An overview of analgesics: opioids, tramadol, and tapentadol (Part 2)

Pain can be caused by several mechanisms, and the development of chronic pain (also known as pain chronification) is a complex and often unpredictable process. Opioids, tramadol, and tapentadol provide pharmacological solutions to chronic pain of cancer or non-cancer origins, particularly if central...

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Main Authors: R. van Rensburg, H. Reuter
Format: Article
Language:English
Published: AOSIS 2019-04-01
Series:South African Family Practice
Online Access:https://safpj.co.za/index.php/safpj/article/view/5001
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author R. van Rensburg
H. Reuter
author_facet R. van Rensburg
H. Reuter
author_sort R. van Rensburg
collection DOAJ
description Pain can be caused by several mechanisms, and the development of chronic pain (also known as pain chronification) is a complex and often unpredictable process. Opioids, tramadol, and tapentadol provide pharmacological solutions to chronic pain of cancer or non-cancer origins, particularly if central sensitization is present. It may also be indicated for short-term use in acute pain. Despite large studies and meta-analyses of opioids for a variety of pain conditions, the evidence for its clinical effectiveness is still unclear. This is, however, mostly due to significant heterogeneity and bias between studies assessed. The dual analgesic mechanisms of tramadol and tapentadol appear to be effective options for pain relief, with an overall lower incidence of opioid-related adverse effects. Tapentadol has an analgesic effect comparable to the strong opioids, which appears to be mediated by its greater mu opioid receptor activity and more selective noradrenaline reuptake inhibition. Tramadol produces less analgesia than tapentadol, but it is also associated with reduced opioid-related adverse effects and dependence. The opioids and tramadol may be significantly affected by polymorphisms of CYP2D6, while this effect is lessened with tapentadol.
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spelling doaj-art-f34c2f99f63d4d7aab01ebe6c188a2eb2025-08-20T03:47:10ZengAOSISSouth African Family Practice2078-61902078-62042019-04-01612162310.4102/safp.v61i2.50013977An overview of analgesics: opioids, tramadol, and tapentadol (Part 2)R. van Rensburg0H. Reuter1Stellenbosch UniversityStellenbosch UniversityPain can be caused by several mechanisms, and the development of chronic pain (also known as pain chronification) is a complex and often unpredictable process. Opioids, tramadol, and tapentadol provide pharmacological solutions to chronic pain of cancer or non-cancer origins, particularly if central sensitization is present. It may also be indicated for short-term use in acute pain. Despite large studies and meta-analyses of opioids for a variety of pain conditions, the evidence for its clinical effectiveness is still unclear. This is, however, mostly due to significant heterogeneity and bias between studies assessed. The dual analgesic mechanisms of tramadol and tapentadol appear to be effective options for pain relief, with an overall lower incidence of opioid-related adverse effects. Tapentadol has an analgesic effect comparable to the strong opioids, which appears to be mediated by its greater mu opioid receptor activity and more selective noradrenaline reuptake inhibition. Tramadol produces less analgesia than tapentadol, but it is also associated with reduced opioid-related adverse effects and dependence. The opioids and tramadol may be significantly affected by polymorphisms of CYP2D6, while this effect is lessened with tapentadol.https://safpj.co.za/index.php/safpj/article/view/5001
spellingShingle R. van Rensburg
H. Reuter
An overview of analgesics: opioids, tramadol, and tapentadol (Part 2)
South African Family Practice
title An overview of analgesics: opioids, tramadol, and tapentadol (Part 2)
title_full An overview of analgesics: opioids, tramadol, and tapentadol (Part 2)
title_fullStr An overview of analgesics: opioids, tramadol, and tapentadol (Part 2)
title_full_unstemmed An overview of analgesics: opioids, tramadol, and tapentadol (Part 2)
title_short An overview of analgesics: opioids, tramadol, and tapentadol (Part 2)
title_sort overview of analgesics opioids tramadol and tapentadol part 2
url https://safpj.co.za/index.php/safpj/article/view/5001
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