1
|
Didier C, Faucher S, Sarra Ferrer M, Lapouge M, Junot S, Jourdan G. Postoperative opioid-free analgesia in dogs undergoing tibial plateau leveling osteotomy: a feasibility study. Front Vet Sci 2024; 11:1394366. [PMID: 39036794 PMCID: PMC11257878 DOI: 10.3389/fvets.2024.1394366] [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: 03/01/2024] [Accepted: 06/19/2024] [Indexed: 07/23/2024] Open
Abstract
Objectives This study was designed to prospectively evaluate the feasibility of an opioid-free anesthesia protocol and describe the quality of recovery and management of postoperative analgesia in dogs after a tibial plateau leveling osteotomy (TPLO). Methods In total, 20 dogs presented for TPLO were included. After premedication with intravenous (IV) medetomidine (0.005-0.007 mg/kg) and midazolam (0.2 mg/kg), the dogs were anesthetized using ketamine (2 mg/kg) and propofol and maintained with isoflurane and ketamine CRI (0.6 mg/kg/h). Sciatic and femoral nerve blocks were performed with bupivacaine 0.5% (0.087 +/- 0.01 and 0.09 +/- 0.02 mL/kg, respectively). Meloxicam (0.2 mg/kg IV) was administered intraoperatively, after osteotomy. Fentanyl (0.002 mg/kg IV) was administered intraoperatively, as rescue analgesia in the case of sustained increase in cardiorespiratory variables. Two pain scores (French 4A-VET and Glasgow short form) were performed at conscious sternal recumbency and 2, 4, 6, 8, 12, and 20 h after extubation and compared to baseline using a Friedman test followed by a Nemenyi post-hoc test. The time taken for the first food intake and urination was reported. Results Intraoperative opioid-free anesthesia was feasible in 11 dogs, whereas 9 dogs received fentanyl once during arthrotomy. No opioid postoperative rescue analgesia was required. Food intake occurred within 6 h, and all dogs were discharged after 24 h without any complication. Conclusion Total opioid-free postoperative analgesia was achieved in all dogs, with adequate recoveries. Although opioid-free anesthesia was feasible in 55% of the population, a single dose of fentanyl was necessary in 45% of the dogs during arthrotomy.
Collapse
Affiliation(s)
- Caroline Didier
- Department of Clinical Sciences, National Veterinary School of Toulouse, University of Toulouse, Toulouse, France
| | - Sarah Faucher
- Department of Clinical Sciences, National Veterinary School of Toulouse, University of Toulouse, Toulouse, France
| | - Marti Sarra Ferrer
- Department of Clinical Sciences, National Veterinary School of Toulouse, University of Toulouse, Toulouse, France
| | | | - Stéphane Junot
- Department of Veterinary Anesthesia and Analgesia, Université de Lyon, VetAgro Sup, Marcy l’Etoile, France
| | - Géraldine Jourdan
- Department of Clinical Sciences, National Veterinary School of Toulouse, University of Toulouse, Toulouse, France
- RESTORE Research Center, University of Toulouse, INSERM, CNRS, EFS, ENVT, Toulouse, France
| |
Collapse
|
2
|
Wolińska R, Kleczkowska P, de Cordé-Skurska A, Poznański P, Sacharczuk M, Mika J, Bujalska-Zadrożny M. Nitric oxide modulates tapentadol antinociceptive tolerance and physical dependence. Eur J Pharmacol 2021; 907:174245. [PMID: 34126091 DOI: 10.1016/j.ejphar.2021.174245] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/31/2021] [Accepted: 06/07/2021] [Indexed: 11/22/2022]
Abstract
Tapentadol, an analgesic with a dual mechanism of action, involving both μ-opioid receptor agonism and noradrenaline reuptake inhibition (MOP-NRI), was designed for the treatment of moderate to severe pain. However, the widely acknowledged risk of analgesic tolerance and development of physical dependence following sustained opioid use may hinder their effectiveness. One of the possible mechanisms behind these phenomena are alterations in nitric oxide synthase (NOS) system activity. The aim of the study was to investigate the tolerance and dependence potential of tapentadol in rodent models and to evaluate the possible role of nitric oxide (NO) in these processes. Our study showed that chronic tapentadol treatment resulted in tolerance to its antinociceptive effects to an extent similar to tramadol, but much less than morphine. A single injection of a non-selective NOS inhibitor, NG-nitro-L-arginine (L-NOArg), reversed the tapentadol tolerance. In dependence studies, repeated administration of L-NOArg attenuated naloxone-precipitated withdrawal in tapentadol-treated mice, whereas a single injection of L-NOArg was ineffective. Biochemical analysis revealed that tapentadol decreased nNOS protein levels in the dorsal root ganglia of rats following 31 days of treatment, while no significant changes were found in iNOS and eNOS protein expression. Moreover, pre-treatment with L-NOArg augmented tapentadol antinociception in an opioid- and α2-adrenoceptor-dependent manner. In conclusion, our data suggest that the NOS system plays an important role in the attenuation of tapentadol-induced tolerance and withdrawal. Thus, inhibition of NOS activity can serve as a promising treatment option for long-term tapentadol use by extending its effectiveness and improving the side-effects profile.
