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Pathway Description
Tramadol Opioid Agonist Action Pathway
Homo sapiens
Drug Action Pathway
Tramadol is a centrally-acting opioid agonist and SNRI (serotonin/norepinephrine reuptake inhibitor) used for the management of moderate to severe pain in adults.
Tramadol binds to mu opioid receptors, stimulating the exchange of GTP for GDP on the G-protein complex. As the effector system is adenylate cyclase and cAMP located at the inner surface of the plasma membrane, opioids decrease intracellular cAMP by inhibiting adenylate cyclase. Subsequently, the release of nociceptive neurotransmitters such as GABA is inhibited. Opioids close N-type voltage-operated calcium channels and open calcium-dependent inwardly rectifying potassium channels. This results in hyperpolarization and reduced neuronal excitability. O-desmethyltramadol acts at A delta and C pain fibres in the dorsal horn of the spinal cord. By decreasing neurotransmitter action there is less pain transmittance into the spinal cord. This leads to less pain perception.
References
Tramadol Opioid Agonist Pathway References
Smith, H. S. (2009). Opioid metabolism. Mayo Clinic Proceedings, 84(7), 613–624. https://doi.org/10.1016/s0025-6196(11)60750-7
Wishart DS, Feunang YD, Guo AC, Lo EJ, Marcu A, Grant JR, Sajed T, Johnson D, Li C, Sayeeda Z, Assempour N, Iynkkaran I, Liu Y, Maciejewski A, Gale N, Wilson A, Chin L, Cummings R, Le D, Pon A, Knox C, Wilson M: DrugBank 5.0: a major update to the DrugBank database for 2018. Nucleic Acids Res. 2018 Jan 4;46(D1):D1074-D1082. doi: 10.1093/nar/gkx1037.
Nassirpour R, Bahima L, Lalive AL, Luscher C, Lujan R, Slesinger PA: Morphine- and CaMKII-dependent enhancement of GIRK channel signaling in hippocampal neurons. J Neurosci. 2010 Oct 6;30(40):13419-30. doi: 10.1523/JNEUROSCI.2966-10.2010.
Chan P, Lufty K. Molecular Changes in Opioid Addiction: The Role of Adenylyl Cyclase and cAMP/PKA System. Progress in Molecular Biology and Translational Science, Volume 137: 203-219, 2016.
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