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Upchurch D, Lin KTT, KuKanich B. Two doses of subcutaneous methadone for postoperative analgesia in dogs undergoing tibial plateau levelling osteotomies. J Small Anim Pract 2024; 65:368-375. [PMID: 38594836 DOI: 10.1111/jsap.13728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/28/2024] [Accepted: 03/20/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVES To evaluate analgesia, sedation and adverse effects of two doses of subcutaneous methadone in dogs undergoing tibial plateau levelling osteotomy. MATERIALS AND METHODS Seventeen client-owned dogs undergoing unilateral tibial plateau levelling osteotomy were randomly allocated to receive either 0.25 mg/kg methadone (eight dogs) or 0.5 mg/kg methadone (nine dogs). All dogs were premedicated with methadone and 2 to 6 mcg/kg dexmedetomidine subcutaneously. They were induced and maintained on a standard protocol. All animals received a second dose of methadone subcutaneously 4 hours after premedication and a 4.4 mg/kg dose of carprofen subcutaneously at 8 hours after premedication. During surgery, blood pressure, heart rate and temperature were assessed every 5 minutes. Postoperatively, sedation scores, temperature, heart rate and Glasgow composite modified pain score - short form were assessed for 12 hours postoperatively. RESULTS One of 17 (5.9%) dogs had intraoperative hypotension, nine of 17 dogs had intra-operative bradyarrhythmias and 17 of 17 dogs had intra-operative hypothermia. No dogs required intra-operative rescue. Composite modified pain score - short form scores were below the threshold for intervention in 16 of 17 (94.1%) animals. Only one of 17 (5.9%) dogs required rescue analgesia. Median sedation score was 0 by the T8 time point. Adverse events were rare in both groups with only vocalisation and hypothermia reported commonly postoperatively. CLINICAL SIGNIFICANCE Two doses of methadone at either 0.25 or 0.5 mg/kg administered via subcutaneous injections pre-operatively and 4 hours later, along with 4.4 mg/kg carprofen subcutaneously 8 hours after the first methadone dose appear to provide sufficient pain control for up to 12 hours in dogs undergoing tibial plateau levelling osteotomy.
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Affiliation(s)
- D Upchurch
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, 66506, USA
| | - K T T Lin
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, 48824, USA
| | - B KuKanich
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, 66506, USA
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Caramalac SM, Albuquerque VB, Oliveira AR, Caramalac SM, Jardim PHDEA, Barbosa CF, Frazílio FDEO. Analgesic, cardiorespiratory effects and motor block characteristics of epidural levobupivacaine alone or in combination with methadone or dexmedetomidine in bitches undergoing unilateral total mastectomy. AN ACAD BRAS CIENC 2022; 94:e20210082. [PMID: 36477226 DOI: 10.1590/0001-3765202220210082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/17/2021] [Indexed: 11/29/2022] Open
Abstract
The aim of this study was to evaluate the latency, extent of analgesia, and duration of motor block of levobupivacaine alone and combined with methadone or dexmedetomidine after epidural administration during and after mastectomy in dogs. Twenty-four mature, mixed-breed female dogs were randomly divided into three experimental groups with eight animals each, according to the agents used in lumbosacral epidural analgesia: levobupivacaine 0.75% alone (1.5mg/kg - control group), levobupivacaine 0.75% (1.5 mg/kg) + methadone 1% (0.3 mg/kg), or levobupivacaine 0.75% (1.5 mg/kg) + dexmedetomidine 0.05% (3 µg/kg). During surgery, cardiorespiratory parameters were evaluated. Rescue analgesia was given when there were signs of nociception and was necessary in all three treatment groups. Since all animals received rescue analgesia during the surgery and immediately post-surgery, the duration of the sensitive block were not evaluated. The extent of sensory block was between the 12º and 13º thoracic vertebrae for the control group, 7º thoracic vertebra to 5º lumbar vertebra (methadone group), and 8º thoracic vertebra to 4º lumbar vertebra for the dexmedetomidine group. Methadone or dexmedetomidine combined with levobupivacaine increased the extent of the sensory block and the duration of the motor block in bitches when administered via the epidural route.
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Affiliation(s)
- Simone M Caramalac
- Universidade Federal do Mato Grosso do Sul, Faculdade de Medicina Veterinária e Ciência Animal, Av. Senador Filinto Muller, 2443, 79070-900 Campo Grande, MS, Brazil
| | - Veronica B Albuquerque
- Universidade Federal do Mato Grosso do Sul, Faculdade de Medicina Veterinária e Ciência Animal, Av. Senador Filinto Muller, 2443, 79070-900 Campo Grande, MS, Brazil
| | - Alice R Oliveira
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Faculdade de Medicina Veterinária e Zootecnia, Departamento de Anestesiologia de Medicina Veterinária, Campus Botucatu, Rua Prof. Doutor Walter Mauricio Correa, s/n, 18618-681 Botucatu, SP, Brazil
| | - Silvana M Caramalac
- Universidade Federal do Mato Grosso do Sul, Faculdade de Medicina Veterinária e Ciência Animal, Av. Senador Filinto Muller, 2443, 79070-900 Campo Grande, MS, Brazil
| | - Paulo Henrique DE A Jardim
- Universidade Federal do Mato Grosso do Sul, Faculdade de Medicina Veterinária e Ciência Animal, Av. Senador Filinto Muller, 2443, 79070-900 Campo Grande, MS, Brazil
| | - Carolynne F Barbosa
- Universidade Federal do Mato Grosso do Sul, Faculdade de Medicina Veterinária e Ciência Animal, Av. Senador Filinto Muller, 2443, 79070-900 Campo Grande, MS, Brazil
| | - Fabrício DE O Frazílio
- Universidade Federal do Mato Grosso do Sul, Faculdade de Medicina Veterinária e Ciência Animal, Av. Senador Filinto Muller, 2443, 79070-900 Campo Grande, MS, Brazil
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KuKanich B, KuKanich K, Locuson CW, Rankin DC, Fitzgerald AH, Cho P, Komp MS. Multiple-dose pharmacokinetics and opioid effects of a novel analgesic with a deterrent to human opioid abuse (methadone-fluconazole-naltrexone) after oral administration in dogs. Am J Vet Res 2021; 82:171-180. [PMID: 33629900 DOI: 10.2460/ajvr.82.3.171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the pharmacokinetics and opioid effects of methadone after administration of multiple doses by means of 2 dosing regimens of methadone-fluconazole-naltrexone. ANIMALS 12 healthy Beagles. PROCEDURES Dogs were randomly allocated (6 dogs/group) to receive 1 of 2 oral dosing regimens of methadone-fluconazole-naltrexone. Treatment 1 doses were administered at 0 (methadone-to-fluconazole-to-naltrexone ratio of 1:5:0.25 mg/kg), 14 (1:5:0.25), 24 (0.5:2.5:0.125), and 38 (0.5:2.5:0.125) hours. Treatment 2 doses were administered at 0 (1:5:0.25), 4 (0.5:2.5:0.125), 10 (0.5:2.5:0.125), and 24 (0.5:2.5:0.125) hours. Blood samples, rectal temperatures, and von Frey antinociceptive measurements were obtained at designated times. RESULTS Compared with baseline, temperatures significantly decreased for treatment 1 group dogs at 2 to ≥ 4 hours and from 16 to ≥ 50 hours (12 hours after last dose) and for treatment 2 group dogs at 2 to ≥ 36 hours (12 hours after last dose), when trough methadone concentrations were ≥ 21.3 ng/mL. Antinociception occurred after the first dose but was not maintained throughout the study. Lesions were noted in some dogs at the application site of the von Frey device. Naltrexone and β-naltrexol were sporadically detected in plasma, and naltrexone glucuronide was consistently detected. CONCLUSIONS AND CLINICAL RELEVANCE Opioid effects were noted after oral administration of the first dose, and data suggested that administering a second dose 6 hours later and every 12 hours thereafter was necessary to maintain opioid effects. Antinociception may have been lost because dogs became averse or hyperalgesic to the von Frey device, such that the antinociception model used here may not be robust for repeated measurements in dogs.
