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Akturk G, Micili SC, Gursoy Doruk O, Hocaoglu N, Akan P, Ergur BU, Ahmed S, Kalkan S. Effects of nicorandil on QT prolongation and myocardial damage caused by citalopram in rats. Biotech Histochem 2023; 98:479-491. [PMID: 37466068 DOI: 10.1080/10520295.2023.2233417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
Citalopram is a selective serotonin re-uptake inhibitor (SSRI) antidepressant; it exhibits the greatest cardiotoxic effect among SSRIs. Citalopram can cause drug-induced long QT syndrome (LQTS) and ventricular arrhythmias. We investigated the protective effect of nicorandil, a selective mitochondrial KATP (mito-KATP) channel opener, on LQTS and myocardial damage caused by citalopram in male rats. In a preliminary study, we determined that the minimum citalopram dose that prolonged the QT interval was 102 mg/kg injected intraperitoneally. For the main study, rats were divided randomly into five experimental groups: untreated control, normal saline + citalopram, nicorandil + citalopram, 5-hydroxydecanoate (5-HD) + citalopram, 5-HD + nicorandil + citalopram. Biochemical and histologic data from blood and heart tissue samples from six untreated control rats were evaluated. Electrocardiographic parameters including QRS duration, QT interval, corrected QT interval (QTc) and heart rate (HR) were assessed, and biochemical parameters including malondialdehyde, reduced glutathione, glutathione peroxidase, superoxide dismutase were measured. We also performed histomorphologic and immunohistochemical examination of heart tissue. Citalopram prolonged QT-QTc intervals significantly and increased significantly the histomorphologic score and proportion of apoptotic cells, but produced no differences in the oxidant and antioxidant parameters. Nicorandil did not prevent citalopram induced QT-QTc interval prolongation and produced no significant changes in oxidant and antioxidant parameters; however, it did reduce histologic damage and apoptosis caused by citalopram.
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Affiliation(s)
- Gozde Akturk
- Department of Medical Pharmacology, Dokuz Eylul University School of Medicine, Izmir, Turkey
- Department of Medical Pharmacology, Mustafa Kemal University School of Medicine, Hatay, Turkey
| | - Serap Cilaker Micili
- Department of Histology and Embryology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Ozlem Gursoy Doruk
- Department of Medical Biochemistry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Nil Hocaoglu
- Department of Medical Pharmacology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Pinar Akan
- Department of Medical Biochemistry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Bekir Ugur Ergur
- Department of Histology and Embryology, Dokuz Eylul University School of Medicine, Izmir, Turkey
- Department of Histology and Embryology, Kyrenia University School of Medicine, Kyrenia, Cyprus
| | - Samar Ahmed
- Department of Biochemistry, Dokuz Eylul University Graduate School of Health Sciences, Izmir, Turkey
| | - Sule Kalkan
- Department of Medical Pharmacology, Dokuz Eylul University School of Medicine, Izmir, Turkey
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Sahin O, Akturk G, Cilaker Micili S, Gursoy Doruk O, Karapinar F, Hocaoglu N, Ergur BU, Akan P, Tuncok Y, Kalkan S. Effect of the selective mitochondrial KATP channel opener nicorandil on the QT prolongation and myocardial damage induced by amitriptyline in rats. J Pharm Pharmacol 2023; 75:415-426. [PMID: 36527252 DOI: 10.1093/jpp/rgac089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 11/10/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES The aim of this study is to evaluate the protective effect of nicorandil, a selective mitochondrial KATP channel opener, on QT prolongation and myocardial damage induced by amitriptyline. METHODS The dose of amitriptyline (intraperitoneal, i.p.) that prolong the QT interval was found 75 mg/kg. Rats were randomized into five groups the control group, amitriptyline group, nicorandil (selective mitochondrial KATP channel opener, 3 mg/kg i.p.) + amitriptyline group, 5-hdyroxydecanoate (5-HD, selective mitochondrial KATP channel blocker, 10 mg/kg i.p.) + amitriptyline group and 5-HD + nicorandil + amitriptyline group. Cardiac parameters, biochemical and histomorphological/immunohistochemical examinations were evaluated. p < 0.05 was accepted as statistically significant. KEY FINDINGS Amitriptyline caused statistically significant prolongation of QRS duration, QT interval and QTc interval (p < 0.05). It also caused changes in tissue oxidant (increase in malondialdehyde)/anti-oxidant (decrease in glutathione peroxidase) parameters (p < 0.05), myocardial damage and apoptosis (p < 0.01 and p < 0.001). While nicorandil administration prevented amitriptyline-induced QRS, QT, QTc prolongation (p < 0.05), myocardial damage and apoptosis (p < 0.05), it did not affect the changes in oxidative parameters (p > 0.05). CONCLUSIONS Our results suggest that nicorandil, a selective mitochondrial KATP channel opener, plays a protective role in amitriptyline-induced QT prolongation and myocardial damage. Mitochondrial KATP channel opening and anti-apoptotic effects may play a role in the cardioprotective effect of nicorandil.
