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Demirsoy MS, Erdil A, Çolak S, Duman E, Sümbül O, Aygun H. Acute treatment with dexketoprofen reduces penicillin induced epileptiform activity in wistar albino rats (dexketoprofen in penicillin induced seizure model). Epilepsy Res 2021; 178:106827. [PMID: 34847424 DOI: 10.1016/j.eplepsyres.2021.106827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 11/12/2021] [Accepted: 11/19/2021] [Indexed: 11/15/2022]
Abstract
AIM Dexketoprofen trometamol is one of the most commonly used anti-inflammatory analgesic agents for pain control. This study aims to investigate the effect of dexketoprofen on penicillin-induced epileptiform activity in rats. METHOD In this study, 28 male Wistar rats weighing 220-240 g were used. Tripolar electrodes were implanted under urethane anesthesia. Epileptiform activity was induced by micro-injection of 500 units (IU) penicillin into the rats' left somatomotor cortex. Dexketoprofen (5, 25, and 50 mg/kg) was administrated intraperitoneally after 30 min of penicillin injection. Epileptiform activity was evaluated by electrocorticography (ECoG). RESULTS The low dose of dexketoprofen administration (5 mg/kg) reduced the mean spike frequency of epileptiform activity 60 min after its injection. However, 25 and 50 mg/kg dexketoprofen significantly reduced the mean spike frequency 30 min after the dexketoprofen injection compared to the control group (p < 0.05). The amplitudes of epileptiform discharges in all groups were unaffected (p > 0.05). CONCLUSION This study revealed that dexketoprofen had a significant anti-seizure effect when applied at 5 mg/kg, 25 mg/kg, and 50 mg/kg (especially at 25 and 50 mg/kg), in the penicillin-induced seizure model. The obtained data revealed that dexketoprofen might play an essential role against epileptic seizures.
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Affiliation(s)
- Mustafa Sami Demirsoy
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Sakarya University, Sakarya, Turkey
| | - Aras Erdil
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Usak University, Usak, Turkey.
| | | | - Esra Duman
- Department of Veterinary Medicine, Laboratory and Veterinary Health Program, Artova Vocational School, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Orhan Sümbül
- Department of Neurology Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Hatice Aygun
- Department of Physiology, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey
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Taylan SB, Bariskaner H. Effects of dexmedetomidine and dexketoprofen on the conduction block of rat sciatic nerve. Neural Regen Res 2020; 15:929-935. [PMID: 31719259 PMCID: PMC6990790 DOI: 10.4103/1673-5374.268926] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 12/28/2018] [Accepted: 09/04/2019] [Indexed: 02/02/2023] Open
Abstract
Dexmedetomidine is a selective α2-adrenoceptor agonist that is used because of its sedative, anxiolytic, and analgesic effects. Dexketoprofen, which is used as an analgesic, is a nonselective nonsteroidal anti-inflammatory drug (NSAID). The use of dexmedetomidine and dexketoprofen as adjuvants to local anesthetics for the peripheral nerve is gradually increasing. In this study, we aimed to investigate the effects of different doses of dexmedetomidine and dexketoprofen on conduction block of rat sciatic nerve. The isolated sciatic nerve from adult rats was transferred to a nerve chamber. The compound action potentials (CAPs) were recorded from stimulated nerve with electrophysiological methods. Dexmedetomidine (n = 8) and dexketoprofen (n = 8) were administered in the chamber with cumulative concentrations of 10-9 to 10-5 M, and the CAPs were recorded for 5 and 10 minutes. The CAP parameters were calculated. Both dexmedetomidine and dexketoprofen significantly depressed all CAP parameters in a dose-dependent manner compared with the control group, i.e., the group in which rats did not receive treatment. CAP parameters showed there was no significant difference in nerve conduction inhibition between dexmedetomidine and dexketoprofen. Higher doses of dexmedetomidine suppressed the conduction in the fast-conducting fibers; however, dexketoprofen was found to suppress the conduction in the slow-conducting fibers in a time-dependent manner and suppress the conduction in the medium- and slow-conducting fibers in a dose-dependent manner. These findings suggest that dexmedetomidine and dexketoprofen exhibit better anesthetic effects on peripheral nerve through different ways of action. The experimental procedures were approved by the Necmettin Erbakan University on January 30, 2013 (approval No. 2013-024).
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Affiliation(s)
- Sengal Bagci Taylan
- Department of Medical Services and Techniques, Vocational School of Health Services, Hakkari University, Hakkari, Turkey
| | - Hulagu Bariskaner
- Department of Pharmacology, School of Medicine, Selcuk University, Konya, Turkey
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3
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Boonstra JL, Cox SK, Martin-Jimenez T. Pharmacokinetics of meloxicam after intramuscular and oral administration of a single dose to American flamingos (Phoenicopertus ruber). Am J Vet Res 2017; 78:267-273. [PMID: 28240949 DOI: 10.2460/ajvr.78.3.267] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine pharmacokinetics after IM and oral administration of a single dose of meloxicam to American flamingos (Phoenicopertus ruber). ANIMALS 14 adult flamingos. PROCEDURES Flamingos were allocated to 2 groups. Each group received a dose of meloxicam (1 mg/kg) by the IM or oral route. After a 4-week washout period, groups received meloxicam via the other route of administration. Plasma meloxicam concentrations were measured with high-performance liquid chromatography. Data for each bird were analyzed. Estimated values of selected pharmacokinetic parameters were compared by use of a linear mixed-effects ANOVA. Pooled concentration-time profiles for each route of administration were analyzed to examine the influence of body weight on pharmacokinetics. RESULTS Mean ± SD maximum plasma concentration was 1.00 ± 0.88 μg/mL after oral administration. This was approximately 15% of the mean maximum plasma concentration of 5.50 ± 2.86 μg/mL after IM administration. Mean time to maximum plasma concentration was 1.33 ± 1.32 hours after oral administration and 0.28 ± 0.17 hours after IM administration. Mean half-life of the terminal phase after oral administration (3.83 ± 2.64 hours) was approximately twice that after IM administration (1.83 ± 1.22 hours). CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that the extent and rate of meloxicam absorption were less after oral administration than after IM administration. Intramuscular administration resulted in a short period during which mean plasma concentrations met or exceeded reported efficacious analgesic concentrations in other species, whereas oral administration did not. These results suggested that higher doses may be required for oral administration.
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Birol Muhammet E, Kocamanoğlu İS, Bozkurt A, Bilge S, Çetinoğlu EÇ. Evaluation of Postoperative Anti-nociceptive Efficacy of Intrathecal Dexketoprofen in Rats. Balkan Med J 2016; 33:245-51. [PMID: 27308067 DOI: 10.5152/balkanmedj.2016.140986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 09/30/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Some studies have suggested that the intrathecal use of cyclooxygenase enzyme inhibitors provides an anti-nociceptive effect. Therefore, the occurrence of side effects seen in systemic usage can be eliminated. AIMS The primary objective of this experimental, randomized, controlled trial was to test the hypothesis asserting that intrathecal dexketoprofen trometamol would demonstrate an analgesic effect during postoperative period. STUDY DESIGN Animal experimentation. METHODS Forty rats were randomized into 4 groups 7 days after intrathecal catheterization; the following drugs were given through catheter lumens: Group Lidocaine (Group L): Lidocaine 20 μg; Group Lidocaine-Morphine (Group LM): Lidocaine 20 μg and morphine 0.5 μgr; Group Lidocaine-Dexketoprofen (Group LD): Lidocaine 20 μg and dexketoprofen trometamol 100 μg; and Group Dexketoprofen (Group D): Dexketoprofen trometamol 100 μg. Paw incision was achieved under ether inhalation. To measure analgesic potential, hot plate and tail immersion tests were used as nociceptive tests during the postoperative period. RESULTS The mean reaction times detected in groups during hot plate and tail immersion tests were shortest in Group L at 15, 30, 45, 60, 75, 90, 105, and 120 minutes after start of surgery (p<0.01, all others). In the groups using dexketoprofen, as in the morphine group, longer reaction times were detected than in the lidocaine group at all measurement times except 120 minutes (p<0.01). CONCLUSION Intrathecal dexketoprofen in the optimal perioperative pain management is effective, and can be administered as an adjuvant in clinics after neurotoxicity studies in animals, and effective dose studies in volunteers.