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Amon T, Kästner SBR, Kietzmann M, Tünsmeyer J. Plasma levels of a methadone constant rate infusion and their corresponding effects on thermal and mechanical nociceptive thresholds in dogs. BMC Vet Res 2021; 17:35. [PMID: 33461553 PMCID: PMC7814539 DOI: 10.1186/s12917-020-02735-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/20/2020] [Indexed: 11/22/2022] Open
Abstract
Background The present study aimed to collect pharmacokinetic data of a methadone continuous rate infusion (CRI) and to investigate its effect on mechanical and thermal nociceptive thresholds. Seven, 47 to 54 months old beagle dogs, weighing 9.8 to 21.2 kg, were used in this experimental, randomized, blinded, placebo-controlled crossover study. Each dog was treated twice with either a methadone bolus of 0.2 mg kg− 1 followed by a 0.1 mg kg− 1 h− 1 methadone CRI (group M) or an equivalent volume of isotonic saline solution (group P) for 72 h. Mechanical and thermal thresholds, as well as vital parameters and sedation were measured during CRI and for further 24 h. Blood samples for methadone plasma concentrations were collected during this 96 h period. Results Percentage thermal excursion (%TE) increased significantly from baseline (BL) until 3 h after discontinuation of CRI in M. Within P and between treatment groups differences were not significant. Mechanical threshold (MT) increased in M until 2 h after CRI discontinuation. Bradycardia and hypothermia occurred in M during drug administration and dogs were mildly sedated for the first 47 h. Decreased food intake and regurgitation were observed in M in five and four dogs, respectively. For methadone a volume of distribution of 10.26 l kg− 1 and a terminal half-life of 2.4 h were detected and a clearance of 51.44 ml kg− 1 min− 1 was calculated. Effective methadone plasma concentrations for thermal and mechanical antinociception were above 17 ng ml− 1. Conclusion A methadone CRI of 0.1 mg kg− 1 h− 1 for 3 days after a loading dose results in steady anti-nociceptive effects in an acute pain model in healthy dogs. Main side effects were related to gastrointestinal tract, hypothermia, bradycardia and sedation.
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Affiliation(s)
- T Amon
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany.
| | - S B R Kästner
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany
| | - M Kietzmann
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover, Foundation, Bünteweg 17, 30559, Hannover, Germany
| | - J Tünsmeyer
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany
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KuKanich B, KuKanich K, Rankin DC, Upchurch DA, Comroe A, Crauer B, Berke K, Klocke EE, Gonzalez SE, Mason D, Jensen G, Orchard R, Fitzgerald AH, Cho P, Komp M. Perioperative analgesia associated with oral administration of a novel methadone-fluconazole-naltrexone formulation in dogs undergoing routine ovariohysterectomy. Am J Vet Res 2020; 81:699-707. [PMID: 33112167 DOI: 10.2460/ajvr.81.9.699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine perioperative analgesia associated with oral administration of a novel methadone-fluconazole-naltrexone formulation in dogs undergoing routine ovariohysterectomy. ANIMALS 43 healthy female dogs. PROCEDURES Dogs were randomly assigned to receive the methadone-fluconazole-naltrexone formulation at 1 of 2 dosages (0.5 mg/kg, 2.5 mg/kg, and 0.125 mg/kg, respectively, or 1.0 mg/kg, 5.0 mg/kg, and 0.25 mg/kg, respectively, PO, q 12 h, starting the evening before surgery; n = 15 each) or methadone alone (0.5 mg/kg, SC, q 4 h starting the morning of surgery; 13). Dogs were sedated with acepromazine, and anesthesia was induced with propofol and maintained with isoflurane. A standard ovariohysterectomy was performed by experienced surgeons. Sedation and pain severity (determined with the Glasgow Composite Pain Scale-short form [GCPS-SF]) were scored for 48 hours after surgery. Rescue analgesia was to be provided if the GCPS-SF score was > 6. Dogs also received carprofen starting the day after surgery. RESULTS None of the dogs required rescue analgesia. The highest recorded GCPS-SF score was 4. A significant difference in GCPS-SF score among groups was identified at 6:30 am the day after surgery, but not at any other time. The most common adverse effect was perioperative vomiting, which occurred in 11 of the 43 dogs. CONCLUSIONS AND CLINICAL RELEVANCE Oral administration of a methadone-fluconazole-naltrexone formulation at either of 2 dosages every 12 hours (3 total doses) was as effective as SC administration of methadone alone every 4 hours (4 total doses) in dogs undergoing routine ovariohysterectomy. Incorporation of naltrexone in the novel formulation may provide a deterrent to human opioid abuse or misuse.
