DRUG NAME Generic Name: Tramadol Brand Name: Ultram Dosage: 50 mg PRN for severe pain Route: Intravenous

CLASSIFICATION - Opioid analgesic

MECHANISM OF ACTION Tramadol acts as a -opioid receptor agonist, serotonin releasing agent, norepinephr ine reuptake inhibitor, NMDA receptor antagonist 5-HT2C receptor antagonist, (7)5 nicotinic acetylcholine receptor antagonist TRPV1 receptor agonist, and M1 and M3 mu scarinic acetylcholine receptor antagonist.

INDICATION -Relief of moderate to moderately severe pain. CONTRAINDICATION -Hypersensitivity to the drug -Raised intracranial pressure -Severe renal impairment

SIDE EFFECTS -Sweating -Dizziness -Nausea -Dry mouth -Fatigue -Constipation

NURSING RESPONSIBILITIES 1) Determine patients past or present history of addiction to or dependence on opoids. 2) Instruct patient to increase fluid intake to prevent dry mouth and constipation. 3) For better analgesic effect, give drugs before onset of intense pain. 4) Reassess level of pain at least 30 minutes after administration. 5) Monitor CV and respiratory status. Withhold dose and notify prescriber if respirations decrease or rate is below 12 breaths/minute.