Which prescription should a nurse question if a client is already receiving tramadol?

The prescription that should be questioned if a client is already receiving tramadol is monoamine oxidase inhibitors (MAOIs). This is due to the potential for serious drug interactions between tramadol and MAOIs. Tramadol can increase serotonin levels in the body, and when combined with an MAOI, it can lead to dangerously high serotonin levels, resulting in a condition known as serotonin syndrome. Symptoms of this syndrome include agitation, confusion, fever, and potentially life-threatening complications.

In contrast, the other medications listed—aspirin, gabapentin, and ibuprofen—do not pose the same level of risk when administered alongside tramadol. Aspirin and ibuprofen are non-steroidal anti-inflammatory drugs (NSAIDs) that can be safely used with tramadol for pain relief, although care should be taken to monitor for increased risk of gastrointestinal bleeding when using NSAIDs. Gabapentin is an anticonvulsant and is often used for neuropathic pain; it does not have significant interactions with tramadol and is frequently prescribed together for patients dealing with chronic pain or neuropathic conditions.