Two mechanisms for the meperidine block of action potential production in frog's skeletal muscle; non-specific and opiate drug receptor mediated blockade

The thermodynamic study of p-methoxycinnamic acid inclusion complex formation, using β-cyclodextrin and hydroxypropyl-β-cyclodextrin

OBJECTIVES

Cyclodextrin's ability to form an inclusion complex with a guest molecule is a function of two factors. The first is steric and depends on the relative size of cyclodextrin cavity to the guest molecule, while the second is the thermodynamic interaction between the different system components. This study therefore aims to determine the effect of β-cyclodextrin and hydroxypropyl-β-cyclodextrin as complex formers, on thermodynamic parameter values (ΔH, ΔG, and ΔS) in the formation of inclusion complex with p-methoxycinnamic acid (pMCA).

METHODS

The pMCA complex formation with β-cyclodextrin or hydroxypropyl-β-cyclodextrin was determined in 0.02 pH 4.0 M acetate buffer and 0.02 M pH 7.0 phosphate buffer, with a 0.2 µ value at 32, 37, and 42 ± 0.5 °C. This experiment was carried out in a waterbath shaker until a saturated solution was obtained. Subsequently, pMCA concentration was determined using UV spectrophotometer at the maximum pMCA wavelength, at each pH.

RESULTS

The result showed pMCA formed inclusion complex with β-cyclodextrin or hydroxypropyl-β-cyclodextrin and exhibited increased solubility with increase in β-cyclodextrin or hydroxypropyl-β-cyclodextrin concentration. This temperature rise led to a decrease in the complex's constant stability (K). Furthermore, the interaction showed a negative enthalpy (∆H<0) and is a spontaneous processes (∆G<0). At pH 4.0, an increase in the system's entropy occurred (∆S>0), however, at pH 7.0, the system's entropy decreased (∆S<0).

CONCLUSIONS

The rise in pMCA solubility with increase in cyclodextrin solution concentration indicates an inclusion complex has been formed, and is supported by thermodynamic data.

Biochemical, Oxidative, and Physiological Changes Caused by Acute Exposure of Fentanyl and Its 3 Analogs in Rodents

Synthesis and bioefficacy of fentanyl and its 8 new 1-substituted analogs (1-8) were earlier reported by us. Of these 8 compounds, N-(1-(2-phenoxyethyl)-4-piperidinyl)propionanilide (2), N-isopropyl-3-(4-( N-phenylpropionamido)piperidin-1-yl)propanamide (5), and N- t-butyl-3-(4-( N-phenylpropionamido)piperidin-1-yl) propanamide (6) were found to be more effective and less toxic compared to fentanyl. The present study reports the acute effect of fentanyl (0.50 Median Lethal Dose (LD₅₀); intraperitoneal) and its 3 analogs (2, 5, and 6) on various biochemical and oxidative parameters in mice and various physiological parameters in rats. Blood alkaline phosphatase (1 hour and 7 days) and urea levels (1 hour) were significantly elevated by fentanyl, while alanine aminotransferase levels (1 hour) were increased by both fentanyl and analog 2 compared to the corresponding control. Increase in partial pressure of carbon dioxide and decrease in partial pressure of oxygen were also caused by fentanyl and analog 2 (1 hour). Analog 6 alone elevated malondialdehyde levels in the brain, liver, and kidney tissues (7 days). The LD₅₀ of fentanyl and analogs 2, 5, and 6 were found to be 0.879, 87.88, 69.80, and 55.44 mg/kg, respectively, in rats. Significant decrease in heart rate, mean arterial pressure, respiratory rate (RR), and neuromuscular transmission was produced by fentanyl and analog 2, while analog 5 decreased the RR alone. The changes, particularly the respiratory depression, were found to be reversed by naloxone, a μ-receptor antagonist. Thereby, indicating involvement of μ-receptor mediated effects of the compounds. To conclude, all the analogs were found to be less toxic compared to fentanyl, suggesting their possible role in pain management.

