يعتبر عقار الالبرازولام Alprazolam من مشتقات البنزوديازيبين benzodiazepine وهو عادة ما يستعمل في علاج حالات القلق, و حالات الهلع المصاحبة للخوف من الأماكن المرتفعة, وأيضا في حالات الإحباط. من ناحية أخري يعتمد تاثير حامض الاسكوربيك Ascorbic acid في الوظائفَ الفسيولوجيةَ بشكل كبير على خاصية الاكسدة والاختزال ,oxido-reduction properties ولكن هناك دلائل مُتزايدة تشيرُ إلي دور مهم جداً لحامض الاسكوربيك Ascorbic acid في وظائفَ الجهاز العصبي المركزي CNSأكثر من كونه عاملِ اختزال اوعامل مساعدِ. فمثلا التأثير علي النشاط العصبي Modulation of synaptic events, النشاط الحركي locomotor activity التأثير في حالةِ الوعي, intermodulation with the consciousness state كلها حقولَ جديدةَ لدراسة نشاطِ حامض الاسكوربيك Ascorbate في الخلايا العصبية. إنّ دورَ glutamate وهو احد السيالات العصبية المحفزة في الدماغ في اضطرابات القلقِ أصبح معترف به أكثر ألان ويسود اعتقاد بان العقار الذي يُنظّمُ وظيفةَ glutamate لَه إمكانية تَحسين و معالجةِ هذه الاِضطراباتِ. وهناك بَعْض الدلائلِ التي تُشيرُ بأنّ glutamate و Ascorbate يرتَبَطان عن طريق عملية heteroexchange, وتقترحُ بأنّ حامض الاسكوربيك Ascorbate قَدْ يَتصرّفُ من خلال نظامِ glutamate للتَأثير على السلوكِ. من هذا المنطلق تَتحرّى الدراسةُ الحاليةُ تأثيراتُ الالبرازولام Alprazolam وحامض الأسكوربيك Ascorbic acid كل علي حدة alone أَو متحدة incombination على سلوكِ القلقِ وعلى مستويات glutamate في مناطقِ منفصلةِ من دماغِ جرذان ويستر البرصاءِAlbino wister rats . كما تدرس تاثير كل منهما علي نشاط العضلات الهيكلية .skeletal muscle activityوقد تمت دراسة التأثير المضاد للقلق anxiolytic effect بإستعمال المتاهةِ المرتفعة المتقاطعة Elevated plus maze, والتأثير على نشاطِ العضلات الهيكلية باستعمال اختبار pull-up test, كما قِيست مستويات الجلوتاميت glutamateفي الدماغِ بإستعمال جهاز كروماتوجرافيا السائلِ العالي الأداءِ High performance liquid chromatography. وتُشيرُ النَتائِجُ المتحصل عليها بأنّ حامضِ الأسكوربيك لَهُ تأثير مضاد للقلق anxiolytic effect يعتمد علي الجرعة ((dose dependent وله تأثيرَ إرخاء للعضلات الهيكلية بدون تأثير منومSedation effect , وقد زادَ حامضِ الأسكوربيك ايضا النشاط الحركي للجرذان .Locomotor activity هذا التأثير المضاد للقلق لحامض الأسكوربيك قَدْ يكون نتيجة تثبيط اطلاق الجلوتاميت glutamate أَو بتحفيز الجابا GABA. كما ان لحامضُ الأسكوربيك أيضاً تأثيرُمضاد للدوبامين Antidopamenergic effect الذي من الممكن ان يُؤثّرُ على السلوكِ. عقار الالبرازولام Alprazolam alone في الجرعةِ المستعملة (2 مج / كيلوجرام) أنتجَ تأثيرَ مضاد للقلق Anxiolytic effect بدون إرخاءِ للعضلات الهيكلية وبدون تاثير منوم effect Sedation. ولَمْ يُؤثّرْ حامضِ الأسكوربيك علي المفعول المضاد للقلق لعقار الالبرازولام عند استعمالهما معا. فالحيوانات عندما عولجتْ بحامضِ الأسكوربيك و عقار الالبرازولام Alprazolam فانهما اظهرا تأثيرا مضافا effect Additive anxiolyticوالذي كَانَ واضحَا عند استعمال الجرعةِ الكبيرةِ لحامضِ الأسكوربيك (500 مج / كيلوجرام). حامض الأسكوربيك لم يَتدخّلُ في عملِ Alprazolam على الجهاز العصبي المركزي CNSولَمْ يُنشّطْ التأثيرَ المركزيَ للالبرازولام Alprazolam فلم يلاحظ أي ثاثير منوم جراء استعمالهما معا. كما ان المعالجة َ بحامضِ الأسكوربيك بالجرعة 125 جم / كيلوجرام أَو 500 جم / كيلوجرام مَع Alprazolam (2 مج / كيلوجرام) أنتجت ْإرخاءَ للعضلات الهيكلية بشكل ملحوظ؛ و هذا قَدْ يكون بسبب تدخلِ حامضِ الأسكوربيك وAlprazolam بآليةِ إنكماشِ العضلةِ الهيكليةِ. كما يمكن ان يكون لحامض الأسكوربيك تأثيرُ مقوي synergestic على Alprazolam كمرخي للعضلات. ومن ناحية اخري اثر حامض أسكوربيك لوحده في مستويات الجلوتاميت glutamate في دماغ الجرذان, حيث زادَ مستويات glutamate في striatum وفي الدماغ المتوسطِ midbrain لكنه انَقصَ هذه المستويات في ساقِ الدماغ brain stem وقشرةِ الدماغ cerebral cortex التي قَدْ تكون بسبب آليةِ heteroexchange للاسكوربيت Ascorbate