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Ferreira da Cruz FS, Natalini CC, Pellin de Molnar BF, Beatriz da Silva Serpa P, Tisotti T, Midon M, Desessards de La Côrte F. Tramadol Effects on Lameness Score After Inhibition of P-GP by Ivermectin Administration in Horses: Preliminary Results. J Equine Vet Sci 2020; 92:103163. [PMID: 32797786 DOI: 10.1016/j.jevs.2020.103163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/08/2020] [Accepted: 06/08/2020] [Indexed: 11/22/2022]
Abstract
This study aimed to evaluate the effects and lameness degree in horses administered tramadol after the P-glycoprotein (P-gp) enteric inhibitor ivermectin. Six horses were randomly distributed into three groups, which received two different doses of tramadol by a nasogastric tube: 1 mg/kg (tramadol group 1(GT1)), 4 mg/kg (tramadol group 4 (GT4)), and tramadol 1 mg/kg combined with ivermectin 0.2 mg/kg PO (ivermectin tramadol group (GT1 + Ive)), with one-week washout interval. Heart rate (HR), respiratory rate (RR), intestinal motility, body temperature, and the degree of lameness were evaluated for 360 minutes. The blood gas parameters were evaluated at 0, 60 minutes, and 120 minutes. There were no differences in HR and the degree of lameness. Hypomotility occurred in GT1 and GT4 only at the end of the evaluation period, and RR increased in all groups. We conclude that inhibition of enteric P-gp by ivermectin did not alter the effects of tramadol, suggesting that tramadol is not a substrate for P-gp. However, future studies should be conducted to assess the interaction between P-gp inhibitors on the pharmacokinetics of tramadol.
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Affiliation(s)
| | - Claudio Correa Natalini
- Postgraduate Program in Animal Medicine: Equine, College of Veterinary Medicine Federal University of Rio Grande do Sul - UFRGS. Av. Bento Gonçalves, Porto Alegre, Rio Grande do Sul, Brazil
| | - Bruna Favieiro Pellin de Molnar
- Postgraduate Program in Animal Medicine: Equine, College of Veterinary Medicine Federal University of Rio Grande do Sul - UFRGS. Av. Bento Gonçalves, Porto Alegre, Rio Grande do Sul, Brazil
| | - Priscila Beatriz da Silva Serpa
- Postgraduate Program in Animal Medicine: Equine, College of Veterinary Medicine Federal University of Rio Grande do Sul - UFRGS. Av. Bento Gonçalves, Porto Alegre, Rio Grande do Sul, Brazil
| | - Tainor Tisotti
- College of Veterinary Medicine, Federal University of Rio Grande do Sul - UFRGS, Porto Alegre, Rio Grande do Sul, Brazil
| | - Monica Midon
- College of Veterinary Medicine, Federal University of Rio Grande do Sul - UFRGS, Porto Alegre, Rio Grande do Sul, Brazil
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KuKanich B, KuKanich K, Rankin DC, Locuson CW, Joo H. Pharmacokinetics and pharmacodynamics of a novel analgesic with a deterrent to human opioid abuse (methadone-fluconazole-naltrexone) after oral administration in dogs. Am J Vet Res 2020; 81:656-664. [PMID: 32700999 DOI: 10.2460/ajvr.81.8.656] [Citation(s) in RCA: 2] [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
OBJECTIVE To determine the effects of coadministration of naltrexone, a human opioid abuse deterrent, on the pharmacokinetics and pharmacodynamics of a methadone-fluconazole combination administered orally to dogs. ANIMALS 12 healthy Beagles. PROCEDURES Dogs (body weight, 10.7 to 13.9 kg) were randomly allocated to 2 groups in a parallel design study. All dogs received fluconazole (100 mg [7.19 to 9.35 mg/kg], PO). Twelve hours later (time 0), dogs were administered methadone (10 mg [0.72 to 0.93 mg/kg]) plus fluconazole (50 mg [3.62 to 4.22 mg/kg]; methadone-fluconazole) or methadone (10 mg [0.72 to 0.93 mg/kg]) plus fluconazole (50 mg [3.60 to 4.67 mg/kg]) and naltrexone (2.5 mg [0.18 to 0.23 mg/kg]; methadone-fluconazole-naltrexone), PO, in a gelatin capsule. Blood samples were collected for pharmacokinetic analysis, and rectal temperature and sedation were assessed to evaluate opioid effects at predetermined times up to 24 hours after treatment. RESULTS Most dogs had slight sedation during the 12 hours after drug administration; 1 dog/group had moderate sedation at 1 time point. Mean rectal temperatures decreased significantly from baseline (immediate pretreatment) values from 2 to ≥ 12 hours and 2 to ≥ 8 hours after methadone-fluconazole and methadone-fluconazole-naltrexone treatment, respectively. Geometric mean maximum observed concentration of methadone in plasma was 35.1 and 33.5 ng/mL and geometric mean terminal half-life was 7.92 and 7.09 hours after methadone-fluconazole and methadone-fluconazole-naltrexone treatment, respectively. Naltrexone was sporadically detected in 1 dog. The active naltrexone metabolite, β-naltrexol, was not detected. The inactive metabolite, naltrexone glucuronide, was detected in all dogs administered methadone-fluconazole-naltrexone. CONCLUSIONS AND CLINICAL RELEVANCE Opioid effects were detected after oral administration of methadone-fluconazole or methadone-fluconazole-naltrexone. Further studies assessing additional opioid effects, including antinociception, are needed.
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Cueni C, Nytko KJ, Thumser-Henner P, Weyland MS, Rohrer Bley C. Methadone does not potentiate the effect of doxorubicin in canine tumour cell lines. Vet Med Sci 2020; 6:283-289. [PMID: 32306524 PMCID: PMC7397897 DOI: 10.1002/vms3.266] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/03/2020] [Accepted: 03/23/2020] [Indexed: 12/17/2022] Open
Abstract
Opioid receptor activation was shown to enhance the efficacy of anti‐neoplastic drugs in several human cancer cell lines. In these cell lines, doxorubicin increased the number of opioid receptors and methadone concurrently enhanced cellular doxorubicin uptake. Triggered through lay press and media, animal owners started to challenge veterinary oncologists with questions about methadone use in anti‐cancer therapy. Especially in veterinary medicine, where side effects of chemotherapy are tolerated to a lesser extent and hence smaller doses are given, agents potentiating chemotherapeutic agents would be an optimal approach to treatment. Canine transitional cell carcinoma cells (TCC, K9TCC), canine osteosarcoma cells (OSA, Abrams) and canine hemangiosarcoma cells (HSA, DAL‐4) were incubated with different combinations of methadone, buprenorphine and doxorubicin, in order to test inhibition of cell proliferation. Opioid receptor density was assessed with fluorescence‐activated cell sorting in drug native and doxorubicin pretreated cells. In TCC and OSA cell lines opioid receptor density increased after doxorubicin pretreatment. In combination treatment, however, we did not find significant potentiation of doxorubicin's inhibitory effect on proliferation in these cell lines. Neither was there a significant increase of the effect of doxorubicin when the opioids were added 24 hr before doxorubicin. Hence, we could not confirm the hypothesis that opioids increase the anti‐proliferative effect of the anti‐neoplastic drug doxorubicin in any of these canine tumour cell lines. The lack of effect on a cellular level does not warrant a clinical approach to use opioids together with doxorubicin in dogs with cancer.
