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Wang X, Zhang R, Chen B, Zhang T, Jin X, Gao P. Preliminary evaluation of the efficacy and safety of brimonidine for deep sedation. Fundam Clin Pharmacol 2024; 38:139-151. [PMID: 37612481 DOI: 10.1111/fcp.12944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/16/2023] [Accepted: 07/20/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Although brimonidine is currently used in the clinical treatment of glaucoma and rosacea, research of the deep sedative effect on animals after systemic administration is reported firstly and has shown promising results. METHODS The median effective dose (ED50 ), the median lethal dose (LD50 ), and the therapeutic index of brimonidine for deep sedation and formalin stimulation assay were determined by various animal experiments. The effect of synergistic anesthesia in rabbits with brimonidine and chloral hydrate was preliminarily evaluated. RESULTS The ED50 of brimonidine for highly effective sedation by intraperitoneal injection in rats was calculated to be 2.05 mg kg-1 with a 95% confidence interval (CI) of 1.87 to 2.25 mg kg-1 . The ED50 of brimonidine for deep sedation by intravenous and intrarectal injection in rabbits was calculated to be 0.087 mg kg-1 with a 95% CI of 0.084 to 0.091 mg kg-1 and 1.65 mg kg-1 with a 95% CI of 1.43 to 1.91 mg kg-1 , respectively. The LD50 of intraperitoneal brimonidine injection in rats was calculated to be 468 mg kg-1 with a 95% CI of 441 to 497 mg kg-1 and a therapeutic index of 228. Brimonidine has a certain analgesic and heart rate lowering effects. CONCLUSION The results confirmed that brimonidine has deep sedation and analgesic effects after systemic administration and has high safety. It can be used in combination with other types of sedative drugs to achieve better effects.
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Affiliation(s)
- Xiaohui Wang
- Laboratory of Traditional Chinese Medicine Preparations, Tianjin Institute of Medical & Pharmaceutical Sciences, Tianjin, China
| | - Rui Zhang
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
| | - Bin Chen
- Laboratory of Medical Biomaterials, Tianjin Institute of Medical & Pharmaceutical Sciences, Tianjin, China
| | - Ting Zhang
- Pharmacokinetics Laboratory, Tianjin Institute of Medical & Pharmaceutical Sciences, Tianjin, China
| | - Xinghua Jin
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
| | - Ping Gao
- Laboratory of Medical Biomaterials, Tianjin Institute of Medical & Pharmaceutical Sciences, Tianjin, China
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Bin C, Xiaohui W, Mengrou S, Xin L, Ting Z, Ping G. Preliminary evaluation of the efficacy and safety of brimonidine for general anesthesia. BMC Anesthesiol 2021; 21:305. [PMID: 34861822 PMCID: PMC8641169 DOI: 10.1186/s12871-021-01516-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/08/2021] [Indexed: 12/04/2022] Open
Abstract
Background To determine the hypnotic and analgesic effects of brimonidine, and evaluate its efficacy and safety for general anesthesia. Potentiation of pentobarbital sleeping time following brimonidine administration was observed in mice, as was the analgesic activity of brimonidine. Methods The median effective dose (ED50) and lethal dose (LD50) of intraperitoneally injected brimonidine were determined in hypnotized mice. In addition, the LD50 of intravenously injected brimonidine, and ED50 of intravenously, intramuscularly, and intrarectally injected brimonidine in hypnotized rabbits were determined. Finally, the synergistic anesthetic effect of brimonidine and chloral hydrate was evaluated in rabbits. Results Intraperitoneal injection of 10 mg/kg brimonidine enhanced the hypnotic effect of a threshold dose of pentobarbital. Intraperitoneally injected brimonidine produced dose-related analgesic effects in mice. The ED50 of intraperitoneally administered brimonidine in hypnotized mice was 75.7 mg/kg and the LD50 was 379 mg/kg. ED50 values of intravenous, intramuscular, and intrarectal brimonidine for hypnosis in rabbits were 5.2 mg/kg, 8.8 mg/kg, and 8.7 mg/kg, respectively; the LD50 of intravenous brimonidine was 146 mg/kg. Combined intravenous administration of 0.6 mg/kg brimonidine and 0.03 g/kg chloral hydrate had a synergistic anesthetic effect. Conclusions Brimonidine elicited hypnotic and analgesic effects after systemic administration and exhibited safety. Moreover, brimonidine enhanced the effects of other types of narcotics when combined. Supplementary Information The online version contains supplementary material available at 10.1186/s12871-021-01516-1.
