Effects of narcotic analgesics, especially pethidine and norpethidine, on renal pelvic smooth muscle in patients with hydronephrosis
Tóm tắt
Relaxation of the renal pelvic smooth muscle is usually attempted as a symptomatic treatment in painful colic of the upper urinary tract. The spasmolytic potency of morphine, pethidine, pentazocine, fentanyl, naloxone and papaverine was evaluated using noradrenaline-contracted pelvic strips from hydronephrotic patients. The order of spasmolytic potency was found to be fentanyl > pethidine = papaverine > pentazocine = naloxone. Morphine produced a dual effect, starting with contraction followed by relaxation. Norpethidine, which is the only metabolite of pethidine occurring in human plasma, had the same relaxing potency as its parent compound, pethidine. Thus, an active metabolite may play a role in the outcome of spasmolytic drug treatment.
Tài liệu tham khảo
Anderson JC, Hynes W (1949) Retrocaval ureter: a case diagnosed preoperatively and treated successfully by plastic operation. Br J Urol 21: 209–214
Belfrage P, Boréus LO, Hartvig P, Irestedt L, Raabe N (1981) Neonatal depression after obstetrical analgesia with pethidine. The role of the injection-delivery time interval and of the plasma concentrations of pethidine and norpethidine. Acta Obstet Gynecol Scand 60: 43–49
Boréus LO (1971) Use of human fetal ileum for evaluation of smooth muscle effects of narcotic analgesics. Eur J Pharmacol 15: 127–131
Boyarsky S, Labay P (1972) Ureteral dynamics — pathophysiology, drugs, and surgical implications. Williams & Wilkins, Baltimore, pp 155–169
Dahlström BE, Paalzow K, Lindberg C, Bogentoft C (1979) Pharmacokinetics and analgesic effect of pethidine (meperidine) and its metabolites in the rat. Drug Metab Dispos 7: 108–112
Del Tacca M, Lecchini S, Stacchini B, Tonini M, Frigo GM, Mazzanti L, Crema A (1974) Pharmacological studies of the rabbit and human pelvis. Naunyn Schmiedebergs Arch Pharmacol 285: 209–222
Deneau GA, Nakai K (1960) Type of toxicity in the monkey as influenced by the rate of metabolic conversion of meperidine and normeperidine. Pharmacologist 2: 98
Gosling JA, Waas ANC (1971) The behaviour of the isolated rabbit renal calix and pelvis compared with that of the ureter. Eur J Pharmacol 16: 100–104
Hannappel J, Golenhofen K (1974) The effect of catecholamines on ureteral perstalsis in different species (dog, guinea-pig and rat). Pfluegers Arch 350: 55–68
Hartvig P, Karlsson KE, Lindberg C, Boréus LO (1977) Simultaneous determination of therapeutic plasma concentrations of pethidine and norpethidine in man by electron capture gas chromatography. Eur J Clin Pharmacol 11: 65–69
Holmberg L, Odar-Cederlöf I, Boréus LO, Heyner L, Ehrnebo M (1982) Comparative disposition of pethidine and norpethidine in old and young patients. Eur J Clin Pharmacol (In press)
Kinn A-C. Nergårdh A (1979) Autonomic receptor functions in the normal and dilated renal pelvis. Urol Res 7: 261–264
Kubacz GJ, Catchpole BN (1972) The role of adrenergic blockade in the treatment of ureteral colic. J Urol 107: 949–951
Lindberg C (1978) Biological fate of pethidine. Thesis, Faculty of Pharmacy, Acta Univ Ups 33: 1–42
Longrigg N (1974) Autonomic innervation of the renal calyx. Br J Urol 46: 357–370
Lutzeyer W (1977) Harnstauungsniere. In: Kremling H, Lutzeyer W, Heintz R (eds) Gynäkologische Urologie und Nephrologie. Urban & Schwarzenberg, München, pp 117–125
Miller JW, Anderson HH (1954) The effect of N-demethylaction on certain pharmacologic actions of morphine, codeine and meperidine in the mouse. J Pharmacol Exp Ther 112: 191–196
Nesbit RM (1956) Diagnosis of intermittent hydronephrosis: Importance of pyelography during episodes of pain. J Urol 75: 767–771
Peters HJ (1978) Pathophysiologie der Nierenkolik und ihre medikamentöse Behandlung. Med Welt 29: 46–49
Risholm L (1954) Studies on renal colic and its treatment by posterior splanchnic block. Acta Chir Scand 107: 599–600
Rutishauser G (1962) Zur Pathogenese der Ureterkolik. Helv Chir Acta 29: 461–469
Szeto HH, Inturrisi CE, Houde R, Saal S, Cheigh J, Reidenberg MM (1977) Accumulation of normeperidine, in active metabolite of meperidine, in patients with renal failure or cancer. Ann Intern Med 86: 738–741