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2021, Number S1

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Rev Cubana Invest Bioméd 2021; 40 (S1)

Psychometric evidence of a scale measuring concern over contagion with COVID-19 among Peruvian interns

Galán ML, Fontes OEA

Language: Spanish
References: 48
Page:
PDF size: 512.14 Kb.


ABSTRACT

Introduction: Paracetamol is among the non-steroidal anti-inflammatory, analgesic and antipyretic drugs most commonly used worldwide. Few studies have focused on clarifying its mechanisms of action on a cardiovascular level.
Objectives: Evaluate the action of paracetamol on the force of contraction of thoracic aortic rings and on the electrical and contractile activity of isolated perfused Wistar rat hearts.
Methods: Measurements were taken of the effects of paracetamol on rat aortic rings denuded of their vascular endothelium. Analysis was performed of the actions of the drug on the isolated perfused rat hearts using the Langendorff method. Evaluation was conducted of the amplitude of the force of cardiac contraction and of intervals QT, QTc, QRS and RR of the electrocardiogram. The conditions (control and presence of paracetamol) were compared with a paired samples Student's t-test (p < 0.05) upon verification of the normality of the data.
Results: Paracetamol had no effects on the vascular smooth muscle of aortic rings or on intervals QT, QTc, QRS and RR of the electrocardiogram at none of the concentrations used. On the other hand, it displayed a statistically significant negative inotropic effect on the isolated hearts dependent on drug concentration. The IC50 estimated for inhibition of the force of cardiac contraction was 17.15 ± 5.33 µmol/L.
Conclusions: The direct cardiovascular actions of paracetamol are modest, which contributes to a good safety margin for its clinical use in patients without cardiovascular disease.


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  26. Brune K, Renner B, Tiegs G. Acetaminophen/paracetamol: a history of errors, failures and false decisions. Eur J Pain. 2015;19(7):953-65.

  27. McCrae JC, Morrison EE, MacIntyre IM, Dear JW, Webb DJ. (2018). Long-term adverse effects of paracetamol - a review. Br J Clin Pharmacol. 2018;84(10):2218-30. DOI: https://doi.org/10.1111/bcp.13656

  28. Przybyla GW, Szychowski KA, Gminski J. Paracetamol - An old drug with new mechanisms of action. Clin Exp Pharmacol Physiol. 2020 Aug 7;00:1-17. DOI: https://doi.org/10.1111/1440-1681.13392

  29. Khabazianzadeh F, Kazemi T, Nakhaee S, Ng PC, Mehrpour O. Acetaminophen poisoning-induced heart injury: a case-based review. DARU J Pharm Sci. 2019:1-13.

  30. Kaya H, Polat B, Albayrak A, Mercantepe T, Buyuk B. Protective effect of an L-type calcium channel blocker, amlodipine, on paracetamol-induced hepatotoxicity in rats. Hum Exp Toxicol. 2018;37(11):1169-79.

  31. Smith AJ. Guidelines for planning and conducting high-quality research and testing on animals. Lab Anim Res. 2020 [acceso 24/10/2020];36:21. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7348107/7.

  32. Galán-Martínez L, Herrera-Estrada I, Fleites-Vázquez A. Direct actions of the flavonoids naringenin, quercetin and genistein on rat cardiac and vascular muscles. J Pharm Pharmacogn Res. 2018;6(3):158-66.

  33. Keeble J, Al-Swayeh O, Moore P. Vasorelaxant effect of nitric oxide releasing steroidal and nonsteroidal anti-inflammatory drugs. Br J Pharmacol. 2001;133(7):1023-8.

  34. Van Der Horst J, Manville RW, Hayes K, Thomsen MB, Abbott GW, Jepps TA. Acetaminophen (Paracetamol) Metabolites Induce Vasodilation and Hypotension by Activating Kv7 Potassium Channels Directly and Indirectly. Arterioscler Thromb Vasc Biol. 2020;40(5):1207-19.

  35. Chiam E, Bellomo R, Churilov L, Weinberg L. The hemodynamic effects of intravenous paracetamol (acetaminophen) vs normal saline in cardiac surgery patients: A single center placebo controlled randomized study. PLoS One. 2018;13(4).

  36. Achuff BJ, Moffett BS, Acosta S, Lasa JJ, Checchia PA, Rusin CG. Hypotensive response to IV acetaminophen in pediatric cardiac patients. Pediatr Crit Care Med. 2019;20(6):527-33.

  37. Nahum E, Weissbach A, Kaplan E, Kadmon G. Hemodynamic effects of intravenous paracetamol in critically ill children with septic shock on inotropic support. J Intensive Care. 2020;8:14. DOI: https://doi.org/10.1186/s40560-020-0430-0

  38. Kelly S, Moran J, Williams P, Burns K, Rowland A, Miners J, et al. Haemodynamic effects of parenteral vs. enteral paracetamol in critically ill patients: a randomised controlled trial. Anaesthesia. 2016;71(10):1153-62.

  39. Maxwell EN, Jonson B, Cammilleri J, Ferreira JA. Intravenous Acetaminophen-Induced Hypotension: A Review of the Current Literature. Ann Pharmacother. 2019 Oct; 53(10):1033-41. DOI: https://doi.org/10.1177/1060028019849716

  40. Merrill GF. Acetaminophen and low-flow myocardial ischemia: efficacy and antioxidant mechanisms. J Physiol Heart Circ Physiol. 2002;282(4):H1341-H1349.

  41. Merrill GF, Rork TH, Spiler NM, Golfetti R. Acetaminophen and myocardial infarction in dogs. J Physiol Heart Circ Physiol. 2004;287(5):H1913-H1920.

  42. Merrill GF, Merrill JH, Golfetti R, Jaques KM, Hadzimichalis NS, Baliga SS, et al. Antiarrhythmic properties of acetaminophen in the dog. Exp Biol Med. 2007;232(9):1245-52.

  43. Doyon S, Klein-Schwartz W, Lee S, Beuhler MC. Fatalities involving acetaminophen combination products reported to United States poison centers. Clin Toxicol. 2013;51(10):941-8.

  44. García-Fuertes D, Villanueva-Fernández E, Crespín-Crespín M. 2016. Drug-induced long-QT and torsades de pointes in elderly polymedicated patients. Arq Bras Cardiol. 2016;106(2):156-9.

  45. Merrill GF, Mcconnell P, Vandyke K, Powell S. Coronary and myocardial effects of acetaminophen: protection during ischemia-reperfusion. J Physiol Heart Circ Physio. 2001;280(6):H2631-H2638.

  46. Forrest JA, Clements J, Prescott L. Clinical pharmacokinetics of paracetamol. Clin Pharmacokinet. 1982;7(2):93-107.

  47. Hall JE. Guyton y Hall. Tratado de fisiología médica. Barcelona, España: Elsevier; 2016: p. 3948.

  48. Godfraind T. Discovery and Development of Calcium Channel Blockers. Front Pharmacol. 2017;8:286. DOI: https://doi.org/10.3389/fphar.2017.00286




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