chemistry

Tapentadol

Tapentadol is a chemistry topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand Tapentadol rather than just read about it. In short: Tapentadol, sold under the brand names Nucynta and Palexia among others, is a synthetic opioid analgesic with a dual mode of action as a highly selective full agonist of the μ-opioid receptor and as a norepinephrine reuptake inhibitor (NRI). Tapentadol is used medically for the treatment of moderate to severe pain.

Key takeaways

Tapentadol belongs to chemistry; place it in that map before memorising details.
Learn the definition first, then one example that makes the definition concrete.
Connect Tapentadol to a quantity you can measure, compute or draw — that is where exam questions come from.
Reproduce the core statement of Tapentadol from memory before moving on to harder problems.

Reference excerpt

Tapentadol, sold under the brand names Nucynta and Palexia among others, is a synthetic opioid analgesic with a dual mode of action as a highly selective full agonist of the μ-opioid receptor and as a norepinephrine reuptake inhibitor (NRI). Tapentadol is used medically for the treatment of moderate to severe pain. It is highly addictive and is a commonly abused drug. Frequently reported adverse effects include euphoria, constipation, nausea, vomiting, headaches, loss of appetite, drowsiness, dizziness, itching, dry mouth, and sweating. More severe adverse reactions can occur, including addiction and dependence, substance abuse, respiratory depression, and an elevated risk of serotonin syndrome. Concurrent use of tapendatol with serotonergic drugs can heighten the risk of excessive serotonin accumulation while concurrent use with CNS depressants — alcohol, benzodiazepines, other opioids — can heighten the risk of profound sedation, dangerously slowed breathing, and death. Analgesia occurs within 32 minutes of oral administration, and lasts for 4–6 hours. Tapentadol is taken by mouth, and is available in immediate-release and controlled-release formulations. Tapentadol's combined mechanism of action is often compared to that of tramadol. Unlike tramadol, tapentadol is not metabolised by cytochrome P450 enzymes, but rather through glucuronidation. Due to this, tapentadol has fewer interactions with other medications and fewer side effects when compared with tramadol. Like tramadol, tapentadol affects both the opioid system and the norepinephrine system to relieve pain. Unlike tramadol, it has only weak effects on the reuptake of serotonin and is a significantly more potent opioid with no known active metabolites. The potency of tapentadol is somewhere between that of tramadol and morphine, with an analgesic efficacy comparable to that of oxycodone despite a lower incidence of side effects. The CDC Opioid Guidelines Calculator estimates a conversion rate of 50mg of tapentadol equaling 10 mg of oral oxycodone in terms of opioid receptor activation. In the late 1980s, Grünenthal developed tapentadol to improve on tramadol, which they had created in 1962. Their goal was to design a molecule that minimized serotonin activity, strongly activated the μ-opioid receptor, inhibited norepinephrine reuptake, and worked without metabolic activation. The result was tapentadol. Due to the high risk of addiction, substance misuse, and dependence, tapentadol is a Schedule II controlled substance in the United States, a Schedule 8 controlled drug in Australia, and a Class A controlled substance in the United Kingdom.

Medical use Tapentadol is used for the treatment of moderate to severe pain for both acute (following e.g. injury or surgery) and chronic musculoskeletal pain. It is also specifically indicated for controlling the pain of diabetic neuropathy when around-the-clock opioid medication is required. Extended-release formulations of tapentadol are not indicated for use in the management of acute pain and are instead indicated only for the relief of severe, disabling pain, that is long-term in nature and cannot be controlled by any other pharmacological means. Tapentadol is pregnancy category C. There are no adequate and well-controlled studies of tapentadol in pregnant women, and tapentadol is not recommended for use in women during and immediately prior to labor and delivery. There are no adequate and well-controlled studies of tapentadol in children.

Contraindications Tapentadol is contraindicated in people with epilepsy or who are otherwise prone to seizures. It raises intracranial pressure so should not be used in people with head injuries, brain tumors, or other conditions which increase intracranial pressure. It increases the risk of respiratory depression so should not be used in people with asthma. As with other μ-opioid agonists, tapentadol may cause spasms of the sphincter of Oddi, and is therefore discouraged for use in patients with biliary tract disease such as both acute and chronic pancreatitis. People who are rapid or ultra rapid metabolizers for the CYP2C9, CYP2C19, and CYP2D6 enzymes may not respond adequately to tapentadol therapy. Due to reduced clearance, tapentadol should be administered with caution to people with moderate liver disease and not at all in people with severe liver disease.

Adverse effects The most commonly reported side effects of tapentadol therapy are constipation, nausea, vomiting, headaches, loss of appetite, drowsiness, dizziness, itching, dry mouth, and sweating. Tapentadol has also been noted to induce feelings of relaxation and euphoria, and it may cause serious side effects such as respiratory depression, serotonin syndrome, addiction and substance dependence. Several studies have found that tapentadol causes less constipation and nausea compared with oxycodone. It has been noted that due to this, treatment adherence may be improved, with fewer people discontinuing tapentadol (when compared with oxycodone). Tapentadol has been demonstrated to reduce the seizure threshold in patients. Tapentadol should be used cautiously in patients with a history of seizures, and in patients who are also taking one or more other drugs which have also been demonstrated to reduce the seizure threshold. Patients at high risk include those using other serotogenic and adrenergic medications, as well as patients with head trauma, metabolic disorders, and those in alcohol and/or drug withdrawals. Tapentadol has been demonstrated to potentially produce hypotension (low blood pressure), and should be used with caution in patients with low blood pressure, and patients who are taking one or more other medications which are also known to reduce blood pressure.

Addiction and abuse

… excerpt ends here. Continue reading the full article.

Illustrations

Worked examples

Example 1 — a first encounter with Tapentadol

Start with the simplest possible case. Write down what Tapentadol claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In chemistry, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to Tapentadol before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about Tapentadol ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of Tapentadol

In research: Tapentadol appears in chemistry research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses Tapentadol in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: Tapentadol is common in secondary-school and first-year university syllabi. It links to neighbouring topics 3-Hydroxyphenyl compounds, Dimethylamino compounds, Drugs developed by Johnson & Johnson, so understanding it makes those chapters shorter.
In everyday life: Look for Tapentadol outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

Affiliate

Preply — study more efficiently by working with a personal tutor. 50% off.

How to study Tapentadol in 20 minutes

Read the reference excerpt below once, without taking notes.
Close the page and write down what Tapentadol means in your own words.
Compare your version with the excerpt and mark what you missed.
Work through the three examples above with pen and paper.
Explain Tapentadol out loud to somebody else — or to Teacher Smith in the lgStudy chat.

Frequently asked questions

What is Tapentadol in simple terms?

Why does Tapentadol matter?

Because it connects several chemistry ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study Tapentadol?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on Tapentadol.