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Affiliation(s)
- Orhan Sahin
- Dokuz Eylul University, School of Medicine, Department of Medical Pharmacology, Izmir, Turkey
| | - Gozde Akturk
- Dokuz Eylul University, School of Medicine, Department of Medical Pharmacology, Izmir, Turkey.,Mustafa Kemal University, School of Medicine, Department of Medical Pharmacology, Hatay, Turkey
| | - Serap Cilaker Micili
- Dokuz Eylul University, School of Medicine, Department of Histology and Embryology, Izmir, Turkey
| | - Ozlem Gursoy Doruk
- Dokuz Eylul University, School of Medicine, Department of Medical Biochemistry, Izmir, Turkey
| | - Fazilet Karapinar
- Dokuz Eylul University, School of Medicine, Department of Medical Pharmacology, Izmir, Turkey
| | - Nil Hocaoglu
- Dokuz Eylul University, School of Medicine, Department of Medical Pharmacology, Izmir, Turkey
| | - Bekir Ugur Ergur
- Dokuz Eylul University, School of Medicine, Department of Histology and Embryology, Izmir, Turkey.,Kyrenia University, School of Medicine, Department of Histology and Embryology, Kyrenia, Cyprus
| | - Pinar Akan
- Dokuz Eylul University, School of Medicine, Department of Medical Biochemistry, Izmir, Turkey
| | - Yesim Tuncok
- Dokuz Eylul University, School of Medicine, Department of Medical Pharmacology, Izmir, Turkey
| | - Sule Kalkan
- Dokuz Eylul University, School of Medicine, Department of Medical Pharmacology, Izmir, Turkey
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Gokalp G, Nalbant T, Berksoy E, Bardak S, Demir G, Demir S, Sahin O, Hocaoglu N. Is hypoglycemia really observed in pediatric beta-blocker intoxications? A case-control study. Arch Pediatr 2021; 29:56-60. [PMID: 34848131 DOI: 10.1016/j.arcped.2021.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 07/14/2021] [Accepted: 10/03/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Beta-blocker (BB) intoxications are common in both childhood and adulthood. In the case of poisoning, bradycardia, hypotension, ventricular dysrhythmias, mental status changes, seizures, hypoglycemia, and bronchospasm may occur. Effects on the cardiovascular system are commonly seen, but hypoglycemia is not frequently observed in clinical practice. In this study, we aimed to answer the question, "Is hypoglycemia more commonly observed in BB intoxications than in other intoxications?" METHOD This was a case-control study conducted in a pediatric emergency department of a university hospital. The case group (Group 1) consisted of cases with BB poisonings and the control group (Group 2) consisted of cases with selective serotonin receptor inhibitor (SSRI) poisonings. Data were obtained from patient files. We recorded the blood glucose levels (BGLs) of all patients on admission to the emergency department and at the 1-, 6-, and 24-h follow-up. The amounts of BBs received by the cases were compared with the specific toxic doses of each drug. The data obtained were analyzed using the Statistical Package for the Social Sciences 22 (SPSS.22) program. Mean and standard deviation for numerical values and frequency for categorical data are reported; at test, chi-square test, and ANOVA tests were used for the analysis. RESULTS The study comprised 40 patients (Group 1) and 40 controls (Group 2). The mean serum BGLs of patients in Group 1 at admission and at the 1-, 6-, and 24-h follow-up were 107.2 ± 46.3 mg/dl, 86.3 ± 20.1 mg/dl, 88.6 ± 28.4 mg/dl, and 86.5 ± 23.7 mg/dl, respectively. The mean values of Group 2 cases were 100 ± 39.5 mg/dl, 92.1 ± 30 mg/dl, 91±28 mg/dl, and 127.8 ± 60.7 mg/dl, respectively, at admission and at the 1-, 6-, and 24-h follow-up (p = 0.4, p < 0.001, p = 0.7, and p < 0.001, respectively). The mean BGLs of patients who were exposed to propranolol at admission and at the 1-, 6-, and 24-h follow-up were significantly lower than those of the patients who had taken different BBs in Group 1. No linear correlation was found between the percentage of exposure to BB toxic doses and BGLs. CONCLUSION Our study showed that the BGLs of patients receiving BBs could be lower, but they were not at a level that would have serious consequences. Nevertheless, the BGLs of all cases of intoxication should be monitored closely.
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Affiliation(s)
- Gamze Gokalp
- Izmir Katip Celebi University Faculty of Medicine: Izmir Katip Celebi Universitesi Tip Fakultesi, Turkey; Dokuz Eylül University: Dokuz Eylul Universitesi Institute of Health Servises, Medical Pharmacology Depatment, Toxicology Devision, Turkey.