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Affiliation(s)
- Er Birol Muhammet
- Department of Anesthesiology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | | | - Ayhan Bozkurt
- Department of Physiology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Sırrı Bilge
- Department of Pharmacology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Erhan Çetin Çetinoğlu
- Department of Anesthesiology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
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Erbaş O, Solmaz V, Aksoy D. Inhibitor effect of dexketoprofen in rat model of pentylenetetrazol-induced seizures. Neurol Res 2016; 37:1096-101. [DOI: 10.1179/1743132814y.0000000391] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Oytun Erbaş
- Gaziosmanpaşa University, School of Medicine, Physiology Department, Tokat, Turkey
| | - Volkan Solmaz
- Gaziosmanpaşa University, School of Medicine, Neurology Department, Tokat, Turkey
| | - Dürdane Aksoy
- Gaziosmanpaşa University, School of Medicine, Neurology Department, Tokat, Turkey
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Ziv NY, Tal M, Shavit Y. The transition from naïve to primed nociceptive state: A novel wind-up protocol in mice. Exp Neurol 2015; 275 Pt 1:133-42. [PMID: 26439312 DOI: 10.1016/j.expneurol.2015.09.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 07/05/2015] [Accepted: 09/29/2015] [Indexed: 12/28/2022]
Abstract
Wind-up (WU) is a progressive, frequency-dependent facilitation of spinal cord neurons in response to repetitive nociceptive stimulation of constant intensity. We identified a new WU-associated phenomenon in naïve mice (not exposed to noxious stimulation immediately prior to WU stimulation), which were subjected to a novel experimental protocol composed of three consecutive trains of WU stimulation. The 1st train produced a typical linear 'wind-up' curve as expected following a repeating series of stimuli; in addition, this 1st train sensitized ('primed') the nociceptive system so that the responses to two subsequent trains (inter-train interval of 10 min) were significantly amplified compared with the response to the 1st train. We named this augmented response potentiation-of-windup, or "PoW". The PoW phenomenon appears to be centrally mediated, as the augmented response was suppressed by administration of an NMDA receptor antagonist (MK-801) and by cutting the spinal cord. Furthermore, the PoW protocol is accompanied by enhanced pain behavior. The 'priming' effect of the 1st train could be mimicked by exposure to natural noxious stimuli prior to the PoW protocol. Presumably, the PoW phenomenon has not been previously reported due to a procedural reason: typically, WU protocols have been executed in 'primed' rather than naïve animals, i.e., animals exposed to nociceptive stimulation prior to the actual WU recording. Our findings indicate that the PoW paradigm can distinguish between 'naïve' and 'primed' states, suggesting its use as a tool for the assessment of central sensitization.
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Affiliation(s)
- Nadav Y Ziv
- Department of Medical Neurobiology, Faculty of Medicine, The Hebrew University of Jerusalem, Israel; Department of Psychology, The Hebrew University of Jerusalem, Israel
| | - Michael Tal
- Department of Medical Neurobiology, Faculty of Medicine and Dentistry, The Hebrew University of Jerusalem, Israel; Center for Research on Pain, The Hebrew University of Jerusalem, Israel
| | - Yehuda Shavit
- Department of Psychology, The Hebrew University of Jerusalem, Israel; Center for Research on Pain, The Hebrew University of Jerusalem, Israel.
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Sagiroglu G. Comparing early postoperative period analgesic effect of dexketoprofene trometamol and lornoxicam in mediastinoscopy cases. Eurasian J Med 2015; 43:23-6. [PMID: 25610155 DOI: 10.5152/eajm.2011.05] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Accepted: 12/01/2010] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE In this study, we aimed comparing early postoperative period analgesic effectiveness and the effects on opioid consumption of intravenous dexketoprofen and lornoxicam that are given preemptively. MATERIALS AND METHODS Forty patients, planned elective mediastinoscopy, were included in this prospective randomized study. These patients were classified in two groups, group D for dexketoprofene trometamol and group L for lornoxicam, randomly. 20 minutes before the operation 50 mg dexketoprofene trometamol and 8 mg lornoxicam were injected intravenously for group D and group L respectively. In postoperative intensive care unit, pain scores, mean arterial pressures, heart rates and peripheric O2 saturations of patients were recorded at 0, 10, 20, 60, 90 and 120(th) minutes. RESULTS When we evaluate the VAS score of the groups, there was a significant decrease in group D in all measured timesstatistically compairing to group L (p<0.001). When both group were evaluated in itself according to 0 minute time, in group L there was a significant decrease at 10 minutes time (p<0.0001) but in group D there was not a significant decrease (p>0.05). CONCLUSION Since intravenous dexketoprofen, applied preemptively, has more potent analgesic effect and causing less opioid consumption in early postoperative period, is better than intravenous lornoxicam.
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Affiliation(s)
- Gonul Sagiroglu
- Department of Anesthesia, Ministry of Health, Sureyyapasa Hospital, Maltepe, Istanbul, Turkey
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Hacibeyoğlu G, Saritaş TB, Saritaş ZK, Korkmaz M, Sevimli A, Mehmetoğlu İ, Otelcioğlu Ş. The determination of histopathological and biochemical effects of the rabbit knee joint injected dexketoprofen trometamol. Fundam Clin Pharmacol 2014; 29:79-85. [PMID: 24673725 DOI: 10.1111/fcp.12074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 03/03/2014] [Accepted: 03/14/2014] [Indexed: 11/28/2022]
Abstract
This study was conducted to investigate possible histopathological effects and biochemical reflections of intra-articular dexketoprofen trometamol. A total of 24 New Zealand rabbits were included in the study. Blood sampling was carried out from all animals on the first day, then they were randomly allocated either to the control group (Group C, n = 9) or the dexketoprofen trometamol group (Group D, n = 15). Group C underwent each two intra-articular injections of saline, 0.25 mL into right and 0.50 mL into left knee. Group D was injected 0.25 mL (6.25 mg) dexketoprofen trometamol into the right knee and 0.50 mL (12.5 mg) into the left. The groups were divided randomly into three. Tissue and blood samples were collected from Groups C1 and D1 on the first day, C2 and D2 on the second day and C3 and D3 on the 10th day of the study. Interleukin-1 (IL-1β), interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α) and C-reactive protein (CRP) levels were studied. The histopathological examination of C and D groups did not present any deterioration. IL-6 basal levels were significantly higher in Group D2 compared with C2 and C3 compared with D3. Basal TNF-α levels were higher compared with day 1 in Group C1, and IL-6 and CRP levels were higher in Group D3. Also, none of the increases in these values are supported by histopathological evaluation results. Consequently, we suppose that dexketoprofen trometamol does not cause histopathological deterioration in articular cartilage of rabbits, and the increases in biochemical parameters exclusively are not clinically significant.
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Affiliation(s)
- Gülçin Hacibeyoğlu
- Anesthesiology and Reanimation Department, Meram Medical School, Necmettin Erbakan University, Konya, Turkey
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Molter CM, Court MH, Cole GA, Gagnon DJ, Hazarika S, Paul-Murphy JR. Pharmacokinetics of meloxicam after intravenous, intramuscular, and oral administration of a single dose to Hispaniolan Amazon parrots (Amazona ventralis). Am J Vet Res 2013; 74:375-80. [DOI: 10.2460/ajvr.74.3.375] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Gao R, Ren T, Feng J, Wang J, Weng Y, Yang R, Tang X. Improvement in the efficacy of dexketoprofen by its prodrug in lipid emulsion. EUR J LIPID SCI TECH 2013. [DOI: 10.1002/ejlt.201200168] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Renchao Gao
- College of Pharmacy, Shenyang Pharmaceutical University, Shenyang, P. R. China
| | - Tianyang Ren
- College of Pharmacy, Shenyang Pharmaceutical University, Shenyang, P. R. China
| | - Jia Feng
- College of Pharmacy, Shenyang Pharmaceutical University, Shenyang, P. R. China
| | - Jing Wang
- College of Pharmacy, Shenyang Pharmaceutical University, Shenyang, P. R. China
| | - Yan Weng
- Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi'an, P. R. China
| | - Rui Yang
- Shenzhen Salubris Pharmaceuticals Co., Ltd., Shenzhen, P. R. China
| | - Xing Tang
- College of Pharmacy, Shenyang Pharmaceutical University, Shenyang, P. R. China
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Kara I, Apiliogullari S, Bagcı Taylan S, Bariskaner H, Celik JB. The effects of dexketoprofen on duration of analgesia to a thermal stimulus when compared with a systemic control in a rat sciatic nerve block with levobupivacaine. Fundam Clin Pharmacol 2012; 28:205-10. [PMID: 23127168 DOI: 10.1111/fcp.12010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2012] [Revised: 08/12/2012] [Accepted: 09/21/2012] [Indexed: 12/01/2022]
Abstract
This study was designed to investigate whether dexketoprofen added to perineuraly or subcutaneously alters the effects of levobupivacaine in a rat model of sciatic nerve blockade. Thirty-six rats received unilateral sciatic nerve blocks along with a subcutaneous injection by a blinded investigator assigned at random. Combinations were as follows: Group 1 (sham) perineural and subcutaneous saline; Group 2, perineural levobupivacaine alone and subcutaneous saline; Group 3, perineural levobupivacaine plus dexketoprofen and subcutaneous saline; Group 4, perineural levobupivacaine and subcutaneous dexketoprofen; Group 5, perineural dexketoprofen and subcutaneous saline; and Group 6, perineural saline and subcutaneous dexketoprofen. The levobupivacaine concentration was fixed at 0.05%, and the dose of dexketoprofen was 1 mg kg(-1) . Sensory analgesia was assessed by paw withdrawal latency to a thermal stimulus every 30 min. The unblocked paw served as the control for the assessment of systemic, centrally mediated analgesia. Perineural and subcutaneous dexketoprofen coadministered with perineural levobupivacaine did not enhance the duration of sensory blockade when compared with levobupivacaine alone. There were significant differences between the operative and control paws for time points 30-90 min in the perineural levobupivacaine alone, levobupivacaine + dexketoprofen and subcutaneous dexketoprofen added levobupivacaine group. Significant differences were not determined between the levobupivacaine alone group and dexketoprofen added groups in operative paw. The effects of dexketoprofen are unknown for perineural administration. There is no significant difference between the analgesic effects of peripheral nerve blocks using levobupivacaine alone and plus subcutaneous or perineural dexketoprofen.
