1
|
Prasad GV, Reddy TM, Narayana AL, Hussain OM, Gopal TV, Shaikshavali P. Construction of the Embedded Li4Ti5O12-MWCNTs Nanocomposite Electrode for Diverse Applications in Electrochemical Sensing and Rechargeable Battery. J Inorg Organomet Polym Mater 2023. [DOI: 10.1007/s10904-023-02584-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
|
2
|
EEG and Sleep Effects of Tramadol Suggest Potential Antidepressant Effects with Different Mechanisms of Action. Pharmaceuticals (Basel) 2021; 14:ph14050431. [PMID: 34064349 PMCID: PMC8147808 DOI: 10.3390/ph14050431] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 04/27/2021] [Accepted: 04/29/2021] [Indexed: 01/18/2023] Open
Abstract
Tramadol is a widely used, centrally acting, opioid analgesic compound, with additional inhibitory effects on the synaptic reuptake of serotonin and noradrenaline, as well as on the 5-HT2 and NMDA receptors. Preclinical and clinical evidence also suggests its therapeutic potential in the treatment of depression and anxiety. The effects of most widely used antidepressants on sleep and quantitative electroencephalogram (qEEG) are well characterized; however, such studies of tramadol are scarce. Our aim was to characterize the effects of tramadol on sleep architecture and qEEG in different sleep–wake stages. EEG-equipped Wistar rats were treated with tramadol (0, 5, 15 and 45 mg/kg) at the beginning of the passive phase, and EEG, electromyogram and motor activity were recorded. Tramadol dose-dependently reduced the time spent in rapid eye movement (REM) sleep and increased the REM onset latency. Lower doses of tramadol had wake-promoting effects in the first hours, while 45 mg/kg of tramadol promoted sleep first, but induced wakefulness thereafter. During non-REM sleep, tramadol (15 and 45 mg/kg) increased delta and decreased alpha power, while all doses increased gamma power. In conclusion, the sleep-related and qEEG effects of tramadol suggest antidepressant-like properties, including specific beneficial effects in selected patient groups, and raise the possibility of a faster acting antidepressant action.
Collapse
|
3
|
Doostmohammadi M, Rahimi HR. ADME and toxicity considerations for tramadol: from basic research to clinical implications. Expert Opin Drug Metab Toxicol 2020; 16:627-640. [PMID: 32476523 DOI: 10.1080/17425255.2020.1776700] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Tramadol is widely being used in chronic pain management for improving patients' life quality and reducing trauma. Although it is listed in several medicinal guidelines, its use is controversial because of the conflicting results obtained in pharmacokinetic/pharmacodynamic studies. This multi-receptor drug acts as µ1 opioid receptor agonist, monoamine reuptake inhibitor, and inhibitor of ligand-gated ion channels and some special protein-coupled receptors. AREAS COVERED This review provides a comprehensive view on the pharmacokinetic, pharmacodynamic, and toxicity of tramadol with a deep look on its side effects, biochemical and pathological changes, and possible drug interactions. In addition, the main ways of tramadol poisoning management describe according to in vivo and clinical trial studies. EXPERT OPINION Given the broad spectrum of targets, increasing the cases of overdoses and toxicity, and probable drugs interaction, it is necessary to take another look at the pharmacology of tramadol. Regarding the adverse effects of tramadol on different tissues, especially the nervous system and liver tissue, more attentions to tramadol metabolites, their interaction with other drugs, and active agents seem critical. Seizure as the most cited effect of tramadol and its destructive effects on tissues would alleviate by co-administration with drugs with antioxidant properties.
Collapse
Affiliation(s)
- Mohsen Doostmohammadi
- Pharmaceutics Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences , Kerman, Iran
| | - Hamid-Reza Rahimi
- Pharmaceutics Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences , Kerman, Iran.,Department of Pharmacology and Toxicology, Faculty of Pharmacy, Kerman University of Medical Sciences , Kerman, Iran
| |
Collapse
|
4
|
Raj K, Chawla P, Singh S. Neurobehavioral Consequences Associated with Long Term Tramadol Utilization and Pathological Mechanisms. CNS & NEUROLOGICAL DISORDERS-DRUG TARGETS 2020; 18:758-768. [DOI: 10.2174/1871527318666191112124435] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 09/17/2019] [Accepted: 10/28/2019] [Indexed: 02/06/2023]
Abstract
:
Tramadol is a synthetic analog of codeine used to treat pain of moderate to severe intensity
and is reported to have neurotoxic potential. At therapeutic dose, tramadol does not cause major side
effects in comparison to other opioid analgesics, and is useful for the management of neurological
problems like anxiety and depression. Long term utilization of tramadol is associated with various neurological
disorders like seizures, serotonin syndrome, Alzheimer’s disease and Parkinson’s disease.
