Effects of verapamil, dantrolene and lanthanum on catecholamine release from rat adrenal medulla

Withdrawal syndrome following cessation of antihypertensive drug therapy

In this study, a review of the available information concerning abrupt withdrawal of antihypertensive drug therapy is presented. Abrupt withdrawal of these drugs can produce a syndrome of sympathetic overactivity that includes nervousness, tachycardia, headache, agitation and nausea 36-72 h after cessation of the drug. A withdrawal syndrome may occur after discontinuation of almost all types of antihypertensive drugs, but mostly occurs with clonidine, beta-blockers, methyldopa and guanabenz. Less commonly can produce a rapid increase of the blood pressure to pre-treatment levels or above, or both and/or myocardial ischaemia. Although the exact incidence of the syndrome is not known, it appears to be rare, at least in patients receiving standard doses of the above antihypertensive drugs. The best treatment is prevention. In this study regarding the withdrawal syndrome that follows cessation of antihypertensive drugs therapy, a reference to the abrupt discontinuation of the main categories of antihypertensive drugs is also attempted.

Attenuation of cardiovascular responses to tracheal extubation: comparison of verapamil, lidocaine, and verapamil-lidocaine combination

We recently showed that verapamil attenuated hemodynamic responses to tracheal extubation. The aim of the current study was to compare the efficacy of a combination of intravenous (I.V.) verapamil (0.1 mg/kg) and I.V. lidocaine (1 mg/kg) with that of each drug alone in suppressing the cardiovascular changes during tracheal extubation and emergence from anesthesia. One hundred adult patients (ASA physical status I) who were to undergo elective minor surgery were randomly assigned to one of four groups (n = 25 each): Group S = saline plus saline (control), Group V = verapamil 0.1 mg/kg I.V. plus saline, Group L = lidocaine 1 mg/kg I.V. plus saline, and Group V-L = verapamil 0.1 mg/kg I.V. plus lidocaine 1 mg/kg I.V. These medications were given 2 min before tracheal extubation. Anesthesia was maintained with 1.0%-2.0% sevoflurane and 60% nitrous oxide (N2O) in oxygen. Muscle relaxation was achieved with vecuronium, and a residual neuromuscular blockade was reversed with neostigmine 0.05 mg/kg (combined with atropine 0.02 mg/kg). Changes in heart rate (HR) and arterial blood pressure (AP) were measured during and after tracheal extubation. In the control group, the HR and systolic and diastolic AP increased significantly during tracheal extubation. Verapamil, lidocaine, and their combination attenuated the increases in these variables. The beneficial effect was the greatest with the combination of verapamil and lidocaine. These findings suggest that verapamil 0.1 mg/kg and lidocaine 1 mg/kg given I.V. concomitantly 2 min before tracheal extubation is a simple and more effective prophylaxis than verapamil or lidocaine alone for attenuating the cardiovascular changes associated with tracheal extubation.

IMPLICATIONS

Tachycardia and hypertension associated with tracheal extubation, which may lead to myocardial ischemia, represent a potential risk for patients with coronary arterial disease. To seek effective pharmacological prophylaxis against these complications, we compared the attenuation of hemodynamic changes among verapamil, lidocaine, and a verapamil/lidocaine combination using ASA physical status I patients and found the combination to be effective.

Inhibition by omega-conotoxin GVIA of adrenal catecholamine release in response to endogenous and exogenous acetylcholine

Effects of the N-type voltage-dependent Ca2+ channel (VDCC) blocker, omega-conotoxin GVIA, and the L-type VDCC blockers, nifedipine and verapamil, on adrenal catecholamine release were examined in anesthetized dogs. These blockers were infused into the adrenal gland through the phrenicoabdominal artery. Splanchnic nerve stimulation at 1 and 3 Hz produced frequency-dependent increases in epinephrine and norepinephrine output determined from adrenal venous blood. Infusion of omega-conotoxin GVIA (0.4 micrograms/min) significantly inhibited the splanchnic nerve stimulation-evoked increases in epinephrine and norepinephrine output. Furthermore, increases in epinephrine and norepinephrine output induced by intraarterial injection of acetylcholine (3 micrograms) into the adrenal gland also were inhibited by omega-conotoxin GVIA (0.4 micrograms/min). Further inhibition of splanchnic nerve stimulation- or exogenous acetylcholine-induced increases in catecholamine output was observed even after the cessation of omega-conotoxin GVIA infusion. Neither nifedipine (1 microgram/min) nor verapamil (10 micrograms/min) affected the splanchnic nerve stimulation-evoked increases in catecholamine output, whereas they inhibited the exogenous acetylcholine-evoked catecholamine release. These results suggest that N-type VDCCs located in adrenal medullary cells may contribute to the release of adrenal catecholamines in response to endogenous and exogenous acetylcholine in the dog.