مَع الجلوتاميت .glutamate استعمال عقار الالبرازولام Alprazolam لوحده زاد بشكل ملحوظ مستوى glutamate في striatum وانَقصَ هذا المستوى في الدماغ المتوسطِ,midbrain الامرالذي يدعو للافتراض بأنّ التأثيرَ المضاد للقلق anxiolytic effect للبنزوديازيبين benzodiazepines لا يُمْكن أنْ يُفسّرَ فقط بواسطة التفاعلِ مع أَو بتحفيز مستقبلات الجابا .GABA وعند استعمال حامض الأسكوربيك مع الالبرازولام فانه لَمْ يَتدخّلُ في تأثير Alprazolam علي مستويات الجلوتاميت glutamate في هذه المناطقِ من الدماغِ لكن بدلاً مِن ذلك اظهرا تأثيراً مماثلاً عندما استعملا سويةً .Abstract Alprazolam is a benzodiazepine derivative that is currently used in the treatment of generalized anxiety, panic attacks with or without agoraphobia and depression. The physiological functions of ascorbic acid are largely dependent on the oxido-reduction properties. However, A growing body of evidence indicates for ascorbate a very important role in CNS functioning rather than just fulfilling the relatively passive roles of general reducing agent and enzymatic cofactor. Modulation of synaptic events, locomotor activity, intermodulation with the consciousness state, are new fields of ascorbate activity. The role of glutamate in anxiety disorders is becoming more recognized with the belief that drugs that modulate glutamatergic function have the potential to improve the current treatment of these severe and disabling illnesses. Some evidence indicates that glutamate and ascorbate are linked via a carrier-mediated heteroexchange process suggesting that ascorbate may act through the glutamate system to influence behavior. The present study investigates the effects of alprazolam and ascorbic acid alone or in combination on anxiety behavior and on glutamate levels in discrete brain regions of albino rats. The anxiolytic effect was studied using a plus maze model, skeletal muscle activity effect was scored using pull-up test and brain levels of glutamate were measured using high performance liquid chromatography. The results indicate that ascorbic acid has dose dependent anxiolytic and muscle relaxation effect with out sedation; it also increased spontaneous motor activity by increasing total lines and entries into open and closed arms. Ascorbic acid may exert its anxiolytic action by decreasing glutamate release or by increasing GABA binding. Ascorbic acid showed also antidopamenergic effect which may influence behavior. Alprazolam alone at the dose used (2mg/kg) produced anxiolytic effect without sedation or muscle relaxation. The anxiolytic effect of alprazolam was not affected by ascorbic acid administration. Animals treated with ascorbic acid and alprazolam together showed additive anxiolytic effect which was clear with the large dose of ascorbic acid (500 mg/kg). Ascorbic acid does not interfere with alprazolam action on CNS and did not potentiate the central effect of alprazolam, otherwise sedation would be observed. The combination treatment of ascorbic acid in a dose of 125mg/kg or 500mg/kg with alprazolam (anxiolytic dose) produced significant and dose dependent muscle relaxation as the regaining position time was increased significantly; this may be due to the interference of ascorbic acid and alprazolam with the mechanism of skeletal muscle contraction. Ascorbic acid may have synergestic effect on alprazolam as muscle relaxant. Ascorbic acid alone increased the levels of glutamate in striatum and in mid brain but decreased these levels in brain stem and cerebral cortex which may due to heteroexchange mechanism of ascorbate with glutamate during glutamate uptake. Alprazolam alone incresed significantly the level of glutamate in striatum and decreased this level in mid brain, which may provided a newer mechanism and may supposes that the anxiolytic effect of benzodiazepines can not be accounted for only by the interaction at the GABA A benzodiazepine receptor complex. Ascorbic acid did not modify the alprazolam effect in these brain regions but instead showed similar effect when combined together.