Tramadol produces seizures through inhibition of nitric oxide, serotonin reuptake and inhibitory effects
on GABA receptors. Extensive tramadol intake alters redox balance through elevating lipid peroxidation
and free radical leading to neurotoxicity and produces neurobehavioral deficits. During Alzheimer’s
disease progression, low level of intracellular signalling molecules like cGMP, cAMP, PKC
and PKA affect both learning and memory. Pharmacologically tramadol produces actions similar to Selective
Serotonin Reuptake Inhibitors (SSRIs), increasing the concentration of serotonin, which causes
serotonin syndrome. In addition, tramadol also inhibits GABAA receptors in the CNS has been evidenced
to interfere with dopamine synthesis and release, responsible for motor symptoms. The reduced
level of dopamine may produce bradykinesia and tremors which are chief motor abnormalities in Parkinson’s
Disease (PD).
Collapse
Affiliation(s)
- Khadga Raj
- Neuroscience Division, Department of Pharmacology, ISF College of Pharmacy, Moga, Punjab 142001, India
| | - Pooja Chawla
- Department of Pharmaceutical Chemistry, ISF College of Pharmacy, Moga, Punjab 142001, India
| | - Shamsher Singh
- Neuroscience Division, Department of Pharmacology, ISF College of Pharmacy, Moga, Punjab 142001, India
| |
Collapse
|
5
|
Pourtalebi Jahromi L, Sasanipour Z, Azadi A. Promising horizon to alleviate Alzeheimer’s disease pathological hallmarks via inhibiting mTOR signaling pathway: A new application for a commonplace analgesic. Med Hypotheses 2018; 110:120-124. [DOI: 10.1016/j.mehy.2017.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 11/19/2017] [Accepted: 12/03/2017] [Indexed: 12/14/2022]
|
6
|
What is the main mechanism of tramadol? Naunyn Schmiedebergs Arch Pharmacol 2015; 388:999-1007. [DOI: 10.1007/s00210-015-1167-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Accepted: 08/10/2015] [Indexed: 12/26/2022]
|
7
|
Miyano K, Minami K, Yokoyama T, Ohbuchi K, Yamaguchi T, Murakami S, Shiraishi S, Yamamoto M, Matoba M, Uezono Y. Tramadol and its metabolite m1 selectively suppress transient receptor potential ankyrin 1 activity, but not transient receptor potential vanilloid 1 activity. Anesth Analg 2015; 120:790-8. [PMID: 25642661 DOI: 10.1213/ane.0000000000000625] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND The transient receptor potential vanilloid 1 (TRPV1) and the transient receptor potential ankyrin 1 (TRPA1), which are expressed in sensory neurons, are polymodal nonselective cation channels that sense noxious stimuli. Recent reports showed that these channels play important roles in inflammatory, neuropathic, or cancer pain, suggesting that they may serve as attractive analgesic pharmacological targets. Tramadol is an effective analgesic that is widely used in clinical practice. Reportedly, tramadol and its metabolite (M1) bind to μ-opioid receptors and/or inhibit reuptake of monoamines in the central nervous system, resulting in the activation of the descending inhibitory system. However, the fundamental mechanisms of tramadol in pain control remain unclear. TRPV1 and TRPA1 may be targets of tramadol; however, they have not been studied extensively. METHODS We examined whether and how tramadol and M1 act on human embryonic kidney 293 (HEK293) cells expressing human TRPV1 (hTRPV1) or hTRPA1 by using a Ca imaging assay and whole-cell patch-clamp recording. RESULTS Tramadol and M1 (0.01-10 μM) alone did not increase in intracellular Ca concentration ([Ca]i) in HEK293 cells expressing hTRPV1 or hTRPA1 compared with capsaicin (a TRPV1 agonist) or the allyl isothiocyanate (AITC, a TRPA1 agonist), respectively. Furthermore, in HEK293 cells expressing hTRPV1, pretreatment with tramadol or M1 for 5 minutes did not change the increase in [Ca]i induced by capsaicin. Conversely, pretreatment with tramadol (0.1-10 μM) and M1 (1-10 μM) significantly suppressed the AITC-induced [Ca]i increases in HEK293 cells expressing hTRPA1. In addition, the patch-clamp study showed that pretreatment with tramadol and M1 (10 μM) decreased the inward currents induced by AITC. CONCLUSIONS These data indicate that tramadol and M1 selectively inhibit the function of hTRPA1, but not that of hTRPV1, and that hTRPA1 may play a role in the analgesic effects of these compounds.