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Affiliation(s)
- Chen Bin
- Tianjin Institute of Medical & Pharmaceutical Sciences, No. 79 Duolun Road, Heping District, Tianjin, 300020, China
| | - Wang Xiaohui
- Tianjin Institute of Medical & Pharmaceutical Sciences, No. 79 Duolun Road, Heping District, Tianjin, 300020, China
| | - Shi Mengrou
- Tianjin Institute of Medical & Pharmaceutical Sciences, No. 79 Duolun Road, Heping District, Tianjin, 300020, China
| | - Li Xin
- Tianjin Institute of Medical & Pharmaceutical Sciences, No. 79 Duolun Road, Heping District, Tianjin, 300020, China
| | - Zhang Ting
- Tianjin Institute of Medical & Pharmaceutical Sciences, No. 79 Duolun Road, Heping District, Tianjin, 300020, China
| | - Gao Ping
- Tianjin Institute of Medical & Pharmaceutical Sciences, No. 79 Duolun Road, Heping District, Tianjin, 300020, China.
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Cobos-Puc L, Aguayo-Morales H. Cardiovascular Effects Mediated by Imidazoline Drugs: An Update. Cardiovasc Hematol Disord Drug Targets 2019; 19:95-108. [PMID: 29962350 DOI: 10.2174/1871529x18666180629170336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 05/05/2017] [Accepted: 04/18/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Clonidine is a centrally acting antihypertensive drug. Hypotensive effect of clonidine is mediated mainly by central α2-adrenoceptors and/or imidazoline receptors located in a complex network of the brainstem. Unfortunately, clonidine produces side effects such as sedation, mouth dry, and depression. Moxonidine and rilmenidine, compounds of the second generation of imidazoline drugs, with fewer side effects, display a higher affinity for the imidazoline receptors compared with α2-adrenoceptors. The antihypertensive action of these drugs is due to inhibition of the sympathetic outflow primarily through central I1-imidazoline receptors in the RVLM, although others anatomical sites and mechanisms/receptors are involved. Agmatine is regarded as the endogenous ligand for imidazoline receptors. This amine modulates the cardiovascular function. Indeed, when administered in the RVLM mimics the hypotension of clonidine. RESULTS Recent findings have shown that imidazoline drugs also exert biological response directly on the cardiovascular tissues, which can contribute to their antihypertensive response. Currently, new imidazoline receptors ligands are in development. CONCLUSION In the present review, we provide a brief update on the cardiovascular effects of clonidine, moxonidine, rilmenidine, and the novel imidazoline agents since representing an important therapeutic target for some cardiovascular diseases.
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Affiliation(s)
- Luis Cobos-Puc
- Department of Pharmacology, Faculty of Chemistry, Autonomous University of Coahuila, Saltillo, Mexico
| | - Hilda Aguayo-Morales
- Department of Pharmacology, Faculty of Chemistry, Autonomous University of Coahuila, Saltillo, Mexico
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Fehér Á, Tóth VE, Al-Khrasani M, Balogh M, Lázár B, Helyes Z, Gyires K, Zádori ZS. Analysing the effect of I 1 imidazoline receptor ligands on DSS-induced acute colitis in mice. Inflammopharmacology 2016; 25:107-118. [PMID: 27873165 DOI: 10.1007/s10787-016-0299-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 11/13/2016] [Indexed: 12/28/2022]
Abstract
Imidazoline receptors (IRs) have been recognized as promising targets in the treatment of numerous diseases; and moxonidine and rilmenidine, agonists of I1-IRs, are widely used as antihypertensive agents. Some evidence suggests that IR ligands may induce anti-inflammatory effects acting on I1-IRs or other molecular targets, which could be beneficial in patients with inflammatory bowel disease (IBD). On the other hand, several IR ligands may stimulate also alpha2-adrenoceptors, which were earlier shown to inhibit, but in more recent studies to rather aggravate colitis. Hence, this study aimed to analyse for the first time the effect of various I1-IR ligands on intestinal inflammation. Colitis was induced in C57BL/6 mice by adding dextran sulphate sodium (DSS) to the drinking water for 7 days. Mice were treated daily with different IR ligands: moxonidine and rilmenidine (I1-IR agonists), AGN 192403 (highly selective I1-IR ligand, putative antagonist), efaroxan (I1-IR antagonist), as well as with the endogenous IR agonists agmatine and harmane. It was found that moxonidine and rilmenidine at clinically relevant doses, similarly to the other IR ligands, do not have a significant impact on the macroscopic and histological signs of DSS-evoked inflammation. Likewise, colonic myeloperoxidase and serum interleukin-6 levels remained unchanged in response to these agents. Thus, our study demonstrates that imidazoline ligands do not influence significantly the severity of DSS-colitis in mice and suggest that they probably neither affect the course of IBD in humans. However, the translational value of these findings needs to be verified with other experimental colitis models and human studies.