Calcium antagonists and vasodilatation

Calcium antagonists comprise a diverse group of chemically unrelated agents that interact with voltage-operated calcium channels (L-type) and thereby inhibit smooth muscle contractility. They are used to treat several major cardiovascular disorders, including hypertension and angina pectoris; they are also studied in congestive heart failure and in atherosclerosis. The current view is that their therapeutic action is related to vasodilatation. This view is an oversimplification, as will be shown in this review. It will also be illustrated that all calcium antagonists are not identical pharmacological agents.

Effects of nifedipine and Bay-K-8644 on the release of catecholamines from the dog adrenal gland in response to splanchnic nerve stimulation

1. The effects of nifedipine and Bay-K-8644 on the release of adrenal catecholamines were examined in anaesthetized dogs. 2. Splanchnic nerve stimulation (SNS) at 1 and 3 Hz produced frequency-dependent increases in adrenaline (ADR) and noradrenaline (NA) output determined from adrenal venous blood. 3. Neither nifedipine (10 and 30 micrograms/kg, i.v.) nor Bay-K-8644 (10 and 30 micrograms/kg, i.v.) modified the SNS-induced increases in catecholamine output. Basal catecholamine output tended to be increased and decreased by nifedipine and Bay-K-8644, respectively. 4. Nifedipine produced significant decreases in arterial pressure and renal blood flow rate. Bay-K-8644 produced a significant increase in arterial pressure associated with a decrease in renal blood flow rate. 5. These results suggest that dihydropyridine-sensitive calcium channels do not play a major role in adrenal catecholamine release evoked by SNS.

Possible regulation of caffeine-induced intracellular Ca2+ mobilization by intracellular free Na+

To gain some understanding of the regulatory mechanism involved in caffeine-induced Ca2+ release in adrenal chromaffin cells, we took advantage of the paradoxical observation that removal of divalent cations potentiated the secretory response to caffeine. We measured the concentration of cytosolic free Ca2+ ([Ca]in) in isolated cat chromaffin cells, by fura-2 microfluorometry, to see whether there was any correlation between the secretory response and the rise in [Ca]in. The caffeine-induced [Ca]in rise and catecholamine secretion were increased by treatment of cells with a divalent cation-deficient solution. These potentiated responses were strongly inhibited either by pretreatment with ryanodine, by the reduction of the external Na+ concentration, or by the addition of Ca2+ channel blockers. Removal of divalent cations caused a large rise in the cytosolic free Na+ concentration ([Na]in), which was measured using SBFI microfluorometry. This rise in [Na]in was reduced either by adding Ca2+ channel blockers or by reducing the external Na+ concentration. These results show a good correlation between caffeine-induced Ca2+ release and [Na]in at the time of stimulation, suggesting that caffeine-induced Ca2+ release is regulated by [Na]in.