Collapse
Affiliation(s)
- Renata Wolińska
- Department of Pharmacodynamics, Centre for Preclinical Research and Technology, Medical University of Warsaw, 1b Banacha Street, 01-793 Warsaw, Poland.
| | - Patrycja Kleczkowska
- Department of Pharmacodynamics, Centre for Preclinical Research and Technology, Medical University of Warsaw, 1b Banacha Street, 01-793 Warsaw, Poland; Military Institute of Hygiene and Epidemiology, 4 Kozielska Street, 01-163 Warsaw, Poland
| | - Anna de Cordé-Skurska
- Department of Pharmacodynamics, Centre for Preclinical Research and Technology, Medical University of Warsaw, 1b Banacha Street, 01-793 Warsaw, Poland
| | - Piotr Poznański
- Department of Experimental Genomics, Institute of Genetics and Animal Biotechnology, Polish Academy of Sciences in Jastrzebiec, Postepu 36A Street, 05-552 Magdalenka, Poland
| | - Mariusz Sacharczuk
- Department of Pharmacodynamics, Centre for Preclinical Research and Technology, Medical University of Warsaw, 1b Banacha Street, 01-793 Warsaw, Poland; Department of Experimental Genomics, Institute of Genetics and Animal Biotechnology, Polish Academy of Sciences in Jastrzebiec, Postepu 36A Street, 05-552 Magdalenka, Poland
| | - Joanna Mika
- Department of Pain Pharmacology, Maj Institute of Pharmacology Polish Academy of Sciences, 12 Smetna Street, 31-343 Krakow, Poland
| | - Magdalena Bujalska-Zadrożny
- Department of Pharmacodynamics, Centre for Preclinical Research and Technology, Medical University of Warsaw, 1b Banacha Street, 01-793 Warsaw, Poland
| |
Collapse
|
3
|
Kleczkowska P, Sulejczak D, Zaremba M. Advantages and disadvantages of disulfiram coadministered with popular addictive substances. Eur J Pharmacol 2021; 904:174143. [PMID: 33971180 DOI: 10.1016/j.ejphar.2021.174143] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/10/2021] [Accepted: 04/28/2021] [Indexed: 01/11/2023]
Abstract
Disulfiram (DSF) is a well-known anti-alcohol agent that inhibits aldehyde dehydrogenase and results in extreme 'hangover' symptoms when consumed with alcohol. This drug, however, has been suggested as useful in other forms of drug addiction due to its beneficial potential in both drug abuse reduction and withdrawal. However, among other drugs used in alcohol dependence, it carries the greatest risk of pharmacological interactions. Concomitant use of DSF and central nervous system stimulants usually leads to harmful, undesirable effects. To date, there is still limited data regarding the detailed safety profile of DSF as a concomitant drug. In this review article, we outline the current state of knowledge about DSF, its broad pharmacological action, as well as therapeutic effects, with a particular emphasis on the molecular understanding of its potential pharmacodynamic interactions with common addictive substances (e.g., alcohol, cocaine, cannabinoids, opioids) supported by relevant examples.
Collapse
Affiliation(s)
- Patrycja Kleczkowska
- Department of Pharmacodynamics, Centre for Preclinical Research (CBP), Medical University of Warsaw, 02-097, Warsaw, Poland; Military Institute of Hygiene and Epidemiology, 01-163, Warsaw, Poland.