Perineural meperidine blocks nerve conduction in a dose-related manner: a randomized double-blind study

BACKGROUND

Meperidine has been shown to exhibit a sensory block in peripheral nerves. However, its motor blockade ability is controversial. The aim of this study was to investigate, electroneurographically, the ability of meperidine to inhibit conduction in both sensory and motor fibres in the ulnar nerve.

MATERIALS AND METHODS

The study was conducted in a double-blind, placebo-controlled fashion. Eighteen healthy volunteers were randomized into three groups (Saline, meperidine 1% and meperidine 2%). Three millilitre of the study solution was administered to the ulnar nerve perineurally at the level of the wrist by the guidance of a nerve stimulator. Sensory nerve action potential (SNAP) and compound motor action potential (CMAP) amplitudes were recorded. At least a 20% decrease in the initial response amplitude was accepted as a block.

RESULTS

The number of individuals with sensory and motor block with saline, meperidine 1% and meperidine 2% were 0/6, 6/6, 6/6 and 0/6, 5/6, 6/6, respectively (P<0.05). The maximum decrease in the median SNAP and CMAP amplitude values were 4.7% and 8.3% with saline; 38.5% and 46.4% with meperidine 1%; and 100% and 97.8% with meperidine 2%, respectively (P<0.05). Median values for the duration of sensory and motor block with meperidine 1% and meperidine 2% were 45, 52.5 and 30, 32.5 min, respectively.

CONCLUSION

Meperidine blocks sensory and motor nerve conduction in a dose-related manner.

Opioid peptides as possible neuromodulators in the frog peripheral nerve system

Sciatic nerves of the frog Rana ridibunda were examined for the effects of applied opioid peptide, methionine-enkephalin, synthetic enkephalin analogue, leucine-enkephalin-NH(2) and opiate antagonist, naloxone. The effect of both peptides in concentrations of 1x10(-6) and 1x10(-5)M or naloxone in 1x10(-6)M was investigated on the action potential parameters using electrophysiological techniques. The isolated nerves were stimulated by single square pulses each of which lasted for 0.5ms at supramaximal strength. Effect of each single dose of peptides at 0min was compared with the remaining time segments. Both peptides produced changes in action potential of nerve when compared with untreated nerves. Methionine-enkephalin in both concentrations reduced the amplitude between 7% and 41% and conduction velocity at about 26-61%. This peptide in the same concentrations prolonged the duration around 12-53% and increased the stimulating voltage at about 9-50%. In contrast, leucine-enkephalin-NH(2) in both concentrations caused a decrease in amplitude between 13% and 48% and in conduction velocity around 20-50%. The same concentrations of this peptide prolonged the duration at about 3-33% and increased the stimulating voltage at about 10-56%, but naloxone in 1x10(-6)M antagonized the responses of both peptides over 75%. The results indicate that both opioid peptides produce changes in action potential parameters in frog peripheral nerve system and these changes are partially reversed by naloxone.

Evidence for the involvement of an opioid system in sciatic nerve of Rana ridibunda

The effect of opioid peptide, D-alanine2-leucine-enkephalin and opioid homolog peptide, des-tyrosine-methionine-enkephalin in concentrations of 1 x 10(-6) and 1 x 10(-5) M was investigated on the action potential parameters of frog sciatic nerve. Des-tyrosine-methionine-enkephalin was used as the control to prove the opioid action of the peptide. The effects of both peptides were examined by means of the extracellular electrophysiological technique. The isolated sciatic nerves were stimulated by single square pulses each of which lasted for 0.5 ms at supramaximal strength. Effect of each single dose of peptides at 0 min was compared with the remaining time segments. Both peptides produced changes on action potential of Rana ridibunda sciatic nerve when compared with untreated nerves. D-alanine2-leucine-enkephalin decreased significantly the amplitude at about 34-83%, the area at about 34-92%. The same concentrations of this peptide decreased significantly the conduction velocity around 35-78%. In contrast, des-tyrosine-methionine-enkephalin reduced the action potential amplitude between 8% and 80%. The same concentrations of this peptide decreased significantly the area at about 12-76% and the conduction velocity around 42-70%. The depression of both peptides in action potential parameters was partially blocked by 1 x 10(-6) M naloxone.