Inhibition of K(+)-evoked [3H]D-aspartate release and neuronal calcium influx by verapamil, diltiazem and dextromethorphan: evidence for non-L/non-N voltage-sensitive calcium channels

The effects of inhibitors of voltage-sensitive calcium channels (VSCC) on K(+)-evoked [3H]D-aspartate release from rat hippocampal slices and the K(+)-evoked increase in intracellular calcium in neocortical neurons in primary culture were examined. K+ caused a concentration-dependent release of [3H]D-aspartate that was approximately 85% dependent on the presence of extracellular calcium. Neither the marine snail toxin, omega-conotoxin GVIA, nor the dihydropyridine VSCC antagonist, nitrendipine, had any effect on K(+)-evoked release of [3H]D-aspartate. omega-Conotoxin GVIA and nitrendipine caused a relatively small (20-30%) inhibition of K(+)-evoked increase in intracellular calcium in neocortical neurons in primary culture. This suggests that K(+)-evoked [3H]D-aspartate release is not dependent on L- or N-type VSCC, whereas K(+)-evoked neuronal calcium influx was only partially dependent on L- and N-type VSCC. Verapamil, dextromethorphan and diltiazem caused a concentration-dependent inhibition of K(+)-evoked release of [3H]D-aspartate with IC50 values of 30, 100 and 120 microM, respectively. The K(+)-evoked increase in intracellular calcium was inhibited with essentially the same rank order of potency, but with slightly greater potencies (IC50 values for verapamil, diltiazem and dextromethorphan were 20, 50 and 50 microM, respectively). At 300 microM, neither verapamil, diltiazem nor dextromethorphan inhibited [3H]D-aspartate release evoked by the calcium ionophore ionomycin, suggesting that these compounds are not acting intracellularly to inhibit the ability of free cytosolic calcium to evoke release.(ABSTRACT TRUNCATED AT 250 WORDS)

The mode of action of caffeine on catecholamine release from perfused adrenal glands of cat

1 Adrenaline and noradrenaline secretion induced by caffeine was investigated in the perfused cat adrenal glands. 2 Caffeine (10-80 mM) caused a dose-dependent increase in both adrenaline and noradrenaline secretion when applied for 1 min and 10 min after replacing Ca2+ with 10(-5)M EGTA in the perfusion solution. The ratio of adrenaline to noradrenaline was about 1:1. Mg2+ and/or Ca2+ inhibited the response to caffeine. 3 When caffeine (40 mM) was repeatedly applied in the absence of extracellular Ca2+, the secretory response almost disappeared but only at the second challenge with caffeine. However, the response was partially restored after readmission of Ca2+ (2.2 mM) and was augmented after the readmission of Ca2+ with ouabain (10(-5) M). 4 Caffeine-induced secretion of adrenaline and noradrenaline increased with the increase in the preloaded concentration of Ca2+ and attained a maximum at 16 mM Ca2+. 5 During perfusion with Ca2+-free Locke solution containing hexamethonium (10(-3)M), acetylcholine (10(-4)M) caused increases in both adrenaline and noradrenaline secretions with a ratio of about 1:2. The secretory responses were partially inhibited by preceding stimulation with exposure to caffeine (80 mM). 6 These results suggest that caffeine mobilizes Ca2+ from an intracellular storage site that may not be entirely the same as that linked to muscarinic receptors, and causes an increase in both adrenaline and noradrenaline secretion from cat adrenal chromaffin cells.

Multiple voltage-sensitive calcium channels are probably involved in endogenous GABA release from striatal neurones differentiated in primary culture

Calcium-dependent release of neurotransmitters is thought to be due to Ca2+ entry into nerve terminals, but the identities of the various voltage-sensitive Ca2+ channels (VSCC) involved in this process remain obscure. To elucidate the types of VSCCs involved in the release process, we studied the effects of various organic Ca2+ channel antagonists and agonists on the release of endogenous gamma-aminobutyric acid (GABA) from mouse striatal neurones differentiated in primary culture. Diltiazem, verapamil and methoxyverapamil (D 600) inhibited K+-evoked (30 mM) GABA release at very high concentrations (greater than 1 microM). The dihydropyridine (DHP) nifedipine, at low concentrations (0.01-1.00 microM), was able to inhibit part of the K+-evoked GABA release (25.6 +/- 7.3% inhibition at 1 microM). This is in agreement with the high affinity of nifedipine for DHP binding sites. The DHPs, BAY K 8644 (EC50 = 41 +/- 15 nM) and CGP 28.392, which possess agonist properties at VSCCs, increased the 15 mM K+-evoked GABA release. The release evoked by the combination of K+ (15 mM) and BAY K 8644 (up to 10 microM) remained smaller than the release elicited by 30 mM K+. The effect of BAY K 8644 (1 microM) was inhibited by nifedipine (IC50 0.55 +/- 0.05 microM). When Na+ ions were replaced by choline, basal and K+-evoked GABA release was significantly increased. Even in the absence of external Na+, nifedipine (1 microM) was not able to totally block the K+ effect. Moreover amiloride, a drug known to inhibit Na+/Ca2+ exchange, and tetrodotoxin (TTX), did not modify the 30 mM K+ response.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of TMB-8 and dantrolene on ACTH- and angiotensin-induced steroidogenesis by frog interrenal gland: evidence for a role of intracellular calcium in angiotensin action

