Implementing a Statistical Model for Protamine Titration: Effects on Coagulation in Cardiac Surgical Patients

as tramadol pharmacology will ensure the optimal pain management without adverse effects or toxicity. The possibility of misuse, withdrawal symptoms, and adverse effects are greater in the case of tramadol because of its unique simultaneous opioid agonist action and serotonin and norepinephrine reuptake inhibitory effects, which increases the potential for drug interactions. A more thorough understanding of tramadol's pharmacology and pharmacokinetics including the effect of CYP genetic polymorphisms will ensure more targeted prescribing practices. In addition, both patients and practitioners should be aware of the potential for drug interactions, possibility of addiction, toxicity risks, and risk of withdrawal. Hopefully, increased knowledge in these areas will improve the possibility of making an optimal decision regarding the use of this drug.