
REBOOT #146 Pain Meds in CKD
The Curbsiders Internal Medicine Podcast
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Tramadall
Tramadall is advertised as having two mechanisms of action. It's got a bivinacent al ight and it's also perceived as a mild opiote. The conversion of the s n or i parent compound, tram at all, to its metabolite is accomplished by an enzim in a liver. We have wildly varying levels of that ensime. Some of us have none, we won't make any opiod. And some of us have several copies of the gen that in codes for two, ty six, will turn tramadall into m one like nobody's business.
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