IMR Press / JIN / Volume 22 / Issue 4 / DOI: 10.31083/j.jin2204104
Open Access Original Research
Flumazenil Pretreatment Reduces Mefenamic Acid-Induced Central Nervous System Toxicity in Mice
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1 Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, 11622 Amman, Jordan
2 Department of Basic Medical Sciences, Al-Balqa Applied University, 1705 Al-Salt, Jordan
3 Faculty of Data Science and Information Technology, INTI International University, 71800 Nilai, Malaysia
4 Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, 60115 Surabaya, Indonesia
5 PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, BE1410 Gadong, Brunei Darussalam
6 School of Medical and Life Sciences, Sunway University, 47500 Sunway City, Malaysia
7 Faculty of Medicine, Cairo University, 11559 Cairo, Egypt
*Correspondence: qais.jarrar@iu.edu.jo (Qais Jarrar); chrismawan-a@ff.unair.ac.id (Chrismawan Ardianto); chiaumingl@sunway.edu.my (Long Chiau Ming)
J. Integr. Neurosci. 2023, 22(4), 104; https://doi.org/10.31083/j.jin2204104
Submitted: 15 September 2022 | Revised: 14 January 2023 | Accepted: 30 January 2023 | Published: 26 July 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Mefenamic acid (MFA), a common analgesic, causes central nervous system (CNS) toxicity at high doses with a proposed activity on the Gamma-aminobutyric acid (GABA) system. However, it remains unknown whether flumazenil (FMZ), a GABA type A receptor (GABAAR) antagonist, can reverse MFA toxicity. Methods: The behavioral and neurophysiological effects of MFA were investigated in mice with and without FMZ pre-treatment. The elevated zero maze (EZM) and marble burying tests were used to assess anxiety-like behaviors and burying activities, respectively. The standard bar test was used to evaluate catalepsy, while the actophotometer test was used to measure locomotor activity. Seizure intensity was scored, and fatalities were counted. Results: Without FMZ pre-treatment, MFA induced behavioral and neurophysiological effects in a dose-dependent manner as follows: At a dose of 20 mg/kg, i.p, MFA-treated mice exhibited anxiety-like behaviors, which was determined by a significant increase in the time spent in the closed areas and a significant decrease in the number of entries to the open areas of the EZM apparatus. These mice also showed a significant decrease in the burying activity, manifested as a significant decrease in the number of buried marbles. At 40 mg/kg, i.p., MFA-treated mice showed catalepsy that was associated with a significant decrease in locomotor activity. At a dose of 80 mg/kg, i.p., mice developed fatal tonic-clonic seizures (seizure score = 4). Pre-treatment with FMZ (5 mg/kg, i.p.) significantly reversed the anxiety-like behaviors and restored marble-burying activity. Additionally, FMZ prevented catalepsy, significantly restored locomotor activity, reduced seizure intensity (seizure score = 0.3) and significantly reduced mortalities. Conclusions: The present study’s findings indicate that activation of the GABAAR is involved in the CNS toxicity of MFA, and FMZ reverses MFA toxicity by interfering with this receptor.

Keywords
neurological disease
psychiatric disease
anxiety
central nervous system
convulsions
gamma-aminobutyric acid type A receptors
GABA
Funding
2019/2018/17-174/The Deanship of Scientific Research and Postgraduate Studies, Isra University
Figures
Fig. 1.
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