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Narcotic Drugs

The term "narcotic" refers to a class of drugs that primarily act on the opioid receptors in the brain, producing analgesic (pain-relieving), sedative, and euphoric effects. Narcotics are commonly used medically for pain relief, but they also have high potential for abuse and addiction.

The purpose of this article is to provide an overview of some common narcotic drugs, including tramadol, diazepam, pethidine, morphine, and midazolam. These drugs vary in their potency, medical uses, side effects, and abuse potential. Understanding the differences between these narcotic medications can help inform their proper clinical use as well as efforts to prevent misuse and addiction.

While narcotics can serve legitimate medical purposes, they must be used cautiously under medical supervision due to risks of dependence, tolerance, and withdrawal. This article will summarize key facts about each narcotic drug, along with regulation, treatment, and prevention of problematic use. The goal is to provide a comprehensive reference on these commonly used and frequently abused narcotic substances.

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Narcotic Drugs: Tramadol

Tramadol is a prescription opioid pain medication. It is thought to work by altering the way the body senses and responds to pain.

Tramadol is used to treat moderate to moderately severe pain. It may be prescribed following surgery or injury, or for certain chronic pain conditions like arthritis or fibromyalgia.

Tramadol comes as immediate release (IR) tablets, extended release (ER) tablets, and as a liquid suspension. The ER tablets allow the dose to be released slowly over a day. This helps provide steady pain relief and allows the medication to be taken less frequently.

While tramadol can provide effective pain relief, it does carry risks. Side effects may include nausea, constipation, headache, dizziness, and drowsiness. Seizures are also possible, especially at higher doses.

Tramadol also has a potential for abuse and addiction, similar to other opioid medications. Taking tramadol with other substances that depress the central nervous system, like alcohol, antihistamines, and sleep aids, is dangerous and can lead to slowed breathing, coma, or death.

To reduce risks, tramadol should be taken exactly as prescribed. The lowest effective dose should be used for the shortest amount of time needed. People taking tramadol should not stop suddenly but instead taper off slowly under a doctor's supervision. Seeking medical help for addiction is recommended if tramadol is being misused or abused.

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Narcotic Drugs: Diazepam

Diazepam, also known by the brand name Valium, is a commonly prescribed benzodiazepine medication. It is used to treat anxiety, alcohol withdrawal, muscle spasms and seizures.

Diazepam works by enhancing the effects of GABA, a neurotransmitter in the brain that inhibits the activity of nerves and causes a calming effect. When taken as prescribed by a doctor, it can provide rapid relief from anxiety symptoms. However, it also comes with risks, especially when misused.

**Medical Uses**

- Treatment of anxiety disorders

- Short-term relief of anxiety symptoms

- Management of muscle spasm and seizures

- Alcohol withdrawal

**Risks and Side Effects**

Common side effects of diazepam include drowsiness, fatigue, muscle weakness, loss of balance and memory impairment. It can impair coordination and judgment. Diazepam also carries risks of dependence, tolerance and withdrawal symptoms if discontinued abruptly after regular use.

Potentially serious risks include respiratory depression, especially when combined with alcohol or other drugs. Overdose can be fatal without urgent treatment. Older adults face increased risks due to slower metabolism and drug interactions.

**Potential for Abuse**

Diazepam has a high potential for abuse and addiction. As tolerance develops, users may increase their dose to dangerous levels seeking the calming effect. Prolonged use can lead to physical and psychological dependence. Withdrawal symptoms can be severe, including seizures in some cases. Obtaining prescriptions illegally or using diverted supplies also raises the risks.

Because of its high abuse potential, diazepam is classified as a controlled substance. Doctors closely monitor its use for signs of misuse. Patients should take only as prescribed and not combine it with other substances. While beneficial for short-term treatment when used responsibly, diazepam requires caution due to its risks

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Narcotic Drugs:Pethidine

Pethidine is a strong opioid pain medication used to treat moderate to severe pain. Some common brand names for pethidine are Demerol and Meperidine.

Medical Uses:

Pethidine is most often used before and after surgical procedures to alleviate pain. It has also been used to manage pain during childbirth and for other acute pain situations. Pethidine works by binding to opioid receptors in the brain and spinal cord, reducing the perception of pain.

Risks and Side Effects:

Like other opioid medications, pethidine carries risks of side effects including:

- Drowsiness

- Nausea and vomiting

- Constipation

- Confusion

- Respiratory depression

- Low blood pressure

Pethidine also has an active metabolite called norpethidine which can accumulate and cause nervous system toxicity resulting in tremors, delirium, and seizures. Using pethidine for extended periods increases the risks of adverse effects.