Analgesic, hemodynamic, and respiratory effects induced by caudal epidural administration of meperidine hydrochloride in mares

OBJECTIVE

To determine the analgesic, hemodynamic, and respiratory effects induced by caudal epidural administration of meperidine hydrochloride in mares.

ANIMALS

7 healthy mares.

PROCEDURE

Each mare received meperidine (5%; 0.8 mg/kg of body weight) or saline (0.9% NaCl) solution via caudal epidural injection on 2 occasions. At least 2 weeks elapsed between treatments. Degree of analgesia in response to noxious electrical, thermal, and skin and muscle prick stimuli was determined before and for 5 hours after treatment. In addition, cardiovascular and respiratory variables were measured and degree of sedation (head position) and ataxia (pelvic limb position) evaluated.

RESULTS

Caudal epidural administration of meperidine induced bilateral analgesia extending from the. coccygeal to S1 dermatomes in standing mares; degree of sedation and ataxia was minimal. Mean (+/- SD) onset of analgesia was 12 +/- 4 minutes after meperidine administration, and duration of analgesia ranged from 240 minutes to the entire 300-minute testing period. Heart and respiratory rates, rectal temperature, arterial blood pressures, Hct, PaO2, PaCO2, pHa, total solids and bicarbonate concentrations, and base excess were not significantly different from baseline values after caudal epidural administration of either meperidine or saline solution.

CONCLUSIONS AND CLINICAL RELEVANCE

Caudal epidural administration of meperidine induced prolonged perineal analgesia in healthy mares. Degree of sedation and ataxia was minimal, and adverse cardiorespiratory effects were not detected. Meperidine may be a useful agent for induction of caudal epidural analgesia in mares undergoing prolonged diagnostic, obstetric, or surgical procedures in the anal and perineal regions.

A comparison of the local anesthetic effects of meperidine, fentanyl, and sufentanil on dorsal root axons

The local anesthetic effects of opioids have been demonstrated in both clinical and laboratory studies. Clinically, both meperidine and sufentanil can produce segmental sensory anesthesia. However, previous studies of the effects of opioids on nerve conduction have all made use of peripheral nerve preparations and yielded conflicting results. In the present study we describe the local anesthetic effects of phenylpiperidine opioids on individual dorsal root axons, the probable target for intrathecal local anesthetics. Dorsal roots were removed from anesthetized adult male rats and maintained in vitro. Standard single fiber recording techniques were used to isolate activity in the individual axons. Drug exposure was accomplished by perfusing the isolated dorsal root with an artificial cerebrospinal fluid containing the study drug at a clinically relevant concentration. Steady-state drug effects were measured after 15-30 min of exposure and compared to control measurements in the same preparation. Meperidine (705 microM) blocked conduction in 61.5% of 39 myelinated and unmyelinated axons, and significantly reduced conduction velocity in the remaining unblocked axons. These effects were not naloxone reversible. Fentanyl (0.6 microM and 3 microM) and sufentanil (1.04 microM) failed to affect the nerve conduction in any dorsal root axon. The discrepancy between laboratory and clinical observations is discussed. We suggest that the site of conduction block may occur at the proximal end of the dorsal root as it passes through the dorsal root entry zone, an anatomically unique segment of the primary sensory pathway with decreased conduction safety for action potential propagation.

Effects of enkephalin, applied intracellularly, on action potentials in vertebrate A and C nerve fibre axons

The effects of leucine enkephalin and D-Ala2, Met5 enkephalinamide (DAMA) were tested on the excitability of sciatic nerves in the frog and guinea-pig and vagus nerves in the guinea pig and rabbit. Both enkephalins depressed the amplitude of the compound action potential of A and C fibres. This depression was blocked by small concentrations of naloxone. In the type of experiment carried out, the drugs were added to the cut end of the nerve and the drugs had to reach their site of action in the central bath by diffusion through the axoplasm. This method of application of drug was necessary because enkephalins had no effect on the action potential when applied extracellularly by perfusion. These results demonstrate the presence of stereospecific opioid receptors located on the inner surface of the cell membranes of peripheral vertebrate nerve axons, sensitive to block by some endogenous opioid peptides. A possible physiological role for these intracellular receptors is suggested.

