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Tokonami F, Kimble B, Govendir M. Pharmacokinetic Profile of Fentanyl in the Koala ( Phascolarctos cinereus) after Intravenous Administration, and Absorption via a Transdermal Patch. Animals (Basel) 2021; 11:ani11123550. [PMID: 34944325 PMCID: PMC8698108 DOI: 10.3390/ani11123550] [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: 11/21/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Koalas can be injured by cars and bushfires, and be affected by painful infectious diseases. When koalas undergo surgery to repair broken bones, they require analgesia. Fentanyl is a potent opioid that can be administered during surgery to provide analgesia. This study describes the rate of elimination of fentanyl in koalas’ blood when administered as a single intravenous injection and consequently calculates the dose rate to administer a constant rate fentanyl infusion into the koalas’ veins to provide short-term pain control. Fentanyl can also be absorbed via the skin into the circulation when applied as a transdermal patch. Although the data for transdermal fentanyl patch absorption is from two koalas only, the results demonstrate that when a patch is applied, pain control is likely to occur 12 h after application to koalas’ skin. Fentanyl may provide effective pain control to koalas either as an intravenous infusion or as a transdermal patch. Abstract Fentanyl was administered as a single intravenous bolus injection at 5 µg/kg to five koalas and fentanyl plasma concentrations for a minimum of 2 h were quantified by an enzyme-linked immunosorbent assay (ELISA). The median (range) fentanyl elimination half-life and clearance were 0.53 (0.38–0.91) h, and 10.01 (7.03–11.69) L/kg/h, respectively. Assuming an analgesic therapeutic plasma concentration of 0.23 ng/mL (extrapolated from human studies), an intravenous constant infusion rate was estimated at approximately between 1.7 to 2.7 µg/kg/h (using the clearance 95% confidence intervals). A transdermal fentanyl patch was applied to the antebrachium of an additional two koalas for 72 h. Fentanyl plasma concentrations were determined during the patch application and after patch removal at 80 h. The fentanyl plasma concentration was greater than 0.23 ng/mL after 12 to 16 h. While the patch was applied, the maximum fentanyl concentration was approximately 0.7 ng/mL from 32 to 72 h. Fentanyl plasma concentrations increased to 0.89 ng/mL 1 h after the patch was removed, and then decreased to a mean of 0.47 ng/mL at 80 h. The transdermal fentanyl patch is likely to provide some level of analgesia but should be initially co-administered with another faster acting analgesic for the first 12 h.
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Affiliation(s)
- Fumie Tokonami
- Currumbin Wildlife Hospital, Currumbin, Gold Coast 4223, Australia;
| | - Benjamin Kimble
- Sydney School of Veterinary Science, The University of Sydney, Camperdown, Sydney 2006, Australia;
| | - Merran Govendir
- Sydney School of Veterinary Science, The University of Sydney, Camperdown, Sydney 2006, Australia;
- Correspondence:
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Thomsen JH, Kjaergaard J, Graff C, Pehrson S, Erlinge D, Wanscher M, Køber L, Bro-Jeppesen J, Søholm H, Winther-Jensen M, Hassager C. Ventricular ectopic burden in comatose survivors of out-of-hospital cardiac arrest treated with targeted temperature management at 33°C and 36°C. Resuscitation 2016; 102:98-104. [DOI: 10.1016/j.resuscitation.2016.02.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 02/18/2016] [Accepted: 02/27/2016] [Indexed: 10/22/2022]
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da Luz VF, Otsuki DA, Gonzalez MMC, Negri EM, Caldini EG, Damaceno-Rodrigues NR, Malbouisson LMS, Viana BG, Vane MF, Carmona MJC. Myocardial protection induced by fentanyl in pigs exposed to high-dose adrenaline. Clin Exp Pharmacol Physiol 2015; 42:1098-107. [DOI: 10.1111/1440-1681.12456] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 06/30/2015] [Accepted: 07/09/2015] [Indexed: 01/02/2023]
Affiliation(s)
| | - Denise Aya Otsuki
- University of Sao Paulo Medical School; Department of Anaesthesiology; São Paulo Brazil
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Xu YC, Li RP, Xue FS, Cui XL, Wang SY, Liu GP, Yang GZ, Sun C, Liao X. κ-Opioid receptors are involved in enhanced cardioprotection by combined fentanyl and limb remote ischemic postconditioning. J Anesth 2015; 29:535-43. [DOI: 10.1007/s00540-015-1998-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 03/04/2015] [Indexed: 11/29/2022]