| | - Tugce Nalbant
- Izmir Tepecik Training and Research Hospital: TC Saglik Bakanligi Izmir Il Saglik Mudurlugu Izmir, Saglik Bilimleri Universitesi Tepecik Egitim ve Arastirma Hastanesi, Turkey
| | - Emel Berksoy
- Izmir Tepecik Training and Research Hospital: TC Saglik Bakanligi Izmir Il Saglik Mudurlugu Izmir, Saglik Bilimleri Universitesi Tepecik Egitim ve Arastirma Hastanesi, Turkey
| | - Sefika Bardak
- Izmir Tepecik Egitim ve Arastirma Hastanesi: TC Saglik Bakanligi Izmir Il Saglik Mudurlugu Izmir Saglik, Bilimleri Universitesi Tepecik Egitim ve Arastirma Hastanesi, Turkey
| | - Gulsah Demir
- Izmir Tepecik Egitim ve Arastirma Hastanesi: TC Saglik Bakanligi Izmir Il Saglik Mudurlugu Izmir Saglik, Bilimleri Universitesi Tepecik Egitim ve Arastirma Hastanesi, Turkey
| | - Sule Demir
- Izmir Tepecik Egitim ve Arastirma Hastanesi: TC Saglik Bakanligi Izmir Il Saglik Mudurlugu Izmir Saglik, Bilimleri Universitesi Tepecik Egitim ve Arastirma Hastanesi, Turkey
| | - Orhan Sahin
- Dokuz Eylül University: Dokuz Eylul Universitesi Institute of Health Servises, Medical Pharmacology Depatment, Toxicology Devision, Turkey
| | - Nil Hocaoglu
- Dokuz Eylül University: Dokuz Eylul Universitesi Institute of Health Servises, Medical Pharmacology Depatment, Toxicology Devision, Turkey; Dokuz Eylul University: Dokuz Eylul Universitesi, Faculty of Medicine, Pharmacology Depatment, Medical Toxicology Devision, Turkey
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Guven H, Durmus N, Hocaoglu N, Guner O, Acar S, Akan P, Calan OG. Protective effects of wheat germ oil against erectile and endothelial dysfunction in streptozotocin-induced diabetic rats. Int J Impot Res 2021; 34:581-587. [PMID: 34108653 DOI: 10.1038/s41443-021-00453-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 05/17/2021] [Accepted: 05/27/2021] [Indexed: 12/14/2022]
Abstract
Our aim was to investigate the protective effect of wheat germ oil (WGO) at different doses on diabetes mellitus (DM)-induced erectile and endothelial dysfunction. Twenty-four male Wistar rats weighing 250-300 g were divided into four groups as; control group treated with saline, DM group, DM group treated with 3 ml/kg WGO (DM + 3WGO group), DM group treated with 6 ml/kg WGO. Type 1 DM was induced by intraperitoneal injection of 60 mg/kg streptozotocin (STZ). STZ-induced diabetic rats received saline, 3 ml/kg WGO, and 6 ml/kg WGO via oral gavage daily for 5 weeks. The density of WGO used was 0.92 g/ml. The protective effect of WGO was evaluated by (i) in vitro vascular function, (ii) in vivo erectile function, and (iii) oxidative stress parameters in both aorta and penile tissue. Acetylcholine-mediated relaxation in the aorta and erectile functions decreased significantly in the DM group (p = 0.018 and p = 0.005). WGO (3 and 6 ml/kg) improved vascular functions in the DM groups (p = 0.001 and p = 0.014). The beneficial effect of WGO on erectile function appeared at higher doses of WGO. However, a higher dose of WGO substantially increased the oxidative stress parameters in both aorta and penile tissue. These findings suggest that the improvement in vascular or erectile function by WGO was not related to antioxidant effects, and new studies are needed to clarify the mechanism.
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Affiliation(s)
- Hulya Guven
- Department of Medical Pharmacology, Istanbul Yeni Yuzyıl University School of Medicine, Istanbul, Turkey.
| | - Nergiz Durmus
- Department of Medical Pharmacology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Nil Hocaoglu
- Department of Medical Pharmacology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Ozge Guner
- Department of Medical Pharmacology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Selin Acar
- Dokuz Eylul University, Institute of Health Sciences, Izmir, Turkey
| | - Pınar Akan
- Department of Medical Biochemistry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Ozlem Gursoy Calan
- Department of Medical Biochemistry, Dokuz Eylul University School of Medicine, Izmir, Turkey
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Kalkan S, Hocaoglu N, Buyukdelig M, Gurdal H. Binding of Amitriptyline to Adenosine A1 or A2a Receptors Using Radioligand Binding Assay. INT J PHARMACOL 2017. [DOI: 10.3923/ijp.2018.116.120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Aydin B, Yurtman MN, Kurtoglu AP, Yildiztepe E, Hocaoglu N, Tuncok Y, Kalkan S. Evaluation of Service Capacity of a Regional Drug and Poison Information Center: Analysis of Data in 2014. J Basic Clin Health Sci 2017. [DOI: 10.5152/jbachs.2017.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Dayar E, Kara E, Yetik-Anacak G, Hocaoglu N, Bozkurt O, Gidener S, Durmus N. Do penile haemodynamics change in the presence of hydrogen sulphide (H2S) donor in metabolic syndrome-induced erectile dysfunction? Andrologia 2017; 50. [DOI: 10.1111/and.12885] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2017] [Indexed: 12/30/2022] Open
Affiliation(s)
- E. Dayar
- Department of Pharmacology; Faculty of Medicine; Dokuz Eylül University; Izmir Turkey
| | - E. Kara
- Department of Pharmacology; Faculty of Medicine; Dokuz Eylül University; Izmir Turkey
| | - G. Yetik-Anacak
- Department of Pharmacology; Faculty of Medicine; Ege University; Izmir Turkey
| | - N. Hocaoglu
- Department of Pharmacology; Faculty of Medicine; Dokuz Eylül University; Izmir Turkey
| | - O. Bozkurt
- Department of Urology; Faculty of Medicine; Dokuz Eylül University; Izmir Turkey
| | - S. Gidener
