The pharmacology of a molluscan smooth muscle

The effects of a number of pharmacologically active substances on contraction and on membrane polarization of the anterior byssal retractor muscle of Mytilus edulis, L., have been studied. Tetramethylammonium bromide, trimethyl(4-oxopentyl)ammonium chloride and nicotine, like acetylcholine, produced depolarization and sustained contraction. Nicotine, on repeated application, lost acetylcholine-like activity and effectively blocked acetylcholine. In order of decreasing potency, methanthelinium, tubocurarine, benzoquinonium, tetraethylammonium, atropine, pentamethonium, and decamethonium blocked acetylcholine action. These agents did not show initial acetylcholine-like action and did not relax sustained contractions. Adrenaline, noradrenaline, tyramine, dibenamine, phentolamine, and lysergic acid diethylamide relaxed sustained contractions without reducing initial depolarization and tension development in response to acetylcholine or electrical stimuli. Adrenaline and noradrenaline often caused depolarization and contraction when first applied, and displayed relaxing action on subsequent application.

Stimulus frequency and neuromuscular block

Muscle twitches of the rat isolated diaphragm and frog sartorius preparations were recorded. It was confirmed that, in the presence of tubocurarine, the degree of neuromuscular block was greater the higher the frequency of stimulation. The results suggest that the quantity of acetylcholine released by each nerve impulse was reduced by increasing the rate of stimulation so that, in a tubocurarine solution, muscle fibres which were only just being fired at a slow rate of stimulation failed to fire at a faster rate.

Facilitation of neuromuscular transmission by anticholinesterase drugs

A close correlation has been shown to exist between the in vitro anticholinesterase potencies of ambenonium, neostigmine, methoxyambenonium and edrophonium chloride and their abilities to increase muscle contractions produced by close-arterial injections of acetylcholine. No correlation was found between the anticholinesterase potencies of the drugs and their potentiations of the maximal twitch in response to electrical stimulation, or their antagonisms of tubocurarine. It is concluded that some action, in addition to inhibition of cholinesterase, contributed to their facilitation at the neuromuscular junction, and it is suggested that this action may be at the prejunctional site.

Pharmacological responses of thiamine-deficient rat tissues

Rats were rendered deficient in thiamine by feeding a synthetic diet free of the vitamin. Responses of the isolated heart to acetylcholine, adrenaline, noradrenaline and isoprenaline, and of the phrenic nerve-diaphragm preparation to tubocurarine, gallamine and eserine, were compared with responses of tissues obtained from littermate rats pair-fed an identical diet with the addition of 25 mug of thiamine hydrochloride per day. In thiamine-deficient tissues eserine failed to produce sustained potentiation of the twitch response of the phrenic nerve-diaphragm preparation to single supramaximal nerve stimuli. The perfused thiamine-deficient heart was more sensitive to acetylcholine, adrenaline, noradrenaline and isoprenaline, which produced greater negative or lesser positive chronotropic and inotropic effects. There was no significant difference in the response of the phrenic nerve-diaphragm preparation to tubocurarine and gallamine, or to eserine with faradic stimulation.

Studies on the repetitive discharges evoked in motor nerve and skeletal muscle after injection of anticholinesterase drugs

Repetitive discharges recorded from the ventral root and from the gastrocnemius muscle in response to single motor nerve shocks applied close to the muscle after injection of edrophonium, neostigmine or ambenonium were studied in cats anaesthetized with chloralose. Two closely spaced volleys with an interval of 1 to 5 msec between them produced more repetitive firing than did a single shock. With longer intervals, the repetitive firing was not potentiated by the second volley. All frequencies of tetanic stimulation depressed the repetitive firing and, for successive stimuli to produce a degree of repetitive firing equivalent to the first, it was necessary to stimulate at frequencies below 2 shocks/sec. With stimulation frequencies higher than 100 shocks/sec, repetitive firing did not occur unless the duration of the tetanus was shorter than about 30 msec when slight repetition followed the last stimulus of the train. With stimulation frequencies of 100 down to 20 shocks/sec, repetitive firing was produced only by the first volley of the tetanus. Subsequent nerve action potentials of the tetanus occurring during the repetitive firing in the nerve following the first volley were partially extinguished by collision with the back discharge. This effect contributed to the waning tetanus, which is characteristic of treatment with an anticholinesterase, but the main depression of tetanic contractions appeared to be a consequence of depolarization block through accumulating acetylcholine. Tubocurarine and benzoquinonium reversed the initial "extinction" phase of the depressed tetani by abolishing the repetitive discharge in the nerve and in larger doses reversed the secondary depressant phase presumably by reducing the excessive end-plate depolarization. The results are discussed in relation to the hypothesis that anticholinesterases may effect transmission by acting at three sites at the neuromuscular junction-on acetylcholinesterase, at the motor nerve ending and at the motor end-plate-and that reaction at any one site may be augmented by the production of reverberating activity across the junction.

