Tramadol Hydrochloride

Tramadol, brand name Ultram and Zydol, is an analgesic that inhibits reuptake of
norepinephrine, serotonin and enhances serotonin release. It alters perception and response to
pain by binding to mu-opiate receptors in the CNS. It is used for the management of moderate
to moderately severe pain. The dosages are 50 mg, 100 mg/24 hours, 200 mg/24hours and
300mg/24 hours. Administration routes are in IV, IM and IVTT. It is contraindicated in patients
who have Hypersensitivity to tramadol or other opioid analgesics, patients on MAO inhibitors,
patients acutely intoxicated with alcohol, hypnotics, centrally acting analgesics, opioids, or
psychotropic drugs, substance abuse, patients on obstetric preoperative medication, abrupt
discontinuation, alcohol intoxication, pregnancy patients, lactation, children and patient
above75 years of age. Drowsiness, dizziness, vertigo, fatigue, headache, somnolence, restlessness, euphoria,
confusion, anxiety, coordination disturbance, sleep disturbances, seizures may occur. Palpitations, vasodilation,
nausea, constipation, vomiting, xerostomia, dyspepsia, diarrhea, abdominal pain, anorexia and flatulence are also
side effects of ranitidine. Other side effects include sweating, anaphylactic reaction (even with first dose),
withdrawal syndrome (anxiety, sweating, nausea, tremors, diarrhea, piloerection, panic attacks, paresthesia,
hallucinations) with abrupt discontinuation, rashes, visual disturbances, urinary retention/frequency and
menopausal symptoms. Nursing considerations are:

Before

 Assess for level of pain relief and administer prn dose as needed but not to exceed the recommended
total daily dose.
 Monitor vital signs and assess for orthostatic hypotension or signs of CNS depression.
 Discontinue drug and notify physician if S&S of hypersensitivity occur.
 Assess bowel and bladder function; report urinary frequency or retention.

During

 You may experience these side effects: Dizziness, sedation, drowsiness, impaired visual acuity; nausea,
loss of appetite.
 Report severe nausea, dizziness, severe constipation.

After

 Exercise caution with potentially hazardous activities until response to drug is known.
 Understand potential adverse effects and report problems with bowel and bladder function, CNS
impairment, and any other bothersome adverse effects to physician.
 Do not breast feed while taking this drug.