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诺氧吗啡作为一种新型脊髓镇痛阿片类药物的药理学特性

Pharmacological characterization of noroxymorphone as a new opioid for spinal analgesia.

作者信息

Lemberg Kim K, Siiskonen Antti O, Kontinen Vesa K, Yli-Kauhaluoma Jari T, Kalso Eija A

机构信息

Institute of Biomedicine/Pharmacology, P. O. Box 63, FI-00014 University of Helsinki, Finland.

出版信息

Anesth Analg. 2008 Feb;106(2):463-70, table of contents. doi: 10.1213/ane.0b013e3181605a15.

Abstract

BACKGROUND

Noroxymorphone is one of the major metabolites of oxycodone. Although oxycodone is commonly used in the treatment of acute and chronic pain, little is known about the antinociceptive effects of noroxymorphone. We present an in vivo pharmacological characterization of noroxymorphone in rats.

METHODS

The antinociceptive properties of noroxymorphone were studied with thermal and mechanical models of nociception in rats.

RESULTS

Intrathecal noroxymorphone (1 and 5 microg/10 microL) induced a significantly longer lasting antinociceptive effect compared with oxycodone (200 microg/10 microL) and morphine (1 and 5 microg/10 microL). Pretreatment with subcutaneous naloxone (1 mg/kg) 15 min before intrathecal drug administration significantly decreased the antinociceptive effect of both noroxymorphone and morphine, indicating an opioid receptor-mediated antinociceptive effect. In the hotplate, paw pressure, and tail flick tests, subcutaneous noroxymorphone was inactive in doses of 5, 10, and 25 mg/kg. Also, no effect on motor function was observed in the rotarod test with doses studied. No antihyperalgesic effect was observed in the carrageenan model for inflammation in rats with subcutaneous noroxymorphone 25 mg/kg.

CONCLUSIONS

The results of this study indicate that noroxymorphone is a potent mu-opioid receptor agonist when administered intrathecally. The lack of systemic efficacy may indicate reduced ability of noroxymorphone to penetrate the blood-brain barrier due to its low calculated logD value (log octanol/water partition coefficient). Thus, noroxymorphone should have a negligible role in analgesia after systemic administration of oxycodone. Because of its spinal efficacy and long duration of effect, noroxymorphone is an interesting opioid for spinal analgesia with a low potential for abuse. Its safety for spinal administration should be assessed before clinical use.

摘要

背景

去甲羟考酮是羟考酮的主要代谢产物之一。尽管羟考酮常用于治疗急慢性疼痛,但对去甲羟考酮的镇痛作用了解甚少。我们展示了去甲羟考酮在大鼠体内的药理学特征。

方法

采用大鼠疼痛的热和机械模型研究去甲羟考酮的镇痛特性。

结果

与羟考酮(200μg/10μL)和吗啡(1和5μg/10μL)相比,鞘内注射去甲羟考酮(1和5μg/10μL)诱导的镇痛作用持续时间明显更长。鞘内给药前15分钟皮下注射纳洛酮(1mg/kg)预处理显著降低了去甲羟考酮和吗啡的镇痛作用,表明其镇痛作用是由阿片受体介导的。在热板、爪压和甩尾试验中,皮下注射去甲羟考酮5、10和25mg/kg剂量时无活性。此外,在所研究的剂量下,在转棒试验中未观察到对运动功能的影响。皮下注射去甲羟考酮25mg/kg对大鼠角叉菜胶炎症模型未观察到抗痛觉过敏作用。

结论

本研究结果表明,鞘内给药时去甲羟考酮是一种有效的μ-阿片受体激动剂。缺乏全身疗效可能表明去甲羟考酮由于其计算出的低logD值(正辛醇/水分配系数)穿透血脑屏障的能力降低。因此,去甲羟考酮在羟考酮全身给药后的镇痛作用中作用可忽略不计。由于其脊髓效能和长效作用,去甲羟考酮是一种有趣的用于脊髓镇痛且滥用潜力低的阿片类药物。其脊髓给药的安全性在临床使用前应进行评估。

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