The influence of intracellular calcium on the steroidogenic response of adrenocortical tissue to ACTH and angiotensin has been studied in the frog, using a perifusion system technique. The release of corticosterone, aldosterone and prostaglandins in the effluent medium was monitored by specific radioimmunoassays. TMB-8 and dantrolene, two potential blockers of calcium mobilization from intracellular pool(s), were tested. Dantrolene (5 X 10(-5) M) significantly reduced basal and angiotensin-induced corticosterone and aldosterone production but had little effect on ACTH-evoked steroid release. Conversely TMB-8 (10(-4) M) profoundly depressed spontaneous as well as ACTH- and angiotensin II-induced corticosteroid secretion, suggesting that this compound may affect not only calcium mobilization from the endoplasmic reticulum pool but also calcium influx. Adrenal glands perifused with both dantrolene and calcium-free medium showed no response to angiotensin II. Conversely, in calcium-free conditions and in the presence of dantrolene, angiotensin II still caused an increase in prostaglandin synthesis. Taken together, these results indicate that 1) dantrolene is a more specific agent than TMB-8 in inhibiting calcium mobilization from intracellular pool(s); 2) ACTH increases corticosteroidogenesis without inducing mobilization of intracellular calcium; 3) angiotensin II stimulates both the efflux of calcium from the endoplasmic reticulum and the influx of calcium through the plasma membrane; 4) calcium is required after prostaglandin production in the steroidogenic response of frog interrenal gland to angiotensin II.

The possible involvement of the phospholipid phase of membranes in mediating the effects of verapamil on Ca2+ transport

The effect of verapamil in a model system of A23187-induced Ca2+-uptake into liposomes was studied. This was done in order to separate the effects of verapamil on the lipid phase of membranes from its effects on membraneous proteins. In the absence of A23187, the liposomes exhibited a very low Ca2+ permeability, which did not change with addition of verapamil. Creation of a valinomycin-induced negative inside membrane potential combined with increased membrane permeability to Ca2+ (A23187), increased Ca2+-entry fivefold and more. Addition of verapamil under these conditions led to a further increase in Ca2+ entry. The negative inside polarization of the liposomes' membrane (as estimated from [3H]TPP+ uptake) was not affected by verapamil. [3H] Verapamil bound specifically to native synaptic plasma membranes with a Kd = 87.4 nM +/- 21.5 (SD) and Bmax = 2.19 pmol/mg protein +/- 0.92 (SD). Specific binding to the liposomes could not be demonstrated. High nonspecific binding of up to about 20% of the total verapamil in the external solution was observed (3.8 pmoles [3H]verapamil/mg phospholipid when 30 nM verapamil was used and 50 nmoles/mg phospholipid when 200 microM [3H] verapamil was used). The high nonspecific binding of verapamil to the liposomes had no detectable effect on the fluidity of their membrane, as seen in fluorescence-anisotropy studies with the fluorescent probe DPH.

Cocaine-calcium channel antagonist interactions

Diltiazem, a benzothiazepine calcium channel antagonist, was given to six healthy men as a single 60 mg oral dose 120 min before IV injection of cocaine (0.2 mg/kg) in a double-blind, placebo-controlled, two-session study. Diltiazem alone produced no significant effects. Cocaine increased blood pressure, heart rate, pupil size and subjective "high" ratings, and decreased skin temperature. Diltiazem pretreatment diminished the cocaine effect on skin temperature, but did not otherwise alter the response to cocaine. Calcium channel antagonists diminish the effects of cocaine in vitro and in animals. Dosage considerations may be critical because of the differential sensitivity of various tissues to calcium channel antagonists.