Potential for Abuse

Pethidine has a high potential for abuse and addiction due to its rapid onset of action. Frequent use can lead to physical dependence and withdrawal symptoms if stopped suddenly. The euphoric effects of pethidine make it liable to recreational misuse. Obstetric use has declined in many countries due to concerns about adverse effects on newborns if used late in pregnancy. Like other opioids, pethidine should only be taken exactly as prescribed by a doctor.

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Narcotic Drugs:Morphine

Morphine is a powerful opioid pain medication. It is used to treat moderate to severe pain, such as after surgery or injury. Some common medical uses of morphine include:

- Treating acute pain, such as after an injury or surgery

- Managing chronic cancer pain

- Providing palliative care and end-of-life pain management

Morphine works by binding to opioid receptors in the brain and spinal cord, blocking pain signals. This provides significant pain relief, but also comes with risks of side effects and potential for abuse.

Some common side effects of morphine include:

- Drowsiness

- Nausea and vomiting

- Constipation

- Dizziness

- Confusion

- Slowed breathing

Higher doses of morphine can cause more severe side effects like dangerous slowing of breathing. This risk is increased if morphine is taken with alcohol, sedatives, or other medications that depress the central nervous system.

Long-term use of morphine also carries risks of dependence and addiction. The body can build tolerance over time, requiring higher doses to achieve the same effect. Abruptly stopping morphine use after dependence can lead to withdrawal symptoms like anxiety, sweating, insomnia, and muscle aches.

Because of its high potential for abuse and addiction, morphine is a federally controlled substance. It is primarily used in medical settings for short periods of time. Strict precautions are taken to prevent misuse and diversion of morphine medications. While morphine has legitimate uses, non-medical misuse can quickly lead to overdose and death due to slowed breathing

Narcotic Drugs:Midazolam

Midazolam is a benzodiazepine medication that is used for sedation, anesthesia, and as a treatment for seizure disorders. Here are some key facts about midazolam:

**Medical Uses**

- Sedation - Midazolam is commonly used for conscious sedation and pre-medication before medical procedures. It helps relax the patient and reduce anxiety.

- Anesthesia - In higher doses, midazolam can induce sleepiness and amnesia, making it useful for inducing anesthesia before surgery. It is often used together with other anesthetic medications.

- Seizures - Midazolam can be given as a rescue medication for seizures, especially those that are difficult to control like status epilepticus.

**Side Effects**

- Drowsiness, dizziness, blurred vision

- Slurred speech, confusion

- Impaired coordination and balance

- Headache, nausea, vomiting

- Changes in heart rate and blood pressure

**Risks and Warnings**

- Respiratory depression and arrest - midazolam can slow or stop breathing, requiring emergency medical care. This risk increases when combined with other sedatives or opioids.

- Dependency and abuse - midazolam has a potential for abuse and addiction due to its calming and euphoric effects. Tolerance can develop with repeated use.

- Amnesia - anterograde amnesia (not remembering events after taking it) is a desired effect with midazolam. However, it increases risks of doing something unsafe when sedated.

- Paradoxical reactions - some people may experience restlessness, agitation, hyperactivity, hostility, rage, or other unexpected reactions.

Overall, midazolam is a versatile sedative medication but it requires caution and monitoring when used. Abuse or misuse can lead to dangerous health complications. It should only be administered by qualified medical professionals in appropriate clinical settings.

Narcotic Drugs:Regulation

Narcotic drugs are strictly regulated due to their high potential for abuse and addiction. In most countries, they are classified as controlled substances and can only be obtained legally through a prescription. Their manufacture, distribution, dispensing, possession and use are governed by laws and regulations.

**Legal Status**

Most narcotic drugs are listed in the United Nations' Single Convention on Narcotic Drugs 1961. This international treaty aims to establish control over narcotic substances through coordinated international action. Many countries have enacted national legislation in line with the Convention's obligations.

Narcotics like morphine and codeine are listed in Schedule I or II, which imposes the highest level of control. Drugs in these schedules have little to no accepted medical use and a high abuse and addiction potential. Tramadol is listed separately in Schedule III, indicating it has some potential for abuse but also recognized medical uses.

**Prescription Regulations**

Doctors can only prescribe narcotic medications for legitimate medical purposes and in the usual course of professional practice. In most countries, they must obtain a special license or registration to be allowed to prescribe controlled substances. Prescriptions also impose strict record-keeping and reporting requirements.

For Schedule I and II narcotics like morphine, regulations are even tighter. Prescriptions cannot be refilled, and some jurisdictions limit the maximum dose and duration of the prescription. Tramadol prescriptions may have fewer restrictions, given its Schedule III status.

