Tramadol hydrochloride.docx
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8/14/2019 Tramadol hydrochloride.docx
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Tramadol hydrochlorideGeneric Name : tramadol hydrochloride
Brand Name:Ultram
Classification:Analgesic, centrally acting
Pregnancy Category C
Dosage & Route
Available forms : Tablets50 mg
ADULTS
Patients who require rapid analgesic effect: 50100 mg PO q 46 hr; do not exceed400 mg/day.
Patients with moderate to moderately severe chronic pain: Initiate at 25 mg/day inthe morning and titrate in 25-mg increments q 3 days to reach 100 mg/day. Then,
increase in 50 mg-increments q 3 days to reach 200 mg/day. After titration, 50100mg q 46 hr; do not exceed 400 mg/day.
Patients with cirrhosis: 50 mg q 12 hr. Patients with creatinine clearance < 30 ml/min: 50100 mg PO q 12 hr. Maximum
200 mg/day.
PEDIATRIC PATIENTS
Safety and efficacy not established.GERIATRIC PATIENTS OR PATIENTS WITH HEPATIC OR RENAL IMPAIRMENT
> 75 yr: Do not exceed 300 mg/day.
Therapeutic actions
Tramadol inhibits reuptake of norepinephrine, serotonin and enhances serotoninrelease. It alters perception and response to pain by binding to mu-opiate receptorsin the CNS.
Indications
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8/14/2019 Tramadol hydrochloride.docx
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Relief of moderate to moderately severe pain
Adverse effects
Sweating, dizziness, nausea, vomiting, dry mouth, fatigue, asthenia, somnolence,confusion, constipation, flushing, headache, vertigo, tachycardia, palpitations,miosis, insomnia, orthostatic hypotension, seizures, CNS stimulation e.g.hallucinations.
Potentially Fatal:Respiratory depression.
Contraindications
Suicidal patients, acute alcoholism; head injuries; raised intracranial pressure;severe renal impairment; lactation.
Nursing considerations
Assessment
History:Hypersensitivity to tramadol; pregnancy; acute intoxication with alcohol,opioids, psychotropic drugs or other centrally acting analgesics; lactation; seizures;
concomitant use of CNS depressants or MAOIs; renal or hepatic impairment; past orpresent history of opioid addiction
Physical:Skin color, texture, lesions; orientation, reflexes, bilateral grip strength,affect; P, auscultation, BP; bowel sounds, normal output; LFTs, renal function tests
Interventions
Control environment (temperature, lighting) if sweating or CNS effects occur. WARNING: Limit use in patients with past or present history of addiction to or
dependence on opioids.
Teaching points
You may experience these side effects: Dizziness, sedation, drowsiness, impairedvisual acuity (avoid driving or performing tasks that require alertness); nausea, loss
of appetite (lie quietly, eat frequent small meals). Report severe nausea, dizziness, severe constipation.