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吗啡对清醒犬胃肠道运动的中枢作用。

Central effects of morphine on GI motility in conscious dogs.

作者信息

Takahashi Toku, Tsuchida Daisuke, Pappas Theodore N

机构信息

Department of Surgery, Duke University Medical Center, Durham, NC 27705, USA.

出版信息

Brain Res. 2007 Aug 29;1166:29-34. doi: 10.1016/j.brainres.2007.06.048. Epub 2007 Jul 10.

Abstract

It has been suggested that morphine has dual effects; emetic effects and anti-emetic effects. The chemoreceptor trigger zone, which is outside the BBB, mediates the emetic effect. In contrast, the vomiting center mediates the anti-emetic effect of opioids. Thus, naloxone methiodide, which does not cross the BBB, antagonizes emetic effects of opioids. We studied whether naloxone methiodide alters abnormal motility pattern induced by morphine in gastrointestinal (GI) tract. Strain gauge force transducers were sutured on the serosal surface of upper GI tract to record the circular muscle contractions in eight dogs. The ventricular access system was implanted to inject morphine intracerebroventricularly (icv). Effects of icv-injection of morphine (0.3-3.0 mug/kg, bolus) on GI motility were studied during intravenous infusion of naloxone hydrochloride or naloxone methiodide. Icv-injection of morphine (3.0 mug/kg) induced retching and vomiting in all dogs tested. Phasic contractions of the jejunum were observed after icv-injection of morphine. These contractions in the jejunum migrated orally to the antrum (retrograde peristaltic contractions; RPCs). Both naloxone hydrochloride and naloxone methiodide treatment virtually abolished the emetic effects of morphine. Naloxone hydrochloride completely abolished morphine-induced RPCs in all dogs, whereas naloxone methiodide converted morphine-induced RPCs to anterograde peristaltic contractions (APCs) in 6 of 8 dogs. Our current study suggests that central opioids may induce APCs and prevent emesis in conscious dogs. Naloxone methiodide may be useful to prevent the undesired side effects of morphine.

摘要

有人提出吗啡具有双重作用

催吐作用和止吐作用。位于血脑屏障之外的化学感受器触发区介导催吐作用。相比之下,呕吐中枢介导阿片类药物的止吐作用。因此,不能穿过血脑屏障的甲硫碘化纳洛酮可拮抗阿片类药物的催吐作用。我们研究了甲硫碘化纳洛酮是否会改变吗啡诱导的胃肠道异常运动模式。将应变片式力传感器缝合在上消化道浆膜表面,以记录8只犬的环行肌收缩情况。植入心室通路系统以便脑室内注射吗啡。在静脉输注盐酸纳洛酮或甲硫碘化纳洛酮期间,研究脑室内注射吗啡(0.3 - 3.0微克/千克,推注)对胃肠动力的影响。脑室内注射吗啡(3.0微克/千克)在所有受试犬中均诱发干呕和呕吐。脑室内注射吗啡后观察到空肠的相性收缩。空肠的这些收缩向口腔方向移行至胃窦(逆行蠕动收缩;RPCs)。盐酸纳洛酮和甲硫碘化纳洛酮治疗几乎完全消除了吗啡的催吐作用。盐酸纳洛酮在所有犬中完全消除了吗啡诱导的RPCs,而甲硫碘化纳洛酮在8只犬中的6只中将吗啡诱导的RPCs转变为顺行蠕动收缩(APCs)。我们目前的研究表明,中枢阿片类药物可能诱导清醒犬出现APCs并预防呕吐。甲硫碘化纳洛酮可能有助于预防吗啡的不良副作用。

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