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Affiliation(s)
- Claudia Cueni
- Division of Radiation Oncology, Vetsuisse Faculty University of Zurich, Zurich, Switzerland.,Center for Clinical Studies at the Vetsuisse Faculty of the University of Zurich, Zurich,, Switzerland
| | - Katarzyna J Nytko
- Division of Radiation Oncology, Vetsuisse Faculty University of Zurich, Zurich, Switzerland.,Center for Clinical Studies at the Vetsuisse Faculty of the University of Zurich, Zurich,, Switzerland
| | - Pauline Thumser-Henner
- Division of Radiation Oncology, Vetsuisse Faculty University of Zurich, Zurich, Switzerland.,Center for Clinical Studies at the Vetsuisse Faculty of the University of Zurich, Zurich,, Switzerland
| | - Mathias S Weyland
- Division of Radiation Oncology, Vetsuisse Faculty University of Zurich, Zurich, Switzerland.,ZHAW School of Engineering, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Carla Rohrer Bley
- Division of Radiation Oncology, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
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KuKanich B, KuKanich K, Rankin D, Locuson CW. The effect of fluconazole on oral methadone in dogs. Vet Anaesth Analg 2019; 46:501-509. [PMID: 30982709 DOI: 10.1016/j.vaa.2019.02.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 02/07/2019] [Accepted: 02/08/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To determine the effects of fluconazole on oral methadone pharmacokinetics and central effects mediated by opioid receptors in dogs. STUDY DESIGN Prospective, incomplete block. ANIMALS A total of 12 healthy Beagle dogs. METHODS Dogs were randomly allocated into two groups of six dogs. In total, four treatments (two treatments/group) were administered including: oral methadone (1 mg kg-1); oral fluconazole (5 mg kg-1) every 12 hours starting 24 hours prior to oral methadone (1 mg kg-1); oral fluconazole (2.5 mg kg-1) every 12 hours starting 24 hours prior to oral methadone (1 mg kg-1); and oral fluconazole (5 mg kg-1) every 24 hours starting 12 hours prior to oral methadone (1 mg kg-1). At least 28 days were implemented as a washout period between fluconazole treatments. Rectal temperature (RT), heart rate (HR), respiratory rate (fR), sedation scores and blood samples were obtained for 24 hours after methadone administration. Plasma drug concentrations were measured with liquid chromatography/mass spectrometry. RESULTS Significantly higher maximum plasma methadone concentration (mean, 25-46 ng mL-1) occurred in all fluconazole-administered treatments than in methadone alone (1.5 ng mL-1). The mean 12 hour methadone plasma concentration in fluconazole treatments was 11-20 ng mL-1. Significantly decreased RT and variable sedation occurred in all fluconazole treatments, but no changes occurred with methadone alone. There were no differences in HR or fR among treatments. CONCLUSIONS AND CLINICAL RELEVANCE Fluconazole significantly increases the extent and duration of oral methadone exposure in dogs resulting in significant central opioid effects.
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Affiliation(s)
- Butch KuKanich
- Department of Anatomy and Physiology and the Institute of Computational Comparative Medicine, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA.
| | - Kate KuKanich
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - David Rankin
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Charles W Locuson
- Vanderbilt University Center for Neuroscience Drug Discovery, Cool Springs Life Science Center, Nashville, TN, USA
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Elwell-Cuddy T, Li M, KuKanich B, Lin Z. The construction and application of a population physiologically based pharmacokinetic model for methadone in Beagles and Greyhounds. J Vet Pharmacol Ther 2018; 41:670-683. [DOI: 10.1111/jvp.12676] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 03/30/2018] [Accepted: 05/18/2018] [Indexed: 01/18/2023]
Affiliation(s)
- Trevor Elwell-Cuddy
- Institute of Computational Comparative Medicine (ICCM); Department of Anatomy and Physiology; College of Veterinary Medicine; Kansas State University; Manhattan Kansas
| | - Miao Li
- Institute of Computational Comparative Medicine (ICCM); Department of Anatomy and Physiology; College of Veterinary Medicine; Kansas State University; Manhattan Kansas
| | - Butch KuKanich
- Institute of Computational Comparative Medicine (ICCM); Department of Anatomy and Physiology; College of Veterinary Medicine; Kansas State University; Manhattan Kansas
| | - Zhoumeng Lin
- Institute of Computational Comparative Medicine (ICCM); Department of Anatomy and Physiology; College of Veterinary Medicine; Kansas State University; Manhattan Kansas
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Lascelles BDX, Brown DC, Maixner W, Mogil JS. Spontaneous painful disease in companion animals can facilitate the development of chronic pain therapies for humans. Osteoarthritis Cartilage 2018; 26:175-183. [PMID: 29180098 DOI: 10.1016/j.joca.2017.11.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 10/17/2017] [Accepted: 11/13/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To outline the role that spontaneous osteoarthritis (OA) in companion animals can play in translational research and therapeutic pharmacological development. OUTLINE Narrative review summarizing the opportunities and limitations of naturally occurring, spontaneous OA as models of human OA pain, with a focus on companion animal pets. The background leading to considering inserting spontaneous disease models in the translational paradigm is provided. The utility of this model is discussed in terms of outcome measures that have been validated as being related to pain, and in terms of the potential for target discovery is outlined. The limitations to using companion animal pets as models of human disease are discussed. CONCLUSIONS Although many steps along the translational drug development pathway have been identified as needing improvement, spontaneous painful OA in companion animals offers translational potential. Such 'models' may better reflect the complex genetic, environmental, temporal and physiological influences present in humans and current data suggests the predictive validity of the models are good. The opportunity for target discovery exists but is, as yet, unproven.
