Medication Card Tramadol (트라마돌)(Kor/Eng)

Classification (분류)

• English: Analgesic – centrally acting synthetic opioid
• Korean: 진통제 – 중추 작용 합성 오피오이드

 

 

 

 

 

Indications (적응증)

• English:
  • Management of moderate to moderately severe pain
  • Chronic pain requiring continuous treatment
• Korean:
  • 중등도에서 중등도-중증 통증 완화
  • 지속적인 치료가 필요한 만성 통증 관리

 

 

 

 

 

 

Therapeutic Effects (치료 효과)

• English:
  • Decreased perception of pain via weak μ-opioid receptor agonism and inhibition of norepinephrine & serotonin reuptake
• Korean:
  • μ-오피오이드 수용체 약한 작용과 노르에피네프린·세로토닌 재흡수 억제를 통해 통증 지각 감소

 

 

 

 

 

 

Absorption (흡수)

• English: Well absorbed orally (~75%)
• Korean: 경구 복용 시 잘 흡수됨 (~75%)

 

 

 

 

 

 

Distribution (분포)

• English: Widely distributed, crosses blood–brain barrier and placenta; small amounts in breast milk
• Korean: 전신에 분포, 혈액-뇌 장벽과 태반 통과, 소량 모유에 분비됨

 

 

 

 

 

 

Protein Binding (단백 결합)

• English: ~20%
• Korean: 약 20%

 

 

 

 

 

 

Metabolism & Excretion (대사 및 배설)

• English: Extensively metabolized in the liver (CYP2D6, CYP3A4); excreted mainly in urine
• Korean: 간(CYP2D6, CYP3A4)에서 광범위하게 대사, 주로 소변으로 배설

 

 

 

 

 

Adverse Effects (부작용)

Common (흔한 부작용):

• Dizziness, headache (어지럼증, 두통)
• Nausea, constipation (구역, 변비)
• Drowsiness (졸림)

Serious (심각한 부작용):

• Seizures (발작)
• Respiratory depression (호흡 억제)
• Serotonin syndrome (세로토닌 증후군 → agitation, fever, muscle rigidity)
• Dependence, abuse potential (의존성과 남용 위험)

 

 

 

 

 

Dosage (투여 용량)

• Adults (성인):
  • Immediate release: 50–100 mg PO every 4–6 hrs (max 400 mg/day)
  • Extended release: 100 mg once daily, may increase every 5 days up to 300 mg/day
• Elderly (노인): Lower dose recommended due to decreased clearance

 

 

 

 

 

Nursing Considerations (간호 시 고려사항)

• Assess pain level before and after administration
• Monitor for respiratory depression, sedation, and signs of serotonin syndrome
• Use with caution in patients with seizure disorders
• Avoid with other CNS depressants (alcohol, benzodiazepines)
• Taper gradually to discontinue (avoid withdrawal)

 

 

 

 

 

Patient Teaching (환자 교육)

English:

• Take exactly as prescribed; do not increase dose without medical advice
• Avoid driving or operating machinery until effects are known
• Avoid alcohol and sedatives (increased risk of drowsiness and respiratory depression)
• Report seizures, confusion, or difficulty breathing
• Do not stop abruptly; tapering may be necessary

Korean (한국어):

• 의사의 지시에 따라 정확히 복용하며, 임의로 용량을 늘리지 마세요
• 약물 효과를 알기 전까지 운전이나 기계 조작을 피하세요
• 술이나 진정제와 함께 복용하지 마세요 (졸림 및 호흡 억제 위험 증가)
• 발작, 혼돈, 호흡 곤란이 있으면 즉시 보고하세요
• 갑자기 중단하지 말고, 점진적으로 줄여야 합니다

 

traMADol (tra-ma-dol) (ConZip, Durela, Qdolo, Ralivia, Tridural, Ultram, Zytram XL)

analgesics (centrally acting), opioid analgesics / Schedule IV

● Indications:  Management of moderate to moderately severe pain, Chronic pain requiring continuous treatment

● Therapeutic effects:  Decreased pain

● Absorption: 75% absorbed after PO

● Distribution: Crosses the placenta; enters breast milk

● Protein binding: 

● Metabolism&Excretion: Mostly metabolized by the liver, excreted mainly in urine

● Onset/Peak/Duration:  PO: Onset 1 hr, Peak 2–3 hr, Duration 4-6 hr, ER: Onset unknown, Peak 1hr, Duration 24hrs

● ADE: CV: vasodilation. Derm: pruritus, sweating. EENT: visual disturbances. Endo: hypoglycemia. F and E: hyponatremia. GI: constipation, nausea, abdominal pain, anorexia, diarrhea, dry mouth, dyspepsia, flatulence, vomiting. GU:↓fertility, menopausal symptoms, urinary retention/frequency. Neuro: hypertonia, SEIZURES, dizziness, headache, somnolence, anxiety, confusion, coordination disturbance, euphoria, malaise, nervousness, sleep disorder, stimulation, weakness.. Resp: RESPIRATORY DEPRESSION (including central sleep apnea and sleep-related hypoxemia). Misc: physical dependence, psychological dependence, tolerance

● Dose: Rapid titration— 50– 100 mg every 4– 6 hr (not to exceed 400 mg/day [300 mg in patients >75 yr]). Gradual titration— 25 mg/day initially,↑by 25 mg/day every 3 days to reach dose of 25 mg 4 times daily, then↑by 50 mg/day every 3 days to reach dose of 50 mg 4 times daily; may then use 50– 100 mg every 4– 6 hr (maximum dose = 400 mg/day)

● contraindication: Hypersensitivity, Patients who are acutely intoxicated with alcohol, sedatives/hypnotics, centrally acting analgesics, opioid analgesics, or psychotropic agents; Patients who are physically dependent on opioid analgesics

● nursing consideration: Assess type, location, and intensity of pain before and 2– 3 hr (peak) after administration. • Assess BP and respiratory rate before and periodically during administration. Respiratory depression has not occurred with recommended doses, • Assess bowel function routinely