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Affiliation(s)
- Inci Kara
- Department of Anesthesiology and Intensive Care, Medical Faculty, Selcuk University, 42250, Konya, Turkey
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12
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Abstract
BACKGROUND Nonsteroidal antiinflammatory drugs, the most commonly used analgesics, reduce pain not only by inhibiting cyclooxygenase at peripheral sites of inflammation but also by potentially inhibiting cyclooxygenase in the central nervous system, especially the spinal cord. Animal studies suggest that products of cyclooxygenase in the spinal cord do not alter pain responses to acute noxious stimuli but reduce pain and sensitization after peripheral inflammation. We used a spinal injection of small doses of the cyclooxygenase inhibitor ketorolac to survey the role of spinal cyclooxygenase in human experimental pain and hypersensitivity states. METHODS After regulatory agency approval and informed consent, we examined the effect of 2.0 mg intrathecal ketorolac in 41 healthy volunteers to acute noxious thermal stimuli in normal skin and to mechanical stimuli in skin sensitized by topical capsaicin or ultraviolet burn. We also examined the effect of intravenous ketorolac. RESULTS Intrathecal ketorolac reduced hypersensitivity when it was induced by a combination of ultraviolet burn plus intermittent heat and, according to one of the two analytical strategies, when it was induced by ultraviolet burn alone. CONCLUSIONS These data suggest a more limited role for spinal cord cyclooxygenase in human pain states than predicted by studies in animals.
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Cole GA, Paul-Murphy J, Krugner-Higby L, Klauer JM, Medlin SE, Keuler NS, Sladky KK. Analgesic effects of intramuscular administration of meloxicam in Hispaniolan parrots (Amazona ventralis) with experimentally induced arthritis. Am J Vet Res 2009; 70:1471-6. [DOI: 10.2460/ajvr.70.12.1471] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Romero‐Sandoval EA, Curros‐Criado MM, Gaitan G, Molina C, Herrero JF. Nitroparacetamol (NCX-701) and pain: first in a series of novel analgesics. CNS DRUG REVIEWS 2008; 13:279-95. [PMID: 17894645 PMCID: PMC6494127 DOI: 10.1111/j.1527-3458.2007.00016.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The combination of numerous classic drugs with nitric oxide donors has led to the development of new compounds with promising therapeutic activities in a great variety of situations, including cardiovascular and respiratory systems, ocular pressure, inflammation, and pain. One of the first compounds developed was NCX-701 or nitroparacetamol, resulting from the combination of paracetamol, a classic and popular analgesic used in a great number of over-the-counter medications because of its antipyretic and analgesic properties, and a nitrooxybutyroyl moiety, which releases nitric oxide at a low but steady level. Although paracetamol is devoid of most of the gastrointestinal toxicity associated with aspirin-like drugs, this type of compounds was first designed to take advantage of the cytoprotective properties of nitric oxide when released at low concentrations. However, the combination of these molecules also resulted in an unexpected enhancement of the analgesic activity of paracetamol. In fact, NCX-701 has been shown to be effective in acute nociception as well as in neuropathic pain, situations in which paracetamol and other COX inhibitors are devoid of any effect. In addition, NCX-701 is more potent and, in some circumstances, more effective than its parent compound in different models of inflammatory pain. Furthermore, whereas paracetamol lacks any effective antiinflammatory action, NCX-701 might reduce inflammation. All these results taken together imply that the mechanism of action of NCX-701 is different from that of paracetamol, although it is not yet established for either molecule. NCX-701 appears to be a promising compound in the treatment of different types of pain, with a likely better profile of side effects than its parent molecule, paracetamol. Although recent clinical trials provided data consistent with the preclinical profile of NCX-701, further studies are needed to support its clinical use.
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Affiliation(s)
- E. Alfonso Romero‐Sandoval
- Department of Anesthesiology, Dartmouth College, Dartmouth Hitchcock Medical Center, Hanover, New Hampshire, USA
| | - M. Mar Curros‐Criado
- Departamento de Fisiología, Facultad de Medicina, Universidad de Alcalá, Madrid, Spain
| | - Gema Gaitan
- Instituto Cajal, Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Carlos Molina
- Departamento de Fisiología, Facultad de Medicina, Universidad de Alcalá, Madrid, Spain
| | - Juan F. Herrero
- Departamento de Fisiología, Facultad de Medicina, Universidad de Alcalá, Madrid, Spain
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Bejarano PF, Herrero JF. A critical appraisal of COX-2 selective inhibition and analgesia: how good so far? Pain Pract 2007; 3:201-17. [PMID: 17147669 DOI: 10.1046/j.1533-2500.2003.03024.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The development of COX-2 selective inhibitors has opened a new era of clinical investigation in NSAIDs. Discussion of the established concepts of inflammation and therapeutical uses of these drugs has changed the rationale for its clinical use and therapeutic labeling of these drugs. A comprehensive discussion across basic science and clinical areas involved in each of these concepts is presented. This led to a remarkable re-evaluation of our insights on their traditionally proposed mechanisms of analgesia, their side-effects, and the clinical indication of NSAIDs as "over the counter" pain killers. This may shift physicians toward a more rational use of this drug class.
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Affiliation(s)
- Pedro F Bejarano
- Department of Anesthesiology, Critical and Palliative Care, Centro Oncológico MD Anderson International-Espana, Madrid, Spain.
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The antinociceptive effect of systemic gabapentin is related to the type of sensitization-induced hyperalgesia. J Neuroinflammation 2007; 4:15. [PMID: 17550605 PMCID: PMC1892010 DOI: 10.1186/1742-2094-4-15] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2007] [Accepted: 06/05/2007] [Indexed: 11/13/2022] Open
Abstract
Background Gabapentin is a structural analogue of gamma-aminobutyric acid with strong anticonvulsant and analgesic activities. Important discrepancies are observed on the effectiveness and potency of gabapentin in acute nociception and sensitization due to inflammation and neuropathy. There is also some controversy in the literature on whether gabapentin is only active in central areas of the nervous system or is also effective in the periphery. This is probably due to the use of different experimental models, routes of administration and types of sensitization. The aim of the present study was to investigate the influence of the spinal cord sensitization on the antinociceptive activity of gabapentin in the absence and in the presence of monoarthritis and neuropathy, using the same experimental protocol of stimulation and the same technique of evaluation of antinociception. Methods We studied the antinociceptive effects of iv. gabapentin in spinal cord neuronal responses from adult male Wistar rats using the recording of single motor units technique. Gabapentin was studied in the absence and in the presence of sensitization due to arthritis and neuropathy, combining noxious mechanical and repetitive electrical stimulation (wind-up). Results The experiments showed that gabapentin was effective in arthritic (max. effect of 41 ± 15% of control and ID50 of 1,145 ± 14 micromol/kg; 200 mg/kg) and neuropathic rats (max. effect of 20 ± 8% of control and ID50 of 414 ± 27 micromol/kg; 73 mg/kg) but not in normal rats. The phenomenon of wind-up was dose-dependently reduced by gabapentin in neuropathy but not in normal and arthritic rats. Conclusion We conclude that systemic gabapentin is a potent and effective antinociceptive agent in sensitization caused by arthritis and neuropathy but not in the absence of sensitization. The potency of the antinociception was directly related to the intensity of sensitization in the present experimental conditions. The effect is mainly located in central areas in neuropathy since wind-up was significantly reduced, however, an action on inflammation-induced sensitized nociceptors is also likely.