Inhibition of calcium uptake and catecholamine release by 8-(N,N-diethylamino)-octyl-3,4,5-trimethoxybenzoate hydrochloride (TMB-8) in cultured bovine adrenal chromaffin cells

Effects of intracellular calcium antagonists, 8-(N,N-diethylamino)-octyl-3,4,5-trimethoxybenzoate hydrochloride (TMB-8) and 1-(5-(p-nitrophenyl)-furfurylidene-amino) hydantoin sodium hydrate (dantrolene sodium), on catecholamine release and 45Ca2+ uptake were studied using cultured bovine adrenal chromaffin cells. TMB-8 inhibited carbamylcholine-evoked catecholamine release and 45Ca2+ uptake in a concentration-dependent manner with a similar potency. On the contrary, dantrolene sodium did not show obvious inhibitory effects of catecholamine release and 45Ca2+ uptake. Although TMB-8 inhibited the high K+-evoked catecholamine release and 45Ca2+ uptake, the potency of the drug was approximately 100-fold less than when used to inhibit the carbamylcholine-evoked catecholamine release and 45Ca2+ uptake. The inhibitory effect of TMB-8 on the carbamylcholine-evoked catecholamine release was not overcome by an increase in an extracellular calcium concentration, and was not due to competitive antagonism at the nicotinic receptor site. Moreover, TMB-8 inhibited the carbamylcholine-stimulated 45Ca2+ efflux, but dantrolene sodium failed to affect it. These results suggest that TMB-8, a well-known intracellular calcium antagonist, prevents the cellular calcium uptake in cultured adrenal chromaffin cells, and thus prevents catecholamine release.

Differential effects of D600, nifedipine and dantrolene sodium on excitation-secretion coupling and presynaptic beta-adrenoceptor responses in rat atria

The stimulation-evoked release of tritium was measured from rat atria labelled with [3H]-noradrenaline. The calcium dependence of evoked release and the facilitation of this release via activation of presynaptic beta-adrenoceptors were examined using D600 (methoxyverapamil), nifedipine and dantrolene sodium. Both D600 and nifedipine at dose levels of 20 and 100 microM inhibited evoked release. Dantrolene (20, 100 microM) reduced release by 25%, the effect being maximal at 20 microM. In the presence of 20 nM isoprenaline, a facilitation of evoked release occurred, which was blocked by 0.1 microM (-)-propranolol. The facilitatory action of isoprenaline was abolished by omission of calcium from the buffer, or by D600 or nifedipine, (100 microM). In contrast, the response to isoprenaline was not modified by dantrolene (20, 100 microM). It is concluded that the evoked release of noradrenaline (NA) utilizes Ca from both intra- and extracellular sources and that isoprenaline increases NA secretion by promoting the depolarization-induced influx of Ca.

Release of endogenous dopamine from tuberoinfundibular neurons

Release of endogenous dopamine(DA) from arcuate-periventricular nucleus-median eminence fragments has been analyzed in an in vitro static incubation system. Exposure of these hypothalamic fragments to increasing concentrations of K+ ions produced a dose-dependent release of endogenous DA. The highest rate of K+-stimulated DA efflux occurred in the first 10 minutes, thereafter it progressively declined reaching prestimulated levels at 30 minutes. If two consecutive depolarizing stimuli of 40 mM KCl were applied to the same hypothalamic fragment, after a 40 minutes rest period, an equivalent release of endogenous DA occurred. Removal of Ca++ ions from the incubation medium containing the Ca++ chelator EGTA caused a decrease of basal DA efflux and completely prevented the K+-induced release of DA. Furthermore when verapamil, a blocker of Ca++ entrance, was added to the incubation medium in a concentration of 50 microM, the K+-induced DA efflux was completely counteracted, whereas spontaneous release was unmodified. Finally nomifensine, a potent blocker of DA uptake, added in vitro in a final concentration of 10 microM, significantly reinforced K+-induced release of endogenous DA. Since nomifensine did not modify basal DA release, this study confirmed its prevalent uptake blocking property rather than its releasing action on DA.

