d DRUG STUDY

GENERIC NAME: Tramadol

Brand name: Ultram
Drug Classificataion: Analgesics
(centrally acting)

DOSAGE, ROUTE, SIDE EFFECTS and

FREQUENCY (prescribed and INDICATION MECHANISM OF ADVERSE REACTIONS
recommended) ACTION (by system)
PO (Adults >18 yr) Rapid Titration – 50-100 CNS: Seizures, Dizziness,
mg4-6 hr (not to exceed 100 mg/day or 300 Moderate to Binds to mu opioid headache, somnolence,
mg in patients > 75yr). Gradual titration – 25 moderately severe receptors. Inhibits anxiety, euphoria, malaise
mg/day initially, increase by 25 mg/day pain reuptake of serotonin and EENT: Visual disturbance
every 3 days to 100 mg/day, then increase norepinephrine in the CV: Vasodilation
by 50 mg/day every 3 days up to 200 CNS GI: Constipation, Nausea,
mg/day or extended release of 100 mg/day, abdominal pain, anorexia,
may be increased by 100 mg increments diarrhea, dry mouth,
every 5 days based on pain level and dyspepsia, flatulence,
tolerability, not to exceed 300 mg/day. vomiting
GU: menopausal symptoms,
urinary retention/frequency.
DERM: Pruritus, Sweating
NEURO: Hypertonia
MISC: Physical dependence,
tolerance

NURSING RESPONSIBILITIES
CONTRAINDICATION/S (at least 10)
Hypersensitivity, Cross-sensitivity with
opioids may occur, Patients who acutely
intoxicated with alcohol,
sedative/hypnotics, centrally acting
analgesics, opioid or psychotropic agents,
Patients who are physically dependent on
opioid analgesics ( may precipitate
 Assess type of location,
withdrawal.
and intensity of pain before 2-3 hr (peak) after administration

 Assess blood pressure and respiratory rate before and

periodically during administration. Respiratory depression has
not occurred with recommender doses.
 Assess bowel function routinely prevention of constipation
should be instituted with increased intake of fluids and bulk
and w/ laxatives to minimize constipating effects
 Assess previous analgesic hx. Tramadol is not recommended
for patients dependent on opiods or who have previously
received opioids for more than 1 wk, may cause opioid
withdrawal symptoms
 Monitor patients for seizures. May occur with in recommended
dose range. Risk increased with higher doses in patients taking
antidepressants (SSRIs, tricyclics, or MAO inhibitors), opioid
analgesics or other drugs that decrease the seizure threshold.
 Do not confuse Tramadol with Toradol (ketorolac)
 Explain therapeutic value of medication before administration
to enhance analgesic effect
 Instruct patient on how and when to ask for medication
 Advise patient to change position slowly to minimize
orthostatic hypotension.
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