Prescribing Safety Assessment (PSA) Practice Exam

Which common side effect of Tramadol is particularly noted in the elderly population?

1. Dizziness

2. Nausea

3. Confusion

4. Insomnia

The correct answer is: Confusion

Tramadol is an analgesic that can have various side effects, and in the elderly population, confusion is particularly notable due to several reasons. The elderly are often more sensitive to medications because of physiological changes such as altered metabolism and organ function. Additionally, they may have comorbidities that increase their risk of experiencing central nervous system side effects. Confusion can arise due to the way Tramadol affects neurotransmitters in the brain, including serotonin and norepinephrine, which can be more pronounced in older adults. This demographic is also at a higher risk for developing delirium, especially when there are factors such as polypharmacy, which is common in older patients taking multiple medications, or existing cognitive impairments. In contrast, while dizziness, nausea, and insomnia are also possible side effects of Tramadol, confusion stands out in the elderly due to its implications for safe medication management and the potential for exacerbating pre-existing cognitive issues. Managing pain in this population requires careful assessment of risks, highlighting the importance of monitoring for confusion and other cognitive effects when prescribing Tramadol.