جمال مصطفي علي بن سعد (2007)

Paracetamol is one of the most widely used drug as antipyretic and analgesic for mild to moderate pain. Currently, paracetamol is the first-line choice for pain management and antipyresis. Ion channels are pore-forming proteins that allow the flow of ions across membranes and involved in many cellular processes; drugs acting on ion channels have long been used for the treatment of many diseases. Objective: To estimate the effect of voltage gated ion channel blockers on analgesic activity of Paracetamol and explore the interaction between ion channel blockers and paracetamol on pain behaviour. Materials and Methods: Male albino mice were used. The central antinociceptive activity was determined by hot plate test and formalin test (Phase I; neuropathic pain). Antiinflammatory activity was determined by formalin test (Phase II). Intraperitoneal injection was adopted. Five groups of mice were used. Group 1; control group (1% T80), group 2; treated with (200mg/kg) paracetamol, group 3; treated with different drugs of ion channel blockers, group 4; received standard drugs, Aspirin (200mg/kg) for formalin test (phase II) or tramadol (5mg/kg) for hot plate test and formalin test (phase I), group 5; received combined treatment of ion channel blockers and paracetamol. Results: Pain produced by noxious stimuli (heat and formalin) was significantly reduced by acute administration of paracetamol. Inflammation pain produced by formalin injection was significantly decreased by acute administration of paracetamol. Acute administration of nifedipine showed significant decrease in nociception and inflammation pain. Combined treatment of nifedipine and paracetamol produced antinociceptive and anti-inflammatory activity but less than the additive effect. Verapamil has no analgesic effect in the two models, and did not change the affect of paracetamol analgesic activity when administered together. Phenytoin produces significant decrease in nociceptive pain using hot plate but not in formalin test (Phase I), and produce significant decrease in inflammatory pain (Phase II). The combined treatment of phenytoin and paracetamol showed analgesic activity less than the additive effect. 4-Aminopyridine produces significant antinociceptive and anti-inflammatory activity. The combined administration of 4-aminopyridine and paracetamol showed analgesic activity, which is less than the additive effect using formalin test, while paracetamol analgesic activity is potentiated by 4-aminopyridine using hot plate test. Conclusion: Paracetamol has antinociception and anti-inflammatory activity on pain model used (Hot plate test and Formalin test). Ion channel blockers produce antinociception and anti-inflammatory activity. Verapamil has no effect on nociception or inflammation pain and no effect on paracetamol analgesic activity. Nifedipine, phenytoin and 4-aminopyridine interact with paracetamol producing less additive analgesic effect, except 4-aminopyridine in thermal stimuli (Hot plate) is more sensitive compared to chemical stimuli (formalin test – phase I), where potentiates paracetamol action.
