Tramadol - Revision history

Helen at 07:36, 5 October 2020

2020-10-05T07:36:06Z

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	[[Category: Drugs]][[Category: Non-opioid Analgesic]] [[Category: opioid analgesic ]]		[[Category: Drugs]][[Category: Non-opioid Analgesic]] [[Category: opioid analgesic ]]
			==Introduction==
	'''Tramadol hydrochloride''' is an opioid analgesic. It also has noradrenergic and serotonergic properties that may contribute to its analgesic activity. Tramadol is used for moderate to severe pain.		'''Tramadol hydrochloride''' is an opioid analgesic. It also has noradrenergic and serotonergic properties that may contribute to its analgesic activity. Tramadol is used for moderate to severe pain.

2020-10-05T05:49:31Z

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	Acute intoxication with: Alcohol, other opioid, other analgesic, hypnotics.		Acute intoxication with: Alcohol, other opioid, other analgesic, hypnotics.
	Uncontrolled epilepsy		Uncontrolled epilepsy

			== FAQ ==
			=== How should I take the tablet? ===
			Follow the doctor's prescription,
			Take with or without food
			Take the medication with plenty of water
			Can be crushed
			=== What should I avoid while taking? ===
			Avoid abrupt withdrawal
			=== What happen if I overdose? ===
			Emergency situation, called 999 immediately
			Antidote: Naloxone
			=== What happen if I miss a dose? ===
			Take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

2020-10-05T05:48:19Z

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	\|The elimination half-life is about 6 hours.		\|The elimination half-life is about 6 hours.
	\|}		\|}

			=Drug Management==
			===Efficiency===
			Pain control
			===Safety===
			mental status, blood pressure, respiratory drive, and misuse / overuse.
			===Drug Interaction===
			Increase risk of serotonin syndrome when used with SNRI, TCA, linezolid.
			===Caution===
			History of epilepsy or seizures excessive bronchial secretion.
			Tolerance and dependence
			===Contraindication===
			Acute intoxication with: Alcohol, other opioid, other analgesic, hypnotics.
			Uncontrolled epilepsy

2020-10-05T05:46:09Z

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	#Nausea and vomiting can be alleviated by metoclopramide.		#Nausea and vomiting can be alleviated by metoclopramide.
	#Intensive supportive therapy may be required to correct respiratory failure and shock. Naloxone is used for rapid reversal of the severe respiratory depression and coma.		#Intensive supportive therapy may be required to correct respiratory failure and shock. Naloxone is used for rapid reversal of the severe respiratory depression and coma.

			==Pharmacokinetics==

			{\|class="wikitable"
			!Oral bioavailability
			\|Tramadol is readily absorbed after oral doses but is subject to some first-pass metabolism.Mean absolute bioavailability is about 70 to 75% after oral dose and 100% after intramuscular injection.
			\|-
			!Onset of action
			\|
			\|-
			!Metabolism
			\|Tramadol is excreted mainly in the urine. Tramadol crosses the placenta, and distributes into breast milk.
			\|-
			!Elimination half-life
			\|The elimination half-life is about 6 hours.
			\|}

2020-10-05T05:44:57Z

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	*A dosage interval of 12 hours is recommended in severe hepatic impairment.		*A dosage interval of 12 hours is recommended in severe hepatic impairment.
	*The dosage interval should also be increased to 12 hours in patients with a creatinine clearance of less than 30 mL/min.		*The dosage interval should also be increased to 12 hours in patients with a creatinine clearance of less than 30 mL/min.

			==Side Effects==
			Euphoria, nausea and vomiting, respiratory depression, constipation and cough suppression, increased fall risk in elderly patients
			===For Opioid Analgesic in general===

			The commonest adverse effects are nausea, vomiting, constipation, drowsiness and confusion.

			Large doses of opioids produce respiratory depression and hypotension, with circulatory failure and deepening coma. Death may occur from respiratory failure.

			===Treatment of Adverse Effects===
			#Constipation can be treated with laxatives such as senna tables and lactulose.
			#Nausea and vomiting can be alleviated by metoclopramide.
			#Intensive supportive therapy may be required to correct respiratory failure and shock. Naloxone is used for rapid reversal of the severe respiratory depression and coma.

2020-10-05T04:39:29Z

Dosage

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	\|100mg up to 4 times daily.		\|100mg up to 4 times daily.
	\|}		\|}

			'''Doses in children


			In the UK, tramadol hydrochloride is licensed for the management of moderate to severe pain in children 12 years and older; usual adult doses may be given.

			'''Administration in hepatic or renal impairment

			*A dosage interval of 12 hours is recommended in severe hepatic impairment.
			*The dosage interval should also be increased to 12 hours in patients with a creatinine clearance of less than 30 mL/min.

2020-10-05T04:38:32Z

Dosage

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	{\|class="wikitable"		{\|class="wikitable"

	!Moderate to severe chronic pain		!Moderate to severe chronic pain :
	\|-		\|-
	!Oral		!Oral

2020-10-05T04:38:17Z

Dosage

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	!Moderate to severe chronic pain		!Moderate to severe chronic pain
	\|-		\|-
	\|
	!Oral		!Oral
	\|50 to 100 mg every 4 to 6 hours. The total oral daily dosage should not exceed 400 mg.		\|50 to 100 mg every 4 to 6 hours. The total oral daily dosage should not exceed 400 mg.

2020-10-05T04:38:07Z

Dosage

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 !Moderate to severe acute pain
 |Initially 100 mg, then 50-100mg q4-6h, maximum 400 mg
 |}

2020-10-05T04:33:05Z

Dosage

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	!Oral		!Oral
	\|Initially 50 mg PRN, then adjust according to response. Maximum 400mg /day		\|Initially 50 mg PRN, then adjust according to response. Maximum 400mg /day

	\|}

	~~!Subcutaneous or intramuscular~~
	~~\|25-100 mg, then 25-100 mg after 4 hours~~
	\|-		\|-
	!~~Intravenous~~		!Modify release fomulation
	\|25-50 mg, then, ~~25-50mg repeated after 4 hours~~		\|100-150 mg QD PRN, maximum 400 mg.
			\|-
			!Moderate to severe acute pain
			\|Initially 100 mg, then 50-100mg q4-6h, maximum 400 mg
	\|}		\|}