الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The liver is a vital organ and its strategic location and multidimensional functions support almost every other organ in the body(Swaroop et al., 2012). Liver often plays a critical role in the metabolism of drugs and xenobiotics, leading to a peculiar risk of toxic effects(Lewis & Stine,2013 ). An association between hepatic drug metabolism and drug induced liver injury(DILI) has been demonstrated, supporting the hypothesis that the formation and accumulation of reactive metabolites beyond a critical threshold can result in hepatotoxicity (Stirnimann et al., 2012). Tramadol is a synthetic, centrally acting analgesic with opioid and non opioid properties. It stimulates the dopamine (D2 ) receptors and also inhibits the gamma amino butyric acid release in central nervous system(Nakamura,et al,2008). Impact of tramadol dependence on liver function tests has been previously reported in few studies, from this view, evaluation of laboratory findings including liver function tests, have a critical role for patient monitoring (Atici et al., 2005).