The mode of neuromuscular blocking action of chlorpromazine

The inhibitory action of chlorpromazine on skeletal muscle has been studied with isolated preparations. In the nerve-muscle preparations of the frog sartorius and the rat diaphragm, the twitch responses to indirect stimulation are much more strongly depressed by chlorpromazine than those to direct stimulation. The conductivity of the nerve trunk is unaffected. The contractures of the frog rectus abdominis muscle caused by acetylcholine are depressed by chlorpromazine,but the contractures due to KCl are not influenced. Larger doses of chlorpromazine cause contracture by themselves, and this cannot be prevented by tubocurarine. In the sartorius muscle of the toad, the depolarization due to acetylcholine is reduced by chlorpromazine. The paralysing action of chlorpromazine adds to that of tubocurarine, and is antagonized to some extent by eserine or neostigmine. Muscles treated with chlorpromazine do not completely recover on washing. High concentrations of chlorpromazine depress the release of acetylcholine by motor-nerve stimulation, although they do not affect the enzymic synthesis of acetylcholine by acetone-dried powder of guinea-pig brain. The differences between the neuromuscular block produced by chlorpromazine and that by tubocurarine are discussed.

Triethylcholine compared with other substances affecting neuromuscular transmission

Triethylcholine (triethyl-2-hydroxyethyl ammonium) has been compared, in its actions on neuromuscular transmission, with the motor end-plate blocking drugs tubocurarine and decamethonium, with the anticholinesterase neostigmine, and with the closely related drug tetraethylammonium. The experiments were carried out on conscious rabbits and mice, on the tibialis anterior muscle of cats under chloralose anaesthesia and on the isolated phrenic nerve-diaphragm preparation of the rat. Anticholinesterase activity was determined manometrically using the Warburg apparatus. Triethylcholine possessed a slight curare-like action, but this effect was shown to be too weak and transient to contribute to the slowly developing and long-lasting transmission failure which occurs selectively in frequently excited nervemuscle preparations and in exercised conscious animals. It was confirmed that the site of the blocking action of triethylcholine was pre-junctional. Triethylcholine often produced a slight potentiation of the contractions before blocking them. This effect was not due to a depolarizing or an anticholinesterase action, and it was concluded that the slight initial facilitating action of triethylcholine on neuromuscular transmission was due to an increase in the quantity of acetylcholine released by the nerve impulse. Tetraethylammonium was much more powerful than triethylcholine in this respect. The pre-junctional transmission failure produced by triethylcholine could not be explained simply on the basis that an initial excessive release led to exhaustion of transmitter.

A comparison between the effects of edrophonium and choline in the skeletal muscles of the cat

The effects of edrophonium and choline have been compared with those of the depolarizing substances acetylcholine, decamethonium, and suxamethonium, in both innervated and chronically denervated tibialis anterior muscles of cats under chloralose anaesthesia. Both edrophonium and choline were more potent antagonists to paralysis by tubocurarine than could be accounted for by their ability to stimulate the motor end-plates directly. It appeared likely that direct depolarization of the end-plate played no part in the anti-curare action of edrophonium and only some part in the anti-curare action of choline. A paralysis produced by the neuromuscular blocking agent, benzoquinonium, was more readily antagonized by a tetanus or by acetylcholine, suxamethonium, and decamethonium than a similar paralysis produced by tubocurarine. The tetraethyl ammonium ion was also slightly more effective against a paralysis by benzoquinonium. On the other hand, edrophonium was about 300 times and choline about five times less potent as an antagonist to benzoquinonium than to tubocurarine. Furthermore, the previous administration of benzoquinonium abolished the antagonistic action to tubocurarine of normally effective doses of edrophonium and reduced that of choline. These results were similar to those previously obtained with neostigmine, physostigmine and ethyl pyrophosphate and suggested that there was some similarity in the mechanism of action of all of these substances. Benzoquinonium, therefore, showed promise as a useful pharmacological tool for distinguishing compounds with this particular type of action. These anti-curare compounds did not appear to act by cholinesterase inhibition, not by an increase in the sensitivity of the motor end-plates. In common with other workers, we suggest that there is a pre-synaptic mechanism of action.

