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The opioid oxycodone use‐dependently inhibits the cardiac sodium channel Na V 1.5
Author(s) -
Meents Jannis E,
Juhasz Krisztina,
StölzleFeix Sonja,
PeuckmannPost Vera,
Rolke Roman,
Lampert Angelika
Publication year - 2018
Publication title -
british journal of pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.432
H-Index - 211
eISSN - 1476-5381
pISSN - 0007-1188
DOI - 10.1111/bph.14348
Subject(s) - oxycodone , sodium channel , nav1.5 , pharmacology , opioid , patch clamp , medicine , sodium channel blocker , chemistry , electrophysiology , long qt syndrome , anesthesia , qt interval , sodium , receptor , organic chemistry
Abstract Background and Purpose Oxycodone is a potent semi‐synthetic opioid that is commonly used for the treatment of severe acute and chronic pain. However, treatment with oxycodone can lead to cardiac electrical changes, such as long QT syndrome, potentially inducing sudden cardiac arrest. Here, we investigate whether the cardiac side effects of oxycodone can be explained by modulation of the cardiac Na v 1.5 sodium channel. Experimental Approach Heterologously expressed human Na v 1.5, Na v 1.7 (HEK293 cells) or Na v 1.8 channels (mouse N1E‐115 cells) were used for whole‐cell patch‐clamp electrophysiology. A variety of voltage‐clamp protocols were used to test the effect of oxycodone on different channel gating modalities. Human stem cell‐derived cardiomyocytes were used to measure the effect of oxycodone on cardiomyocyte beating. Key Results Oxycodone inhibited Na v 1.5 channels, concentration and use‐dependently, with an IC 50 of 483 μM. In addition, oxycodone slows recovery of Na v 1.5 channels from fast inactivation and increases slow inactivation. At high concentrations, these effects lead to a reduced beat rate in cardiomyocytes and to arrhythmia. In contrast, no such effects could be observed on Na v 1.7 or Na v 1.8 channels. Conclusions and Implications Oxycodone leads to an accumulation of Na v 1.5 channels in inactivated states, with a slow time course. Although the concentrations needed to elicit cardiac arrhythmias in vitro are relatively high, some patients under long‐term treatment with oxycodone as well as drug abusers and addicts might suffer from severe cardiac side effects induced by the slowly developing effects of oxycodone on Na v 1.5 channels.