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Affiliation(s)
- B D X Lascelles
- Comparative Pain Research Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA; Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA; Center for Pain Research and Innovation, UNC School of Dentistry, Chapel Hill, NC, USA; Center for Translational Pain Research, Department of Anesthesiology, Duke University, Durham, NC, USA.
| | - D C Brown
- Translational Comparative Medicine Research, Elanco Animal Health, Greenfield, IN, USA
| | - W Maixner
- Center for Translational Pain Research, Department of Anesthesiology, Duke University, Durham, NC, USA
| | - J S Mogil
- Department of Psychology, Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada; Department of Anesthesia, Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
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Kongara K. Pharmacogenetics of opioid analgesics in dogs. J Vet Pharmacol Ther 2017; 41:195-204. [DOI: 10.1111/jvp.12452] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 07/28/2017] [Indexed: 02/03/2023]
Affiliation(s)
- K. Kongara
- Animal Welfare Science and Bioethics Centre; Institute of Veterinary, Animal and Biomedical Sciences, Massey University; Palmerston North New Zealand
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Amengual M, Leigh H, Rioja E. Postoperative respiratory effects of intravenous fentanyl compared to intravenous methadone in dogs following spinal surgery. Vet Anaesth Analg 2017; 44:1042-1048. [DOI: 10.1016/j.vaa.2016.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 09/28/2016] [Accepted: 11/01/2016] [Indexed: 11/25/2022]
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Pypendop BH, Shilo‐Benjamini Y, Ilkiw JE. Effect of morphine, methadone, hydromorphone or oxymorphone on the thermal threshold, following intravenous or buccal administration to cats. Vet Anaesth Analg 2016; 43:635-642. [DOI: 10.1111/vaa.12356] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 12/05/2015] [Indexed: 11/27/2022]
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15
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Slingsby LS, Sear JW, Taylor PM, Murrell JC. Effect of intramuscular methadone on pharmacokinetic data and thermal and mechanical nociceptive thresholds in the cat. J Feline Med Surg 2016; 18:875-881. [PMID: 26404026 PMCID: PMC11132222 DOI: 10.1177/1098612x15605164] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives The aim of the study was to assess simultaneous pharmacokinetics and thermal and mechanical antinociception after intramuscular methadone (0.6 mg/kg) in 10 cats. Methods Thermal and mechanical threshold (TT and MT, respectively) testing and blood collection were conducted at baseline and up to 24 h after administration. Methadone plasma concentrations were determined by liquid chromatography-tandem mass spectrometry and pharmacokinetic parameters were estimated by a non-compartmental method. TT and MT were analysed using ANOVA ( P <0.05). Time of maximum plasma concentration (Tmax), time of onset of antinociception and time of reaching cut-out threshold (TT 55°C; MT 30 Newtons [N]) were determined. Results TT and MT increased above baseline from 20-240 mins and 5-40 mins, respectively, after intramuscular (IM) administration ( P <0.005). Mean maximum delta T (measured as TT minus baseline threshold) was 7.9°C (95% confidence interval [CI] 4.3-11.6) at 60 mins and mean maximum delta F (measured as MT minus baseline threshold) was 4.2 (95% CI 1.6-6.7) N at 45 mins. IM methadone concentration-time data decreased curvilinearly, and gave a clearance estimate of mean 9.1 ml/kg/min (range 5.2-15.7) with median Tmax at 20 mins (range 5-360 mins). Conclusions and relevance IM data followed classical disposition and elimination in all cats. Plasma concentrations after IM administration were associated with an antinociceptive effect, including negative hysteresis. These data can be used for devising dosing schedules for methadone in clinical feline practice.
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Affiliation(s)
| | - John W Sear
- John Radcliffe Hospital, University of Oxford, Oxford, UK
| | | | - Joanna C Murrell
- School of Veterinary Science, University of Bristol, Bristol, UK
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Thames BE, Lovvorn J, Papich MG, Wills R, Archer T, Mackin A, Thomason J. The effects of clopidogrel and omeprazole on platelet function in normal dogs. J Vet Pharmacol Ther 2016; 40:130-139. [PMID: 27452307 DOI: 10.1111/jvp.12340] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 05/24/2016] [Indexed: 12/12/2022]
Abstract
Omeprazole is used concurrently with clopidogrel to reduce gastrointestinal adverse effects. In humans, the concurrent use of these two drugs can reduce the antiplatelet efficacy of clopidogrel. Our objective was to determine the effects of omeprazole and clopidogrel on platelet function in healthy dogs. A crossover study utilized turbidimetric aggregometry (ADP and collagen) and the PFA-100® with the collagen/ADP cartridge to evaluate platelet function in eight healthy dogs during the administration of clopidogrel (1 mg/kg/24 h p.o.), omeprazole (1 mg/kg/24 h p.o.), and a combination of clopidogrel and omeprazole. Drug metabolite concentrations were also measured. Compared to pretreatment, on Days 3 and 5, with ADP as the agonist, there was a significant decrease in maximum amplitude on aggregometry for both clopidogrel and clopidogrel/omeprazole groups. The following revealed no significant differences between clopidogrel and clopidogrel/omeprazole groups when compared on Days 3 and 5: maximum amplitude on aggregometry with ADP or collagen agonists, and PFA-100® closure times. When compared to the clopidogrel group, clopidogrel metabolite concentrations in the clopidogrel/omeprazole group were significantly higher on Days 3 and 5. The concurrent administration of omeprazole and clopidogrel in healthy dogs was associated with an increase in the plasma concentration of an inactive metabolite of clopidogrel, but does not significantly alter the antiplatelet effects of clopidogrel.
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Affiliation(s)
- B E Thames
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS, USA
| | - J Lovvorn
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS, USA
| | - M G Papich
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - R Wills
- Departments of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS, USA
| | - T Archer
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS, USA
| | - A Mackin
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS, USA
| | - J Thomason
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS, USA
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Navarrete-Calvo R, Gutiérrez-Bautista ÁJ, Granados MM, Domínguez JM, Fernández-Sarmiento JA, Quirós-Carmona S, Morgaz J. Comparison of the isoflurane concentration of using dexketoprofen or methadone at premedication during orthopedic surgery in dogs. Res Vet Sci 2016; 105:36-40. [DOI: 10.1016/j.rvsc.2016.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 12/09/2015] [Accepted: 01/12/2016] [Indexed: 10/22/2022]
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KuKanich B, KuKanich K. Chloramphenicol significantly affects the pharmacokinetics of oral methadone in Greyhound dogs. Vet Anaesth Analg 2015; 42:597-607. [DOI: 10.1111/vaa.12257] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 12/13/2014] [Indexed: 11/29/2022]
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Gharavi R, Hedrich W, Wang H, Hassan HE. Transporter-Mediated Disposition of Opioids: Implications for Clinical Drug Interactions. Pharm Res 2015; 32:2477-502. [PMID: 25972096 DOI: 10.1007/s11095-015-1711-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 05/06/2015] [Indexed: 01/08/2023]
Abstract
Opioid-related deaths, abuse, and drug interactions are growing epidemic problems that have medical, social, and economic implications. Drug transporters play a major role in the disposition of many drugs, including opioids; hence they can modulate their pharmacokinetics, pharmacodynamics and their associated drug-drug interactions (DDIs). Our understanding of the interaction of transporters with many therapeutic agents is improving; however, investigating such interactions with opioids is progressing relatively slowly despite the alarming number of opioids-mediated DDIs that may be related to transporters. This review presents a comprehensive report of the current literature relating to opioids and their drug transporter interactions. Additionally, it highlights the emergence of transporters that are yet to be fully identified but may play prominent roles in the disposition of opioids, the growing interest in transporter genomics for opioids, and the potential implications of opioid-drug transporter interactions for cancer treatments. A better understanding of drug transporters interactions with opioids will provide greater insight into potential clinical DDIs and could help improve opioids safety and efficacy.
