Name of Patient

E. F.

Age

24 y.o

Height

52

Diagnosis

G1P1 (1001) PU delivered breech iive birth by 1o LSCTS

Sex

Female

Weight

55 kg

Author

M. M. Olmillo

Website

milkv.co.vu

A/N

youre welcome J

DRUG DATA
Generic name:
Tramadol Hcl

CLASSIFICATION
Pharmacologic:
Opioid analgesic

Trade name/s:
Ryzolt, Ultram
Patients dose:
500mg q 6o
Minimum dose:
25mg/day

MECHANISM OF
ACTION

Binds to mu-opioid
receptors and inhibits
the reuptake of
norepinephrine and
serotonin

Therapeutic:
Centrally-acting
analgesic

Pregnancy
Category Risk: C

Onset:
1 hr
Peak:
2 hr

Maximum dose:
500mg/day

Metabolism:
Hepatic; 6-7 hr
Availability:
Tablets: 50mg
ER tablets: 100,
200, 300 mg

Distribution:
Crosses placenta,
enters breast milk
Excretion: urine

Route:
IVTT

Source: 2011
Lippincotts NDG

Source: 2011
Lippincotts NDG

Source: 2011
Lippincotts NDG

INDICATIONS

General:
> relief of
moderate to
moderately
severe pain
> relief of
moderate to
severe chronic
pain in adults who
need around-theclock treatment
for extended
periods (ER
tablets)
> unlabeled uses:
premature
ejaculation;
restless leg
syndrome

Patients actual
indication:
> relief of
moderate to
moderately
severe pain

Source: 2011
Lippincotts NDG

CONTRAINDICATI
ON

Contraindicated with
allergy to tramadol or
opioids or acute
intoxication with alcohol,
oipioids or psychoactive
drugs

ADVERSE
EFFECTS

CNS: asterixis,
dizziness,
weakness,
headache,
drowsiness
CV: orthostatic
hypotension

Precaution:
Use cautiously with
pregnancy, lactation,
seizures, concomitant
use of CNS depressants,
MAOIs, SSRIs, TCAs,
renal impairment,
hepatic impairment

GI: nausea,
anorexia, vomiting,
diarrhea

Interactions:
Drug-drug: decreased
effectiveness with
carbamazepine,
increased risk of
tramadol toxicity with
MAOIs or SSRIs.

Local: pain,
phlebitis at
injection site

Source: 2011
Lippincotts NDG

Source: 2011
Lippincotts NDG

GU: polyuria,
nocturia
Hematologic:
hypokalemia

Other: muscle
cramps and
muscle spasms,
weakness, arthritic
pain

NURSING
RESPONSIBILITIE
S

Before:
> check the doctors order.
> assess for hypersensitivity to
tramadol, pregnancy, lactation,
seizures
>assess for skin color, texture,
lesions, mental status, take V/S
> check for the patency of the IV line
> review the purpose and importance
of the drug
During:
> administer with food or milk to
prevent GI upset
> measure and record regular
weights to monitor fluid changes
> administer drug early in the day so
increased urination will not disturb
sleep
> control environment (temperature,
lighting) if sweating or CNS effects
occur
After:
> document and record.
> monitor serum electrolytes,
hydration, and liver function during
long-term therapy
> provide diet rich in potassium or
give supplemental potassium
>report if side effects occur.

Source: 2011 Lippincotts Nursing

Drug Guide