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The potency and efficacy of intrathecally administered morphine has been shown to be lesser in models of spinal nerve ligation, compared to that administered to control rats, tapentadol and its prolonged use can lead to tolerance and to the need to increase doses over time The inhibitors of the reuptake of monoamines (inhibitors of the reuptake of serotonin, norepinephrine, tricyclic and non-tricyclic) are among the first-line treatment options for chronic pain Serotonin (5-HT) is released from the modulating pathways descending from the pons to the spinal cord, and the inhibition of its reuptake leads to an increase in the activation of the 5-HT receptors in spinal neurons, which helps to modulate the nociceptive spinal processing (12) .
Likewise, the inhibition of norepinephrine reuptake (INR) in the axonic endings of the inhibitory noradrenergic descending pathways, increases the extracellular concentration of norepinephrine (NE) tapentadol in the spinal cord, which can also produce anti-nociception by the activation of the α2 adrenergic receptors which can be of particular interest in chronic neuropathic pain .
Generally, these medications are usually well tolerated even though their palexia cheaptickets tapentadol cheapest pregabalina y tapentadol tapentadol is it addictive palexia analgesic efficacy is often unsatisfactory Combining both action mechanisms (MRA and INR agonist behavior) in the same molecule could produce according to that stated before, to an efficient strategy to treat chronic neuropathic pain .
Tramadol binds to the μ,σ and κ receptors with low affinity, and therefore is less effective than other opioid agonists to treat severe pain; however this characteristic produces side effects not common for opioids although seizures, nausea, tapentadol sr tapentadol lekarstwo nucynta with tylenol tapentadol uk schedule tapentadol australian vomiting headache and dizziness are still possible (15) .
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