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Affiliation(s)
- Robert Gharavi
- Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, 20 N Pine Street, Rooms: N525 (Office), Baltimore, Maryland, 21201, USA
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Papich MG, Martinez MN. Applying Biopharmaceutical Classification System (BCS) Criteria to Predict Oral Absorption of Drugs in Dogs: Challenges and Pitfalls. AAPS JOURNAL 2015; 17:948-64. [PMID: 25916691 DOI: 10.1208/s12248-015-9743-7] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 11/12/2014] [Indexed: 01/29/2023]
Abstract
The Biopharmaceutical Classification System (BCS) has been a prognostic tool for assessing the potential effects of formulation on the human drug oral bioavailability. When used in conjunction with in vitro dissolution tests, the BCS can support the prediction of in vivo product performance and the development of mechanistic models that support formulation assessments through the generation of "what if" scenarios. To date, the applicability of existing human BCS criteria has not been evaluated in dogs, thereby limiting its use in canine drug development. Therefore, we examined 50 drugs for which absolute bioavailability (F) was available both in dogs and humans. The drugs were also evaluated for any potential association between solubility (calculated from the dose number, Do) or lipophilicity (LogP) and F in dogs. In humans, solubility is determined in 250 mL of fluid. However, the appropriate volume for classifying drug solubility in dogs has not been established. In this analysis, the estimated volume of a water flush administered to fasted dogs (6 mL) and a volume of 250 mL scaled to a Beagle dog (35 mL) were examined. In addition, in humans, a Do value greater than 1.0 is used to define a compound as highly soluble and a LogP value greater than 1.72 as high permeability. These same criteria were applied for defining highly soluble and highly permeable in dogs. Whether using 35 or 6 mL to determine Do, the canine solubility classification remained unchanged for all but seven compounds. There were no clear associations between a drug's F in dogs and humans or between the canine value of F and either its human BCS classification, its LogP value, or the canine Do estimate. There was a tendency for those drugs with canine values of F equal to or greater than 80% to have LogP values equal to or greater than 1.0. Exceptions to this observation tended to be those compounds known to be absorbed via mechanisms other than passive diffusion (e.g., via transporters or paracellular transporters). Although there are limitations to the approach used in this study, the results of our assessment strongly suggest that the human BCS classification system requires substantial modification before it can be reliably applied to dogs.
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Affiliation(s)
- Mark G Papich
- College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, North Carolina, 27607, USA,
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Abstract
Veterinary surgeons in the UK were invited to complete an internet survey concerning their attitudes to chronic pain in dogs. UK veterinary surgeons numbering 215 completed surveys in full along with 48 worldwide specialists in anaesthesia and 37 worldwide specialists in oncology. Osteoarthritis, dental and aural disease, vertebral and spinal cord conditions, neoplasia and skin conditions were considered important causes of chronic pain in dogs. UK practitioners used significantly fewer classes of analgesic drugs regularly than either category of specialist. The major barriers to adequate treatment of chronic pain were reported as difficulties with pain assessment, expense of drugs, and difficulties with owner compliance. Illustrations of six common neoplastic conditions were used and scored for pain according to prior experience by practitioners. All six conditions were consistently described as involving some degree of pain with primary bone tumour and oral tumour, causing severe pain and moderate to severe pain, respectively. Years since graduation and specialist status affected the pain scores attributed to the conditions. There was a significant correlation between the pain score attributed to the illustrated condition, and the tendency to administer analgesia.
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Affiliation(s)
- A Bell
- School of Veterinary Medicine, University of Glasgow, Bearsden, Glasgow G61 1QH, UK
| | - J Helm
- School of Veterinary Medicine, University of Glasgow, Bearsden, Glasgow G61 1QH, UK
| | - J Reid
- School of Veterinary Medicine, University of Glasgow, Bearsden, Glasgow G61 1QH, UK
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Murrell J, Flaherty D. Extending postoperative opioid analgesia in dogs 1. Oral drug administration. IN PRACTICE 2014. [DOI: 10.1136/inp.g3941] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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KuKanich B. Outpatient Oral Analgesics in Dogs and Cats Beyond Nonsteroidal Antiinflammatory Drugs. Vet Clin North Am Small Anim Pract 2013; 43:1109-25. [DOI: 10.1016/j.cvsm.2013.04.007] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Methadone in healthy goats – Pharmacokinetics, behaviour and blood pressure. Res Vet Sci 2013; 95:231-7. [DOI: 10.1016/j.rvsc.2013.02.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 01/29/2013] [Accepted: 02/22/2013] [Indexed: 11/24/2022]
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Martinez MN, Antonovic L, Court M, Dacasto M, Fink-Gremmels J, Kukanich B, Locuson C, Mealey K, Myers MJ, Trepanier L. Challenges in exploring the cytochrome P450 system as a source of variation in canine drug pharmacokinetics. Drug Metab Rev 2013; 45:218-30. [DOI: 10.3109/03602532.2013.765445] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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KuKanich B, Spade J. Pharmacokinetics of hydrocodone and hydromorphone after oral hydrocodone in healthy Greyhound dogs. Vet J 2012; 196:266-8. [PMID: 23098635 DOI: 10.1016/j.tvjl.2012.09.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Revised: 08/23/2012] [Accepted: 09/13/2012] [Indexed: 10/27/2022]
Abstract
The purpose of this study was to determine the pharmacokinetics of hydrocodone and its active metabolite hydromorphone in six healthy Greyhound dogs. Hydrocodone bitartrate was administered at a targeted dose of 0.5 mg/kg PO. Plasma concentrations of hydrocodone and hydromorphone were determined by liquid chromatography triple quadrupole mass spectrometry. The mean hydrocodone CMAX was 11.73 ng/mL at 0.74 h with a terminal half-life of 1.60 h. The mean hydromorphone CMAX was 5.2 ng/mL at 1.37 h with a terminal half-life of 3.07 h. Mean plasma hydromorphone concentrations exceeded 2 ng/mL from 0.5 to 8 h after hydrocodone administration. Further studies assessing the antinociceptive effects of oral hydrocodone are needed.
