Tramadol: a dual action pain reliever

General
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Tramadol
Class
Centrally acting analgesic.
Weak opioid agonist (u-opioid receptors).
Also inhibits serotonin & norepinephrine reuptake → dual mechanism.

Mechanism of Action

  1. p-opioid receptor agonism → weak opioid efect for pain relief.
  2. Serotonin-+ norepinephrine reuptake inhibition → enhances descending pain inhibitory pathways.

Uses
• Moderate to moderately severe pain (postoperative, musculoskeletal, neuropathic).
• Alternative in patients not tolerating NSAIDs or when stronger opioids not
needed.
Sometimes used in chronic pain and neuropathic pain (with caution).

Adverse Effects
Common: Nausea, vomiting, dizziness, constipation, sedation.
Serious:
Seizures (lowers seizure threshold).
Serotonin syndrome (esp. if combined with SSRIS, SNRIS, MAOIS).
Respiratory depression (less than morphine, but possible at high doses/with other depressants).
Dependence & withdrawal (lower risk than morphine, but still present).

Contraindications
• Epilepsy or history of seizures (risk ^).
Concomitant use with MAO inhibitors, SSRIS, SNRIs → risk of serotonin syndrome.
•Severe respiratory depression.
Head trauma (can increase intracranial pressure).

1 Like
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Informative!

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Informative

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This post gives a clear summary of Tramadol. I learned that it works in two ways acting on opioid receptors and blocking pain signals through serotonin and norepinephrine. It’s useful for moderate pain, especially when NSAIDs can’t be used. But we should be careful with side effects like dizziness, seizures, and serotonin syndrome. As a pharmacy graduate, I feel it’s important to explain these risks to patients.

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informative