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Bayındır S, Gökmen N, Erbayraktar S, Küçükgüçlü S, Yılmaz O, Şahin Ö, Öçmen E, Erdost HA, Sağıroğlu E. Cardioprotective Effects of Remifentanil in a Sympathetic Hyperactivity Model in Rabbits. Turk J Anaesthesiol Reanim 2015; 43:225-31. [PMID: 27366503 DOI: 10.5152/tjar.2015.88319] [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: 06/01/2014] [Accepted: 10/30/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE In this study, the antiarrhythmic and anti-ischemic effects of a 6 μg kg(-1) min(-1) infusion dose of remifentanil are investigated in a central sympathetic hyperactivity model in rabbits. METHODS In this study, 18 New Zealand rabbits were used. The subjects were randomly divided into three groups (n=6) and received 10 μmol L(-1) glutamate intracerebroventricularly to provide the central sympathetic hyperactivity. In group 1, 10 μmol L(-1) glutamate was used; in group 2, 1 h before L-glutamate injection, 40 mg kg(-1) N (omega)-nitro-L-arginine methyl ester was intravenously (iv) administered; and in group 3, also 1 h before L-glutamate injection, 40 mg kg(-1) N (omega)-nitro-L-arginine methyl ester was iv administered. A 6 μg kg(-1) min(-1) dose of remifentanil infusion was administered 5 min before L-glutamate injection. Heart rate, systolic arterial pressure and mean arterial pressure were measured and recorded. Within 15 min of the intracerebroventricular L-glutamate injection, premature ventricular complexes, bigeminy ventricular arrhythmia, ventricular tachycardia, ST-segment shift and T-wave inversions were recorded. RESULTS When incidences of heart rate, rate pressure product, premature ventricular complexes and bigeminy ventricular arrhythmia were compared between groups, significant differences were not determined. Mean arterial pressure was more significantly increased in group 2 than in the other groups (p<0.05). Ventricular tachycardia, ST-segment shift and T-wave inversions were significantly lower in group 3 than in groups 1 and 2 (p<0.05). CONCLUSION Remifentanil (6 μg kg(-1) min(-1) for 5 min of infusion) prevented life-threatening ventricular tachycardia and electrocardiographic signs of myocardial ischemia in a model of arrhythmia resulting from the association of central sympathetic overactivity.
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Affiliation(s)
- Selen Bayındır
- Department of Anaesthesiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Necati Gökmen
- Department of Anaesthesiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Serhat Erbayraktar
- Department of Neurosurgery, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Semih Küçükgüçlü
- Department of Anaesthesiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Osman Yılmaz
- Department of Animal Research Center, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Ömer Şahin
- Department of Anaesthesiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Elvan Öçmen
- Department of Anaesthesiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Hale Aksu Erdost
- Department of Anaesthesiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Emel Sağıroğlu
- Department of Anaesthesiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
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Chong CP, van Gaal WJ, Profitis K, Ryan JE, Savige J, Lim WK. Electrocardiograph Changes, Troponin Levels and Cardiac Complications After Orthopaedic Surgery. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2013. [DOI: 10.47102/annals-acadmedsg.v42n1p24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Introduction: The relationship between electrocardiograph (ECG) changes and troponin levels after the emergency orthopaedic surgery are not well characterised. The aim of this study was to determine the correlation between ECG changes (ischaemia or arrhythmia), troponin elevations perioperatively and cardiac complications. Materials and Methods: One hundred and eighty-seven orthopaedic patients over 60 years of age were prospectively tested for troponin I and ECGs were performed on the first 3 postoperative mornings or until discharge. Results: The incidences of pre- and postoperative troponin elevation were 15.5% and 37.4% respectively, the majority were asymptomatically detected. Most of the patients who sustained a troponin rise did not have any concomitant ECG changes (51/70 or 72.9%). Postoperative ECG changes were noted in 18.4% (34/185) and of those with ECG changes, slightly more than half (55.9%) had a troponin elevation. Most ECG changes occurred on postoperative day 1 and were non-ST elevation in type. ECG changes occurred more frequently with higher troponin levels. Postoperative troponin elevation (P = 0.018) and not preoperative troponin level (P = 0.060) was associated with ECG changes on univariate analysis. Two premorbid factors were predictors of postoperative ECG changes using multivariate logistical regression; age [odds ratio (OR), 1.05; 95% CI, 1.005 to 1.100, P = 0.029) and sex OR, 2.4; 95% CI, 1.069 to 5.446, P = 0.034). Twenty patients sustained postoperative cardiac complications; 9 (45%) were associated with ECG changes and 16 (80%) with postoperative troponin elevation. Pre- or postoperative troponin elevation better predicted cardiac complications compared with preoperative ECG changes. Conclusion: Electrocardiograph changes do not necessarily accompany troponin elevations after the emergency orthopaedic surgery but are more likely to have higher troponin levels. The best predictor of postoperative cardiac complications is troponin elevation.