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Affiliation(s)
- Butch KuKanich
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA.
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27
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Vinson RK. Pharmacokinetics of a New Immediate-Release Methadone Tablet Formulation with Decreased In vitro Solubility. Clin Drug Investig 2012; 32:487-95. [DOI: 10.2165/11633550-000000000-00000] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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28
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Campagnol D, Teixeira-Neto FJ, Peccinini RG, Oliveira FA, Alvaides RK, Medeiros LQ. Comparison of the effects of epidural or intravenous methadone on the minimum alveolar concentration of isoflurane in dogs. Vet J 2012; 192:311-5. [DOI: 10.1016/j.tvjl.2011.08.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Revised: 08/10/2011] [Accepted: 08/16/2011] [Indexed: 10/17/2022]
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Linardi RL, Stokes AM, Keowen ML, Barker SA, Hosgood GL, Short CR. Bioavailability and pharmacokinetics of oral and injectable formulations of methadone after intravenous, oral, and intragastric administration in horses. Am J Vet Res 2012; 73:290-5. [DOI: 10.2460/ajvr.73.2.290] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kukanich B, Kukanich KS, Rodriguez JR. The effects of concurrent administration of cytochrome P-450 inhibitors on the pharmacokinetics of oral methadone in healthy dogs. Vet Anaesth Analg 2011; 38:224-30. [PMID: 21492388 DOI: 10.1111/j.1467-2995.2011.00602.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The objective was to examine the effects of inhibiting cytochrome P450 (CYP) on the pharmacokinetics of oral methadone in dogs. STUDY DESIGN Prospective non-randomized experimental trial. ANIMALS Six healthy Greyhounds (three male and three female). METHODS The study was divided into two phases. Oral methadone (mean = 2.1 mg kg(-1) PO) was administered as whole tablets in Phase 1. In Phase 2 oral methadone (2.1 mg kg(-1) PO) was administered concurrently with ketoconazole (13.0 mg kg(-1) PO q 24 hours), chloramphenicol (48.7 mg kg(-1) PO q 12 hours), fluoxetine (1.3 mg kg(-1) PO q 24 hours), and trimethoprim (6.5 mg kg(-1) PO q 24 hours). Blood was obtained for analysis of methadone plasma concentrations by liquid chromatography with mass spectrometry. The maximum plasma concentration (C(max)), time to C(max) (T(max)), and the area under the curve from time 0 to the last measurable time point above the limit of quantification of the analytical assay (AUC(0-LAST)) were compared statistically. RESULTS The C(max) of methadone was significantly different (p=0.016) for Phase 1 (5.5 ng mL(-1)) and Phase 2 (171.9 ng mL(-1)). The AUC(0-LAST) was also significantly different (p=0.004) for Phase 1 (13.1 hour ng mL(-1)) and Phase 2 (3075.2 hour ng mL(-1)). CONCLUSION AND CLINICAL RELEVANCE Concurrent administration of CYP inhibitors with methadone significantly increased the area under the curve and plasma concentrations of methadone after oral administration to dogs. Further studies are needed assessing more clinically relevant combinations of methadone and CYP inhibitors.
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Affiliation(s)
- Butch Kukanich
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA.
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KuKanich B. Pharmacokinetics of acetaminophen, codeine, and the codeine metabolites morphine and codeine-6-glucuronide in healthy Greyhound dogs. J Vet Pharmacol Ther 2010; 33:15-21. [PMID: 20444020 DOI: 10.1111/j.1365-2885.2009.01098.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to determine the pharmacokinetics of codeine and the active metabolites morphine and codeine-6-glucuronide after i.v. codeine administration and the pharmacokinetics of acetaminophen (APAP), codeine, morphine, and codeine-6-glucuronide after oral administration of combination product containing acetaminophen and codeine to dogs. Six healthy Greyhound dogs were administered 0.734 mg/kg codeine i.v. and acetaminophen (10.46 mg/kg mean dose) with codeine (1.43 mg/kg mean dose) orally. Blood samples were collected at predetermined time points for the determination of codeine, morphine, and codeine-6-glucuronide plasma concentrations by LC/MS and acetaminophen by HPLC with UV detection. Codeine was rapidly eliminated after i.v. administration (T(1/2) = 1.22 h; clearance = 29.94 mL/min/kg; volume of distribution = 3.17 L/kg) with negligible amounts of morphine present, but large amounts of codeine-6-glucuronide (C(max) = 735.75 ng/mL) were detected. The oral bioavailability of codeine was 4%, morphine concentrations were negligible, but large amounts of codeine-6-glucuronide (C(max) = 1952.86 ng/mL) were detected suggesting substantial first pass metabolism. Acetaminophen was rapidly absorbed (C(max) = 6.74 microg/mL; T(max) = 0.85 h) and eliminated (T(1/2) = 0.96 h). In conclusion, the pharmacokinetics of codeine was similar to other opioids in dogs with a short half-life, rapid clearance, large volume of distribution, and poor oral bioavailability. High concentrations of codeine-6-glucuronide were detected after i.v. and oral administration.
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Affiliation(s)
- B KuKanich
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506-5802, USA.
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Credie RG, Teixeira Neto FJ, Ferreira TH, Aguiar AJA, Restitutti FC, Corrente JE. Effects of methadone on the minimum alveolar concentration of isoflurane in dogs. Vet Anaesth Analg 2010; 37:240-9. [DOI: 10.1111/j.1467-2995.2010.00528.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lakhman SS, Ma Q, Morse GD. Pharmacogenomics of CYP3A: considerations for HIV treatment. Pharmacogenomics 2010; 10:1323-39. [PMID: 19663676 DOI: 10.2217/pgs.09.53] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The understanding of the cytochrome P450 3A SNP in antiretroviral therapy is important, because it is highly inducible, extremely polymorphic and metabolizes many of the drugs that are key components of highly active antiretroviral therapy regimens. This enzyme is prolific and promiscuous towards drug and xenobiotic substrate selection and it is also unpredictable among individuals, having a 5- to 20-fold variability in its ability to contribute to drug clearance. The importance of human CYP3A pharmacogenetics is also gaining attention in other established areas of pharmacotherapy as it may contribute to the goal of predicting efficacy and/or toxicity, specifically with the discovery of null allele CYP3A4*20. This review summarizes the current understanding, implications of genetic variation in the CYP3A enzymes, the central role of CYP3A in linking human genetics, the pharmacokinetics and resulting pharmacodynamic responses to certain antiretroviral drugs, and their eventual place in applied clinical pharmacotherapy.
