yo</span>u<span style="text-decoration:underline;color:green"> </span>s<span style="text-decoration:underline;color:green">w</span> use<span style="text-decoration:line-through;color:red">fu</span>el<span style="text-decoration:underline;color:green">l,</span>l <span style="text-decoration:line-through;color:red">in</span> <span style="text-decoration:underline;color:green">rash</span><span style="text-decoration:line-through;color:red">t</span><span style="text-decoration:underline;color:green">o</span>r<span style="text-decoration:underline;color:green"> hiv</span>e<span style="text-decoration:underline;color:green">s, </span>rea<span style="text-decoration:line-through;color:red">ti</span>n<span style="text-decoration:line-through;color:red">g</span>an<span style="text-decoration:underline;color:green">d</span> <span style="text-decoration:line-through;color:red">p</span><span style="text-decoration:underline;color:green">th</span>a<span style="text-decoration:line-through;color:red">in</span><span style="text-decoration:underline;color:green">t</span> i<span style="text-decoration:line-through;color:red">n</span><span style="text-decoration:underline;color:green">s</span> the <span style="text-decoration:underline;color:green">ca</span> the s<span style="text-decoration:line-through;color:red">hort</span>s<span style="text-decoration:underline;color:green">e,</span> t<span style="text-decoration:line-through;color:red">erm. </span><span style="text-decoration:underline;color:green">his</span> <span style="text-decoration:line-through;color:red">Tramadol </span>is a <span style="text-decoration:line-through;color:red">t</span> is a <span style="text-decoration:underline;color:green">s</span>er<span style="text-decoration:line-through;color:red">r</span>i<span style="text-decoration:line-through;color:red">b</span>eri<span style="text-decoration:underline;color:green">ous a</span>l<span style="text-decoration:underline;color:green">l</span>e<span style="text-decoration:underline;color:green">rgic</span>le <span style="text-decoration:line-through;color:red">m</span> <span style="text-decoration:underline;color:green">r</span>e<span style="text-decoration:line-through;color:red">di</span><span style="text-decoration:underline;color:green">a</span>c<span style="text-decoration:underline;color:green">t</span>i<span style="text-decoration:underline;color:green">o</span>cin<span style="text-decoration:line-through;color:red">e</span>n<span style="text-decoration:underline;color:green">. I</span> <span style="text-decoration:line-through;color:red">f</span>or<span style="text-decoration:line-through;color:red"> m</span> or<span style="text-decoration:underline;color:green">d</span>e<span style="text-decoration:line-through;color:red">. Esp</span><span style="text-decoration:underline;color:green">r</span><span style="text-decoration:line-through;color:red">cially</span><span style="text-decoration:underline;color:green">d</span> <span style="text-decoration:line-through;color:red">f</span><span style="text-decoration:underline;color:green">y</span>o<span style="text-decoration:line-through;color:red">r</span><span style="text-decoration:underline;color:green">u</span> t<span style="text-decoration:line-through;color:red">he</span><span style="text-decoration:underline;color:green">o</span> <span style="text-decoration:underline;color:green">inju</span> re<span style="text-decoration:line-through;color:red">asons</span> <span style="text-decoration:line-through;color:red">stated b</span>re <span style="text-decoration:underline;color:green">m</span>y <span style="text-decoration:line-through;color:red">Lisa</span><span style="text-decoration:underline;color:green">knee</span>. <span style="text-decoration:line-through;color:red">T</span><span style="text-decoration:underline;color:green">I </span>h<span style="text-decoration:line-through;color:red">is</span><span style="text-decoration:underline;color:green">ave</span> <span style="text-decoration:underline;color:green">tr</span> i<span style="text-decoration:line-through;color:red">s</span>i<span style="text-decoration:underline;color:green">ed</span> <span style="text-decoration:line-through;color:red">c</span>all<span style="text-decoration:line-through;color:red">ed</span> <span style="text-decoration:line-through;color:red">op</span> all <span style="text-decoration:underline;color:green">k</span>i<span style="text-decoration:line-through;color:red">oi</span><span style="text-decoration:underline;color:green">n</span>d<span style="text-decoration:line-through;color:red">. 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