Indication/

Contraindication
Mechanism of Action

Therapeutic Effect/
Side Effect/ Adverse
Effect
Nursing Consideration
Generic Name: Tramadol
Hydrochloride

Brand Name:
Ultram, Ultracet

Classification:
Analgesic
(Central Acting)

Route: Parenteral

Dosage & Frequency:
200 mg in 100 ml NSS

Date Ordered:
July 13, 2013




Indication for the patient:
To treat moderately severe
pain

Contraindications:
Hypersensitivity
Acute intoxication of any of
the following: alcohol,
narcotics, centrally acting
analgesics, opioids,
hypnotics, psychotropic
drugs.
Tramadol is a centrally
acting synthetic opioid
analgesic. Although its
mode of action is not
completely understood,
from animal tests, at
least two complementary
mechanisms appear
applicable: binding of
parent and M1
metabolite to -opioid
receptors and weak
inhibition of reuptake of
norepinephrine and
serotonin.

This drug may worsen
CNS and respiratory
depression in these
patients.

Headache
Fast heart rate
Overactive reflexes
Nausea and vomiting,
Diarrhea

Adverse reactions:
CNS: Drowsiness,
dizziness, vertigo,
headache, anxiety,
confusion, euphoria,
disturbance, fatigue,
fever, insomnia,
hallucinations, tremor,
lethargy, weakness
CV: vasodilation, chest
pain, orthostatic
hypotension
ENDO: hot flashes
GI: N&V, constipation,
diarrhea, dyspepsia, dry
mouth,
Musculoskeletal:
hypertonia, back, limb or
neck pain
Skin: rash, dermatitis,
flushing
Respiratory: chest pain,
dyspnea, cough
Other: flulike illness
Assess type, location,
and intensity of pain
before and 2-3 hr (peak)
after administration.
Reassess level of pain at
least 30 minutes after
administration.
Monitor patient closely
for evidence of serotonin
syndrome, such as
agitation, hallucinations,
coma, tachycardia, labile
blood pressure,
hyperthermia,
hyperreflexia,
incoordination, nausea,
vomiting, or diarrhea.
Monitor CV and
respiratory status.
Withhold dose and notify
prescriber if respirations
decrease or rate is below
12 bpm.
Monitor bowel and
bladder function.
Anticipate need for
laxative.
For better analgesic
effect, give drugs before
onset of intense pain.