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Geometrical correspondence between phenazocine and the enkephalins.

Calculations have been performed on phenazocine using Allinger's MM2 (molecular mechanics II) program with full energy minimization. The N-phenethyl group was found to have considerable flexibility with a number of low-energy conformers. The best N-phenethyl axial conformer was 1.6 kcal/mol higher in energy than the best equatorial one. Calculations were also performed on the beta isomer of phenazocine with the result that the energy difference between the best equatorial and axial conformers rose to a substantial 4.6 kcal/mol. The hypothesis that opiate agonism requires an N substituent in the axial position does not appear to be consistent with the increased potency of beta isomers in which axial N substituents are thermodynamically more unstable. Comparisons have also been made between the low-energy conformers of phenazocine and those that have been observed or proposed for the enkephalins. One conformation of the tyrosine portion of the enkephalins that was observed by X-ray crystallography by Karle et al. was found to be a good fit to morphine-like opiates. The backbone conformer suggested by Gorin et al. was found to be the best fit to the two phenyl rings of phenazocine.

Enkephalins↗

Effects of ketazocine, ethylketazocine and phenazocine on schedule-controlled behavior: antagonism by naloxone.

Dose-effect curves were determined for phenazocine (0.64-2.5 mg/kg), ketazocine (1.25-80 mg/kg) and ethylketazocine (1.25-80 mg/kg) in pigeons responding under a multiple fixed-ratio 30-response, fixed-interval 5-min schedule of grain presentation. All three opioid agonists decreased responding with the larger doses. The effects of phenazocine were completely antagonized by small doses of naloxone (0.01-1 mg/kg), whereas the effects of ethylketazocine required larger doses of naloxone (1-10 mg/kg) to be completely antagonized. The behavioral effects of ketazocine were partially attenuated by naloxone, but were not antagonized completely even by a 10 mg/kg dose of naloxone. These data from the pigeon are consistent with previous interpretations that the effects of phenazocine are mediated by actions at a mu opioid receptor, whereas the effects of ketazocine and ethylketazocine are mediated by actions at a kappa opioid receptor.

Analgesics, Opioid↗

Double-blind clinical trial of the analgesic effects of phenazocine hydrobromide (Narphen) compared with morphine sulphate in patients with acute abdominal pain.

No significant difference could be detected either by clinical impression or statistical analysis in the relief of pain afforded by 2.5 mg phenazocine hydrobromide (Narphen) and 10 mg morphine sulphate when given by intramuscular injection to patients with acute abdominal pain. Phenazocine does not cause spasm of the sphincter of Oddi and so is recommended for treating biliary or pancreatic pain.

Abdomen↗

A cross-over comparison of the effect of morphine, pethidine, pentazocine, and phenazocine on biliary pressure.

The effects on biliary pressure of pentazocine, morphine, pethidine, and phenazocine were compared by direct measurement through a ;T' tube after choledochotomy. In two within-patient comparisons, the mean increases in biliary pressure following intramuscular morphine were significantly greater than those following pentazocine. When pethidine and phenazocine were compared with pentazocine, the mean increases were lower following pentazocine but not to a statistically significant extent. Pentazocine appears to be the most appropriate strong analgesic in biliary and pancreatic disease.

Biliary Tract↗