RESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Proteinuria/etiología , Glomerulonefritis por IGA/etiología , Enfermedades Renales/etiología , Degeneración Hepatolenticular/inducido químicamente , Síndrome Nefrótico/inducido químicamente , Proteinuria/patología , Encefalina D-Penicilamina (2,5)/efectos adversos , Acetato de Zinc/administración & dosificación , Fibrinolíticos/administración & dosificación , Ceruloplasmina/administración & dosificación , Cobre/orina , Síndrome Nefrótico/complicaciones , Síndrome Nefrótico/tratamiento farmacológico , Encefalina D-Penicilamina (2,5)/administración & dosificaciónRESUMEN
No disponible
Asunto(s)
Humanos , Femenino , Adulto , Degeneración Hepatolenticular/complicaciones , Seudoxantoma Elástico/inducido químicamente , Encefalina D-Penicilamina (2,5)/efectos adversos , Acetato de Zinc/uso terapéuticoRESUMEN
BACKGROUND AND PURPOSE: For patients experiencing inadequate analgesia and intolerable opioid-related side effects on one strong opioid analgesic, pain relief with acceptable tolerability is often achieved by rotation to a second strong opioid. These observations suggest subtle pharmacodynamic differences between opioids in vivo. This study in rats was designed to assess differences between opioids in their in vivo profiles. EXPERIMENTAL APPROACH: Male Sprague Dawley rats were given single i.c.v. bolus doses of morphine, morphine-6-glucuronide (M6G), fentanyl, oxycodone, buprenorphine, DPDPE ([D-penicillamine(2,5) ]-enkephalin) or U69,593. Antinociception, constipation and respiratory depression were assessed using the warm water tail-flick test, the castor oil-induced diarrhoea test and whole body plethysmography respectively. KEY RESULTS: These opioid agonists produced dose-dependent antinociception, constipation and respiratory depression. For antinociception, morphine, fentanyl and oxycodone were full agonists, buprenorphine and M6G were partial agonists, whereas DPDPE and U69,593 had low potency. For constipation, M6G, fentanyl and buprenorphine were full agonists, oxycodone was a partial agonist, morphine produced a bell-shaped dose-response curve, whereas DPDPE and U69,593 were inactive. For respiratory depression, morphine, M6G, fentanyl and buprenorphine were full agonists, oxycodone was a partial agonist, whereas DPDPE and U69,593 were inactive. The respiratory depressant effects of fentanyl and oxycodone were of short duration, whereas morphine, M6G and buprenorphine evoked prolonged respiratory depression. CONCLUSION AND IMPLICATIONS: For the seven opioids we assessed, no two had the same profile for evoking antinociception, constipation and respiratory depression, suggesting that these effects are differentially regulated. Our findings may explain the clinical success of 'opioid rotation'. LINKED ARTICLES: This article is part of a themed section on Opioids: New Pathways to Functional Selectivity. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-2.
Asunto(s)
Analgésicos Opioides/efectos adversos , Analgésicos Opioides/uso terapéutico , Estreñimiento/inducido químicamente , Dolor/tratamiento farmacológico , Insuficiencia Respiratoria/inducido químicamente , Animales , Bencenoacetamidas/efectos adversos , Bencenoacetamidas/uso terapéutico , Buprenorfina/efectos adversos , Buprenorfina/uso terapéutico , Aceite de Ricino , Diarrea/inducido químicamente , Diarrea/tratamiento farmacológico , Encefalina D-Penicilamina (2,5)/efectos adversos , Encefalina D-Penicilamina (2,5)/uso terapéutico , Fentanilo/efectos adversos , Fentanilo/uso terapéutico , Calor , Masculino , Morfina/efectos adversos , Morfina/uso terapéutico , Derivados de la Morfina/efectos adversos , Derivados de la Morfina/uso terapéutico , Oxicodona/efectos adversos , Oxicodona/uso terapéutico , Pirrolidinas/efectos adversos , Pirrolidinas/uso terapéutico , Ratas Sprague-Dawley , Insuficiencia Respiratoria/fisiopatologíaRESUMEN
No disponible
Asunto(s)
Humanos , Bronquiolitis Obliterante/inducido químicamente , Encefalina D-Penicilamina (2,5)/efectos adversos , Factores de RiesgoRESUMEN
La afección renal es infrecuente en la esclerosis sistémica, a diferencia de otras colagenosis. La aparición de síndrome nefrótico se ha relacionado con el uso de fármacos, especialmente la D-penicilamina, o raramente como manifestación de amiloidosis secundaria, bastante infrecuente en la esclerosis sistémica. Presentamos un caso de síndrome nefrótico en una paciente con esclerosis sistémica, producido por una glomerulonefritis membranosa, descrito de forma excepcional en la literatura (AU)
The renal affectation is infrequent in scleroderma, unlike other collagen diseases. The appearance of nephrotic syndrome has been related to the drug use, specially the D-penicilamine, or rarely as a manifestation of secondary amilodosis, quite infrequent in scleroderma. We report a case of nephrotic syndrome in a patient with systemic scleroderma, produced by a membranous glomerulonephritis, exceptionally described in literature (AU)