Collapse
Affiliation(s)
- Kanako Miyano
- From the *Division of Cancer Pathophysiology, National Cancer Center Research Institute, Chuo-ku, Tokyo, Japan; †Department of Anesthesiology and Critical Care Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan; ‡Tsumura Research Labs, Tumura & Co., Inashiki-gun, Ibaraki, Japan; §Division of Biostatistics, Tohoku University Graduate School of Medicine, Clinical Research Data Center, Tohoku University Hospital, Sendai, Miyagi, Japan; ∥Department of Palliative Medicine, Seirei Sakura Citizen Hospital, Sakura-shi, Chiba, Japan; and ¶Department of Palliative Medicine, Aomori Prefectural Central Hospital, Aomori-city, Aomori, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Minami K, Uezono Y. The recent progress in research on effects of anesthetics and analgesics on G protein-coupled receptors. J Anesth 2012; 27:284-92. [PMID: 23099434 DOI: 10.1007/s00540-012-1507-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 10/09/2012] [Indexed: 11/25/2022]
Abstract
The exact mechanisms of action behind anesthetics and analgesics are still unclear. Much attention was focused on ion channels in the central nervous system as targets for anesthetics and analgesics in the 1980s. During the 1990s, major advances were made in our understanding of the physiology and pharmacology of G protein coupled receptor (GPCR) signaling. Thus, several lines of studies have shown that G protein coupled receptors (GPCRs) are one of the targets for anesthetics and analgesics and especially, that some of them inhibit the functions of GPCRs, i.e,, muscarinic receptors and substance P receptors. However, these studies had been focused on only G(q) coupled receptors. There has been little work on G(s)- and G(i)-coupled receptors. In the last decade, a new assay system, using chimera G(i/o)-coupled receptor fused to Gq(i5), has been established and the effects of anesthetics and analgesics on the function of G(i)-coupled receptors is now more easily studied. This review highlights the recent progress of the studies regarding the effects of anesthetics and analgesics on GPCRs.
Collapse
Affiliation(s)
- Kouichiro Minami
- Cancer Pathophysiology Division, National Cancer Center Research Institute, Tokyo 104-0045, Japan.
| | | |
Collapse
|
9
|
Wang F, Shen X, Xu S, Liu Y. Preoperative tramadol combined with postoperative small-dose tramadol infusion after total abdominal hysterectomy: a double-blind, randomized, controlled trial. Pharmacol Rep 2010; 61:1198-205. [PMID: 20081257 DOI: 10.1016/s1734-1140(09)70184-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2008] [Revised: 09/29/2009] [Indexed: 10/25/2022]
Abstract
This double blind, randomized, controlled trial investigated whether a single preoperative intravenous (iv) dose of tramadol (100 mg) given 30 min before abdominal hysterectomy resulted in improved analgesic efficacy, reduced postoperative morphine patient-controlled analgesia (PCA) use and reduced side effects when combined with a postoperative small-dose tramadol infusion. Two-hundred twenty-four patients undergoing elective abdominal hysterectomy were randomly allocated to one of two groups: the tramadol group (n = 113) received iv tramadol (100 mg) 30 min before surgery, and the control group (n = 111) received an equivalent volume of normal saline. Upon awakening from general anesthesia, all patients received a loading dose of 0.5 mg/kg of tramadol and a small-dose infusion of tramadol (0.1 mg/kg/h) for 48 h. In addition, all patients were connected to morphine PCA delivering a morphine bolus of 0.02 mg/kg with a 6-min lock-out. Data on pain intensity at rest and during movement, morphine consumption, side-effects and overall patient satisfaction were recorded. A total of 189 patients completed the study. Preemptive tramadol was associated with superior analgesia at rest and with movement in the first 24 h after surgery (p < 0.01), a longer interval to first morphine PCA request (p = 0.019), and reduced morphine PCA use (p = 0.017). The tramadol group had reduced nausea (p = 0.015), dizziness (p = 0.001) and drowsiness (p = 0.0001), while other side-effects were similar. In conclusion, a single dose of iv tramadol (100 mg) 30 min prior to abdominal hysterectomy improves analgesia, and reduces morphine PCA requirements, nausea, dizziness and drowsiness when combined with a postoperative small-dose tramadol infusion and morphine PCA when compared to the same analgesic regimen that omitted the preemptive tramadol.
