Dexmedetomidine and ST-91 analgesia in the formalin model is mediated by alpha2A-adrenoceptors: a mechanism of action distinct from morphine

BACKGROUND AND PURPOSE

Intrathecal administration of alpha(2)-adrenoceptor agonists produces potent analgesia. This study addressed the subtype of spinal alpha(2)-adrenoceptor responsible for the analgesic effects of i.t. dexmedetomidine and ST-91 in the formalin behavioural model and their effects on primary afferent substance P (SP) release and spinal Fos activation.

EXPERIMENTAL APPROACH

The analgesic effects of i.t. dexmedetomidine and ST-91 (alpha(2) agonists) were tested on the formalin behavioural model. To determine the subtype of alpha(2)-adrenoceptor involved in the analgesia, i.t. BRL44408 (alpha(2A) antagonist) or ARC239 (alpha(2B/C) antagonist) were given before dexmedetomidine or ST-91. Moreover, the ability of dexmedetomidine and ST-91 to inhibit formalin-induced release of SP from primary afferent terminals was measured by the internalization of neurokinin(1) (NK(1)) receptors. Finally, the effects of dexmedetomidine on formalin-induced Fos expression were assessed in the dorsal horn.

KEY RESULTS

Intrathecal administration of dexmedetomidine or ST-91 dose-dependently reduced the formalin-induced paw-flinching behaviour in rats. BRL44408 dose-dependently blocked, whereas ARC239 had no effect on the analgesic actions of dexmedetomidine and ST-91. Dexmedetomidine and ST-91 had no effect on the formalin-induced NK(1) receptor internalization, while morphine significantly reduced the NK(1) receptor internalization. On the other hand, both dexmedetomidine and morphine diminished the formalin-induced Fos activation. The effect of dexmedetomidine on formalin-induced Fos activation was reversed by BRL44408, but not ARC239.

CONCLUSION AND IMPLICATIONS

These findings suggest that alpha(2A)-adrenoceptors mediate dexmedetomidine and ST-91 analgesia. This effect could be through a mechanism postsynaptic to primary afferent terminals, distinct from that of morphine.

Effectiveness of a genetics self-instructional module for nurses involved in egg donor screening

OBJECTIVE

To evaluate the effectiveness of a self-instructional module in increasing nurses' knowledge of genetics.

DESIGN

Pretest/posttest study design. Participants completed a pretest questionnaire used to measure baseline knowledge of basic human genetic concepts and risk assessment and collect descriptive data. Participants then reviewed a self-instructional module and completed a posttest questionnaire.

SETTING

Study materials were mailed to 262 registered nurses involved in screening egg donors at 177 reproductive health centers in the United States from July to September 2000.

PARTICIPANTS

Sixty-five registered nurses working at reproductive health centers. One hundred of 262 eligible nurses completed the pretest (38% return rate) and 65 of these 100 nurses also completed the posttest (65% retention rate).

INTERVENTION

A 22-page self-instructional booklet on genetic risk assessment.

MAIN OUTCOME MEASURES

Pretest and posttest responses.

RESULTS

There was a significant increase of 20.8% in participants' mean knowledge score on the posttest (M = 89.0%, SD = 8%, range = 67%-100%) as compared with the pretest (M = 69.0%, SD = 12%, range = 42%-92%), based on paired t-test analysis (t = 11.74, SE = 0.426, p < .0001).

CONCLUSION

A genetics self-instructional module for registered nurses was effective in increasing knowledge of basic human genetic concepts and risk assessment. More in-depth independent study programs in genetics for nurses are recommended.

Changes in thymidine uptake in the gastrointestinal tract of the rat following treatment with 16,16-dimethyl prostaglandin E2

Thymidine uptake in the organs of the gastrointestinal tract of the rat was studied to determine if cell synthesis was involved in the increases in weight of the stomach, small intestine and colon which result from treatment with 16,16-dimethyl prostaglandin E2 (16,16-dimethyl PGE2). Animals were treated for 2 days with 16,16-dimethyl PGE2. They were injected with the 3H-thymidine, sacrificed and the organs of interest were removed. The total amount of tritium in the stomach, duodenum, jejunum, ileum, and colon was determined. Thymidine uptake was significantly increased in the duodenum (1.50 times), jejunum (1.53 times), and colon (1.40 times) but not in the stomach and ileum. The increases were dose related in the duodenum and jejunum. The colon showed a similar dose response pattern but the changes with dose did not reach significance. These results confirm and extend a previous report that 16,16-dimethyl PGE2 increased thymidine uptake in the duodenum but not the stomach. This is different from gastrin which has been shown by others to increase thymidine uptake in the stomach, duodenum, ileum and colon.

Partial characterization of the gastrointestinal weight changes produced in the female rat by 16,16-dimethylprostaglandin E2

Oral and subcutaneous administration of 16,16-dimethylprostaglandin E2 (16,16-dimethyl PGE2) resulted in an increase in the dry weight of the stomach and small intestine of the female rat. This weight response was rapid, controlled rather than continuously progressing, dose dependent and reversible. The dry weight of the colon also increased but this was not studied in detail. Two-day treatment with 16,16-dimethyl PGE2 caused an increase in the incorporation of 3H-thymidine into the duodenum, jejunum and colon suggesting an increase in cell number. Incorporation into the stomach and ileum was not changed. The number of goblet cells per crypt was increased by prostaglandin treatment in all parts of the small intestine. Since these are mucus producing cells, the small intestine may have increased in cell number and mucus production. Both anti-secretory and cytoprotective doses of 16,16-dimethyl PGE2 caused weight increases in the stomach and small intestine. However, the weight gain by itself was not sufficient to protect the stomach or small intestine from necrotic agents after the prostaglandin was discontinued.