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tramadol hcl

tramadol hcl

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Published by: Cherrylyn Ceniza Ferrer on May 25, 2012
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GENERIC/ BRAND NAME & CLASSIFICATION Generic: tramadol hydrochloride Brand: Ultram Classification: central nervous system (cns) agent;

analgesic; narcotic (opiate) agonist

DOSE, STRENGTH & FORMULATION Ordered: 50 mg IVTT Timing: every 6 hours Duration: Other forms: tablets: 50 mg

INDICATION/ MECHANISMS OF DRUG ACTION Indications: Management of moderate to moderately severe pain. Mechanism of action: A centrally acting analgesic not related chemically to opiates. Precise mechanism is not known. Two complimentary mechanisms may be applicable: It may bind to muOpioid receptors and inhibit reuptake or norepinephrine and serotonin. The analgesic effect is only partially antagonized by the antagonist naloxone. Causes significantly less respiratory depression than morphine. In contrast to morphine, tramadol does not cause release of histamine. Produces dependence of mu- opioid type (i.e., like codeine or dextropropoxyphene); however, there is little evidence of abuse.

ADVERSE/ SIDE EFFECTS DRUG INTERACTION CNS: dizziness, vertigo, headache, somnolence, CNS stimulation, anxiety, confusion, incoordination, euphoria, nervousness, sleep disorders, seizures, paresthesia, cognitive dysfunction, hallucinations, tremor, amnesia, concentration difficulty, abnormal gait, migraine, development of drug dependence, speech disorders, depression, increased risk of seizures. GI: Nausea, constipation, vomiting, dyspepsia, dry mouth, diarrhea, abdominal pain, anorexia, flatulence, GI bleeding, hepatitis, stomatitis, dysgeusia, liver failure.




• Check doctor’s order. • Let the patient verbalize her name.

- To prevent medication error. - To correctly identify the patient so as to prevent error. - So that the patient will not be knowledge deficit about the medication she is taking. - Keeping patient well- hydrated reduces risk of nephrotoxicity. - To indicate patient’s baseline data and monitor drug’s effectiveness. - To establish proper precationary measures and management for possible adverse effects of the drug.

• Explain the possible side effects of the drug.

1. Do not perform activities that require mental alertness; drug may cause drowsiness and impair mental or physical performance. Alcohol may intensify drug effects. 2. Report lack of response. Review list of side effects (nausea, dizziness, constipation) that one may experience and report if persistent or intolerable. 3. Advise patient to avoid alcohol while taking tramadol. 4. Urge caregivers to watch patient closely for evidence of suicidal tendencies, especially when therapy starts or dosage changes and to report

• Monitor any changes in intake and output of the patient.

• Assess patient’s infection before therapy and regularly thereafter. • Be alert for signs and drug interactions like fever and rashes, notify physician immendiately.

Tolerance occurs but is relatively mild. concerns at once to prescriber. menstrual disorder. . abnormal ECG. allergic reation. StevensJohnson syndrome. serotonin • Assess patient’s and family’s knowledge of drug therapy. malaise. vesicles. . suicidal tendency. tachycardia. . Body as a whole: asthenia. Rapidly absorbed after PO administration. Miscellaneous: anaphylaxis. urticaria. syncope. CV: Vasodilation. sweating. pulmonary edema/ embolism. visual disturbances. dyspnea. palpitations. dysuria. tinnitus. hypertonia. toxic epidermal necrolysis. weight loss. myocardial ischemia.It may mask evidence and disrupt assessment of the abdomen. Dermatologic: pruritus. Ophthalmic: miosis. Food does not affect the rate or extent of absorption. • Avoid giving tramadol to patients with acute abdominal conditions.To know patient’s and family’s knowledge about the drug. cataracts. the withdrawal syndrome is not as severe as with other opiates. rash. orthostatic hypotension. accidental injury. GU: urinary retention/ frequency. hypertension. deafness. menopausal symptoms.

SSRIs/ increase risk . Naloxone/ increase risk of seizures if naloxone used for tramadol overdose. CNS depressants/ Additive CNS depression. Promethazine/ increase risk of seizures. MAO Inhibitors/ increase risk of seizures. Carbamazepine/ decrease tramadol effect R/T increase metabolism.syndrome. Drug Interaction: Alcohol/ increase respiratory depression. Cyclobenzaprine/ increase risk of seizures. Digoxin/ increase risk (rare) of digoxin toxicity. Quinidine/ increase levels of tramadol and decrease levels of M1 R/T inhibition of metabolism. Anesthetics. general/ increase respiratory depression.

Warfarin/ increase PT and INR.of seizures and increase risk of serotonin syndrome. Tricyclic antidepressants/ increase risk of seizures. .

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