To : Ilene
Re : Ultram(tramidol)

Ultram is a new opioid-like analgesic.  It is included in my '96
Edition, but I have enclosed a monograph below.

TRAMADOL
Tramadol is a new class analgesic that most closely resembles the
opiates, although it is not a controlled substance and appears to have
reduced addictive potential.  It appears to be slightly more potent than
codeine.  After oral use, its onset of analgesia is within 1 hour and
reaches a peak in 2-3 hours.  Following a single IV 100 mg dose of
tramadol,  the cumulative excretion in breastmilk within 16 hours was
100 ug of tramadol (0.1% of the maternal dose) and 27 ug of the M1
metabolite.  The manufacturer does not recommend use in lactating women
because its safety in pediatric patients is unknown.

Half-life= 7 hrs
M/P ratio = 0.1
Oral Bioavail = 60%

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To      : Denise
Re      : Diflucan(fluconazole)

Diflucan is now available in a liquid formulation,  you do not need to
crush tablets or formulate it.  Current formulations contain 10 and 40
mg/ml of solution.  Recommended dosing for infants is 6 mg/kg/day stat,
followed by 3 mg/kg/day thereafter.  It is only cleared by the
manufacturer for infants 6 months and older,  but as you stated, it is
commonly used in NICU's.

Regards
Tom Hale, Ph.D.