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吗啡与布托啡诺(施他宁)对胃肠道及胆道系统的比较性影响。

Comparative gastrointestinal and biliary tract effects of morphine and butorphanol (Stadol).

作者信息

Roebel L E, Cavanagh R L, Buyniski J P

出版信息

J Med. 1979;10(4):225-38.

PMID:43349
Abstract

Butorphanol, levo-N-cyclobutylmethyl-3,14 beta-dihydroxy-morphinan, is a new agonist-antagonist type analgetic agent which is 4 to 8 times more potent than morphine in experimental animals and man. Butorphanol and morphine were evaluated in mice and dogs for their gastrointestinal and biliary tract smooth muscle effects. Morphine decreased the propulsion of a charcoal meal through the gastrointestinal tract of the mouse in a dose related manner with the maximal inhibition obtainable being 90%. Butorphanol produced a maximal inhibition of motility of only 40% with very high doses producing less of an inhibitory effect than lower doses. In dogs, morphine caused a dose-dependent increase in duodenal smooth muscle activity and a dose-dependent decrease in bile duct flow. A clinically effective i.v. dose of morphine (0.1 mg/kg) produced a statistically significant spasmogenic effect on dog biliary tract and gastrointestinal smooth muscle, while a clinically effective equianalgetic i.v. dose of butorphanol (0.025 mg/kg i.v.) had little or not effect on the biliary or gastrointestinal systems. These findings indicate that at equianalgetic doses, butorphanol should produce less constipation and less biliary tract and gastrointestinal smooth muscle spasm than morphine.

摘要

布托啡诺,左旋-N-环丁基甲基-3,14β-二羟基吗啡喃,是一种新型激动-拮抗型镇痛药,在实验动物和人体中其效力比吗啡强4至8倍。对布托啡诺和吗啡在小鼠和犬身上进行了胃肠道和胆道平滑肌效应的评估。吗啡以剂量相关的方式降低炭末在小鼠胃肠道的推进速度,最大抑制率可达90%。布托啡诺即使在非常高的剂量下,对运动的最大抑制率也仅为40%,且高剂量产生的抑制作用比低剂量小。在犬身上,吗啡导致十二指肠平滑肌活动剂量依赖性增加以及胆管流量剂量依赖性减少。临床有效静脉注射剂量的吗啡(0.1mg/kg)对犬胆道和胃肠道平滑肌产生了具有统计学意义的致痉挛作用,而临床等效镇痛静脉注射剂量的布托啡诺(0.025mg/kg静脉注射)对胆道或胃肠道系统几乎没有影响。这些发现表明,在等效镇痛剂量下,布托啡诺引起的便秘、胆道和胃肠道平滑肌痉挛应比吗啡少。

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