Effects of opioids on the ACh-induced contraction of the toad rectus

The inhibitory effect of morphine, nalorphine, oxymorphone, naloxone, naltrexone, N-methylnaloxone, levorphanol, levallophan, dextrorphan, dextrallophan, levo-methadone, dextro-methadone, pethidine, leu-enkephalin and U-50 488 on the acetylcholine (ACh)-induced contraction of the toad rectus was investigated. The dose-response curves obtained in the absence and presence of increasing concentrations (0.1-3.2 or 10-320 mumol/l) of each opioid were subjected to three types of inhibition model discrimination, namely competitive, noncompetitive and uncompetitive. The results show that the opioids, except morphine, nalorphine and levorphanol, inhibit the ACh-induced contraction by multiple modes of action. Except for the morphinans, the opioids inhibit competitively indicating that they are able to compete with ACh for cholinergic receptors at the nicotinic site. The opioids also inhibit noncompetitively (except oxymorphone and N-methylnaloxone) and uncompetitively (except oxymorphone) indicating the possible existence of separate opioid binding sites and the combination of the opioids with the ACh receptor complex, respectively. The effect of morphine and levorphanol on the ACh-induced contraction varies with the concentration of the two opioids. At concentrations below 80 mumol/l both opioids tend to inhibit the contraction while at concentrations of 80 mumol/l and above there is no apparent effect. Nalorphine has no effect on the contraction at the concentrations (10-320 mumol/l) employed in the study. An apparent structure-activity relationship between the phenanthrenes and the various binding sites is noticeable; so also is the difference in the activity between the dextro and levo-isomers of levorphanol and levallorphan indicating that the receptors exhibit stereospecificity.

The effects of morphine and morphine-related compounds on the rate of afferent discharges from the pulmonary receptors in bullfrog

We examined the effects of morphine and morphine-related compounds on the rate of afferent discharges from the pulmonary receptors in bullfrog. Morphine (1 X 10(-5) - 1 X 10(-3) M) decreased the rate of spontaneous afferent discharges in a concentration-dependent manner, but hardly affected the rate of afferent discharges synchronized with lung inflation. Dihydrocodeine, naloxone and dextrorphan had the same effects as morphine. Levallophan (1 X 10(-4) M), pentazocine (1 X 10(-4) M) and pethidine (1 X 10(-3) M) clearly decreased both rates of the spontaneous afferent discharges and the afferent discharges synchronized with lung inflation. In the presence of naloxone or levallorphan at the concentration of 1 X 10(-5) M, morphine (1 X 10(-5) and 1 X 10(-4) M) caused an additive decrease in the rate of afferent discharges. Dextromethorphan and apomorphine at the concentration of 1 X 10(-4) M caused an increase in the rate of spontaneous afferent discharges followed by decrease in both rates of the spontaneous afferent discharges and the afferent discharges synchronized with lung inflation. When dextromethorphan or apomorphine was washed out and the rates of afferent discharges were almost restored to the levels before application of each drug, reapplication of these drugs caused no increase in the rate of spontaneous afferent discharges, but the drugs inhibited the generation of afferent discharges. All of these drugs did not affect the flow rate of perfusion solution from the pulmonary vein.

Stereospecificity of an opiate action on the excitable membrane of frog skeletal muscle fibres

Intracellular microelectrode studies were conducted to examine the actions of the optical isomers levorphanol and dextrorphan on the isolated frog sartorius muscle preparation. Both isomers, in bath concentrations which had minimal effect on action potential amplitude and gNa (3 X 10(-5) M), caused a large depression of gK. High bath concentrations (3 X 10(-4) M) of both drugs caused an initial depression of sodium and potassium conductance processes, gNa and gK, respectively, however only levorphanol, but not dextrorphan, could produce a specific, late-occurring depression of gNa that could be blocked by the opiate antagonists, nalorphine or naloxone. These findings indicate that the late-occurring depressant effect on gNa is stereospecific and reinforce previous findings which demonstrated that opiate drugs interact with opiate receptors associated with the sodium channels of the frog muscle fibre membranes.

