Tramadol (Ultram) Middle step. Non opiod but his is a opiod wantabe! Quasi-opioid. Ultram is not a controlled substance in IDAHO!
MIDDLE GUY: drug of choice for doctors who have pts where Ibuprofen and tylenol not enough but they dont want to rx Lortab or Vicodin
moderate pain, works by a "dual" or two ways to help with pain. Weakly binds to (mu) opiod receptors AND inhibits uptake of NE and serotonin
S/E: GI upset, drowsiness, enhance seizures by (lowering seizure threshold), diaphoresis