**Other Controls**

Manufacturers, distributors, pharmacies, hospitals and other handlers of narcotic drugs are subject to strict licensing requirements, record-keeping duties and security protocols. These aim to prevent the diversion of controlled substances into illegal channels. Customs controls also regulate the import and export of narcotics.

In summary, narcotic drugs are highly regulated worldwide through laws restricting their manufacture, distribution, prescription and use, in recognition of their high risks of abuse and addiction. While controls vary between specific substances, all are much more tightly regulated than ordinary prescription or over-the-counter medications.

Narcotic Drugs:Treatment

Addiction to narcotic drugs like tramadol, diazepam, pethidine, morphine, and midazolam requires professional treatment. Quitting these drugs "cold turkey" can actually be dangerous and lead to severe withdrawal symptoms. The most effective treatments incorporate both therapy and medication.

Residential inpatient treatment removes the person from their daily environment and provides round-the-clock clinical care. Patients live at the treatment facility and participate in individual and group counseling, 12-step meetings, relaxation therapy, art therapy, and other treatments. Medications may be used to ease withdrawal symptoms and drug cravings. The length of stay is typically 30-90 days.

Outpatient treatment allows the patient to live at home while attending regular therapy sessions multiple times per week. This option works well for people with jobs, school, or family commitments. Therapy helps identify the root causes of addiction and develop healthy coping skills. Medication-assisted treatment (MAT) combines behavioral therapy with medications like buprenorphine, methadone, or naltrexone. MAT helps normalize brain chemistry, block the euphoric effects of opioids, and reduce cravings.

Seeking treatment from an accredited, evidence-based, addiction-focused program gives patients the highest chance of achieving and maintaining sobriety. Having a strong support system is also critical. Peer support groups like Narcotics Anonymous provide social connection, shared understanding, and a community focused on recovery. With comprehensive treatment and ongoing support, healing from addiction is possible.

Prevention

Preventing narcotic drug abuse requires a multi-pronged approach focused on education, prescribing guidelines, and monitoring

Education

- Educating the public, especially youth, about the dangers of narcotic drugs is crucial. Schools and community organizations can provide evidence-based drug prevention programs.

- Education should start early and continue through high school and college. Programs that boost self-esteem, teach coping skills, and promote healthy decision making can empower youth to avoid drug use.

- For adults, public health campaigns can spread awareness of the risks of narcotic drugs, especially when misused or combined with other substances like alcohol.

Prescribing Guidelines

- Doctors should follow evidence-based prescribing guidelines to avoid over-prescribing narcotic painkillers. Prescriptions should be limited to cases of severe, acute pain and for short durations.

- Alternatives like NSAIDs, physical therapy, and cognitive behavioral therapy should be tried before narcotics for chronic pain.

- Doctors should screen patients for addiction risk factors and monitor those on narcotics for signs of dependence.

Monitoring

- Monitoring programs like prescription drug monitoring databases can help identify patients obtaining narcotics from multiple doctors ("doctor shopping").

- Pharmacies should verify prescriptions and watch for falsifications or people seeking early refills.

- Law enforcement and public health agencies should work together to monitor illicit sales and implement harm reduction strategies like needle exchanges.

With education, smart prescribing, and monitoring, communities can help prevent narcotic drug addiction and overdose deaths. A collaborative public health approach is key.

Conclusion

Narcotic drugs can provide valuable medical benefits when used properly, but also carry risks of misuse and addiction. Tramadol, diazepam, pethidine, morphine, and midazolam discussed here are among the most widely used and abused narcotic analgesics and sedatives. While each has its own specific properties, all produce effects ranging from pain relief and relaxation to euphoria by interacting with opioid receptors in the brain and central nervous system. However, they also depress respiratory function and can cause dangerous or even fatal overdoses in excessive amounts, especially when combined with alcohol or other drugs.

These substances are regulated internationally as controlled substances due to their high potential for abuse and dependence. Those who use them medically as prescribed typically do not become addicted, but recreational use carries grave risks. People who become dependent on narcotics like these experience extremely unpleasant withdrawal symptoms if they stop suddenly, creating a cycle of addiction. The most effective approaches focus on both reducing narcotic misuse through education and limiting illicit supply, while improving access to supervised addiction treatment programs. If used judiciously under medical supervision, narcotic drugs can improve quality of life - but utmost care is required to balance their benefits with the inherent dangers of abuse and addiction.

In summary, narcotic analgesics and sedatives like tramadol, benzodiazepines, opiates, and others are invaluable in medicine, but also hazardous outside controlled medical use. A nuanced public understanding and balanced regulatory approach can help maximize their value while minimizing harm. Though addiction poses daunting challenges, it is a treatable disease. With thoughtful policies and compassion for those afflicted, society can reap the benefits of these drugs while providing hope and help for those who struggle with dependence.