Intercostal muscle biopsy studies in myasthenia gravis: clinical correlations and the direct effects of drugs and myasthenic serum

We have found a wide range of mean MEPP amplitude in intercostal muscle biopsies from 43 patients with MG, including several values in the normal range. There was no correlation between MEPP amplitude and the severity of clinical disease as assessed by manual muscle testing or by single-fiber EMG measurements of jitter in arm muscles. Through most of these patients were in a state of clinical remission or marked improvement after treatment with prednisone, we could not attribute the difference between our results and those of others to this factor alone. The application of morphine, meperidine and aminoglycoside antibiotics to intercostal muscle in vitro confirms effects previously demonstrated in rat muscle: (1) At equal therapeutic concentrations, meperidine has greater neuromuscular blocking effects than does morphine, but neither has significant effects at concentrations achieved in the serum clinically. (2) Tobramycin, netilmicin and neomycin have varying severity and sites of action, but their effects are the same in human myasthenic muscle as in normal rat muscle. Bath application of serum from myasthenic patients produces an acute, reversible worsening of neuromuscular blockade in myasthenic muscle. Electrophysiologic measurements in intercostal biopsies from patients with MG can provide information about the basic abnormality of neuromuscular transmission in this disease and can confirm the relevance of studies made in animal muscle.

Candidate mechanisms for inhibition of neurotransmitter release by narcotic analgesics and endorphins

Some neurones are endowed with receptors for endorphins and narcotic analgesics. Activation of these receptors results in a depression of the release of transmitter per impulse. It is currently believed that narcotic analgesics and endorphins depress the stimulus-induced influx of calcium (Ca2+) into the terminal and thereby modify the amount of the ion which triggers the release of the transmitter from intracellular stores. The influx of Ca2+ is largely governed by the Ca2+ "channel", which opens during depolarization of the neuronal membrane either after an action potential (electrical stimulus) or in the presence of high extracellular potassium (K+) or nicotinic stimulants (chemical stimulus). The evoked influx of Ca2+ can be affected by a direct action on the Ca2+ "channel" or by primary actions on other membrane properties that subsequently regulate the Ca2+ "channel". In many tissues narcotic analgesics and endorphins fail to inhibit transmitter release. This may be accounted for by the possibility that either such neurones lack presynaptic opiate receptors or that the function of existing receptors remains latent under the experimental conditions employed. Currently, there is insufficient evidence for endorphins physiologically modulating transmitter release.

Pharmacologic responses of cells of a neuroblastoma X glioma hybrid clone and modulation of synapses between hybrid cells and mouse myotubes

Cells of the hybrid clone NG108-15 responded to 5-hydroxytryptamine (5-HT), dopamine or acetylcholine with graded depolarizations involving membrane conductance increases. Responses desensitized during continuous application of the neurotransmitters, and responses to 5-HT and dopamine cross-desensitized: a desensitizing application of one neurotransmitter also desensitized the hybrd cell to the other neurotransmitter. 5-HT and acetylcholine did not cross-desensitize. The hybrid cell 5-HT response was not attenuated by D-LSD, and was blocked by 10(-5) M morphine, although not via binding to naloxone-sensitive opiate receptors. 5-HT or the prostaglandin PGF2alpha caused the release of acetylcholine at the synapses of hybrid cells with mouse myotubes. Application of 5-HT or PGF2alpha also facilitated the synaptic release elicited by hybrid cell action potentials. Following treatment with the antimitotic agent cytosine arabinoside, co-cultures of hybrid cells and mouse myotubes exhibited plentiful synaptic connections only if maintained in medium containing 1 mM dibutyryl cAMP (dBcAMP). After X-irradiation, co-cultures were synaptically active even in the absence of dBcAMP. Thus, methods have been found to regulate both the short-term and long-term synaptic activity of NG108-15 hybrid cells.