DRUG MOA: INDICATION: SIDE  Increased risk of NURSING

CLASSIFICATION: inhibits  Moderate to severe EFFECTS & convulsions or INTERACTIONS/

Opiod Analgesic reuptake of pain ADVERSE serotonin syndrome HEALTH
norepinephrine,  Maintenance EFFECTS: w/ SSRI, serotonin- TEACHINGS:
DOSAGE: 50 mg serotonin and Resp norepinephrine  Patients
enhances CONTRAINDICATIONS: depression, reuptake inhibitors who suffer
ROUTE: IV serotonin  Suicidal patients; seizure, (SNRI), TCA and other from
release. It alters acute intoxication dizziness, emotional
seizure threshold
GENERIC: perception and w/ hypnotics, headache, disturbance
lowering drugs (e.g.
Tramadol response to centrally acting somnolence, or
pain by binding bupropion,
BRAND: analgesics, opioids, weakness, depression,
Betram to mu-opiate CNS mirtazapine,
psychotropic drugs history of
receptors in the or alcohol; stimulation tetrahydrocannabinol)
CNS. (e.g. anxiety,  Decreased serum epilepsy or
uncontrolled
euphoria, concentrations w/ risk of
epilepsy, acute or
hallucinations), carbamazepine seizure,
severe bronchial
asthma, asthenia,  May potentiate the head injury,
hypercapnia or sweating, anti-depressant effect increased
significant resp confusion, of norepinephrine, 5- intracranial
depression in coordination HT agonists or lithium pressure
unmonitored disturbance,  Increased INR and  CYP2D6
settings or absence paraesthesia, intermediate
ecchymoses w/
of resuscitative hypoaesthesia, and poor
coumarin derivatives
equipment. amnesia, metabolisers
(e.g. warfarin)
 Not intended for cognitive
 Potentially Fatal:  Renal and
narcotic withdrawal dysfunction, hepatic
depression, Increased risk of
treatment. Severe impairment
dysphoria, seizures w/ MAOIs
renal and hepatic  Elderly
impairment. constipation, Enhanced CNS
depressant effect w/  Pregnancy
 CYP2D6 ultra-rapid nausea, and
metabolisers. vomiting, alcohol
lactation
 Concomitant use w/ dyspepsia,
diarrhoea,  Patient
MAOIs or w/in 2
wk after withdrawal abdominal Counselling
of MAOIs. pain, anorexia,  May impair
flatulence, wt ability to
loss, drive or
gastroenteritis, operate
pruritus, rash, machinery
dermatitis,  Monitoring
urticaria, Parameters
bronchospasm, Monitor
angioedema, pain relief,
anaphylaxis,
resp rate,
allergic
BP, pulse
reaction,
Stevens- rate; signs of
Johnson tolerance,
syndrome, abuse, or
toxic suicidal
epidermal ideation
necrolysis,
vasodilation,
orthostatic
hypotension,
syncope,
tachycardia,
flushing, chest
pain,
palpitations,
MI, HTN,
peripheral
ischaemia,
menopausal
symptoms,
dysuria,
menstrual
disorder,
micturition
difficulty,
haematuria.