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Miranda HF, Puig MM, Dursteler C, Prieto JC, Pinardi G. Dexketoprofen-induced antinociception in animal models of acute pain: Synergy with morphine and paracetamol. Neuropharmacology 2007; 52:291-6. [PMID: 17074372 DOI: 10.1016/j.neuropharm.2006.07.025] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2006] [Revised: 06/29/2006] [Accepted: 07/14/2006] [Indexed: 01/10/2023]
Abstract
The antinociceptive activity of dexketoprofen was studied in mice using the acetic acid writhing test (acute tonic pain), the tail flick test (acute phasic pain) and the formalin assay (inflammatory pain). Isobolographic analysis was used to study the antinociceptive interactions between morphine and paracetamol co-administered with dexketoprofen. In the writhing test, the intraperitoneal administration of dexketoprofen or ketoprofen resulted in parallel dose-response curves with equal efficacy, but higher relative potency for dexketoprofen. In the tail flick test, the curves were parallel with similar efficacy and potency. The administration of morphine or paracetamol in both tests resulted in dose-response curves not parallel with that of dexketoprofen, which showed a potency between morphine and paracetamol. In the formalin assay, the antinociceptive activity of morphine during phase I was 122, 295 and 1695 times higher than dexketoprofen, ketoprofen and paracetamol, respectively. Isobolographic analysis demonstrated that the combination of sub-analgesic doses of dexketoprofen with morphine or with paracetamol was strongly synergic in all three tests. Synergistic drug combinations should improve effective pharmacological treatment of pain, minimizing drug specific adverse effects. These findings are undoubtedly worthy of additional controlled clinical trials in severe pain syndromes.
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Affiliation(s)
- Hugo F Miranda
- Pharmacology Program, ICBM, Faculty of Medicine, University of Chile, Clasificador 70.000, Independencia 1027, Santiago 7, Chile.
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Mannila A, Kokki H, Heikkinen M, Laisalmi M, Lehtonen M, Louhisto HL, Järvinen T, Savolainen J. Cerebrospinal Fluid Distribution of Ketoprofen after Intravenous Administration in Young Children. Clin Pharmacokinet 2006; 45:737-43. [PMID: 16802854 DOI: 10.2165/00003088-200645070-00008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the cerebrospinal fluid (CSF) distribution of an NSAID, ketoprofen, in children. Ketoprofen concentrations were determined from the CSF, plasma and protein-free plasma samples. METHODS Children (n = 21), aged 13-94 months, were given intravenous ketoprofen (1 mg/kg) prior to surgery under spinal anaesthesia. Single venous blood and CSF samples from each patient were collected simultaneously 7-67 minutes after the drug administration. Ketoprofen concentrations in the samples were determined using gas chromatography-mass spectrometry. RESULTS Ketoprofen entered the CSF and was detectable in all samples. However, CSF delivery was limited; the ratio of ketoprofen concentration in CSF to plasma remained below 0.006 at all times. Ketoprofen was highly bound (> 98%) to plasma proteins. The free ketoprofen fraction was not in equilibrium with the CSF, and no clear peak drug concentration in the CSF was observed. CONCLUSION This study shows that ketoprofen is able to enter the CSF of children, which enables central analgesic effects of ketoprofen. However, the slow distribution of ketoprofen into the CSF and the apparently low absolute concentrations has to be taken into account when central analgesic effects are desired.
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Affiliation(s)
- Anne Mannila
- Department of Pharmaceutical Chemistry, University of Kuopio, Kuopio, Finland.
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Curros-Criado MM, Herrero JF. The antinociceptive effects of the systemic adenosine A1 receptor agonist CPA in the absence and in the presence of spinal cord sensitization. Pharmacol Biochem Behav 2005; 82:721-6. [PMID: 16403570 DOI: 10.1016/j.pbb.2005.11.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2005] [Accepted: 11/24/2005] [Indexed: 11/17/2022]
Abstract
Adenosine A1 receptor agonists are effective antinociceptive agents in neuropathic and inflammatory pain, though they appear to be weak analgesics in acute nociception. Important discrepancies are observed on the effectiveness and potency of adenosine analogues when comparing different studies, probably due to the use of different ligands, models of antinociception, routes of administration and types of sensitization. We studied the systemic antinociceptive effects of the adenosine A1 receptor agonist N6-cyclopentyladenosine (CPA) in spinal cord neuronal responses from adult male rats in acute nociception and in sensitization due to arthritis and neuropathy. The experiments showed that CPA was effective in the three experimental conditions, with a similar potency in reducing responses to noxious mechanical stimulation (ID50s: 20 +/- 1.2 microg/kg in acute nociception, 18 +/- 1.1 microg/kg in arthritis, 17.4 +/- 2 microg/kg in neuropathy). The phenomenon of wind-up was also dose-dependently reduced by CPA in the three experimental situations although the main action was seen in arthritis. Depression of blood pressure by CPA was not dose-dependent. We conclude that systemic CPA is a potent and effective analgesic in sensitization due to arthritis and neuropathy but also in acute nociception. The effect is independent of the cardiovascular activity and is centrally mediated since wind-up was inhibited.
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Affiliation(s)
- M Mar Curros-Criado
- Departamento de Fisiología, Facultad de Medicina, Universidad de Alcalá, Madrid, Spain
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20
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Schulte H, Sollevi A, Segerdahl M. Dose-dependent effects of morphine on experimentally induced cutaneous pain in healthy volunteers. Pain 2005; 116:366-374. [PMID: 15982813 DOI: 10.1016/j.pain.2005.05.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2005] [Revised: 04/15/2005] [Accepted: 05/03/2005] [Indexed: 10/25/2022]
Abstract
This study examines the dose dependent analgesic effects of two doses of morphine and a single dose of alfentanil on experimentally induced cutaneous pain. In 16 healthy volunteers pain was induced by a skin burn injury and by continuous electrical skin stimulation. Mechanical pain thresholds (PT, von Frey filament), area of secondary hyperalgesia (SH) and 'wind-up like pain' upon repetitive stimulation (40-g load, 3Hz, 30s) were assessed. Analgesic effects on these pain parameters were tested at steady-state IV infusions of morphine, 50% (plasma concentration 15ng/ml) and 100% (plasma concentration 30ng/ml) of maximal tolerable dose to be given to healthy volunteers, and with an effective dose of alfentanil (plasma concentration 70ng/ml). All effects were compared to active placebo, midazolam infusion (20microg/kg for 10min). Alfentanil significantly diminished the SH area in the burn injury model as well as in the electrical pain model. Additionally, alfentanil increased PT several fold in both models. The high dose of morphine showed a similar analgesic response pattern as alfentanil even though the effects were only statistically significant in the electrical pain model. The low dose of morphine as well as placebo did not affect these pain parameters. 'Wind-up like pain' was not influenced by any of the given drugs. In conclusion, the present study clearly indicates dose dependent effects of morphine on experimentally induced cutaneous pain. The high dose of morphine (30ng/ml) was approximately equianalgesic to the administered alfentanil dose (70ng/ml).
