Clinical Geriatrics

Even though February is the shortest month of the year, it has been designated as the time to remember two of the most important issues affecting the older individual—heart disease and visual impairment. February has been designated American Heart Month, apparently as a tribute to Valentine’s Day, and Age-related Macular Degeneration (AMD)/Low Vision Awareness Month. The importance of addressing matters of the heart is widely recognized, whereas maintenance of ophthalmic health may be marginalized and help only sought after permanent damage has already occurred. Prevention is key and early recognition and treatment may make all the difference in preserving vision and function, which can improve quality of life; therefore, I thought it would be a good idea to remind everyone of just how significant a problem visual impairment is.

Morphine, codeine, hydromorphone, are among the drugs that are immediately recognized as narcotic agents. Despite its narcotic-like effects, tramadol is not considered to be a narcotic by the Federal Controlled Substances Act; however, both Kentucky and Sweden classifi ed tramadol as a controlled substance in 2008. In this Physician’s Perspective, Dr. Gambert provides a case scenario that urges the reader to consider what criteria are needed to establish an agent as a narcotic.

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