natoshaba...My mom has had cirrhosis of the liver for 3 years. She was given tramadol once before and had 3 grand-mal seizures. Her DR said it was an allergic reaction. The nursing home she is in now has been giving her tramadol around the clock for 6 days even though her medical records state she is allergic. The nursing home had to call 911 because they thought my mother was having a stroke because of sudden slurred speech and loss of coordination. A CT was done and her liver is now in complete failure and enlarged as well as her spleen. Her ammonia level was 61 when first tested at the ER and now is at 127. She has had episodes of encephalopathy when her ammonia level is high and seems like she is going through it again. Until yesterday, medically, she was pretty stable for a person in her condition. Is it possible tramadol could have caused all these news problems and medical decline? Also, what can I do about the nurse and staff DR at the nursing home giving my mother a medication that it clearly says in her records she is allergic to?
Can tramadol cause liver failure in a person with cirrhosis of the liver or an elarged liver?
- Posted:
- 15 Jul 2012 by natoshabarrow
- Topics:
- seizures, cirrhosis, allergic reactions, tramadol, liver
Responses (4)
Delila15 Jul 2012
Hi, check out this link on DC about Tramadol and liver disease...
http://www.drugs.com/disease-interactions/tramadol.html#Liver_Disease
I would suggest you contact your local Citizens Advice center or similar to discuss the details around your mums treatment, or alternatively contact a solicitor. They will be able to advise you on your/your mothers rights.
Considering the warnings of Tramadol usage in liver failure it is worrying that your mum was still prescribed it. Also take note of the dosage instructions on the link - 50mg in 12 hours suggested. What was her prescribed dosage?
kaismama15 Jul 2012
If it is clearly marked in her records, the doctor and the nursing home have got a big problem. I'd love to get into her chart and see what went on there. Someone dropped the ball somewhere. The doc when he ordered it, the nurse who admitted her if it wasn't in her admission work, the nurses who gave the medication, and the nursing home. Did they tell you without you asking that they had given it to her? Does she wear a bracelet from the nursing home that says she's allergic to it? I would call a good lawyer if I were you. They will check into everything and let you know what is to be done. From what you're saying I'd say you have a pretty good lawsuit. I worked in nursing homes for years, and part of my job was to check into these things, and I know that a good shake up from a legal inspection helps everyone.
15 Jul 2012
Here is what I found in the prescribing info: Hepatic
Metabolism of tramadol and M1 is reduced in patients with advanced cirrhosis of the liver, resulting in both a larger area under the concentration time curve for tramadol and longer tramadol and M1 elimination half-lives (13 hrs. for tramadol and 19 hrs. for M1). In cirrhotic patients, adjustment of the dosing regimen is recommended (see DOSAGE AND ADMINISTRATION).
Geriatric
Healthy elderly subjects aged 65 to 75 years have plasma tramadol concentrations and elimination half-lives comparable to those observed in healthy subjects less than 65 years of age. In subjects over 75 years, maximum serum concentrations are elevated (208 vs. 162 ng/mL) and the elimination half-life is prolonged (7 vs. 6 hours) compared to subjects 65 to 75 years of age. Adjustment of the daily dose is recommended for patients older than 75 years (see DOSAGE AND
It is metabolized in the liver, and any drug that is can be a risk to the liver.
endlessPred15 Jul 2012
Also be sure to report immediately to the state licensing for nursing homes. You may find they have other complaints as well. There are huge fines and loss of Medicare and Medicaid benefits if too many reports. Also contact Medicare and any other insurance she may be on. A lot to do? Yes. But since you are in a wait state with her health at least there are things to do.
Also be sure to be in direct contact with her regular physician, not the home physician. Make sure she has a medical directive signed so you can deal with her records and power of attorney if not done yet.
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I agree with reporting it, however it could be more then one nurse that is the problem and alot more then incompetence going on here. That is why I suggested a lawyer.
Yep, lawyer comes after reporting. It is the first question you will be asked. Did you report this? No way would I pay an attorney to do this paperwork. after all, an attorney looks for cash settlement. That isn't going to help all the people suffering from this type of carelessness or get your mother in a better situation.
Be sure to document everything. When, who, how long. Keep a journal. These things take time. In the mean time, she will benefit greatly from your help.
You are so right about that. Also every discussion you have with anyone related to the nursing home or any of the staff. I would tape it if they allow you to. I've seen nursing homes try to hang the poor nurse out to dry when its not humanly possible to think most of the time they're working. The doctor will say they didn't point it out to him, the nursing home will say the nurse should have done it. The doc will say the nurse shouldn't have given it if she knew it was contraindicated, even tho he ordered it, etc. The nursing home will try to get out of any responsibility at all. Medication errors are happening more and more, and for the most part, its the fault of the nursing home who is trying to make money by not hiring enough staff to do the work properly. The lawyer will get into staffing. Some states have regulations as to how many nurses have to be working, some don't. Hopefully yours does, as this would make the job even easier.
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When I was auditing these things, I wasn't very popular with the nursing home owners, because I would dig into everything. Fortunately I was working for them because they needed evaluation of what happened.