Tramadol Dual Mechanism — FRCA Primary MCQ
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Correct answer: D — Inhibition of noradrenaline reuptake with enhanced serotonin release
The best answer is “Inhibition of noradrenaline reuptake with enhanced serotonin release”. Tramadol is an opioid with additional inhibition of neuronal noradrenaline reuptake and enhancement of serotonin release. These actions explain clinically important serotonergic interactions. It is not an anticholinesterase, irreversible COX inhibitor, class-I antiarrhythmic or NK1 antagonist.
Reference: Tramadol 50 mg capsules, Summary of Product Characteristics: https://www.medicines.org.uk/emc/product/11609/smpc