- Department of Pharmacology; Faculty of Medicine; Dokuz Eylül University; Izmir Turkey
| | - N. Durmus
- Department of Pharmacology; Faculty of Medicine; Dokuz Eylül University; Izmir Turkey
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Saracoglu TM, Hocaoglu N, Yanturali S, Atilla R, Tanay Demirdoven B, Bayram B. Retrospective Analysis of Anticonvulsant Exposures Admitted to Department of Emergency Medicine in Dokuz Eylül University Hospital. J Basic Clin Health Sci 2017. [DOI: 10.5152/jbachs.2017.77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Hocaoglu N, Yildiztepe E, Bayram B, Aydin B, Tuncok Y, Kalkan S. Demographic and Clinical Characteristics of Theophylline Exposures between 1993 and 2011. Balkan Med J 2014. [DOI: 10.5152/balkanmedj.2014.13159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Oransay K, Hocaoglu N, Buyukdeligoz M, Tuncok Y, Kalkan S. The role of adenosine receptors and endogenous adenosine in citalopram-induced cardiovascular toxicity. Indian J Pharmacol 2014; 46:378-85. [PMID: 25097274 PMCID: PMC4118529 DOI: 10.4103/0253-7613.135948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 09/11/2013] [Accepted: 05/10/2014] [Indexed: 11/08/2022] Open
Abstract
Aim: We investigated the role of adenosine in citalopram-induced cardiotoxicity. Materials and Methods: Protocol 1: Rats were randomized into four groups. Sodium cromoglycate was administered to rats. Citalopram was infused after the 5% dextrose, 8-Cyclopentyl-1,3-dipropylxanthine (DPCPX; A1 receptor antagonist), 8-(-3-chlorostyryl)-caffeine (CSC; A2a receptor antagonist), or dimethyl sulfoxide (DMSO) administrations. Protocol 2: First group received 5% dextrose intraperitoneally 1 hour prior to citalopram. Other rats were pretreated with erythro-9-(2-hydroxy-3-nonyl) adenine (EHNA; inhibitor of adenosine deaminase) and S-(4-Nitrobenzyl)-6-thioinosine (NBTI; inhibitor of facilitated adenosine transport). After pretreatment, group 2 received 5% dextrose and group 3 received citalopram. Adenosine concentrations, mean arterial pressure (MAP), heart rate (HR), QRS duration and QT interval were evaluated. Results: In the dextrose group, citalopram infusion caused a significant decrease in MAP and HR and caused a significant prolongation in QRS and QT. DPCPX infusion significantly prevented the prolongation of the QT interval when compared to control. In the second protocol, citalopram infusion did not cause a significant change in plasma adenosine concentrations, but a significant increase observed in EHNA/NBTI groups. In EHNA/NBTI groups, citalopram-induced MAP and HR reductions, QRS and QT prolongations were more significant than the dextrose group. Conclusions: Citalopram may lead to QT prolongation by stimulating adenosine A1 receptors without affecting the release of adenosine.
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Affiliation(s)
- Kubilay Oransay
- Department of Pharmacology, Dokuz Eylul University, School of Medicine, Inciralti, Izmir, Turkey
| | - Nil Hocaoglu
- Department of Pharmacology, Dokuz Eylul University, School of Medicine, Inciralti, Izmir, Turkey
| | - Mujgan Buyukdeligoz
- Department of Pharmacology, Dokuz Eylul University, School of Medicine, Inciralti, Izmir, Turkey
| | - Yesim Tuncok
- Department of Pharmacology, Dokuz Eylul University, School of Medicine, Inciralti, Izmir, Turkey
| | - Sule Kalkan
- Department of Pharmacology, Dokuz Eylul University, School of Medicine, Inciralti, Izmir, Turkey
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Affiliation(s)
- Feriyde Çalişkan Tür
- Department of Emergency Medicine, S.B. Izmir Tepecik Research and Training Hospital, İzmir, Turkey
| | - Nur Zafer
- Department of Emergency Medicine, S.B. Izmir Tepecik Research and Training Hospital, İzmir, Turkey
| | - Nil Hocaoglu
- Department of Pharmacology, Dokuz Eylül University Medical School, Izmir, Turkey
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Aydin B, Hocaoglu N, Gidener S. Could decitabine treatment impair memory functions in humans? Med Hypotheses 2012; 79:639-41. [DOI: 10.1016/j.mehy.2012.07.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Accepted: 07/29/2012] [Indexed: 12/21/2022]
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Abstract
We investigated the contribution of endogenous adenosine to amitriptyline-induced cardiovascular toxicity in rats. A control group of rats was pretreated with intraperitoneal (i.p.) 5% dextrose and received intravenous 0.94 mg/kg/min of amitriptyline for 60 minutes. The second and third groups of rats pretreated with i.p. 10 mg/kg of erythro-9-(2-hydroxy-3-nonyl)adenine (EHNA), an adenosine deaminase inhibitor, and i.p. 1 mg/kg of S-(4-nitrobenzyl)-6-thioinosine (NBTI), a facilitated adenosine transport inhibitor, received 5% dextrose and amitriptyline infusion, respectively. Outcome parameters were mean arterial pressure (MAP), heart rate (HR), QT and QRS durations, and plasma adenosine concentrations. Plasma adenosine concentrations were increased in all groups. In the control group, amitriptyline decreased MAP and HR and prolonged QT and QRS durations after 10 minutes of infusion. In EHNA/NBTI-pretreated rats, amitriptyline prolonged QRS duration at 10 and 20 minutes. In EHNA/NBTI pretreated rats, amitriptyline-induced MAP, HR reductions, and QRS prolongations were more significant than that of dextrose-infusion-induced changes. Our results indicate that amitriptyline augmented the cardiovascular effects of endogen adenosine by increasing plasma levels of adenosine in rats.