Ion permeation and conduction in a human recombinant 5-HT3 receptor subunit (h5-HT3A)

1. A human recombinant homo-oligomeric 5-HT3 receptor (h5-HT3A) expressed in a human embryonic kidney cell line (HEK 293) was characterized using the whole-cell recording configuration of the patch clamp technique. 2. 5-HT evoked transient inward currents (EC50 = 3.4 microM; Hill coefficient = 1.8) that were blocked by the 5-HT3 receptor antagonist ondansetron (IC50 = 103 pM) and by the non-selective agents metoclopramide (IC50 = 69 nM), cocaine (IC50 = 459 nM) and (+)-tubocurarine (IC50 = 2.8 microM). 3. 5-HT-induced currents rectified inwardly and reversed in sign (E5-HT) at a potential of -2.2 mV. N-Methyl-D-glucamine was finitely permeant. Permeability ratios PNa/PCs and PNMDG/PCs were 0.90 and 0.083, respectively. 4. Permeability towards divalent cations was assessed from measurements of E5-HT in media where Ca2+ and Mg2+ replaced Na+. PCa/PCs and PMg/PCs were calculated to be 1.00 and 0.61, respectively. 5. Single channel chord conductance (gamma) estimated from fluctuation analysis of macroscopic currents increased with membrane hyperpolarization from 243 fS at -40 mV to 742 fS at -100 mV. 6. Reducing [Ca2+]o from 2 to 0.1 mM caused an increase in the whole-cell current evoked by 5-HT. A concomitant reduction in [Mg2+]o produced further potentiation. Fluctuation analysis indicates that a voltage-independent augmentation of gamma contributes to this phenomenon. 7. The data indicate that homo-oligomeric receptors composed of h5-HT3A subunits form inwardly rectifying cation-selective ion channels of low conductance that are permeable to Ca2+ and Mg2+.

Haloperidol does not produce dopamine cell depolarization-block in paralyzed, unanesthetized rats

A widely accepted theory postulates that chronic treatment with neuroleptics causes, in rats, the depolarization block of the majority of midbrain dopamine (DA) neurons. However, we reported that such treatment fails to reduce the number of spontaneously active DA neurons when the neuronal sampling is performed in the d-tubocurarine-paralyzed instead of chloral-hydrate anesthetized preparation. The present experiments were aimed at verifying whether the negative results might be due to the use of d-tubocurarine as paralyzing agent. Rats were chronically treated with haloperidol (0.5 mg kg-1 i.p., daily) for 3 to 4 weeks. Two to three hours after the last injection, the number of spontaneously active DA neurons in the ventral tegmental area (VTA) were sampled, and their discharging characteristics analyzed, both in animals under chloral hydrate anesthesia and in rats immobilized either with d-tubocurarine, gallamine or succinylcholine. The results indicate that chronic treatment with haloperidol reduced the number of spontaneously active VTA-DA neurons by about 65% in animals under chloral hydrate anesthesia, but failed to modify the number of spontaneously firing DA neurons in rats immobilized with d-tubocurarine, gallamine or succinylcholine. The results indicate that the depolarization block of DA neurons does not occur in the paralyzed preparation and raise doubts about the presence of this phenomenon in the intact non- anesthetized unrestrained animal.

Comparison of rocuronium and d-tubocurarine for prevention of succinylcholine-induced fasciculations and myalgia

PURPOSE

We compared d-tubocurarine and rocuronium for the prevention of succinylcholine-induced fasciculations and postoperative myalgia (POM) and evaluated the influence of both drugs on the speed of onset and recovery of succinylcholine.