| | - Dorota Sulejczak
- Department of Experimental Pharmacology, Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106, Warsaw, Poland
| | - Malgorzata Zaremba
- Military Institute of Hygiene and Epidemiology, 01-163, Warsaw, Poland; Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research (CBP), Medical University of Warsaw, 02-097, Warsaw, Poland
| |
Collapse
|
4
|
de Corde-Skurska A, Krzascik P, Lesniak A, Sacharczuk M, Nagraba L, Bujalska-Zadrozny M. Disulfiram Abrogates Morphine Tolerance-A Possible Role of µ-Opioid Receptor-Related G-Protein Activation in the Striatum. Int J Mol Sci 2021; 22:4057. [PMID: 33919998 PMCID: PMC8071001 DOI: 10.3390/ijms22084057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/30/2021] [Accepted: 04/06/2021] [Indexed: 12/22/2022] Open
Abstract
One of the key strategies for effective pain management involves delaying analgesic tolerance. Early clinical reports indicate an extraordinary effectiveness of off-label disulfiram-an agent designed for alcohol use disorder-in potentiating opioid analgesia and abrogation of tolerance. Our study aimed to determine whether sustained µ-opioid signaling upon disulfiram exposure contributes to these phenomena. Wistar rats were exposed to acute and chronic disulfiram and morphine cotreatment. Nociceptive thresholds were assessed with the mechanical Randal-Selitto and thermal tail-flick tests. µ-opioid receptor activation in brain structures important for pain processing was carried out with the [35S]GTPγS assay. The results suggest that disulfiram (12.5-50 mg/kg i.g.) augmented morphine antinociception and diminished morphine (25 mg/kg, i.g.) tolerance in a supraspinal, opioid-dependent manner. Disulfiram (25 mg/kg, i.g.) induced a transient enhancement of µ-opioid receptor activation in the periaqueductal gray matter (PAG), rostral ventromedial medulla (RVM), hypothalamus, prefrontal cortex and the dorsal striatum at day 1 of morphine treatment. Disulfiram rescued µ-opioid receptor signaling in the nucleus accumbens and caudate-putamen 14 days following morphine and disulfiram cotreatment. The results of this study suggest that striatal µ-opioid receptors may contribute to the abolition of morphine tolerance following concomitant treatment with disulfiram.
Collapse
Affiliation(s)
- Anna de Corde-Skurska
- Department of Pharmacodynamics, Centre for Preclinical Research and Technology, Medical University of Warsaw, Banacha 1b Str., 02-097 Warsaw, Poland; (A.d.C.-S.); (A.L.)
| | - Pawel Krzascik
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology, Medical University of Warsaw, Banacha 1b Str., 02-097 Warsaw, Poland;
| | - Anna Lesniak
- Department of Pharmacodynamics, Centre for Preclinical Research and Technology, Medical University of Warsaw, Banacha 1b Str., 02-097 Warsaw, Poland; (A.d.C.-S.); (A.L.)
| | - Mariusz Sacharczuk
- Department of Experimental Genomics, Institute of Genetics and Animal Biotechnology in Jastrzebiec, Polish Academy of Sciences, Postepu 36A Str., 05-552 Magdalenka, Poland;
| | - Lukasz Nagraba
- Department of Orthopaedics and Rehabilitation, Medical University of Warsaw, Bursztynowa 2 Str., 04-749 Warsaw, Poland;
| | - Magdalena Bujalska-Zadrozny
- Department of Pharmacodynamics, Centre for Preclinical Research and Technology, Medical University of Warsaw, Banacha 1b Str., 02-097 Warsaw, Poland; (A.d.C.-S.); (A.L.)
| |
Collapse
|
5
|
Frączek K, Kowalczyk A, Pekala M, Kasarello K, Sygitowicz G, Sulejczak D, Zaremba M, Konop M, Frankowska M, Filip M, Bujalska-Zadrozny M, Kleczkowska P. The Positive and Negative Outcome of Morphine and Disulfiram Subacute Co-Administration in Rats in the Absence of Ethanol Challenge. Pharmaceutics 2020; 13:pharmaceutics13010029. [PMID: 33375279 PMCID: PMC7823937 DOI: 10.3390/pharmaceutics13010029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/13/2020] [Accepted: 12/22/2020] [Indexed: 01/21/2023] Open
Abstract
Recently, a well-known anti-alcohol agent, disulfiram (DSF), has gain much interest, as it was found to be effective in the treatment of cocaine abusers, thus also giving hope for patients addicted to opioids and other illicit drugs. Therefore, this study was aimed to investigate the possible outcome that might occur within the subacute co-administration of both morphine (MRF) and DSF in rats, but in the absence of ethanol challenge. As observed, intraperitoneal DSF dose-dependently enhanced MRF-mediated analgesia with the maximal efficacy at a dose of 100 mg/kg. Furthermore, MRF-induced tolerance and aggressive behavior were significantly reduced by DSF (100 mg/kg, i.p.) in comparison to MRF solely. Nonetheless, significant blood biochemical markers of hepatotoxicity were found (i.e., alteration in the levels of glutathione, blood urea nitrogen, etc.), following a combination of both drugs. Likewise, histological analysis of liver tissue revealed severe changes in the group of DSF + MRF, which includes swelling, cell death, damage to certain vessels, and hemorrhages into the liver parenchyma. Our findings indicate that DSF should be used with extreme caution, especially within the course of subacute concomitant use with MRF, as several possible side effects may take place.