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Affiliation(s)
- Sule Kalkan
- Department of Pharmacology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
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Bayram B, Hocaoglu N, Atilla R, Kalkan S. Effects of terlipressin in a rat model of severe uncontrolled hemorrhage via liver injury. Am J Emerg Med 2011; 30:1176-82. [PMID: 22100472 DOI: 10.1016/j.ajem.2011.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Revised: 08/24/2011] [Accepted: 09/08/2011] [Indexed: 10/15/2022] Open
Abstract
BACKGROUND Animal experiments and clinical studies have shown that vasopressin infusion in cases of uncontrolled hemorrhagic shock is a promising treatment. However, there are only a few studies regarding the application of terlipressin in hemorrhagic cases. This study was designed to evaluate the effects of terlipressin vs controlled fluid resuscitation on hemodynamic variables and abdominal bleeding in a rat model of uncontrolled hemorrhage via liver injury. METHODS A total of 21 average weight 250 ± 30 g Wistar rats were used. A midline celiotomy was performed, and approximately 65% of the median and left lateral lobes were removed with sharp dissection. After creation of the liver injury, rats were randomized into 1 of 3 resuscitation groups, the control group, Lactated Ringer's (LR) group, and terlipressin group, with 7 rats in each group. Blood samples were taken from rats for arterial blood gas analysis. At the end of the experiments, free intraperitoneal blood was collected on preweighed pieces of cotton, and the amount of free blood was determined by the difference in wet and dry weights. RESULTS In response to resuscitation, the terlipressin group demonstrated a significant elevation in mean arterial pressure (MAP). Blood loss was greater in the LR group compared with the control group (12.8 ± 1.9 mL vs 8.2 ± 0.7 mL, P < .05). At the end of the experiments, 5 rats in the control group, 5 in the LR group, and 2 in the terlipressin group died. The average survival rates were 28.6%, 28.6%, and 71.4%, respectively. CONCLUSIONS Compared with the control group, intravenous terlipressin bolus after liver injury contributed to an increase in MAP and survival rates without increasing abdominal bleeding.
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Affiliation(s)
- Basak Bayram
- School of Medicine, Department of Emergency Medicine, Dokuz Eylul University, Izmir, Turkey.
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Hocaoglu N, Kalkan S, Buyukdeligoz M, Oransay K, Tuncok Y. Is serum S100B protein a biomarker for amitriptyline-induced cardiovascular toxic effects? Cardiovasc Toxicol 2011; 12:115-22. [PMID: 22052576 DOI: 10.1007/s12012-011-9147-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The aim of this study was to assess the role of serum S100B protein as a biomarker for cardiovascular effects in an anesthetized rat model of amitriptyline toxicity. Adult male Wistar rats (n = 28) were randomized into four groups. While the control group received normal saline, the experimental groups received different doses of amitriptyline (0.625 or 0.94 or 1.25 mg/kg/min) infusion. Mean arterial pressure (MAP), heart rate (HR), electrocardiogram parameters, and serum S100B protein levels were recorded during the experiment. Linear Pearson's correlation coefficient was used to examine the association between cardiovascular parameters and serum levels of S100B protein. In the experimental groups, amitriptyline caused a significant decrease in MAP and HR (P < 0.001), a prolongation in QRS duration and QT intervals (P < 0.01), but it did not change PR intervals significantly. At the end of the experiment of the second group, a significant correlation was found between HR and serum S100B protein levels (r = -0.963, P = 0.037). At the end of the experiment of the third and fourth groups, a significant correlation between MAP, HR, all ECG parameters, and serum S100B protein levels was found. Serum S100B protein levels correlate well with amitriptyline-induced cardiovascular toxicity and can be used as a biomarker for predicting cardiovascular toxic effects of amitriptyline.
