Wilcox G L, Carlsson K H, Jochim A, Jurna I
Brain Res. 1987 Mar 3;405(1):84-93. doi: 10.1016/0006-8993(87)90992-9.
Clonidine and morphine depress nociceptive reflex responses when given alone; when given in combination, the effect of each is potentiated by the other. The present study was designed to test if activity in ascending axons evoked by electrical stimulation of afferent C-fibers in the sural nerve of the rat also exhibits potentiation of the depressant effects of clonidine and morphine when both drugs are administered in combination by intrathecal (i.t.) injection to the lumbar spinal cord. For comparison, experiments were also carried out on the tail-flick response in rats. The results show that clonidine produced a dose-dependent inhibition of the tail-flick response (Ed50 20 micrograms); a combination of ineffective doses of clonidine (0.3 microgram) and morphine (2 micrograms) significantly inhibited the tail-flick response; clonidine (35 micrograms) reduced spontaneous, C-fiber-evoked and, due to co-activation, A delta-fibre-evoked activity in ascending axons; and clonidine at a threshold (0.3 microgram) or higher (3 micrograms) dose administered together with morphine at a dose (2 micrograms) that caused only a moderate inhibition produced a supra-additive effect in significantly depressing spontaneous. A delta- and C-fiber-evoked ascending activity. The dose-response curve of depression by morphine alone of C-fiber-evoked activity (ED50 8 micrograms) is significantly shifted by clonidine to the left (ED50 0.9 microgram). Naloxone (0.2 mg/kg) injected intravenously did not affect the inhibition of ascending activity caused by clonidine at the highest dose (35 micrograms), but it reduced the depressant effect of combined i.t. administration of clonidine and morphine. The potentiation of the antinociceptive effects of clonidine and morphine given in combination are possibly due to actions of the two drugs at different sites between the nociceptive afferents and the neurons sending their axons to the brain.
可乐定和吗啡单独使用时可抑制伤害性反射反应;联合使用时,二者的作用相互增强。本研究旨在测试,经鞘内(i.t.)注射至大鼠腰脊髓联合给予可乐定和吗啡时,电刺激大鼠腓肠神经传入C纤维所诱发的上行轴突活动是否也表现出可乐定和吗啡抑制作用的增强。为作比较,还对大鼠的甩尾反应进行了实验。结果显示,可乐定对甩尾反应产生剂量依赖性抑制(半数有效量为20微克);无效剂量的可乐定(0.3微克)和吗啡(2微克)联合使用可显著抑制甩尾反应;可乐定(35微克)可降低上行轴突的自发活动、C纤维诱发活动以及因共同激活而产生的Aδ纤维诱发活动;阈剂量(0.3微克)或更高剂量(3微克)的可乐定与仅产生中度抑制作用剂量(2微克)的吗啡联合使用时,在显著抑制自发活动、Aδ纤维和C纤维诱发的上行活动方面产生超相加效应。单独使用吗啡对C纤维诱发活动的抑制剂量反应曲线(半数有效量为8微克)因可乐定而显著左移(半数有效量为0.9微克)。静脉注射纳洛酮(0.2毫克/千克)不影响最高剂量(35微克)可乐定对上行活动的抑制,但可降低鞘内联合给予可乐定和吗啡的抑制作用。可乐定和吗啡联合使用时抗伤害感受作用的增强可能是由于这两种药物在伤害性传入神经与将轴突发送至脑的神经元之间的不同位点发挥作用。