Liver and kidney toxicity in chronic use of opioids: An experimental long term treatment model |
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Authors: | Sebnem Atici Ismail Cinel Leyla Cinel Nurcan Doruk Gulcin Eskandari Ugur Oral |
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Institution: | (1) Department of Anesthesiology and Reanimation, Mersin University, School of Medicine, Mersin, Turkey;(2) Department of Pathology, Mersin University, School of Medicine, Mersin, Turkey;(3) Department of Biochemistry, Mersin University, School of Medicine, Mersin, Turkey |
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Abstract: | In this study, histopathological and biochemical changes due to chronic usage of morphine or tramadol in liver and kidney
were assessed in rats. Thirty male Wistar rats (180–220 g) were included and divided into three groups. Normal saline (1 ml)
was given intraperitoneally as placebo in the control group (n = 10). Morphine group (n = 10) received morphine intraperitoneally at a dose of 4, 8, 10 mg/kg/day in the first, second and the third ten days of
the study, respectively. Tramadol group (n = 10), received the drug intraperitoneally at doses of 20, 40 and 80 mg/kg/day in the first, second and the third ten days
of the study, respectively. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH),
creatinin, blood urea nitrogen (BUN) and malondialdehyde (MDA) levels were measured in the serum. Liver and kidney specimens
were evaluated by light microscopy. Serum ALT, AST, LDH, BUN and creatinin levels were significantly higher in morphine group
compared to the control group. Serum LDH, BUN and creatinin levels were significantly increased in the morphine group compared
to the tramadol group. The mean MDA level was significantly higher in morphine group compared to the tramadol and control
groups (P<0.05). Light microscopy revealed severe centrolobular congestion and focal necrosis in the liver of morphine and
tramadol groups, but perivenular necrosis was present only in the morphine group. The main histopathologic finding was vacuolization
in tubular cells in morphine and tramadol groups. Our findings pointed out the risk of increased lipid peroxidation, hepatic
and renal damage due to long term use of opioids, especially morphine. Although opioids are reported to be effective in pain
management, their toxic effects should be kept in mind during chronic usage
Presented at the 10th XX Annual ESRA Congress, 6–9 April 2002, Warsaw, Poland. |
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Keywords: | Kidney toxicity liver toxicity morphine tramadol |
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