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Affiliation(s)
- Nil Hocaoglu
- Department of Medical Pharmacology, Dokuz Eylul University School of Medicine, Inciralti, 35340, Izmir, Turkey.
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Yuruktumen A, Hocaoglu N, Ersel M, Ozsarac M, Kiyan S. Acute Hepatitis Associated with Thymus Vulgaris Oil Ingestion; Case Report. Turk J Emerg Med 2011. [DOI: 10.5505/1304.7361.2011.79664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Oransay K, Kalkan S, Hocaoglu N, Arici A, Tuncok Y. An alternative antidote therapy in amitriptyline-induced rat toxicity model: theophylline. Drug Chem Toxicol 2010; 34:53-60. [DOI: 10.3109/01480545.2010.495947] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kalkan S, Hocaoglu N, Oransay K, Unverir P, Tuncok Y. Cardiovascular medication exposures and poisonings in Izmir, Turkey: A 14-year experience. Hum Exp Toxicol 2010; 30:347-53. [DOI: 10.1177/0960327110371256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cardiovascular medications (CVMs) are frequently prescribed for cardiovascular diseases. The unconscious use of cardiovascular drugs may lead to severe clinical manifestations, even to death, especially when in overdose. The objective of this study is to clarify the profile of CVM exposures admitted to Department of Emergency Medicine in Dokuz Eylul University Hospital (EMDEU) between 1993 and 2006. Case demographics, type of the medication, route and reason for exposure, clinical effects and outcome were recorded. Related to the CVM exposures, 105 poisoning cases were admitted. Mean age of children and adults were 12.8 ± 1.0 and 30.1 ± 1.8, respectively. Females were dominating (77.1%). Poisoning by accident occurred mainly among children in the 0—6 age group (64.3%) and suicide attempt was predominant in the 19—29 age group (47.8%). The most common ingested CVMs admitted to EMDEU were calcium channel blockers (19.7%), beta-blockers (17.3%), angiotensin converting enzyme inhibitors and diuretics (11.8%). Most of the patients were asymptomatic (59.1%). Frequently observed symptom was altered consciousness (18.6%). Antihypertensive drugs are responsible for the most of the CVM exposures. Prospectively designed multi-centered studies are needed to reflect the epidemiological properties of cardiovascular drug exposures throughout our country and would be very valuable for the determination of preventive measures.
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Affiliation(s)
- Sule Kalkan
- Department of Pharmacology, Dokuz Eylul University School of Medicine, Inciralti, Izmir Turkey,
| | - Nil Hocaoglu
- Department of Pharmacology, Dokuz Eylul University School of Medicine, Inciralti, Izmir Turkey
| | - Kubilay Oransay
- Department of Pharmacology, Dokuz Eylul University School of Medicine, Inciralti, Izmir Turkey
| | - Pinar Unverir
- Department of Emergency Medicine, Dokuz Eylul University School of Medicine, Balcova, Izmir, Turkey
| | - Yesim Tuncok
- Department of Pharmacology, Dokuz Eylul University School of Medicine, Inciralti, Izmir Turkey
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Kalkan S, Hocaoglu N, Arici A(A, Oransay K, Ergor G, Tuncok Y. Effects of Adenosine Receptor Antagonists on Survival in Amitriptyline-poisoned Mice. Drug Chem Toxicol 2010; 33:233-7. [DOI: 10.3109/01480540903130690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kalkan S, Ozdemir D, Ergur BU, Hazardın NU, Akgun A, Topcu A, Kaplan YC, Hocaoglu N, Oransay K, Tuncok Y. Protective Effect of an Adenosine A1Receptor Agonist Against Metamidophos-Induced Toxicity and Brain Oxidative Stress. Toxicol Mech Methods 2009; 19:148-53. [DOI: 10.1080/15376510802355141] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Akgun A, Kalkan S, Hocaoglu N, Gidener S, Tuncok Y. Effects of adenosine receptor antagonists onamitriptyline-induced QRS prolongation in isolated rat hearts. Clin Toxicol (Phila) 2009; 46:677-85. [DOI: 10.1080/15563650701338237] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Kalkan S, Hocaoglu N, Akgun A, Oransay K, Ergor G, Tuncok Y. Effects of adenosine receptor antagonists on survival in amitriptyline-poisoned mice. Toxicol Lett 2008. [DOI: 10.1016/j.toxlet.2008.06.760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kalkan S, Hocaoglu N, Oransay K, Unverir P, Tuncok Y. Cardiovascular medication exposures reported to Drug and Poison Information Center (DPIC) in Izmir, Turkey: A 14 year experience. Toxicol Lett 2008. [DOI: 10.1016/j.toxlet.2008.06.759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Oray NC, Hocaoglu N, Oray D, Demir O, Atilla R, Tuncok Y. Sedative-Hypnotic Medication Exposures and Poisonings in Izmir, Turkey*. Basic Clin Pharmacol Toxicol 2008; 103:380-5. [DOI: 10.1111/j.1742-7843.2008.00303.