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Affiliation(s)
- Helène Schulte
- Department for Clinical Science, Intervention and Technology, CLINTEC, Unit for Anaesthesia, Karolinska University Hospital Huddinge, S-141 86 Huddinge, Sweden
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21
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Gaitan G, Herrero JF. Subanalgesic doses of dexketoprofen and HCT-2037 (nitrodexketoprofen) enhance fentanyl antinociception in monoarthritic rats. Pharmacol Biochem Behav 2004; 80:327-32. [PMID: 15680185 DOI: 10.1016/j.pbb.2004.12.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2004] [Revised: 10/22/2004] [Accepted: 12/02/2004] [Indexed: 11/21/2022]
Abstract
Subanalgesic doses of the non-steroidal antiinflammatory drugs (NSAID) dexketoprofen trometamol and nitroparacetamol (NCX-701) enhance mu-opiate fentanyl effect in acute nociception. It is not known if a similar combination of drugs is effective in situations of spinal cord sensitization. The aim of this study was to assess if the enhancement of fentanyl antinociception can be observed in carrageenan-induced monoarthritis, when combined with dexketoprofen (DKT) or nitrodexketoprofen (HCT-2037). Withdrawal reflexes were recorded as single motor units in male Wistar rats anesthetized with alpha-chloralose. Fentanyl was studied alone and in the presence of 0.4, 0.8 micromol/kg of DKT or 0.3 micromol/kg of HCT-2037. In responses to noxious mechanical stimulation, the ID50 of fentanyl was enhanced twofold by 0.8 micromol/kg DKT and more than fourfold by HCT-2037 and no significant recovery was observed 45 min later. DKT 0.4 micromol/kg was, however, very little effective. The opioid antagonist naloxone did not reverse the effect. Enhancement of fentanyl effect on wind-up was only observed with HCT-2037 but not with DKT. We conclude that the combined administration of subanalgesic doses of dexketoprofen derivatives, specially its nitroderivative, and the mu-opiate fentanyl is an effective antinociceptive therapy in situations of articular inflammation involving a naloxone-independent mechanism of action.
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Affiliation(s)
- Gema Gaitan
- Departamento de Fisiología, Facultad de Medicina, Campus Universitario, Universidad de Alcalá, Alcalá de Henares, 28871 Madrid, Spain
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22
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Jinks SL, Antognini JF, Dutton RC, Carstens E, Eger EI. Isoflurane depresses windup of C fiber-evoked limb withdrawal with variable effects on nociceptive lumbar spinal neurons in rats. Anesth Analg 2004; 99:1413-1419. [PMID: 15502040 DOI: 10.1213/01.ane.0000135635.32227.da] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Windup is a progressive increase in responses of nociceptive spinal cord neurons to repeated electrical C fiber stimulation. We hypothesized that isoflurane would depress windup at approximately the minimum alveolar anesthetic concentration (MAC) required to suppress purposeful movement in response to noxious stimulation. We recorded windup responses in single lumbar spinal neurons (n = 17) to a series of 15 repetitive electrical stimuli delivered at 1 Hz to the hindpaw at C fiber strength; hindpaw withdrawal force was simultaneously recorded. The total number of action potentials per 15 stimuli (mean +/- sem as a percentage of each neuron's maximal response) was 83% +/- 5%, 84% +/- 5%, 67% +/- 7%, and 57% +/- 8% at 0.7, 0.9, 1.1, and 1.4 MAC, respectively. The 0.9 and 1.1 MAC values differed significantly from each other, whereas the 0.7 and 0.9 MAC values differed from the 1.4 MAC value (P < 0.05). The reduced firing was attributed to a depression of the initial C fiber-evoked responses in most units, and a reduction in windup slope over the initial 5 stimuli in 6 units. Muscle force was 67%, 11%, and 4% of the 0.7 MAC value at 0.9, 1.1, and 1.4 MAC, respectively. Isoflurane depressed excitability and variably affected windup of lumbar spinal cord neurons, while uniformly depressing windup of limb withdrawals in a concentration-dependent manner.
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Affiliation(s)
- Steven L Jinks
- *Department of Anesthesiology and Pain Medicine, and †Section of Neurobiology, Physiology, and Behavior, University of California, Davis; and ‡Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California
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23
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Gaitan G, Ahuir FJ, Soldato PD, Herrero JF. Comparison of the antinociceptive activity of two new NO-releasing derivatives of the NSAID S-ketoprofen in rats. Br J Pharmacol 2004; 143:533-40. [PMID: 15451773 PMCID: PMC1575428 DOI: 10.1038/sj.bjp.0705958] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
1 Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit cyclooxygenase (COX) enzymes inducing analgesic, anti-inflammatory and antipyretic actions. They are not devoid of severe side effects and so, the search for new compounds with similar or higher effectiveness and a lower incidence of undesired actions is important. Nitric oxide (NO)-releasing NSAIDs resulted from this search. 2 We have compared the antinociceptive effectiveness of cumulative doses of two new NO-releasing derivatives of S-ketoprofen, HCT-2037 and HCT-2040, using the recording of spinal cord nociceptive reflexes in anesthetized and awake rats and after intravenous and oral administration. 3 S-ketoprofen and HCT-2040 were equieffective in reducing responses to noxious mechanical stimulation after i.v. administration in anesthetized animals (ID50s: 1.3+/-0.1 and 1.6+/-0.2 micromol kg(-1) respectively), but did not modify wind-up. HCT-2037 was two-fold more potent (ID50 of 0.75+/-0.1 micromol kg(-1)) in responses to mechanical stimuli and very effective in reducing wind-up (63+/-17% of control; P<0.01; MED: 0.4 micromol kg(-1)), indicating a greater activity than the parent compound. 4 In awake animals with inflammation, HCT-2037 p.o. fully inhibited mechanical allodynia, 91+/-12% reduction, and hyperalgesia, 94+/-8% reduction. Equivalent doses of S-ketoprofen only partially reduced either allodynia (50+/-11%) or hyperalgesia (40+/-4%). The effect on responses to noxious thermal stimulation was similar for the two compounds. 5 We conclude that the molecular changes made in the structure of S-ketoprofen including an NO moiety in its structure, improve the antinociceptive profile of the compound opening new perspectives in a safer use of NSAIDs as analgesic drugs.
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Affiliation(s)
- Gema Gaitan
- Departamento de Fisiología, Facultad de Medicina, Universidad de Alcalá, Madrid, Spain
| | - F Javier Ahuir
- Departamento de Fisiología, Facultad de Medicina, Universidad de Alcalá, Madrid, Spain
| | | | - Juan F Herrero
- Departamento de Fisiología, Facultad de Medicina, Universidad de Alcalá, Madrid, Spain
- Author for correspondence:
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Herrero JF, Romero-Sandoval EA, Gaitan G, Mazario J. Antinociception and the new COX inhibitors: research approaches and clinical perspectives. CNS DRUG REVIEWS 2003; 9:227-52. [PMID: 14530796 PMCID: PMC6741672 DOI: 10.1111/j.1527-3458.2003.tb00251.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
New generations of cyclooxygenase (COX) inhibitors are more potent and efficacious than their traditional parent compounds. They are also safer than the classic non-steroidal anti-inflammatory drugs (NSAIDs) and are starting to be used not only for low to moderate intensity pain, but also for high intensity pain. Three different strategies have been followed to improve the pharmacological profile of COX inhibitors: 1. Development of COX-2 selective inhibitors. This is based on the initial hypothesis that considered COX-2 as the enzyme responsible for the generation of prostaglandins only in inflammation, and, therefore, uniquely responsible for inflammation, pain and fever. Initial expectations gave rise to controversial results, still under discussion. The second generation of these compounds is being developed and should contribute to clarifying both their efficacy and the specific functions of the COX enzymes. 2. Modified non-selective COX inhibitors. Molecules like nitro-NSAIDs or tromethamine salt derivatives have been synthesized considering that both COX-1 and COX-2 are responsible for the synthesis of prostaglandins involved either in homeostatic functions or inflammation. Nitroaspirin, nitroparacetamol or dexketoprofen trometamol are some examples of molecules that are already showing an important clinical efficacy. The modifications performed in their structures seem to lower the unwanted side effects as well as to enhance their analgesic efficacy. 3. Combined therapy of classic NSAIDs with other drugs. This strategy looks for improvements in the incidence of adverse effects or to take advantage of the synergistic enhancement of their therapeutic effects. Some of the molecules resulting from these strategies are very valuable as therapeutic agents and open a wide range of possibilities in the treatment of high intensity pain, including neuropathic pain, and opiate sparing therapy.
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Affiliation(s)
- Juan F Herrero
- Departamento de Fisología, Facultad de Medicina, Universidad de Alcalá, Madrid, Spain.
