Tramadol

Question 1

Therapeutic Classification

Answer 1

Analgesic

Question 2

Pharmacologic Classification

Answer 2

centrally acting nonopioid analgesic

Question 3

Pregnancy Category

Answer 3

C

Question 4

Mechanism of Action

Answer 4

o Drug and one of metabolites bind to mu receptor
• causes weak opioid agonist activity
o Inhibits norepinephrine and serotonin reuptake in spinal nerves
o Inhibits transmission of pain impulse

Question 5

Indications

Answer 5

o Moderate pain
o Off-label uses
• Neuropathic pain
• Restless leg syndrome

Question 6

Contraindictions

Answer 6

o Hypersensitivity
o History of depression or suicidal ideation
o Pregnancy

Question 7

Precautions

Answer 7

o	Codeine allergies
o	History of drug abuse
o	COPD
o	Renal/hepatic impairment
o	Increased ICP
o	History of seizures

Question 8

Drug Interactions

Answer 8

o	Increased risk of seizures
•	Carbamazepine, certain antidepressants
•	MAOIs
o	Sudden death if combined with ethanol
o	Reduced analgesic effect
o	If used with inhibitors of CYP2D6 enzyme

Question 9

Adverse Effects

Answer 9

o	Dizziness
o	Headache
o	Nausea
o	Vomiting
o	Constipation
o	Lethargy
o	CNS stimulation effects
o	Seizures
o	Respiratory depression
o	Physical dependence possible

Question 10

Nursing Responsibility

Answer 10

o	Full assessment, including pain scale
o	History of substance abuse
o	Bowel function
o	Effectiveness of drug
o	Adverse effects