Lux F, Brase D A, Dewey W L
Department of Pharmacology and Toxicology, Medical College of Virginia/Virginia Commonwealth University, Richmond.
J Pharmacol Exp Ther. 1988 Apr;245(1):187-94.
The s.c. administration of morphine (2.5-80 mg/kg) produced a dose-dependent hyperglycemia, whereas morphine (12.5-50 micrograms) given i.t. in the lumbar region caused a dose-dependent hypoglycemia in unanesthetized mice. Both effects on blood glucose were antagonized by s.c. naloxone, although inhibition of i.t. morphine required a higher naloxone dose. Naloxone pretreatment with 2 mg/kg, but not 1 mg/kg s.c., potentiated a hyperglycemic response to i.t. saline. High i.t. doses of morphine caused an early (within 2 min) scratching behavior that was not inhibited by naloxone or glucose loading and a later (greater than 20 min) tonic convulsive behavior (opisthotonus). Lethality was partially inhibited by glucose loading which delayed, but did not prevent, the hypoglycemic effect of i.t. morphine. The hypoglycemic effect of i.t. morphine was also delayed in streptozotocin-diabetic ICR mice and diabetic (db/db) C57BL/KsJ mice, but the latter were more sensitive to lethality, which occurred without hypoglycemia or seizures. All these effects of i.t. morphine were completely blocked by acute spinal transection of T10-T11, but the nociceptive, hypoglycemic and opisthotonic effects were not mimicked by i.c.v. morphine (6.25-50 micrograms) in ICR mice, which showed a bell-shaped hyperglycemic dose-response relationship and a brief explosive motor behavior at the higher doses (25-50 micrograms). It is concluded that the effects of morphine on blood glucose and on behavior are dependent upon the route of administration, and that the convulsive effect of i.t. morphine may be facilitated by the production of a profound hypoglycemia, which involves a spinal, rather than supraspinal or systemic, action of morphine.
皮下注射吗啡(2.5 - 80毫克/千克)会产生剂量依赖性高血糖,而在未麻醉小鼠的腰部进行鞘内注射吗啡(12.5 - 50微克)则会引起剂量依赖性低血糖。皮下注射纳洛酮可拮抗这两种对血糖的影响,不过抑制鞘内注射吗啡引起的反应所需的纳洛酮剂量更高。以2毫克/千克而非1毫克/千克皮下注射进行纳洛酮预处理,会增强对鞘内注射生理盐水的高血糖反应。高剂量鞘内注射吗啡会引发早期(2分钟内)抓挠行为,该行为不受纳洛酮或葡萄糖负荷抑制,以及后期(超过20分钟)强直性惊厥行为(角弓反张)。葡萄糖负荷可部分抑制致死率,其虽延迟但未阻止鞘内注射吗啡的低血糖作用。鞘内注射吗啡的低血糖作用在链脲佐菌素诱导的糖尿病ICR小鼠和糖尿病(db/db)C57BL/KsJ小鼠中也会延迟出现,但后者对致死率更敏感,致死率出现时无低血糖或惊厥现象。鞘内注射吗啡的所有这些作用均被T10 - T11节段的急性脊髓横断完全阻断,但在ICR小鼠中,脑室内注射吗啡(6.25 - 50微克)不会模拟伤害性、低血糖和角弓反张作用,脑室内注射吗啡呈现钟形高血糖剂量 - 反应关系,且在较高剂量(25 - 50微克)时会出现短暂的爆发性运动行为。结论是,吗啡对血糖和行为的影响取决于给药途径,鞘内注射吗啡的惊厥作用可能因严重低血糖的产生而加剧,这涉及吗啡的脊髓而非脊髓以上或全身作用。