Poikilocytosis and tissue damage as negative impacts of tramadol on juvenile of Tilapia (Oreochromis niloticus)

Pharmaceuticals residue was detected in the water bodies as a consequence of the incomplete treatment. Recently, the side impacts of that residue on aquatic creatures have received a considerable attention. However, there is insufficient information about the effect of the most consumed narcotic drug (tramadol) on fish as an aquatic model. Thus, this study aims at investigating the poikilocytosis and tissue damage in Oreochromis niloticus after the exposure to 100 and 200 mg/L of tramadol hydrochloride. Three groups of fish were used; one as a control group, and the other two groups were exposed to 100 mg/L and 200 mg/L of tramadol hydrochloride respectively for 25 days. Exposure to tramadol caused a significant increase in the percentage of poikilocytosis compared to the control group. Poikilocytosis included tear-drop cell, spindle-shaped cell, sickle cell, schistocyte, blebbed cell, acanthocyte, eccentric nucleus, amoebocyte, dividing cell, and crenated cell. Moreover, liver tissue in fish exposed to tramadol showed degeneration and vacuolization of hepatocytes and atrophy of pancreatic acini as signs of histopathological alterations. Histopathological changes of brain showed severe gliosis, dark neurons, and vacuolization in fish exposed to tramadol compared to control fish. Gills tissue showed erosion, epithelial lifting, and secondary lamellae shrinking in fish exposed to tramadol compared to control fish. In conclusion, tramadol induced histopathological changes in liver, brain, and gills of Oreochromis niloticus as well as poikilocytosis were indicated clearly. Therefore, tramadol leakage to waters should be avoided to preserve aquatic creatures.

ADME and toxicity considerations for tramadol: from basic research to clinical implications

INTRODUCTION

Tramadol is widely being used in chronic pain management for improving patients' life quality and reducing trauma. Although it is listed in several medicinal guidelines, its use is controversial because of the conflicting results obtained in pharmacokinetic/pharmacodynamic studies. This multi-receptor drug acts as µ₁ opioid receptor agonist, monoamine reuptake inhibitor, and inhibitor of ligand-gated ion channels and some special protein-coupled receptors.

AREAS COVERED

This review provides a comprehensive view on the pharmacokinetic, pharmacodynamic, and toxicity of tramadol with a deep look on its side effects, biochemical and pathological changes, and possible drug interactions. In addition, the main ways of tramadol poisoning management describe according to in vivo and clinical trial studies.

EXPERT OPINION

Given the broad spectrum of targets, increasing the cases of overdoses and toxicity, and probable drugs interaction, it is necessary to take another look at the pharmacology of tramadol. Regarding the adverse effects of tramadol on different tissues, especially the nervous system and liver tissue, more attentions to tramadol metabolites, their interaction with other drugs, and active agents seem critical. Seizure as the most cited effect of tramadol and its destructive effects on tissues would alleviate by co-administration with drugs with antioxidant properties.