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Affiliation(s)
- Ágnes Fehér
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, Semmelweis University, Nagyvárad tér 4, Budapest, 1089, Hungary
| | - Viktória E Tóth
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, Semmelweis University, Nagyvárad tér 4, Budapest, 1089, Hungary
| | - Mahmoud Al-Khrasani
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, Semmelweis University, Nagyvárad tér 4, Budapest, 1089, Hungary
| | - Mihály Balogh
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, Semmelweis University, Nagyvárad tér 4, Budapest, 1089, Hungary
| | - Bernadette Lázár
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, Semmelweis University, Nagyvárad tér 4, Budapest, 1089, Hungary
| | - Zsuzsanna Helyes
- Department of Pharmacology and Pharmacotherapy, Szentagothai Research Centre and MTA-NAP B Chronic Pain Research Group, University of Pécs, Pécs, Hungary
| | - Klára Gyires
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, Semmelweis University, Nagyvárad tér 4, Budapest, 1089, Hungary
| | - Zoltán S Zádori
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, Semmelweis University, Nagyvárad tér 4, Budapest, 1089, Hungary.
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Zádori ZS, Tóth VE, Fehér Á, Philipp K, Németh J, Gyires K. Evidence for the gastric cytoprotective effect of centrally injected agmatine. Brain Res Bull 2014; 108:51-9. [DOI: 10.1016/j.brainresbull.2014.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 07/19/2014] [Accepted: 07/31/2014] [Indexed: 02/07/2023]
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Aceros H, Farah G, Noiseux N, Mukaddam-Daher S. Moxonidine modulates cytokine signalling and effects on cardiac cell viability. Eur J Pharmacol 2014; 740:168-82. [PMID: 25036265 DOI: 10.1016/j.ejphar.2014.06.047] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 06/23/2014] [Accepted: 06/25/2014] [Indexed: 10/25/2022]
Abstract
Regression of left ventricular hypertrophy and improved cardiac function in SHR by the centrally acting imidazoline I1-receptor agonist, moxonidine, are associated with differential actions on circulating and cardiac cytokines. Herein, we investigated cell-type specific I1-receptor (also known as nischarin) signalling and the mechanisms through which moxonidine may interfere with cytokines to affect cardiac cell viability. Studies were performed on neonatal rat cardiomyocytes and fibroblasts incubated with interleukin (IL)-1β (5 ng/ml), tumor necrosis factor (TNF)-α (10 ng/ml), and moxonidine (10(-7) and 10(-5) M), separately and in combination, for 15 min, and 24 and 48 h for the measurement of MAPKs (ERK1/2, JNK, and p38) and Akt activation and inducible NOS (iNOS) expression, by Western blotting, and cardiac cell viability/proliferation and apoptosis by flow cytometry, MTT assay, and Live/Dead assay. Participation of imidazoline I1-receptors and the signalling proteins in the detected effects was identified using imidazoline I1-receptor antagonist and signalling protein inhibitors. The results show that IL-1β, and to a lower extent, TNF-α, causes cell death and that moxonidine protects against starvation- as well as IL-1β -induced mortality, mainly by maintaining membrane integrity, and in part, by improving mitochondrial activity. The protection involves activation of Akt, ERK1/2, p38, JNK, and iNOS. In contrast, moxonidine stimulates basal and IL-1β-induced fibroblast mortality by mechanisms that include inhibition of JNK and iNOS. Thus, apart from their actions on the central nervous system, imidazoline I1-receptors are directly involved in cardiac cell growth and death, and may play an important role in cardiovascular diseases associated with inflammation.