METHODS

Seventy-five women undergoing surgery of short duration were studied. They were randomized to one of three groups: group SAL received normal saline followed three minutes later by 1.0 mg.kg-1 succinylcholine; group ROC received 0.05 mg.kg-1 rocuronium + 1.5 mg.kg-1 succinylcholine; group DTC received 0.05 mg.kg-1 d-tubocurarine + 1.5 mg.kg-1 succinylcholine. Single-twitch stimulation was applied to the ulnar nerve every 10 sec and the EMG response of the adductor pollicis was recorded. Fasciculations were assessed by a blinded observer on a scale of 0-3. Patients were asked 24 and 48 hr later to rate POM using a scale of 0-10.

RESULTS

The interval needed for twitch height to decrease to 10% of initial value after succinylcholine was longer in group ROC (58 +/- 20 sec) (mean +/- SD) compared with group SAL (44 +/- 13 sec) (P < 0.05). Recovery to 20% occurred faster in group ROC (324 +/- 83 sec) than in groups SAL (456 +/- 103 sec) and DTC (450 +/-132 sec) (P < 0.05). Fasciculations were more intense in groups SAL than in groups ROC and DTC (P < 0.001). Patients rated POM as less intense 24hr postoperatively only in group ROC (1.2 +/- 2.4) compared with group SAL (3.3 +/- 3.5) (P < 0.05).

CONCLUSION

Rocuronium prevents succinylcholine-induced fasciculations and POM. Rocuronium also delays the onset of succinylcholine and shortens its duration compared with d-tubocurarine.

Tourniquet-induced hypertension correlates with autonomic nervous system changes detected by power spectral heart rate analysis

STUDY OBJECTIVE

To determine the autonomic changes associated with pneumatic tourniquet-induced hypertension as measured by power spectral heart rate analysis (PSHR).

DESIGN

Prospective study.

SETTING

Tertiary teaching hospital.

PATIENTS

21 healthy-patients scheduled for lower extremity surgery, during which pneumatic tourniquet inflation was expected to exceed 90 minutes.

INTERVENTIONS

Hemodynamic and PSHR data collected at 5 minute intervals during inflation of the pneumatic tourniquet. Tourniquet-induced hypertension (T-HTN) defined at 30% increase above baseline.

MEASUREMENTS AND MAIN RESULTS

Blood pressure, heart rate, maximum changes in low frequency variability (LFa), high frequency variability (HFa), and their ratio (LFa/HFa) were measured. Of the 21 patients, 11 had T-HTN. A significantly greater increase in LFa and LFa/HFa ratio was seen in the T-HTN group, where patients were greater in age. LFa, HFa, and ratio were not significantly different with T-HTN until 60 minutes or greater. Best correlation with T-HTN occurred with maximum increase in LFa/HFa ratio compared with increase in LFa or decrease in HFa.

CONCLUSION

Tourniquet hypertension correlated with activation of the sympathetic nervous systems, as measured by PSHR variables.

Intracellular recordings from spinal neurons during ‘swimming’ in paralysed amphibian embryos

Intracellular microelectrode recordings have been made from probable moto- neurons in the spinal cord ofXenopus laevisembryos during Active ‘swimming’ in preparations paralysed with the neuromuscular blocking agent tubocurarine. These cells had resting potentials of -50 mV or more. During spontaneous or stimulus- evoked ‘swimming’ episodes: (a) the cells were tonically excited; the level of tonic synaptic excitation and the conductance increase underlying it were both inversely related to the ‘swimming’ cycle period; (b) the cells usually fired one spike per cycle in phase with the motor root burst on the same side; spikes did not overshoot zero and were evoked by phasic excitatory synaptic input on each cycle, superimposed on the tonic excitation; (c) in phase with motor root discharge on the opposite side of the body, the cells were hyperpolarized by a chloride-dependent inhibitory postsynaptic potential. The nature of synaptic potentials during ‘swimming’ was evaluated by means of intracellular current injections. The ‘swimming’ activity could be controlled by natural stimuli. The results provide clear evidence on the relation of tonic excitation to rhythmic locomotory pattern generation, and indirect evidence for reciprocal inhibitory coupling between antagonistic motor systems.