Peripheral α2-adrenoceptor antagonism affects the absorption of intramuscularly coadministered drugs

Vet Anaesth Analg. 2018 Jul;45(4):405-413. doi: 10.1016/j.vaa.2018.01.008. Epub 2018 Feb 3.

Abstract

Objective: We determined the possible effects of a peripherally acting α2-adrenoceptor antagonist, MK-467, on the absorption of intramuscularly (IM) coadministered medetomidine, butorphanol and midazolam.

Study design: Randomized, experimental, blinded crossover study.

Animals: Six healthy Beagle dogs.

Methods: Two IM treatments were administered: 1) medetomidine hydrochloride (20 μg kg-1) + butorphanol (100 μg kg-1) + midazolam (200 μg kg-1; MBM) and 2) MBM + MK-467 hydrochloride (500 μg kg-1; MBM-MK), mixed in a syringe. Heart rate was recorded at regular intervals. Sedation was assessed with visual analog scales (0-100 mm). Drug concentrations in plasma were analyzed with liquid chromatography-tandem mass spectrometry, with chiral separation of dex- and levomedetomidine. Maximum drug concentrations in plasma (Cmax) and time to Cmax (Tmax) were determined. Paired t-tests, with Bonferroni correction when appropriate, were used for comparisons between the treatments.

Results: Data from five dogs were analyzed. Heart rate was significantly higher from 20 to 90 minutes after MBM-MK. The Tmax values for midazolam and levomedetomidine (mean ± standard deviation) were approximately halved with coadministration of MK-467, from 23 ± 9 to 11 ± 6 minutes (p = 0.049) for midazolam and from 32 ± 15 to 18 ± 6 minutes for levomedetomidine (p = 0.036), respectively.

Conclusions and clinical relevance: MK-467 accelerated the absorption of IM coadministered drugs. This is clinically relevant as it may hasten the onset of peak sedative effects.

Keywords: MK-467; dog; intramuscular; medetomidine; peripheral α(2)-antagonist; α(2)-agonist.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adrenergic alpha-2 Receptor Antagonists / pharmacology*
  • Animals
  • Butorphanol / administration & dosage*
  • Butorphanol / blood
  • Butorphanol / pharmacokinetics
  • Chromatography, High Pressure Liquid / veterinary
  • Cross-Over Studies
  • Deep Sedation / methods
  • Deep Sedation / veterinary
  • Dogs
  • Drug Combinations
  • Drug Interactions
  • Female
  • Heart Rate / drug effects
  • Hypnotics and Sedatives / administration & dosage*
  • Hypnotics and Sedatives / blood
  • Hypnotics and Sedatives / pharmacokinetics
  • Injections, Intramuscular / veterinary*
  • Male
  • Medetomidine / administration & dosage*
  • Medetomidine / blood
  • Medetomidine / pharmacokinetics
  • Midazolam / administration & dosage*
  • Midazolam / blood
  • Midazolam / pharmacokinetics
  • Quinolizines / blood
  • Quinolizines / pharmacology*
  • Tandem Mass Spectrometry / veterinary

Substances

  • Adrenergic alpha-2 Receptor Antagonists
  • Drug Combinations
  • Hypnotics and Sedatives
  • Quinolizines
  • vatinoxan
  • Medetomidine
  • Butorphanol
  • Midazolam