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25
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Gaitán G, Del Soldato P, Herrero JF. Low doses of nitroparacetamol or dexketoprofen trometamol enhance fentanyl antinociceptive activity. Eur J Pharmacol 2003; 481:181-8. [PMID: 14642784 DOI: 10.1016/j.ejphar.2003.09.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We have reported that subeffective doses of the nonsteroidal anti-inflammatory drug (NSAID) dexketoprofen trometamol enhances micro-opioid receptor agonist fentanyl antinociception. The aim of this study was to assess if this effect can also be observed with other new cyclooxygenase-inhibitors such as nitroparacetamol, and in responses to high intensity electrical stimulation (wind-up). Single motor units were recorded in male Wistar rats under alpha-chloralose anaesthesia. The antinociceptive effect of fentanyl was studied alone and in the presence of subeffective doses of dexketoprofen trometamol or nitroparacetamol. In responses to noxious mechanical stimulation, the potency of fentanyl was enhanced by more than threefold in the presence of the NSAIDs and no significant recovery was observed after 45 min. The opioid antagonist naloxone and the alpha(2)-adrenoceptor antagonist atipamezol did not reverse the effect. The enhancement of the effect of fentanyl in wind-up was lower though significant. We conclude that the co-administration of subeffective doses of new cyclooxygenase-inhibitors and the micro-opioid receptor agonist fentanyl should be considered as a potential pain therapy.
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Affiliation(s)
- Gema Gaitán
- Departamento de Fisiología, Facultad de Medicina, Campus Universitario, Universidad de Alcalá, Alcalá de Henares, 28871 Madrid, Spain
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26
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Alfonso Romero-Sandoval E, Del Soldato P, Herrero JF. The effects of sham and full spinalization on the antinociceptive effects of NCX-701 (nitroparacetamol) in monoarthritic rats. Neuropharmacology 2003; 45:412-9. [PMID: 12871658 DOI: 10.1016/s0028-3908(03)00193-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Nitric oxide (NO)-releasing NSAIDs have been shown to be safer and more potent as antinociceptive and anti-inflammatory agents than their parent compounds. NCX-701 (nitroparacetamol), in contrast to paracetamol, is an effective antinociceptive drug in normal animals but their effectiveness in monoarthritis has not been compared. We have now investigated this question by comparing the antinociceptive effects of i.v. NCX-701 and paracetamol in monoarthritic rats under alpha-chloralose anesthesia. The influence of spinalization on the effects of NCX-701 was also studied. NCX-701 and paracetamol were equipotent in reducing single motor unit responses to noxious mechanical stimulation, ID50s of 320+/-1.2 and 305+/-1.2 micromol/kg, respectively. The mechanism of action seems to be different since NCX-701, but not paracetamol, reduced wind-up. This effect suggests a central action, probably within the spinal cord. Sham spinalization reduced the effect of NCX-701 on nociceptive responses drastically. In spinalized animals, however, the effect was similar to that observed in intact animals, indicating a strong effect of NCX-701 at spinal sites, which counterbalances the decrease in the activity induced by the surgery. We conclude that NCX-701 is an effective antinociceptive drug in arthritic animals, with a mechanism of action located in the spinal cord, and different to that of paracetamol.
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Affiliation(s)
- E Alfonso Romero-Sandoval
- Departamento de Fisiología, Facultad de Medicina, Campus Universitario, Universidad de Alcalá, Alcalá de Henares, 28871, Madrid, Spain
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27
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Hanna MH, Elliott KM, Stuart-Taylor ME, Roberts DR, Buggy D, Arthurs GJ. Comparative study of analgesic efficacy and morphine-sparing effect of intramuscular dexketoprofen trometamol with ketoprofen or placebo after major orthopaedic surgery. Br J Clin Pharmacol 2003; 55:126-33. [PMID: 12580983 PMCID: PMC1894736 DOI: 10.1046/j.1365-2125.2003.01727.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
AIMS Multimodal analgesia is thought to produce balanced and effective postoperative pain control. A combined therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) and opiates could result in synergistic analgesia by acting through different mechanisms. Currently there are very few parenterally administered NSAIDs suitable for the immediate postoperative period. Therefore, this study was undertaken to assess the analgesic efficacy, relative potency, and safety of parenteral dexketoprofen trometamol following major orthopaedic surgery. METHODS One hundred and seventy-two patients elected for prosthetic surgery, were randomized to receive two intramuscular injections (12 hourly) of either dexketoprofen 50 mg, ketoprofen 100 mg or placebo in a double-blind fashion. Postoperatively, the patient's pain was stabilized, then they were connected to a patient- controlled analgesia system (PCA) of morphine for 24 h (1 mg with 5 min lockout). RESULTS The mean cumulative amount of morphine (CAM) used was of 39 mg in the dexketoprofen group and 45 mg in the ketoprofen group vs 64 mg in the placebo group. (Reduction in morphine use was approximately one-third between the active compounds compared with placebo (adjusted mean difference of -25 mg between dexketoprofen and placebo and -23 mg between ketoprofen and placebo. These differences were statistically significant: P </= 0.0003; 95% CI -35, -14. Pain-intensity scores were consistently lower with the active compounds, the lowest corresponded to the dexketoprofen-treated patients. Regarding sedation, there were statistically significant differences between the two active compounds and placebo only at the 2nd and 13th hours. Wound bleeding was specifically measured with no statistically significant differences found between all the groups. CONCLUSIONS Intramuscular administration of dexketoprofen trometamol 50 mg has good analgesic efficacy both in terms of opioid-sparing effect and control of pain after major orthopaedic surgery.
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Affiliation(s)
- M H Hanna
- King's College Hospital, Pain Research Unit, London, UK.
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You HJ, Dahl Morch C, Chen J, Arendt-Nielsen L. Simultaneous recordings of wind-up of paired spinal dorsal horn nociceptive neuron and nociceptive flexion reflex in rats. Brain Res 2003; 960:235-45. [PMID: 12505677 DOI: 10.1016/s0006-8993(02)03895-7] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
To study the sensory-motor interaction of spinal processing underlying the neuronal mechanisms of the nociceptive flexion reflex (NFR) and its temporal facilitation, 16 spinal dorsal horn (DH) wide-dynamic-range (WDR) neurons and paired 16 single motor units (SMU) from the gastrocnemius soleus muscle (GS) were simultaneously recorded using extracellular single unit and electromyographic techniques in spinal, halothane-anesthetized rats. The paired DH WDR neuron and GS SMU showed a parallel increase in the firing rate and duration of spike responses to noxious pinch stimuli applied to their common cutaneous receptive field (cRF) on the ipsilateral hind paw skin. Innocuous brush or pressure evoked no, or less, firing in the SMU but evoked a graded increase in spike responses in the simultaneously-recorded WDR neuron. Moreover, both pressure and noxious pinch stimuli evoked a short-lasting after-discharge (for several min) in the WDR neuron but without any after-discharge in the simultaneously-recorded SMU. The paired WDR neuron and SMU also showed a parallel basal response (termed as early and late components according to latency), after-discharge and wind-up of the late response to repetitively applied supra-threshold electrical stimulation (intensity: >1.5 T, duration: 1 ms and frequency: 1 Hz for 15 s). Linear regression and cross-correlation histogram analyses showed that the DH WDR neuron had a significant correlation with the simultaneously-recorded SMU and they were functionally located in the spinally-organized NFR circuitry via polysynaptic connections. Systemic administration of fentanyl, an opioid receptor agonist, resulted in a parallel, naloxone-reversible suppression of both basal late response component and wind-up response in both WDR neuron and SMU paired; however, fentanyl suppressed only the early response of the SMU without any effect on that of the DH WDR neuron. The present results provide new direct evidence showing an essential role of spinal DH WDR neurons in the mediation of spinally-organized NFR as well as its temporal facilitation (wind-up). Based on these data, the spinal DH WDR neuron seems to function as a signal discriminator or frequency encoder of multireceptive primary afferent impulses that may determine excitable level of motor output and the occurrence of a behavioral NFR via polysynaptic connections. Consequently, the spinal WDR neuron-mediated NFR and its temporal facilitation are likely to be modulated by spinal endogenous opioid peptides via opioid receptors on the nociceptive sensory components of the spinally-organized NFR circuitry.
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Affiliation(s)
- Hao-Jun You
- Center for Sensory-Motor Interaction (SMI), Laboratory for Experimental Pain Research, Aalborg University, Fredrik Bajers Vej 7, building D-3, DK-9220, Aalborg, Denmark
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29
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Gaitán G, Herrero JF. Subeffective doses of dexketoprofen trometamol enhance the potency and duration of fentanyl antinociception. Br J Pharmacol 2002; 135:393-8. [PMID: 11815374 PMCID: PMC1573153 DOI: 10.1038/sj.bjp.0704491] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The combination of classic non-steroidal antiinflammatory drugs (NSAIDs) with opiates induces more analgesia than the summed effect of each drug given separately. No studies have been performed using new generation NSAIDs and fentanyl nor on the duration of this effect. We have studied the analgesic effect of fentanyl alone and after the administration of subeffective doses of dexketoprofen trometamol in rat nociceptive responses. The responses were evoked by noxious mechanical stimulation and were recorded as single motor units in male Wistar rats anaesthetized with alpha-chloralose. The effective dose 50 (ED(50)) observed with fentanyl was 22.4 +/- 1.5 microg kg(-1) and full recovery was apparent 20 min later. The administration of a total dose of 40 microg kg(-1) of dexketoprofen trometamol did not induce any significant effect on the nociceptive responses. In the presence of dexketoprofen trometamol, the ED(50) for fentanyl was 5 fold lower than before: 3.8 +/- 1.1 microg kg(-1) and no significant recovery was observed 45 min later. The opioid antagonist naloxone (200 microg kg(-1)) did not reverse the effect, although in control experiments the same dose was able to prevent any action of fentanyl given alone. We conclude that the combination of fentanyl and subeffective doses of dexketoprofen trometamol induces a more potent and longer lasting analgesic effect than that observed with fentanyl alone, and that this is not an opioid mediated action.