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Product List - psychiatric and Narcotics drugs

It requires official approval from the Ministry of Health of the importing country(IMPORT PERMISSION)

Product Name Strength
Amisulpride 400mg Tablets 10 Tab x 10 Blisters /Box
Aripiprazole 10mg Tablets 10 Tab x 10 Blisters /Box
Clozapine 100mg Tablets 10 Tab x 10 Blisters /Box
Olanzapine 10mg Tablets 10 Tab x 10 Blisters /Box
Olanzapine 10mg Tablets 10 Tab x 10 Blisters /Box
paroxetine 20mg 10 Tab x 10 Blisters /Box
Quetiapine 100mg 10 Tab x 10 Blisters /Box
Quetiapine 200mg 10 Tab x 10 Blisters /Box
Risperdal 2mg Tablets 10 Tab x 10 Blisters /Box
Risperdal 4mg Tablets 10 Tab x 10 Blisters /Box
Fluoxetine 20mg Tablets 10 Tab x 10 Blisters /Box
Seroxat 20mg Tablets 10 Tab x 10 Blisters /Box
Leponex 100mg Tablets 10 Tab x 10 Blisters /Box
Cognitol 5mg Tablets 10 Tab x 10 Blisters /Box
Tegretol 400mg Tablets 10 Tab x 10 Blisters /Box
Depakine 500mg Tablets 10 Tab x 10 Blisters /Box
Clomipramine 75mg 10 Tab x 10 Blisters /Box
Suxamethonium 100mg injection 10 Tab x 10 Blisters /Box
Tramadol hcl 250mg tablet 10 Tab x 10 Blisters /Box
Haloperidol 5mg injection 10 Amp x 1 tray/Box
Thiopental Sodium 500mg vial One Vial / Box
Ketoprofen 50mg /ml injection 10 Amp x 1 tray/Box
Ephedrine HCL Injection 25mg/ml 10 Amp x 1 tray/Box
Diazepam Injection 10mg /2ml 10 Amp x 1 tray/Box
Midazolam Injection 5mg /ml 10 Amp x 1 tray/Box
Morphine sulphate Injection 10mg/ml 10 Amp x 1 tray/Box
Pethidine Injection 50mg /ml 10 Amp x 1 tray/Box
Tramadol Hydrochloride Injection 50mg /ml 10 Amp x 1 tray/Box
Tramadol Hydrochloride Tablets 100mg 10 Tablets X 20 blisters
Tramadol Hydrochloride Tablets 100mg 10 Tablets X 10 blisters

Product List - Vial Injections

Product Name Strength
Omeprazol 40 mg IV VIAL 10ml or 5ml
Pantoprazole Sodium for Injection 40mg
Lansoprazole for Injection 30 mg
Ceftriaxone 1gm/10ml IV VIAL +10ml water
Ceftriaxone 1gm/10ml VIAL +Lidocain 1%
Ceftriaxone IM/IV VIAL 500mg/15 ml
Ampicillin Na VIAL 0.5 g/Vial
Ampicillin Na VIAL 1g/Vial
Cefotaxime Sodium for VIAL 1g/Vial
Ceftazidime For I.M/I.V VIAL 1g/Vial
Cefepime For I.M/I.V VIAL 1g/Vial
Meropenem VIAL Injection 1g/20ml/Vial
Procaine Penicillin(0.4mega/7ml) 400.000 U/7ml
Procaine Penicillin(0.6mega/7ml) 600.000 U/7ml
Procaine Penicillin(1.2mega/7ml) 800.000 U/7ml
Procaine Penicillin (0.8mega/7ml) 1200.000 U/7ml
Benzathine Penicillin for Injection 1.2mega/7ml
Vancomycin Hcl injection 500mg 500mg/Vial
Vancomycin Hcl injection 500mg 1g/Vial
Heparin Sodium Injection 5ml:5000 units
Heparin Sodium Injection 5ml:25000 units
Amoxicillin Na and Clavulanate Potassium for Inj(augmentin) G Powder 1.2
Amoxicillin Na and Clavulanate Potassium for Inj(augmentin) G Powder 0.6
lyophilized Hydrocortisone Na Succinate 3ml:0.1gm
aseptic lyophilized Hydrocortisone Na Succinate 7m:0.1gm
Phenobarbital Sodium Injection 1ml:0.1g
Piperacillin Sodium and Tazobactam Na for Inj 4.5g

