Tramadol DS PDF

Republic of the Philippines
Cebu Normal University

Osmeña Blvd., Cebu City, 6000, Philippines
College of Nursing
Telephone No.: (+63 32) 254 4837
Email: cn@cnu.edu.ph
Website: www.cnu.edu.ph
DRUG STUDY
Patient’s Initials:H.K Date of Admission:APRIL 12, 2023 Diagnosis: MODERATE TO SEVERE DULL, ACHING PAIN
Age:60 YEARS OLD Height: N/A Weight.:N/A Clinical Intervention: PO MEDICATIONS
Sex:MALE Ward:ED Bed No.: N/A Name of Physician: N/A
Drug Information Classification Mechanism of Action Indication Contraindications Side Effects Nursing Responsibilities
Generic Name: Pharmacologic Pharmacology: General Acute intoxication with (per system preferably) Before Drug Administration:
Tramadol Classification: Mechanism of Action: Indication/s: centrally acting Cardiac disorders: 1. Advise patients that centrally acting
Analgesic Tramadol is a centrally Moderate to analgesics, hypnotics, Palpitations, tachycardia. analgesics are usually more effective if given
Trade Name: acting analgesic that has severe acute and psychotropic drugs, Gastrointestinal before pain becomes severe; emphasize that
TDL opioid agonist properties. chronic pain, alcohol, or other opioids; disorders: Nausea, adequate pain control will allow better
It binds to μ-opiate painful diagnostic uncontrolled epilepsy, vomiting, dry mouth, participation in physical therapy.
Minimum Dose: receptors in the CNS procedures and significant respiratory constipation, abdominal 2. Advise patients to avoid alcohol and other
1 tab resulting in inhibition of surgery. depression, acute or discomfort, dyspepsia. CNS depressants because of the increased
ascending pain severe bronchial asthma General disorders and risk of sedation and decreased CNS function.
Maximum Dose: pathways, thus altering (in unmonitored setting administration site 3. Advise patient to increase fluid intake
>400 mg o 4 tabs Therapeutic the perception of and Patient’s or lack of resuscitative conditions: Fatigue,
Classification: response to pain. Its Indication: equipment), known or asthenia.
Patient’s Dose: Antipyretic. inhibition of neuronal To relieve mild to suspected Musculoskeletal and During Drug Administration:
1 tab uptake of norepinephrine moderate pain due gastrointestinal connective tissue 1. Educate patients about the dangers of
and enhancement of to headache obstruction (including disorders: Muscle overdose; encourage patients to adhere to a
Route: serotonin release may paralytic ileus). Children spasticity. proper dosing schedule.
PO also contribute to its <12 years and in Nervous system 2. Emphasize that the risk of physical addiction
analgesic effect. children <18 years who disorders: Dizziness, (tolerance and dependence) is usually
Frequency: have undergone drowsiness, headache, minimal during short-term treatment of pain.
BID Pharmacokinetics: tonsillectomy and/or tremor. 3. Advise patients that addiction is more likely
Absorption: Rapidly and adenoidectomy. Psychiatric disorders: during excessive or inappropriate use of
completely absorbed CYP2D6 ultrarapid and Anxiety, agitation, centrally acting analgesics.
College of Nursing
Telephone No.: (+63 32) 254 4837
following oral poor metabolizers. emotional lability,
Availability/Form: administration. Concomitant use or euphoria, hallucinations, After Drug Administration:
Tab Bioavailability: Oral: within 14 days after nervousness. 1. Watch for new seizures or increased seizure
Approx 75% (immediate MAOI therapy. Use for Skin and subcutaneous activity, especially at the onset of drug
Contents: release); approx 85-90% narcotic withdrawal tissue disorders: treatment. Document the number, duration,
Tramadol HCl. (modified release; as treatment or during light Pruritus, urticaria, rash, and severity of seizures, and report these
compared to immediate planes of anaesthesia. hyperhidrosis, toxic findings immediately to the physician or
release); IM: 100%. Time epidermal necrolysis, nursing staff.
to peak plasma Stevens-Johnson 2. Be alert for excessive sedation or
concentration: Tramadol: syndrome. somnolence. Notify a physician or nurse
Approx 2 hours immediately if the patient is unconscious or
(immediate release); extremely difficult to arouse.
approx 4-12 hours 3. Monitor other changes in mood and behavior,
(modified release). including euphoria, confusion, malaise,
Distribution: Widely nervousness, and anxiety. Notify physicians if
distributed in the body. these changes become problematic.
Crosses the placenta; 4. Use appropriate pain scales (visual analogue
enters breast milk (small scales, others) to document whether this
amounts). Volume of drug is successful in helping manage the
distribution: IV: 2.9 L/kg patient's pain.
(females); 2.6 L/kg 5. Assess any incoordination or increased
(males). Plasma protein muscle tone. Report any coordination
binding: Approx 20%. problems or hypertonia that might impair
Metabolism: Extensively function or increase the risk of falls.
metabolised in the liver 6. Assess dizziness that might affect gait,
mainly via N- and balance, and other functional activities (See
O-demethylation by Appendix C). Report balance problems and
CYP2D6 and CYP3A4 functional limitations to the physician and
College of Nursing
Telephone No.: (+63 32) 254 4837
isoenzyme, nursing staff, and caution the patient and
glucuronidation, and family/caregivers to guard against falls and
sulfation into several trauma.
metabolites;
O-desmethyltramadol
(M1) is the only active
metabolite.
Excretion: Via urine (60%
as metabolites, approx
30% as unchanged drug).
Elimination half-life: Oral:
Immediate release: 6.3 ±
1.4 hours (tramadol); 7.4
± 1.4 hours (M1).
Modified release: Cap:
Approx 10 hours
(tramadol); approx 11
hours (M1); Tab: Approx
7.9 hours (tramadol); 8.8
hours (M1).
References (at least 2):

