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腺苷激酶抑制剂GP683对犬地氟烷麻醉需求量的影响。

The effect of GP683, an adenosine kinase inhibitor, on the desflurane anesthetic requirement in dogs.

作者信息

Wang B, Tang J, White P F, Foster A C, Grettenberger H M, Kopcho J, Wender R H

机构信息

Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas, 75235-9068, USA.

出版信息

Anesth Analg. 1997 Sep;85(3):675-80. doi: 10.1097/00000539-199709000-00035.

Abstract

UNLABELLED

The availability of an analgesic compound devoid of the side effects associated with the commonly used opioid and nonsteroidal antiinflammatory drugs would be useful during the perioperative period. Although adenosine has analgesic and anesthetic-sparing properties, it also produces dose-dependent cardiovascular depression. Inhibitors of adenosine kinase may be able to provide analgesia without producing acute cardiovascular or respiratory depression. This preliminary study investigated the effects of a novel adenosine kinase-inhibiting drug, GP683, on the minimum alveolar anesthetic concentration (MAC) of desflurane in dogs. Seven mongrel dogs were administered one of three different GP683 dose regimens (or the solvent) by intravenous infusion on separate occasions according to a cross-over study design. After determining the baseline desflurane MAC value, GP683 was infused at 75, 150, or 300 microg x kg(-1) x min(-1) for 5 min as a loading dose, followed by 15, 30, or 60 microg x kg(-1) x min(-1) for an additional 85 min to maintain a stable plasma drug level. The desflurane MAC was redetermined 30-90 min after starting the study drug or vehicle infusion, and 30-90 min and 120-180 min after termination of the infusion. Cardiovascular variables and plasma concentrations of GP683 were determined at specific intervals before, during, and after the MAC determinations. The three GP683 dose regimens produced 22%, 31%, and 50% decreases in the desflurane MAC, respectively. In addition, there was good correlation between the decrease in desflurane MAC and the plasma GP683 concentration (r = -0.78). Although the mean arterial pressure (MAP) was decreased up to 25% by the highest infusion rate of GP683, adjustments in the desflurane concentration to an equi-MAC value resulted in normalization of the MAP values. Furthermore, GP683 produced no changes in heart rate. In conclusion, the adenosine kinase-inhibiting drug, GP683, produced dose-dependent decreases in the desflurane MAC of dogs without producing untoward hemodynamic changes.

IMPLICATIONS

An investigational drug (GP683) that can increase the levels of an important endogenous substance in the body (adenosine) has been found to decrease the anesthetic requirement in dogs without producing adverse effects on the cardiovascular system.

摘要

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在围手术期,有一种镇痛化合物可避免常用阿片类药物和非甾体抗炎药的副作用,这将很有用。尽管腺苷具有镇痛和节省麻醉剂的特性,但它也会产生剂量依赖性的心血管抑制。腺苷激酶抑制剂可能能够提供镇痛作用而不产生急性心血管或呼吸抑制。这项初步研究调查了一种新型腺苷激酶抑制药物GP683对犬地氟醚最低肺泡有效浓度(MAC)的影响。根据交叉研究设计,七只杂种犬在不同时间分别静脉输注三种不同剂量方案的GP683(或溶剂)之一。在确定基线地氟醚MAC值后,以75、150或300μg·kg⁻¹·min⁻¹的剂量静脉输注GP683 5分钟作为负荷剂量,然后以15、30或60μg·kg⁻¹·min⁻¹的剂量再输注85分钟以维持稳定的血浆药物水平。在开始输注研究药物或赋形剂后30 - 90分钟,以及输注结束后30 - 90分钟和120 - 180分钟重新测定地氟醚MAC。在MAC测定之前、期间和之后的特定时间间隔测定心血管变量和GP683的血浆浓度。三种GP683剂量方案分别使地氟醚MAC降低了22%、31%和50%。此外,地氟醚MAC的降低与血浆GP683浓度之间存在良好的相关性(r = -0.78)。尽管GP683的最高输注速率使平均动脉压(MAP)降低了25%,但将地氟醚浓度调整至等效MAC值可使MAP值恢复正常。此外,GP683对心率没有影响。总之,腺苷激酶抑制药物GP683可使犬的地氟醚MAC呈剂量依赖性降低,且不产生不良血流动力学变化。

启示

已发现一种研究性药物(GP683)可增加体内一种重要内源性物质(腺苷)的水平,它能降低犬的麻醉需求,且对心血管系统无不良影响。

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