Collapse
Affiliation(s)
- FuZhou Wang
- Department of Anesthesiology, Affiliated Nanjing Maternal and Child Health Care Hospital, Nanjing Medical University, No. 123, Tianfei Xiang, Mochou Road, Nanjing 210004, China.
| | | | | | | |
Collapse
|
10
|
Abstract
The under-treatment of postoperative pain has been recognised to delay patient recovery and discharge from hospital. Despite recognition of the importance of effective pain control, up to 70% of patients still complain of moderate to severe pain postoperatively. The mechanistic approach to pain management, based on current understanding of the peripheral and central mechanisms involved in nociceptive transmission, provides newer options for clinicians to manage pain effectively. In this article we review the rationale for a multimodal approach with combinations of analgesics from different classes and different sites of analgesic administration. The pharmacological options of commonly used analgesics, such as opioids, NSAIDs, paracetamol, tramadol and other non-opioid analgesics, and their combinations is discussed. These analgesics have been shown to provide effective pain relief and their combinations demonstrate a reduction in opioid consumption. The basis for using non-opioid analgesic adjuvants is to reduce opioid consumption and consequently alleviate opioid-related adverse effects. We review the evidence on the opioid-sparing effect of ketamine, clonidine, gabapentin and other novel analgesics in perioperative pain management. Most available data support the addition of these adjuvants to routine analgesic techniques to reduce the need for opioids and improve quality of analgesia by their synergistic effect. Local anaesthetic infiltration, epidural and other regional techniques are also used successfully to enhance perioperative analgesia after a variety of surgical procedures. The use of continuous perineural techniques that offer prolonged analgesia with local anaesthetic infusion has been extended to the care of patients beyond hospital discharge. The use of nonpharmacological options such as acupuncture, relaxation, music therapy, hypnosis and transcutaneous nerve stimulation as adjuvants to conventional analgesia should be considered and incorporated to achieve an effective and successful perioperative pain management regimen.
Collapse
Affiliation(s)
- Srinivas Pyati
- Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA
| | | |
Collapse
|
11
|
Minami K, Uezono Y, Ueta Y. Pharmacological aspects of the effects of tramadol on G-protein coupled receptors. J Pharmacol Sci 2007; 103:253-60. [PMID: 17380034 DOI: 10.1254/jphs.cr0060032] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Tramadol is an analgesic that is used worldwide, but its mechanisms of action have not been elucidated. It has been speculated that tramadol acts primarily through the activation of micro-opioid receptors and the inhibition of monoamine reuptake. The majority of studies to date have focused on ion channels in the central nervous system as targets of anesthetics and analgesics. During the past decade, major advances have been made in our understanding of the physiology and pharmacology of G-protein coupled receptor (GPCR) signaling. Several studies have shown that GPCRs and ion channels are targets for analgesics and anesthetics. In particular, tramadol has been shown to affect GPCRs, including muscarinic acetylcholine receptors and 5-hydroxytryptamine receptors. Here, the effects of tramadol on monoamine transporters, GPCRs, and ion channels are presented, and recent research on the pharmacology of tramadol is discussed.
Collapse
Affiliation(s)
- Kouichiro Minami
- Department of Anesthesiology and Critical Care Medicine, Jichi Medical University, Japan.
| | | | | |
Collapse
|