Collapse
Affiliation(s)
- Karolina Frączek
- Centre for Preclinical Research (CBP), Department of Pharmacodynamics, Medical University of Warsaw, Banacha 1B, 02-097 Warsaw, Poland; (K.F.); (A.K.); (M.P.); (M.B.-Z.)
| | - Agnieszka Kowalczyk
- Centre for Preclinical Research (CBP), Department of Pharmacodynamics, Medical University of Warsaw, Banacha 1B, 02-097 Warsaw, Poland; (K.F.); (A.K.); (M.P.); (M.B.-Z.)
| | - Martyna Pekala
- Centre for Preclinical Research (CBP), Department of Pharmacodynamics, Medical University of Warsaw, Banacha 1B, 02-097 Warsaw, Poland; (K.F.); (A.K.); (M.P.); (M.B.-Z.)
| | - Kaja Kasarello
- Centre for Preclinical Research (CBP), Department of Experimental and Clinical Physiology, Medical University of Warsaw, Banacha 1B, 02-097 Warsaw, Poland;
| | - Grażyna Sygitowicz
- Department of Clinical Chemistry and Laboratory Diagnostics, Medical University of Warsaw, Banacha 1, 02-097 Warsaw, Poland;
| | - Dorota Sulejczak
- Department of Experimental Pharmacology, Mossakowski Medical Research Institute, Polish Academy of Sciences, Pawinskiego 5, 02-106 Warsaw, Poland;
| | - Malgorzata Zaremba
- Centre for Preclinical Research (CBP), Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Banacha 1B, 02-097 Warsaw, Poland;
- Military Institute of Hygiene and Epidemiology, Kozielska 4, 01-163 Warsaw, Poland
| | - Marek Konop
- Centre for Preclinical Research (CBP), Department of Experimental Physiology and Pathophysiology, Medical University of Warsaw, Banacha 1B, 02-097 Warsaw, Poland;
| | - Malgorzata Frankowska
- Laboratory of Drug Addiction Pharmacology, Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Krakow, Poland; (M.F.); (M.F.)
| | - Malgorzata Filip
- Laboratory of Drug Addiction Pharmacology, Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, 31-343 Krakow, Poland; (M.F.); (M.F.)
| | - Magdalena Bujalska-Zadrozny
- Centre for Preclinical Research (CBP), Department of Pharmacodynamics, Medical University of Warsaw, Banacha 1B, 02-097 Warsaw, Poland; (K.F.); (A.K.); (M.P.); (M.B.-Z.)
| | - Patrycja Kleczkowska
- Centre for Preclinical Research (CBP), Department of Pharmacodynamics, Medical University of Warsaw, Banacha 1B, 02-097 Warsaw, Poland; (K.F.); (A.K.); (M.P.); (M.B.-Z.)
- Military Institute of Hygiene and Epidemiology, Kozielska 4, 01-163 Warsaw, Poland
- Correspondence: ; Tel.: +48-22-1166127
| |
Collapse
|
6
|
Abstract
This paper is the forty-first consecutive installment of the annual anthological review of research concerning the endogenous opioid system, summarizing articles published during 2018 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides and receptors as well as effects of opioid/opiate agonists and antagonists. The review is subdivided into the following specific topics: molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors (2), the roles of these opioid peptides and receptors in pain and analgesia in animals (3) and humans (4), opioid-sensitive and opioid-insensitive effects of nonopioid analgesics (5), opioid peptide and receptor involvement in tolerance and dependence (6), stress and social status (7), learning and memory (8), eating and drinking (9), drug abuse and alcohol (10), sexual activity and hormones, pregnancy, development and endocrinology (11), mental illness and mood (12), seizures and neurologic disorders (13), electrical-related activity and neurophysiology (14), general activity and locomotion (15), gastrointestinal, renal and hepatic functions (16), cardiovascular responses (17), respiration and thermoregulation (18), and immunological responses (19).
Collapse
Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY, 11367, United States.
| |
Collapse
|