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Affiliation(s)
- Sukhwinder S Lakhman
- Department of Pharmaceutical Sciences, DYC School of Pharmacy, Buffalo, NY 14201 USA
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KuKANICH B, HUBIN M. The pharmacokinetics of ketoconazole and its effects on the pharmacokinetics of midazolam and fentanyl in dogs. J Vet Pharmacol Ther 2010; 33:42-9. [DOI: 10.1111/j.1365-2885.2009.01105.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Grubb T. What Do We Really Know About the Drugs We Use to Treat Chronic Pain? Top Companion Anim Med 2010; 25:10-9. [DOI: 10.1053/j.tcam.2009.10.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2009] [Accepted: 10/05/2009] [Indexed: 11/11/2022]
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Ingvast-Larsson C, Holgersson A, Bondesson U, Lagerstedt AS, Olsson K. Clinical pharmacology of methadone in dogs. Vet Anaesth Analg 2010; 37:48-56. [DOI: 10.1111/j.1467-2995.2009.00476.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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LINARDI RL, STOKES AM, BARKER SA, SHORT C, HOSGOOD G, NATALINI CC. Pharmacokinetics of the injectable formulation of methadone hydrochloride administered orally in horses. J Vet Pharmacol Ther 2009; 32:492-7. [DOI: 10.1111/j.1365-2885.2009.01071.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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MAIANTE AA, TEIXEIRA NETO FJ, BEIER SL, CORRENTE JE, PEDROSO CEBP. Comparison of the cardio-respiratory effects of methadone and morphine in conscious dogs. J Vet Pharmacol Ther 2009; 32:317-28. [DOI: 10.1111/j.1365-2885.2008.01042.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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GRABOWSKI T, JAROSZEWSKI JJ. Bioavailability of veterinary drugsin vivoandin silico. J Vet Pharmacol Ther 2009; 32:249-57. [DOI: 10.1111/j.1365-2885.2008.01034.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mathews KA. Neuropathic pain in dogs and cats: if only they could tell us if they hurt. Vet Clin North Am Small Anim Pract 2009; 38:1365-414, vii-viii. [PMID: 18954689 DOI: 10.1016/j.cvsm.2008.09.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Neuropathic pain is difficult to diagnose in veterinary patients because they are unable to verbalize their pain. By assuming that neuropathic pain may exist based on the history of events that each patient has experienced, a focused client history and neurologic examination may identify a lesion resulting in persistent or spontaneous pain. Once neuropathic pain is diagnosed, a trial analgesic or acupuncture session(s) should be prescribed with instructions for owners to observe behavior. Dosing of the analgesic can be titrated to the patient's needs while avoiding adverse effects. When a particular analgesic may be ineffectual, an alternate class should be tried. As research into the neurobiologic mechanisms of neuropathic pain continues, specific therapies for its management should eventually appear in the human clinical setting and subsequently be investigated for veterinary clinical use.
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Affiliation(s)
- Karol A Mathews
- Emergency and Critical Care Medicine, Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, N1G 2W1, Canada.
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Mealey KL, Jabbes M, Spencer E, Akey JM. Differential expression ofCYP3A12andCYP3A26mRNAs in canine liver and intestine. Xenobiotica 2008; 38:1305-12. [DOI: 10.1080/00498250802446146] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mayer UK, Glos K, Schmid M, Power HT, Bettenay SV, Mueller RS. Adverse effects of ketoconazole in dogs a retrospective study. Vet Dermatol 2008; 19:199-208. [DOI: 10.1111/j.1365-3164.2008.00675.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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KuKanich B, Hogan BK, Krugner-Higby LA, Smith LJ. Pharmacokinetics of hydromorphone hydrochloride in healthy dogs. Vet Anaesth Analg 2008; 35:256-64. [DOI: 10.1111/j.1467-2995.2007.00379.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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KuKanich B, Borum SL. The disposition and behavioral effects of methadone in Greyhounds. Vet Anaesth Analg 2008; 35:242-8. [DOI: 10.1111/j.1467-2995.2007.00369.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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KuKanich B, Coetzee JF, Gehring R, Hubin M. Comparative disposition of pharmacologic markers for cytochrome P-450 mediated metabolism, glomerular filtration rate, and extracellular and total body fluid volume of Greyhound and Beagle dogs. J Vet Pharmacol Ther 2007; 30:314-9. [PMID: 17610404 DOI: 10.1111/j.1365-2885.2007.00875.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of the study was to compare the disposition of pharmacologic markers for cytochrome P-450 (CYP) metabolism, glomerular filtration rate (GFR), and extracellular (ECFV) and total body fluid volumes (TBFV) of Greyhounds and Beagles. Six healthy Greyhound and six healthy Beagle dogs were studied. Antipyrine, a marker for CYP metabolism and TBFV, and inulin, a marker for the GFR and ECFV, were administered i.v. Samples were collected at predetermined times and plasma was analyzed by validated high-pressure liquid chromatography (HPLC) methods. There were no differences in the disposition or pharmacokinetic parameters for inulin between the dog breeds. However, the clearance of antipyrine (mean = 8.33 mL/min/kg) in Greyhounds was significantly slower than Beagles (13.42 mL/min/kg, P = 0.004). The volume of distribution of antipyrine was significantly larger in Greyhounds (0.789 L/kg) than in Beagles (0.644 L/kg, P = 0.01). The half-life of antipyrine was significantly longer in Greyhounds (1.09 h) compared with Beagles (0.55 h, P = 0.002). The in vitro plasma protein binding of antipyrine was significantly less in Greyhounds (28%) compared with Beagles (40.3%, P = 0.008). Greyhounds exhibited significantly slower CYP metabolism, higher TBFV, and lower in vitro protein binding of antipyrine compared with Beagles. No differences in GFR or ECFV were found.
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Affiliation(s)
- B KuKanich
- Department of Anatomy, PharmCATS, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA.
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