هناء مدحت الزقلعي (2014)

Abstract Benzodiazepines are frequently prescribed as anxiolytics, sedatives hypnotics, and muscle relaxants as well as anticonvulsants. Non-steroidal anti-inflammatory drugs (NSAIDs) are also the most widely used for their anti-inflammatory, analgesic and antipyretic activities. Because of the chronic nature of epilepsy, NSAIDs may be used with benzodiazepines in patients with epilepsy. Therefore, there’s a probability of an interaction of NSAIDs and benzodiazepines in clinical practice. In order to study such interactions experimentally, an animal model was used. Thus, this thesis was aimed to explore pharmacological interactions between selective and non selective NSAIDs and diazepam anticonvulsant effect. Convulsion was induced in male albino mice by picrotoxin in two different doses (6 and 8 mg/kg), NSAIDs were used according to selectivity to cyclooxygenase enzyme (COX): Aspirin at 10 mg/kg (COX-1 selective inhibitor) and Aspirin at 100 and 200 mg/kg, diclofenac 10 and 20 mg/kg (non selective COX inhibitors) and celecoxib 20 mg/kg (COX-2 selective inhibitor). Diazepam at 1 and 2 mg/kg were chosen as low doses and parameters of convulsive behavior of picrotoxin deviation. psy, NSAIDs may be used with benzodiazepines in patients with epilepsy. Therefore, there’s a probability of an interaction of NSAIDs and benzodiazepines in clinical practice. In order to study such interactions experimentally, an animal model was used. Thus, this thesis was aimed to explore pharmacological interactions between selective and non selective NSAIDs and diazepam anticonvulsant effect. Convulsion was induced in male albino mice by picrotoxin in two different doses (6 and 8 mg/kg), NSAIDs were used according to selectivity to cyclooxygenase enzyme (COX): Aspirin at 10 mg/kg (COX-1 selective inhibitor) and Aspirin at 100 and 200 mg/kg, diclofenac 10 and 20 mg/kg (non selective COX inhibitors) and celecoxib 20 mg/kg (COX-2 selective inhibitor). Diazepam at 1 and 2 mg/kg were chosen as low doses and parameters of convulsive behavior of picrotoxin were observed in this thesis: onset time, episode frequency and death occurrence within post-injection of picrotoxin for 24 hrs. Aspirin in low dose (10 mg/kg) showed protection against death to about 50%. This protection which seems to be partially effective as anticonvulsant agent, however, higher dose of Aspirin (100 mg/kg) did not produce any significant change against convulsing in mice, Aspirin 200 mg/kg showed highly significant reduction of episode frequency (P < 0.001) and decreased percent of death. Furthermore, Aspirin 200 mg/kg in combination with diazepam has potentiated the effect of diazepam to complete protection against convulsion induced by picrotoxin. With respect to diclofenac, diclofenac pretreated-mice did not show any significant effect at 10 and 20 mg/kg with picrotoxin but in combination with diazepam showed significant potentiated effect of diazepam. Moreover, COX-2 inhibitor (celecoxib) alone delayed onset of convulsion without significant influence against the control but significantly decreased episodes and percent of death. Also in combination of celecoxib and diazepam, a highly potentiation of the effect and almost complete protection against convulsion behavior were noted (P < 0.001). Thus, it can be concluded that the studied NSAIDs have anticonvulsant behavior-like activity alone and in combination with diazepam. The most profound effect of anticonvulsant activity was showed in low episodes and mortality rate. In combination with diazepam, NSAIDs have more positive potential role in diazepam anticonvulsant effect. The present findings may also suggest that NSAIDs most likely COX-2 selective inhibitor is more potentiated diazepam’s anticonvulsant activity than COX-1 selective and non-selective inhibitors and such interaction could be more likely to be pharmacodynmic type.
نجمية محمد الزواوي (2014)