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Oransay K, Kalkan S, Hocaoglu N, Arici A, Tuncok Y. A promising antidote for amitriptyline-induced cardiovascular toxicity: Theophylline. Toxicol Lett 2008. [DOI: 10.1016/j.toxlet.2008.06.758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Pancytopenia is a rare but serious adverse effect of low-dose methotrexate (MTX) sodium therapy, and this case report describes a very early-onset of pancytopenia and cutaneous lesions after three days of ingestion. A 64-year-old man was presented to Emergency Department with weakness, fever, poor appetite, nausea, and vomiting after he had had accidentally ingested MTX tablets (2.5 mg) twice a day for the last three days. On initial examination, several painful lesions in his oral mucosa and a cutaneous ulceration on his right foot were also observed. He had severe pancytopenia, poor kidney functions, and abnormal coagulation parameters. The blood level of MTX was found to be within therapeutic range. He was treated with leucovorine, intravenous antibiotics, and appropriate blood transfusions; he was discharged from hospital without any sequela. Pancytopenia associated with low-dose (cumulative dose of 15 mg in 3 days) MTX therapy had not been reported previously. The Naranjo probability scale showed pancytopenia and skin ulcer associated with low-dose MTX therapy as probable adverse reactions. Risk factors for pancytopenia such as renal insufficiency, hypoalbuminemia, low folate levels, concomitant infections, concomitant use of drugs, and folate supplementation were not identified in our patient. Although pancytopenia associated with low-dose MTX therapy is not expected as early as 3 days after initiation of the therapy, physicians should also be aware of this life threatening adverse effect during the very first days of MTX therapy for rheumatoid arthritis patients.
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Affiliation(s)
- N Hocaoglu
- Staff of Pharmacology, Department of Pharmacology, Dokuz Eylul University, School of Medicine, Izmir, Turkey
| | - R Atilla
- Department of Emergency Medicine, Dokuz Eylul University, School of Medicine, Izmir, Turkey
| | - F Onen
- Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Y Tuncok
- Staff of Pharmacology, Department of Pharmacology, Dokuz Eylul University, School of Medicine, Izmir, Turkey
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Abstract
The aim of this study was to investigate the effect of glucagon on cardiovascular parameters in anesthetized rat model of tricyclic antidepressant overdose. Toxicity was induced by infusion of amitriptyline 0.94 mg/kg/min until a 40–45% of reduction in mean arterial pressure was observed. Amitriptyline infusion rats were then randomized into three groups. Control group of rats (group 1) received a bolus of 5% dextrose followed by the continuous infusion of dextrose, whereas treatment groups received 1 mg/kg (group 2) or 2 mg/kg (group 3) bolus doses of glucagon followed by continuous infusion (0.1 mg/kg/min) of glucagons for 60 min. Mean arterial pressure, heart rate, and electrocardiogram were recorded. Amitriptyline caused a significant decrease in mean arterial pressure and a prolongation in QRS, yet it did not change the heart rate. High-bolus dose of glucagon (2 mg/kg) followed by glucagon infusion significantly increased mean arterial pressure at 40, 50, and 60 min ( P < 0.05) and shortened the prolonged QRS at 50 and 60 min ( P < 0.05) when compared with control group. There was also a significant increase in heart rate. In conclusion, bolus doses followed by a continuous infusion of glucagon were found to be effective in reversing the hypotension and QRS prolongation in the rat model of amitriptyline toxicity. Further studies are needed to reveal the exact mechanism of the proposed effect.
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Affiliation(s)
- YC Kaplan
- Dokuz Eylul University School of Medicine, Department of Pharmacology, Inciralti, 35340 Izmir, Turkey
| | - N Hocaoglu
- Dokuz Eylul University School of Medicine, Department of Pharmacology, Inciralti, 35340 Izmir, Turkey
| | - K Oransay
- Dokuz Eylul University School of Medicine, Department of Pharmacology, Inciralti, 35340 Izmir, Turkey
| | - S Kalkan
- Dokuz Eylul University School of Medicine, Department of Pharmacology, Inciralti, 35340 Izmir, Turkey
| | - Y Tuncok
- Dokuz Eylul University School of Medicine, Department of Pharmacology, Inciralti, 35340 Izmir, Turkey
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Abstract
The objective of this study is to analyze exposures concerning analgesics that were reported to Dokuz Eylul University Drug and Poison Information Center (DPIC) and admitted to the Department of Emergency Medicine in Dokuz Eylul University Hospital (EMDEU) between 1993 and 2004. Demographics of the patients, characteristics of analgesic exposures, performed treatment attempts and outcome of the poisoned patients were recorded on standard data forms and were then entered into a computerized database program. Statistical analysis was performed by using the chi-square test. The DPIC recorded 55 962 poisoning calls, 48 654 (86.9%) of them related to medicines. Analgesics accounted for 16.3% (7 939 cases) of all medicine-related exposures; among them 446 exposures were admitted to EMDEU. More than half of the analgesic exposure calls and admitted cases involved adults (55.9%, 4 440). Females dominated in all age groups (70.3%, 5 578). Mean age was 20.2 +/- 11.8. The most involved analgesics were paracetamol (47.9%), propionic acid derivatives (16.1%) and salicylates (13.7%). Most of the poisonings were intentional (75.1%), especially in 19-29 years age group of adults and 13-18 years age group of children. Most of the patients reported to DPIC and admitted to EMDEU were asymptomatic (84.4% and 54.7%, respectively). Gastrointestinal decontamination methods were performed more frequently for admitted poisoning cases before hospital admission than reported poisoning cases (61% vs. 23%). Paracetamol ingestion was the most common cause of analgesic exposures reported to our DPIC. Most of the analgesic exposures reported to DPIC were asymptomatic or mild. DPICs have an important role for the referral of analgesic exposures without unnecessary gastrointestinal decontamination procedures.