Product List - IV INFUSION

Product Name Strength
Paracetamol 1G IV infusion 100ml glass bottle
Metronidazole 500mg IV infusion 100ml glass bottle
Ciprofloxacine 200mg IV infusion 20ml plastic bottle
0.9% Na Chloride IV Inj 500ml plastic bottle
5% Glucose Injection 250ml:12.5g,500ml:25g
10% Glucose Injection 250ml:12.5g,500ml:25g
Sodium Lactate Ringer`s Inj 500ml Plastic Bottle
5% Glu + 0.9% Na Chlorid inj 250ml: Glu 12.5g,NaCl 2.25g
5% Glu + 0.9% Na Chlorid inj 500ml: Glu 25g,NaCl 4.5g
10% Glu + 0.9% Na Chlorid inj 250ml: Glu 25g,NaCl 2.25g
10% Glu + 0.9% Na Chlorid inj 500ml: Glu 50g,NaCl 4.5g
Mannitol injection 250ml:50g P Bottle

Product List - SYRUP

Product Name Strength
Amoxicillin 125mg + Clavulanic Acid 31.5mg 100 ml glass Bottle
Amoxicillin 250mg + Clavulanic Acid 62.5mg 100 ml glass Bottle
Amoxicillin 400mg + Clavulanic Acid 75mg 100 ml glass Bottle
Azithromycine 100mg 15ml 1bottle/Box
Metronidazole 125mg 100 ml glass Bottle
Metronidazole 250mg 100 ml glass Bottle
Amoxicillin 125 mg 100 ml glass Bottle
Amoxicillin 250 mg 100 ml glass Bottle
Paracetamol syrup 250mg/5ml 250mg/5ml syrup
Ibuprofen Dry Suspension 100mg/5ml 100ml Suspension

Product List - TABLETS

Product Name Strength
Azithromycine 500mg Tab(3 tabs) 3 tablets X 1 blister
Metronidazole 500mg Tab(14 tabs) 7 tablets X 2 blisters
Ciprofloxacine 500mg TAB(10 tabs) 10 tablets X 1 blister
Amoxicillin 250mg + Clavulanic Acid 125mg(14 tabs) 7 tablets x 2 blister
Amoxicillin 500mg + Clavulanic Acid 125mg(14 tabs) 7 tablets x 2 blister
Amoxicillin 875mg + Clavulanic Acid 125mg(14 tabs) 7 tablets x 2 blister
Nitrofurantoin 100mg Tablets 10 tablets X 1 blister
Aspirin Enteric-coated 500mg 10 tablets X 1 blister
Paracetamol 500mg 10 tablets X 1 blister
Ibuprofen 400mg 10 tablets X 1 blister
Diclofenac Na 400mg 10 tablets X 1 blister
Diclofenac 50mg + Paracetamol 500mg 10 tablets X 1 blister
Folic acid 5mg Tab 10 tablets X 1 blister
Ciprofloxacin Tablets 10 tablets X 1 blister
Doxycycline 100mg Tab 10 tablets X 1 blister
Meloxicam 15mg Tab 10 tablets X 2 blisters
Fluconazole 150mg Tab 10 tablets X 2 blisters
Simvastatin 40mg Tab 10 tablets X 2 blisters
Prednisolone 5mg Tab 10 tablets X 2 blisters
Spiramycin 750,000 unit Tab 10 tablets X 2 blisters
Spiramycin 1,500,000 unit Tab 10 tablets X 2 blisters

Product List - CAPSULES

Product Name Strength
Amoxicillin 500mg(16 Capsules) 8 cap X 2 blisters
Ampicillin Capsules 10 cap X 2 blisters
Cloxacillin Na Capsules 10 cap X 2 blisters
Piroxicam Capsule 10 cap X 2 blisters
Tetracyline 250 mg Capsule 10 cap X 2 blisters
Oxytetracycline 250mg Capsule 10 cap X 2 blisters
Spiramycin 375,000 unit Cap 10 cap X 2 blisters
Indomethacin 25mg Capsule 10 cap X 2 blisters

Product List - Suppository

Product Name Strength
Paracetamol 125mg suppository 5 Supp x 2 blister
Paracetamol 250mg suppository 5 Supp x 2 blister
Policresulen Vaginal 90mg Suppository 4 Supp x 2 blister
Chlorhexidine Acetate 20mg Supp 5 Supp x 2 blister
Miconazole Nitrate Vaginal 100mg Supp 5 Supp x 2 blister
Clotrimazole Vaginal 150mg Supp 5 Supp x 2 blister
Metronidazole Vaginal 500mg Supp 5 Supp x 2 blister
Indomethacin 500mg Supp 5 Supp x 2 blister