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Affiliation(s)
- Gema Gaitán
- Departamento de Fisiología, Facultad de Medicina, Universidad de Alcalá, Madrid, Spain
| | - Juan F Herrero
- Departamento de Fisiología, Facultad de Medicina, Universidad de Alcalá, Madrid, Spain
- Author for correspondence:
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Dualé C, Raboisson P, Molat JL, Dallel R. Systemic morphine reduces the wind-up of trigeminal nociceptive neurons. Neuroreport 2001; 12:2091-6. [PMID: 11447313 DOI: 10.1097/00001756-200107200-00010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We assessed the effects of intravenous morphine on the wind-up of nociceptive neurons of the spinal trigeminal nucleus oralis (Sp5O). Extracellular recordings of Sp5O nociceptive convergent neurons were performed in intact halothane-anesthetized rats. Wind-up of C-fiber-evoked responses was elicited by repetitive electrical stimulation (train of 16 shocks, 0.66 Hz) of their receptive field at C-fiber intensity (3 times the threshold). Wind-up was tested for its sensitivity to morphine (6 mg/kg,i.v.), and the specificity of the effects was verified with naloxone (0.4 mg/kg, i.v.). Nineteen convergent neurons displaying wind-up were recorded. Morphine reduced the wind-up of all but one. In five cases, notwithstanding a reduced wind-up, the neuronal response evoked by the first stimulus in the train (initial input) was unexpectedly increased. Naloxone always antagonized morphine inhibitory effects on the wind-up. When administered systemically, morphine reduced the wind-up of trigeminal nociceptive neurons. This inhibitory effect occurred independently of morphine's ability to affect the initial C-fiber-evoked input. Our findings support the idea that systemic morphine probably blocks wind-up by acting at opioid receptors located postsynaptically to nociceptive primary afferents.
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Affiliation(s)
- C Dualé
- Laboratoire de Physiologie Oro-Faciale, Faculté de Chirurgie Dentaire, 11 Bd Charles de Gaulle, 63000 Clermont-Ferrand, France
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Mazario J, Gaitan G, Herrero JF. Cyclooxygenase-1 vs. cyclooxygenase-2 inhibitors in the induction of antinociception in rodent withdrawal reflexes. Neuropharmacology 2001; 40:937-46. [PMID: 11378164 DOI: 10.1016/s0028-3908(01)00020-x] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Non-steroidal antiinflammatory drugs (NSAIDs) inhibit the cyclooxygenase (COX) enzyme and so they are effective analgesic, antiinflammatory and antipyretic drugs. The discovery of COX-2 led to the search for new NSAIDs with a selective action over this isoenzyme. The experiments performed to date have shown either more, less or no different efficacy of new COX-2 selective NSAIDs when compared to the non-selective inhibitors, probably because the comparison has not been performed under similar conditions. We have therefore compared the analgesic activity of six NSAIDs with different selectivity for the COX isoenzymes. The experiments were performed using the recording of spinal cord nociceptive reflexes in anaesthetised rats and in awake mice. The non-selective COX inhibitors, such as dexketoprofen trometamol, were effective in reducing nociceptive responses both in normal and monoarthritic rats (ED50s: 0.31 and 3.97 micromol/kg, respectively), and in mice with paw inflammation (12.5 micromol/kg, p < 0.01). The COX-1 selective inhibitor SC-58560 showed efficacy in normal rats (ED50: 0.8 micromol/kg) and in mice with paw inflammation (15 micromol/kg, p < 0.05), but not in monoarthritic rats. The COX-2 selective inhibitors celecoxib (105 micromol/kg) and rofecoxib (128 micromol/kg) however, were not effective in any of the groups studied. We conclude that inhibition of both COX isoenzymes is needed to achieve an effective analgesia in inflammation.
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Affiliation(s)
- J Mazario
- Departamento de Fisiología, Facultad de Medicina, Campus Universitario, Universidad de Alcalá, Alcala de Henares 28871, Madrid, Spain
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Page GG, Blakely WP, Ben-Eliyahu S. Evidence that postoperative pain is a mediator of the tumor-promoting effects of surgery in rats. Pain 2001; 90:191-9. [PMID: 11166986 DOI: 10.1016/s0304-3959(00)00403-6] [Citation(s) in RCA: 187] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
We have previously shown in rats that the provision of analgesic doses of morphine significantly reduces the tumor-promoting effects of undergoing and recovering from surgery. Because morphine had no effect in non-operated animals, and because a single preoperative dose given hours before tumor inoculation was effective, we have suggested that it is the pain-relieving effects of the drug that underlies its beneficial impact. To support and strengthen this suggestion, two different regimens of analgesia were employed, the systemic administration of the more selective mu-agonist, fentanyl, and the intrathecal (i.t.) administration of bupivacaine plus morphine. To assess host resistance against metastasis, we used a lung clearance assay of the MADB106 mammary adenocarcinoma, a natural killer (NK)-sensitive syngeneic cell line that metastasizes only to the lungs. Female and male Fischer 344 rats were randomly assigned to one of four groups using a 2x2 experimental design: experimental laparotomy under halothane anesthesia versus anesthesia alone, by drug treatment versus vehicle. In the first in vivo experiment, fentanyl was administered 20 min before surgery (40 microg/kg subcutaneously (s.c.)), and at the end of surgery in a slow-release suspension (20 microg/kg s.c.). In the second in vivo experiment, bupivacaine (10 microg) plus morphine (20 microg) in 50 microl was administered i.t. before surgery. Surgery resulted in a 3- to 4-fold increase in the lung retention of MADB106 cells in both males and females, and the observed surgery-induced increase in lung tumor retention was reduced by more than 65% in the fentanyl-treated animals and more than 45% in the animals receiving i.t. bupivacaine plus morphine. Neither drug regimen exerted effects in the anesthesia only animals. Surgery also resulted in a significant suppression of whole blood NK activity assessed at 5 h postoperatively, the same time point at which MADB106 tumor cells were inoculated in the in vivo studies. Unlike the in vivo study, fentanyl suppressed NK activity at this time point in non-operated rats, but had no effect in operated rats. Taken together, these findings strengthen the suggestion that the management of perioperative pain is a critical factor in preventing surgery-induced decreases in host resistance against metastasis. If similar relationships between pain and metastasis occur in humans, then pain control must become a priority in the postoperative care of individuals with cancer.
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MESH Headings
- Adenocarcinoma
- Analgesics, Opioid/administration & dosage
- Analgesics, Opioid/pharmacology
- Anesthetics, Local/administration & dosage
- Animals
- Antiviral Agents
- Bupivacaine/administration & dosage
- Exploratory Behavior/drug effects
- Female
- Fentanyl/administration & dosage
- Idoxuridine
- Injections, Spinal
- Killer Cells, Natural/metabolism
- Laparotomy
- Lung Neoplasms/blood
- Lung Neoplasms/immunology
- Lung Neoplasms/secondary
- Male
- Morphine/administration & dosage
- Pain, Postoperative/blood
- Pain, Postoperative/drug therapy
- Pain, Postoperative/immunology
- Rats
- Rats, Inbred F344
- Surgical Procedures, Operative/adverse effects
- Tumor Cells, Cultured
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Affiliation(s)
- G G Page
- School of Nursing, Johns Hopkins University, 525 North Wolfe Street, Baltimore, MD 21205, USA.