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Affiliation(s)
- Nil Hocaoglu
- Department of Pharmacology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
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Kalkan S, Hocaoglu N, Akgun A, Gidener S, Tuncok Y. Effects of adenosine receptor antagonists on amitriptyline-induced vasodilation in rat isolated aorta. Clin Toxicol (Phila) 2007; 45:600-4. [PMID: 17558638 DOI: 10.1080/15563650701397068] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Although we have previously demonstrated the beneficial effects of adenosine receptor antagonists in preventing cardiovascular toxicity of amitriptyline in rats, it is not clear whether adenosine receptors in heart or in vasculature are dominant. The aim of the current study was to investigate the role of adenosine A(2a) receptors on amitriptyline-induced vasodilation in rat isolated aorta. METHODS After determining EC(80) of noradrenalin (NA) (the concentration of noradrenalin that produces 80% of maximal contractile response) as 10(-5)M, the IC(50) value of amitriptyline was measured in rat isolated aorta (the drug concentration causing a half- maximal inhibition of contractile responses to NA); IC(50) of amitriptyline was then compared in the presence of the DPCPX (a selective adenosine A(1) antagonist), CSC (a selective A(2a) antagonist) or DMSO (a solvent for adenosine antagonists). Statistical analysis was done using the Student t test. RESULTS Amitriptyline-inhibited 49.9 +/- 3.7 % contractile response to NA on aorta segments at 1.8 x 10(-5)M (IC(50)). While DPCPX increased amitriptyline-induced inhibition on contractile response to NA dose dependently, CSC decreased the contractile response to NA only at 10(-5)M. DMSO did not change amitriptyline-induced IC(50). CONCLUSION Adenosine A(2a) receptor stimulation seems to be responsible partly for amitriptyline-induced vasodilation and hypotension since the adenosine A(1) antagonist, DPCPX, increased amitriptyline-induced vasodilation in rat isolated aorta.
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Affiliation(s)
- Sule Kalkan
- Dokuz Eylul University, School of Medicine, Department of Pharmacology, Izmir, Turkey.
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Murat N, Hocaoglu N, Karatosun V, Yorukoglu K, Gidener S, Gunal I. The effects of non-selective and cyclooxygenase-2-selective non-steroidal anti-inflammatory drugs on heterotopic ossification in rats. Med Sci Monit 2005; 11:BR449-51. [PMID: 16319781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2004] [Accepted: 04/07/2005] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Review of the literature revealed several experimental studies on the effects of selective COX-2 inhibitors on fracture healing, but no reports were encountered regarding the effects of these compounds on experimental heterotopic bone formation, so the present study was conducted. MATERIAL/METHODS Thirty adult male Wistar rats were divided into three groups of ten animals each. Tibial and femoral bones were collected from the rats, cleaned and demineralized, and diaphyseal parts were implanted in muscle pouches created in the right gluteal region, one into each rat. Group 1 received DFU (5,5-dimethyl-3-(3-fluorophenyl)-4-(4-methylsulphonyl)phenyl-2(5H)-furanone), a highly selective COX-2 inhibitor, at a dose of 1.1 mg/kg/day. Group 2 received 2 mg/kg/day of indomethacin. The drugs were administered by oral gavage with 0.5% methyl cellulose as a delivery vehicle for eleven days, beginning on the first postoperative day. Group 3 received only methyl cellulose. RESULTS Thirty days after the implantation of the demineralized bone matrix, 6/10 of DFU-treated, 9/9 of the indomethacin-treated, and 8/9 of the control rats displayed new bone formation. CONCLUSIONS The results of this study suggest that no form of non-steroidal anti-inflammatory drug has inhibitory effects on heterotopic bone formation in rats. In our opinion, bone formation is a quite complex process that requires several events and is regulated by several factors, so further investigations other than those using non-steroidal anti-inflammatory drugs are required.
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Affiliation(s)
- Nergiz Murat
- Department of Pharmacology, Dokuz Eylul University Hospital, Izmir, Turkey
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Gumustekin M, Kalkan S, Murat N, Gur O, Hocaoglu N, Gidener S. The role of circadian rhythm on the pharmacokinetic of methotrexate in streptozotocin-induced diabetes mellitus rats. BIOL RHYTHM RES 2005. [DOI: 10.1080/09291010500079692] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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