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Affiliation(s)
- Henry Aceros
- Centre Hospitalier de L'Université de Montréal Research Center (CRCHUM), Montreal, Québec, Canada; Department of Pharmacology, Université de Montréal, Montreal, Québec, Canada
| | - Georges Farah
- Centre Hospitalier de L'Université de Montréal Research Center (CRCHUM), Montreal, Québec, Canada; Department of Pharmacology, Université de Montréal, Montreal, Québec, Canada
| | - Nicolas Noiseux
- Centre Hospitalier de L'Université de Montréal Research Center (CRCHUM), Montreal, Québec, Canada; Department of Medicine, Université de Montréal, Montreal, Québec, Canada
| | - Suhayla Mukaddam-Daher
- Centre Hospitalier de L'Université de Montréal Research Center (CRCHUM), Montreal, Québec, Canada; Department of Pharmacology, Université de Montréal, Montreal, Québec, Canada; Department of Medicine, Université de Montréal, Montreal, Québec, Canada.
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Karlafti EF, Hatzitolios AI, Karlaftis AF, Baltatzi MS, Koliakos GG, Savopoulos CG. Effects of moxonidine on sympathetic nervous system activity: An update on metabolism, cardio, and other target-organ protection. J Pharm Bioallied Sci 2013; 5:253-6. [PMID: 24302832 PMCID: PMC3831737 DOI: 10.4103/0975-7406.120067] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 12/23/2012] [Accepted: 06/10/2013] [Indexed: 01/08/2023] Open
Abstract
Moxonidine is the newest, second-generation, centrally acting antihypertensive agent. It has selective agonist activity at imidazoline I1 receptors and less adverse effects than the other centrally acting drugs. This fact authorizes the frequent use of moxonidine in clinical practice, as monotherapy or in combination with other antihypertensive agents. Also, moxonidine has beneficial effects in obese and metabolic syndrome and in target-organs, such as heart and kidneys.
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Affiliation(s)
- Eleni F Karlafti
- Department of Internal Medicine, AHEPA Hospital, Thessaloniki, Greece
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An “I” on Cardiac Hypertrophic Remodelling: Imidazoline Receptors and Heart Disease. Can J Cardiol 2012; 28:590-8. [DOI: 10.1016/j.cjca.2012.02.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Revised: 02/01/2012] [Accepted: 02/14/2012] [Indexed: 11/24/2022] Open
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Mukaddam-Daher S, Menaouar A, Paquette PA, Jankowski M, Gutkowska J, Gillis MA, Shi YF, Calderone A, Tardif JC. Hemodynamic and cardiac effects of chronic eprosartan and moxonidine therapy in stroke-prone spontaneously hypertensive rats. Hypertension 2009; 53:775-81. [PMID: 19273740 DOI: 10.1161/hypertensionaha.108.126524] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The renin-angiotensin and sympathetic nervous systems play critical interlinked roles in the development of left ventricular hypertrophy, fibrosis, and dysfunction. These studies investigated the hemodynamic and cardiac effects of monoblockade and coblockade of renin-angiotensin and sympathetic nervous systems. Stroke-prone spontaneously hypertensive rats (16 weeks old; male; n=12 per group) received the sympatholytic imidazoline compound, moxonidine (2.4 mg/kg per day); the angiotensin-receptor blocker eprosartan (30 mg/kg per day), separately or in combination; or saline vehicle for 8 weeks, SC, via osmotic minipumps. Blood pressure and heart rate were continuously measured by radiotelemetry. After 8 weeks, in vivo cardiac function and structure were measured by transthoracic echocardiography and a Millar conductance catheter, and the rats were then euthanized and blood and heart ventricles collected for various determinations. Compared with vehicle, the subhypotensive dose of moxonidine resulted in lower (P<0.01) heart rate, left ventricular hypertrophy, cardiomyocyte cross-sectional area, interleukin 1 beta, tumor necrosis factor-alpha, and mRNA for natriuretic peptides. Eprosartan reduced pressure (P<0.01), as well as extracellular signal-regulated kinase (ERK) 44 phosphorylation, Bax/Bcl-2, and collagen I/III, and improved left ventricular diastolic function (P<0.03). Combined treatment resulted in greater reductions in blood pressure, heart rate, left ventricular hypertrophy, collagen I/III, and inhibited inducible NO synthase and increased endothelial NO synthase phosphorylation, as well as reduced left ventricular anterior wall thickness, without altering the other parameters. Thus, in advanced hypertension complicated with cardiac fibrosis, sympathetic inhibition and angiotensin II blockade resulted in greater reduction in blood pressure and heart rate, inhibition of inflammation, and improved left ventricular pathology but did not add to the benefits of angiotensin II blockade on cardiac function.
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