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Abstract
This paper is the twenty-second installment of the annual review of research concerning the opiate system. It summarizes papers published during 1999 that studied the behavioral effects of the opiate peptides and antagonists, excluding the purely analgesic effects, although stress-induced analgesia is included. The specific topics covered this year include stress; tolerance and dependence; learning, memory, and reward; eating and drinking; alcohol and other drugs of abuse; sexual activity, pregnancy, and development; mental illness and mood; seizures and other neurologic disorders; electrical-related activity; general activity and locomotion; gastrointestinal, renal, and hepatic function; cardiovascular responses; respiration and thermoregulation; and immunologic responses.
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Affiliation(s)
- A L Vaccarino
- Department of Psychology, University of New Orleans, New Orleans, LA 70148, USA.
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Ossipov MH, Jerussi TP, Ren K, Sun H, Porreca F. Differential effects of spinal (R)-ketoprofen and (S)-ketoprofen against signs of neuropathic pain and tonic nociception: evidence for a novel mechanism of action of (R)-ketoprofen against tactile allodynia. Pain 2000; 87:193-199. [PMID: 10924812 DOI: 10.1016/s0304-3959(00)00280-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The spinal activity of racemic ketoprofen and its enantiomers in models of neuropathic and tonic pain was explored in rats. Tactile allodynia and thermal hyperalgesia were induced by tight ligation of the L(5)/L(6) spinal nerves. Tonic pain was modeled by the formalin-induced flinch response. The spinal injection of (S)-ketoprofen alone or of morphine alone did not produce antiallodynic activity. A 1:1 combination of these drugs produced a robust dose-dependent antiallodynic action, consistent with previous observations where (S)-ketorolac combined with morphine also produced antiallodynia. (R)-ketoprofen given alone spinally produced a dose-dependent antiallodynia, but its activity was not augmented by spinal morphine. Conversely, (S)-ketoprofen, but not (R)-ketoprofen, blocked the second phase of the formalin-induced flinch response; neither enantiomer significantly blocked phase one of the formalin response. Again, (S)-, but not (R)-ketoprofen, interacted synergistically with spinal morphine in suppressing the phase II formalin response. These results are consistent with a spinal COX inhibitory action of (S)-ketoprofen. These results also point to a novel, as yet undefined, mechanism of action of (R)-ketoprofen against signs of neuropathic pain that does not appear to involve COX inhibition. The ability to modulate tactile allodynia is of special interest as this represents an aspect of clinical neuropathic pain that is very difficult to treat adequately.
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Affiliation(s)
- M H Ossipov
- Department of Pharmacology, University of Arizona Health Sciences Center, Tucson, AZ 85724, USA Sepracor, Inc., Marlborough MA 01752, USA
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Herrero JF, Laird JM, López-García JA. Wind-up of spinal cord neurones and pain sensation: much ado about something? Prog Neurobiol 2000; 61:169-203. [PMID: 10704997 DOI: 10.1016/s0301-0082(99)00051-9] [Citation(s) in RCA: 489] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Wind-up is a frequency-dependent increase in the excitability of spinal cord neurones, evoked by electrical stimulation of afferent C-fibres. Although it has been studied over the past thirty years, there are still uncertainties about its physiological meaning. Glutamate (NMDA) and tachykinin NK1 receptors are required to generate wind-up and therefore a positive modulation between these two receptor types has been suggested by some authors. However, most drugs capable of reducing the excitability of spinal cord neurones, including opioids and NSAIDs, can also reduce or even abolish wind-up. Thus, other theories involving synaptic efficacy, potassium channels, calcium channels, etc. have also been proposed for the generation of this phenomenon. Whatever the mechanisms involved in its generation, wind-up has been interpreted as a system for the amplification in the spinal cord of the nociceptive message that arrives from peripheral nociceptors connected to C-fibres. This probably reflects the physiological system activated in the spinal cord after an intense or persistent barrage of afferent nociceptive impulses. On the other hand, wind-up, central sensitisation and hyperalgesia are not the same phenomena, although they may share common properties. Wind-up can be an important tool to study the processing of nociceptive information in the spinal cord, and the central effects of drugs that modulate the nociceptive system. This paper reviews the physiological and pharmacological data on wind-up of spinal cord neurones, and the perceptual correlates of wind-up in human subjects, in the context of its possible relation to the triggering of hyperalgesic states, and also the multiple factors which contribute to the generation of wind-up.
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MESH Headings
- Afferent Pathways/physiology
- Analgesics/pharmacology
- Anesthetics, Local/pharmacology
- Animals
- Anti-Inflammatory Agents, Non-Steroidal/pharmacology
- Cats
- Humans
- Hyperalgesia/physiopathology
- Inflammation
- Ion Transport/drug effects
- Models, Neurological
- Morphine/pharmacology
- Nerve Fibers/drug effects
- Nerve Fibers/physiology
- Nerve Tissue Proteins/drug effects
- Nerve Tissue Proteins/physiology
- Neuralgia/physiopathology
- Neuronal Plasticity/drug effects
- Neuronal Plasticity/physiology
- Neurons, Afferent/drug effects
- Neurons, Afferent/physiology
- Neuropeptides/physiology
- Nociceptors/physiology
- Pain/drug therapy
- Pain/physiopathology
- Receptors, Metabotropic Glutamate/drug effects
- Receptors, Metabotropic Glutamate/physiology
- Receptors, N-Methyl-D-Aspartate/drug effects
- Receptors, N-Methyl-D-Aspartate/physiology
- Receptors, Neurokinin-1/drug effects
- Receptors, Neurokinin-1/physiology
- Reflex/physiology
- Spinal Cord/cytology
- Spinal Cord/physiopathology
- Substance P/physiology
- Synaptic Transmission/drug effects
- Viscera/innervation
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Affiliation(s)
- J F Herrero
- Departamento de Fisiología, Edificio de Medicina, Campus Universitario, Universidad de Alcalá, 28871 Alcalá de Henares, Madrid, Spain.
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Abstract
Metamizol has been considered as a peripherally acting non-steroidal antiinflammatory drug, though a central action is possible. The aim of the present study was to elucidate if metamizol induces antinociception in the single motor unit preparation, in normal rats versus rats with carrageenan-induced monoarthritis, and whether this action is produced at central and/or peripheral sites. Metamizol induced a potent antinociceptive effect in both groups of animals, though the effect on responses evoked by natural stimulation was stronger in hyperalgesic rats. Metamizol also depressed wind-up in a dose-dependent manner. We conclude that metamizol is a potent antinociceptive agent both in normal and hyperalgesic animals and that the effect was induced both at peripheral and central sites, at the level of the spinal cord.
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Affiliation(s)
- J Mazario
- Departamento de Fisiología, Facultad de Medicina, Universidad de Alcalá, Madrid, Spain
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Herrero JF, Solano RE. The antinociceptive effect of the mu-opioid fentanyl is reduced in the presence of the alpha(2)-adrenergic antagonist idazoxan in inflammation. Brain Res 1999; 840:106-14. [PMID: 10517958 DOI: 10.1016/s0006-8993(99)01780-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Interactions between alpha(2)-adrenergic and mu-opioid systems play an important role in the modulation of hyperalgesic states. The antinociceptive effects of alpha(2)-adrenergic agonists and mu-opioids are potentiated when co-administered; however, attempts to induce cross reversal of the antinociceptive effects of alpha(2)-adrenergic and mu-opioid systems have produced contradictory results. We have studied the possible endogenous tonic control of the alpha(2)-adrenergic systems in the modulation of pain in inflammation, and the interactions between the two antinociceptive systems in rat spinal cord nociceptive reflexes activated by both natural and electrical stimulation. The facilitatory actions of the alpha(2)-adrenergic antagonist idazoxan were compared in control rats and in animals with carrageenan-induced paw inflammation. The antinociceptive effect of the mu-opioid fentanyl was tested alone and in the presence of idazoxan. In agreement with some previous observations, idazoxan i.v. produced no change in responses to natural and electrical stimulation in normal animals. In animals with inflammation, idazoxan only induced facilitation of responses evoked by noxious thermal stimulation but not by mechanical or electrical stimulation. Fentanyl reduced the responses to either stimuli with lower potency in the presence of idazoxan, but only in animals with inflammation. Its dose-response curve was shifted to the right between 1.8- and 3. 5-fold depending on the stimulus used. It is concluded that the increase of thermal responses by idazoxan in animals with inflammation is probably due to changes in the peripheral blood flow. Nevertheless, since an interaction with mu-opioids is clear in inflammation, endogenous alpha(2)-adrenergic systems play an important role in the modulation of the effectiveness of opioids during inflammation.
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Affiliation(s)
- J F Herrero
- Departamento de Fisiología, Facultad de Medicina, Universidad de Alcalá, Campus Univ. Alcala en Henares, Madrid, Spain.
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