DRUG NAME MECHANISM OF
ACTION
Tramadol (marketed as
GENERIC: Ultram, and as generics) is an
Tramadol opioid pain medication used
to treat moderate to
BRAND: moderately severe pain.
Ambidol When taken as an immediate-
release oral formulation, the
CLASS: onset of pain relief usually
occurs within about an hour.
THERAPEUTIC: It has two different
Opiate (narcotic) mechanisms. First, it binds to
analgesics. the μ-opioid receptor.
Second, it inhibits the
PHARMACOLOGIC reuptake of serotonin and
synthetic derivative norepinephrine. Serious side
effects may include: seizures,
ROUTE increased risk of suicide,
IV serotonin syndrome,
decreased alertness, and drug
DOSAGE addiction.
50mg
SOURCES:
FREQUENCY https://www.researchgate.net/
Every 6 hours publication/270282807_Tram
adol_synthesis_and_mechani
sm_of_action
INDICATION / CONTRAINDICATION ADVERSE EFFECT NURSING RESPONSIBILITIES
INDICATIONS: CNS: dizziness, vertigo, Special considerations
Moderate to moderately severe pain. headache, somnolence, CNS • Drug has been reported to reduce seizure
CONTRAINDICATION: stimulation, asthenia, anxiety, threshold. Monitor patient closely for seizures.
Contraindicated in patients hypersensitive to confusion, coordination • Serious and rarely fatal anaphylactoid reactions
drug; in patients experiencing acute intoxication with disturbance, euphoria, have been reported
alcohol; and in those taking hypnotics, centrally nervousness, sleep disorder, (less than 1%).
acting analgesics, opioids, or psychotropic drugs. seizures, malaise. ALERT Don’t confuse tramadol with
The combination product (Ultracet) shouldn’t be trazodone.
used in patients with impaired hepatic function. CV: vasodilation. • Monitor patient’s CV and respiratory status
Use cautiously in patients at risk for seizures or and stop dose if respirations decrease or rate is
respiratory depression; in those with increased EENT: visual disturbances. less than 12 breaths/minute or if patient exhibits
intracranial pressure or head injury, acute abdominal signs of respiratory depression.
conditions, impaired renal or hepatic function; and in GI: nausea, constipation, • Monitor patient for drug dependence. Because
patients physically dependent on opioids. vomiting, dyspepsia, dry drug dependence similar to codeine or
mouth, diarrhea, abdominal dextropropoxyphene can occur, the potential for
DRUG TO DRUG INTERACTION: pain, anorexia, flatulence. abuse exists.
Carbamazepine: Increases tramadol metabolism.
Monitor patient closely. Dosage adjustment may be GU: urine retention, urinary Patient education
needed. frequency, increased creatinine • Instruct patient to take drug only as prescribed.
CNS depressants: Causes additive effects. Use clearance, proteinuria, • Caution patient to avoid potentially hazardous
together cautiously. Tramadol dose may need to be menopausal symptoms. activities that require mental alertness until
reduced. adverse CNS effects of drug are known.
MAO inhibitors, neuroleptic drugs: Increases risk Musculoskeletal: hypertonia.
of seizures. Monitor patient closely.
Respiratory: respiratory
DRUG TO FOOD INTERACTION: depression.
Alcohol use: Increases CNS depression. Discourage
alcohol use. Skin: pruritus, diaphoresis,
rash.