Tramadol use in treatment of Pain

Tramadol is used to treat moderate to moderately severe pain . The extended release from of Tramadol is for around the clock treatment of pain.
    Tramadol is an opioid  analgesic which has two different mechanisms of action(MOA). 1.By binding to  μ-opioid receptors.  2.By inhibiting re-uptake of serotonin and norepinephrine ( Neurotransmitters which play important role in mood ).When administered Tramadol is metabolized to O-desmethyltramol which is significantly more potent opioid .
               It's analgesic effect initiates 1 hour after oral administration and reaches to peak effect in 2 to 4 hours . Common adverse effects include diziness, nause,vertigo,constipation , headache,vomitting, somnolance.
      Tramadol is first  developed and marketed as "Tramal"by Grunenthal GmbH ,a German company in 1977 .It is now available with brand names Conzip,Rybix,Ryzolt,Ultram,Ultram ER,ODT.

Dosage:
Tablets 50 mg - Immediate release
Tablets 100,200,300 mg -Extended release
Capsules 100,200,300 mg-Extended release

Chemistry of Tramadol:
Structure:
Tramadol stereoisomers
IUPAC Name:2-[(Dimethylamino)methyl]-1-(3-methoxyphenyl)cyclohexano

Moleuclar Forumula:C16H25NO2

Molecular weight:263.4

Mechanisam of action: Tramadol acts by binding to μ-opioid  receptors and also by inhibiting reuptake  of serotonin and norepinephrine .