Key words: Cardiovascular, Fracture, Myocardial ischaemia, Myocardial infarction, Surgery
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Affiliation(s)
| | | | | | - Julie E Ryan
- The Northern Hospital, Epping, Victoria, Australia
| | - Judy Savige
- Northern Clinical Research Centre, Northern Health, The University of Melbourne, Victoria, Australia
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Abstract
BACKGROUND Propofol is an intravenous anesthetic that is widely used to anesthetize patients during neurosurgical procedures. Although propofol is considered to be an essential component of contemporary management of acute brain injury in the operating room and in critical care settings, propofol-induced hypotension (PIH) remains a frequent and undesirable side effect. After 3 decades of clinical use, multiple proposed causes of PIH, and conflicting experimental results, the mechanism of PIH is still a puzzle for neuroscience and anesthesiology. This study evaluated the role of opioid receptors in PIH. METHODS Pentobarbital-anesthetized rats were subjected to systemic or central pretreatment with naloxone followed by intravenous or central administration of propofol. RESULTS In the absence of pretreatment with naloxone, intravenous (7.5 mg/kg) and intracistenal propofol (10 µg) injection induced 45% and 35% reductions in the mean arterial pressure, respectively (P<0.05). Both systemic (5 mg/kg) and central (100 µg) pretreatment with naloxone prevented PIH without independently affecting mean arterial pressure. CONCLUSIONS This experiment in anesthetized rats indicates that central and peripheral opioid receptor blockade prevents PIH, suggesting that these receptors are involved in the cardiovascular alterations elicited by propofol administration.
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El-Mosallamy AE, Sleem AA, Abdel-Salam OM, Shaffie N, Kenawy SA. Antihypertensive and Cardioprotective Effects of Pumpkin Seed Oil. J Med Food 2012; 15:180-9. [DOI: 10.1089/jmf.2010.0299] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Amany A. Sleem
- Department of Pharmacology, National Research Centre, Cairo, Egypt
| | - Omar M.E. Abdel-Salam
- Department of Pharmacology, National Research Centre, Cairo, Egypt
- Department of Toxicology and Narcotics, National Research Centre, Cairo, Egypt
| | - Nermeen Shaffie
- Department of Pathology, National Research Centre, Cairo, Egypt
| | - Sanaa A. Kenawy
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
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Role of central and peripheral opioid receptors in the cardioprotection of intravenous morphine preconditioning. Ir J Med Sci 2011; 180:881-5. [DOI: 10.1007/s11845-011-0734-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 07/07/2011] [Indexed: 10/17/2022]
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Lessa MA, Tibiriçá E. Pharmacologic Evidence for the Involvement of Central and Peripheral Opioid Receptors in the Cardioprotective Effects of Fentanyl. Anesth Analg 2006; 103:815-21. [PMID: 17000787 DOI: 10.1213/01.ane.0000237284.30817.f6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND We investigated the involvement of central and peripheral opioid receptors (OR) in the cardioprotective effects of fentanyl (FENT) in a model of myocardial ischemia/reperfusion injury associated with pharmacologically induced sympathetic overactivity in anesthetized rabbits. METHODS Central sympathetic stimulation was achieved through intracerebroventricular injection of l-glutamate in animals submitted to 35 min of coronary occlusion followed by 120 min of reperfusion. Rabbits received naloxone HCl intracerebroventricularly or naloxone methiodide IV, a quaternary compound that does not cross the blood-brain barrier, 5 min before FENT treatment (5 or 50 microg/kg, IV). RESULTS Infarct area was reduced only by FENT 50 (from 51% +/- 2% to 24% +/- 2%). This protective effect was abolished by peripheral (42% +/- 4%), but not central, OR blockade (32% +/- 3%). The number of premature ventricular complexes during the ischemic period (54 +/- 3) was reduced by FENT 50 (19 +/- 7), an effect blunted by central (40 +/- 3) but not peripheral (18 +/- 7) blockade of OR. During reperfusion, the number of premature ventricular complexes (134 +/- 50) was reduced to 9 +/- 5 by FENT 50 and was prevented by central (42 +/- 4) as well as peripheral (20 +/- 11) OR blockade. The mortality rate (50%) and incidence of ventricular tachycardia (55%) were completely abolished by FENT 50. CONCLUSIONS We conclude that fentanyl's effects for limiting myocardial ischemic injury are mediated via peripheral ORs while opioid's antiarrhythmic actions are mediated via central OR agonism.
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Affiliation(s)
- Marcos A Lessa
- Department of Physiology and Pharmacodynamics, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil
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Sugiyama A, Takahara A, Honsho S, Nakamura Y, Hashimoto K. A Simple In Vivo Atrial Fibrillation Model of Rat Induced by Transesophageal Atrial Burst Pacing. J Pharmacol Sci 2005; 98:315-8. [PMID: 15968140 DOI: 10.1254/jphs.scj05002x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
A simple in vivo closed-chest atrial fibrillation (Af) model of rats was developed. Af was reproducibly induced by transesophageal atrial burst pacing for 30 s in each of the pentobarbital-anesthetized rats, whereas the cardiohemodynamic condition as well as the inducibility and duration of Af episode was stable over time. Moreover, the anti-Af effect of the class Ic drug pilsicainide was confirmed in this model, which was essentially the same as those reported previously in other Af animal models and clinical practice. Thus, this new model may become an alternative to current techniques.
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Affiliation(s)
- Atsushi Sugiyama
- Department of Pharmacology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Japan.
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