Tramadol: Indication, Dosage, Side Effect, Precaution | MIMS Philippines
Tramadol: Uses, Side Effects, Dosage, Warnings - Drugs.com
College of Nursing
Telephone No.: (+63 32) 254 4837
College of Nursing
Telephone No.: (+63 32) 254 4837
PRODUCT ASSESSMENT RUBRICS FOR DRUG STUDY
Student Name:Jannel Reggie M Pasa Year/Section:BSN-2B Date:April 12, 2023 Score: ___/30
Directions: Please select the appropriate rating using the following descriptions.
Element Very Satisfactory Satisfactory Needs Improvement Comments

Drug ☐ Accurately presented all of the patient and drug information ☐ Accurately presented most of the patient and drug ☐ Accurately presented some of the patient and drug information
Information (name [brand & generic], dosage [patient’s dose; min. & max], information related to the case. 1 missing information or error related to the case. 2 or more missing information or errors noted.
(10%) frequency, route, availability, contents) related to the case. [3] noted. [2] [1]
Classification ☐ Accurately presented the classification (therapeutic and ☐ Accurately presented the classification related to the drug ☐ Inaccurately presented the classification related to the drug.
(10%) pharmacologic) related to the drug. [3] but with 1 irrelevant information or error noted. [2] Classification is not relevant to the drug. [1]
☐ Accurately presented the indication/s (general & ☐ Accurately presented the indication/s related to the drug ☐ Inaccurately presented the indication/s related to the drug.
Indication (10%)
patient-specific) related to the drug. [3] but with 1 irrelevant information or error noted. [2] Indication is not relevant to the drug. [1]
Mechanism of ☐ Accurately presented the mechanism of action ☐ Accurately presented the mechanism of action of the drug ☐ Inaccurately presented the mechanism of action of the drug.
Action (10%) (pharmacokinetics, pharmacodynamics) of the drug. [3] but with 1 irrelevant information or error noted. [2] Mechanism of action is not relevant to the drug. [1]
☐ Accurately presented all of the common contraindications ☐ Accurately presented most of the common ☐ Accurately presented some of the common contraindications
Contraindicatio related to the drug. [3] contraindications related to the drug. 1 missing information related to the drug. 2 or more missing information or errors noted.
n (10%) or error noted. [2] [1]
☐ Accurately presented all of the common side effects related to ☐ Accurately presented most of the common side effects ☐ Accurately presented some of the common side effects related
Side Effects
the drug. [3] related to the drug. 1-2 missing information or errors noted. to the drug. 3 or more missing information or errors noted. [1]
(10%)
[2]
Nursing ☐ Accurately presented all of the common nursing ☐ Accurately presented most of the common nursing ☐ Accurately presented some of the common nursing
Responsibilities responsibilities (before, during, and after) related to the drug. [9] responsibilities related to the drug. 1-2 missing information responsibilities related to the drug. 3 or more missing information
(30%) or errors noted. [7] or errors noted. [3]
☐ Presented at least 2 sources that are updated (within 5 years), ☐ Presented only one source that is updated (within 5 years), ☐ No source was presented. Sources are not updated (more than 5
References
relevant, and credible. [3] relevant, and credible. Other sources are not updated, credible years), relevant, and credible. [1]
(10%) or relevant. [2]
Sub-score = ____ = ____ = ____
Evaluated by:
College of Nursing
Telephone No.: (+63 32) 254 4837
_______________________________________
Signature over Printed Name of Clinical Instructor

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Republic of the Philippines

Cebu Normal University

References (at least 2):

PRODUCT ASSESSMENT RUBRICS FOR DRUG STUDY

Element Very Satisfactory Satisfactory Needs Improvement Comments

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