Bujalska-Zadrożny Magdalena, Kulik Kamila, Ordak Michał, Sasinowska-Motyl Małgorzata, Gąsińska Emilia, de Corde Anna, Kowalczyk Agnieszka, Sacharczuk Mariusz, Naruszewicz Marek
Department of Pharmacodynamics, Centre for Preclinical Research and Technology, Medical University of Warsaw, Warsaw, Poland.
Chair and Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland.
PLoS One. 2016 Oct 28;11(10):e0161776. doi: 10.1371/journal.pone.0161776. eCollection 2016.
As previously reported, magnesium sulphate administered parenterally significantly increased an opioid antinociception in different kinds of pain. Since the typical form of magnesium salts are poorly and slowly absorbed from the gastrointestinal tract we examined whether their micronized form could increase opioids induced antinociception.
In behavioural studies on rats morphine, tramadol and oxycodone together with magnesium (lactate dihydrate, hydroaspartate, chloride) in micronized (particles of size D90 < 50 μm) and conventional forms were used. Changes in pain thresholds were determined using mechanical stimuli. The intestinal absorption of two forms of magnesium lactate dihydrate (at the doses of 7.5 or 15 mg ions) in the porcine gut sac model were also compared.
Micronized form of magnesium lactate dihydrate or hydroaspartate but not chloride (15 mg of magnesium ions kg-1) enhanced the analgesic activity of orally administered opioids, significantly faster and more effective in comparison to the conventional form of magnesium salts (about 40% for oxycodone administered together with a micronized form of magnesium hydroaspartate). Moreover, in vitro studies of transport across porcine intestines of magnesium ions showed that magnesium salts administered in micronized form were absorbed from the intestines to a greater extent than the normal form of magnesium salts.
The co-administration of micronized magnesium organic salts with opioids increased their synergetic analgesic effect. This may suggest an innovative approach to the treatment of pain in clinical practice.
如先前报道,胃肠外给予硫酸镁可显著增强阿片类药物对不同类型疼痛的镇痛作用。由于镁盐的典型形式从胃肠道吸收较差且缓慢,我们研究了其微粉化形式是否能增强阿片类药物诱导的镇痛作用。
在大鼠行为学研究中,使用了吗啡、曲马多和羟考酮,以及微粉化(粒径D90 < 50μm)和常规形式的镁(乳酸二水合物、天门冬氨酸氢镁、氯化镁)。使用机械刺激测定疼痛阈值。还比较了猪肠囊模型中两种形式的乳酸二水合镁(剂量为7.5或15mg离子)的肠道吸收情况。
微粉化的乳酸二水合镁或天门冬氨酸氢镁而非氯化镁(15mg镁离子/kg)增强了口服阿片类药物的镇痛活性,与常规形式的镁盐相比,起效显著更快且更有效(与微粉化的天门冬氨酸氢镁一起给予羟考酮时约提高40%)。此外,镁离子跨猪肠道转运的体外研究表明,微粉化形式的镁盐比正常形式的镁盐从肠道吸收的程度更大。
微粉化有机镁盐与阿片类药物联合使用可增强其协同镇痛效果。这可能为临床实践中的疼痛治疗提示一种创新方法。