The inhibition of Ca uptake in cardiac membrane vesicles by verapamil

Cardiac membrane vesicles take up Ca2+ in response to Na+ gradient (high inside) and negative inside membrane potential. Both components of the Ca2+ uptake, the Na+ gradient dependent uptake and the membrane potential dependent uptake are inhibited by verapamil; the action is dose-dependent and the concentrations of verapamil required to inhibit the Ca2+ uptake to 50% of its maximal value are 50 and 60 microM respectively. In the concentration ranges tested (50-750 microM Ca2+), the inhibitory effect of verapamil could not be antagonized by increasing the Ca2+ concentration of the medium. Introducing verapamil into the vesicles by rapid freezing and slow thawing of the vesicles had the same inhibitory effect as adding the same concentration of verapamil on the outside of the vesicles. Adding verapamil to both sides of the vesicle membrane led to higher inhibition of Ca2+ uptake. It is proposed that addition of verapamil can cause a change in cardiac membranes which is manifested by a decrease in the driving membrane potential and Ca2+ transport.

Interaction between the calcium entry blocker nifedipine with the alpha 1-adrenoreceptor-mediated increase in diastolic pressure elicited by catecholamines

In the pithed normotensive rat the effect of the calcium entry blocker nifedipine was studied on alpha 1-adrenoreceptor-mediated pressor responses of intravenously administered (-)-noradrenaline, dopamine and (-)-adrenaline as well as of (-)-noradrenaline released from sympathetic neurones by DMPP, tyramine, McN-A-343 and electrical stimulation of the spinal cord at the level Th5-L4. The alpha 1-adrenoreceptor-mediated pressor responses to both intravenously administered and neuronally released catecholamines were moderately antagonized by nifedipine. The alpha 1-adrenoreceptor-mediated increase in diastolic pressure elicited by DMPP was unique in its extreme insensitivity to blockade by nifedipine. The results support the hypothesis that phenylethylamine-like alpha 1-adrenoreceptor agonists induce an increase in diastolic pressure relatively independent of extracellular calcium in contrast to imidazolidine-like agonists. The data may be interpreted as indicating that each alpha 1-adrenoreceptor agonist activates the alpha 1-adrenoreceptor in a unique way.

The inhibition of Na-dependent Ca uptake by verapamil in synaptic plasma membrane vesicles

This study on the effect of verapamil on the Na+-dependent Ca2+ uptake system (Na+-Ca2+ exchanger) of synaptic plasma membrane (SPM) vesicles showed that verapamil inhibited the Na+-dependent Ca2+ uptake in a dose dependent manner. A 50% inhibition was obtained with 175 microM verapamil. Calcium uptake in SPM vesicles is dependent on the Na+ gradient across the membrane and on the membrane potential. Both components of the Ca2+ uptake system were inhibited by verapamil. Na+-coupled GABA uptake in SPM vesicles was also inhibited by verapamil in a similar dose-dependent fashion. It seems therefore that verapamil inhibits Na+ gradient driven processes in synaptic plasma membrane vesicles.

Calcium antagonists and histamine secretion from rat peritoneal mast cells

The calcium antagonists verapamil and nifedipine inhibited histamine release induced from rat peritoneal mast cells by a number of secretory stimuli. However, the concentrations required were much higher than those active in smooth muscle preparations. The inhibition was unaffected by elevated levels of external calcium and the drugs prevented release in the absence of added calcium. The novel calcium antagonist, PY 108-068, had no effect on histamine secretion from mast cells. These results suggest that calcium channels in the mastocyte may differ from those in smooth muscle and that at concentrations required to inhibit secretion, verapamil and nifedipine may have non-specific stabilizing effects on the mast cell membrane.

Contrasting effect of verapamil on catecholamine release induced by acetylcholine and by NaCl-omission from the bovine adrenal medulla

Verapamil (3 X 10(-4) M) produced a 92.2% inhibition on the release of catecholamines induced by acetylcholine in perfused bovine adrenal glands. This blocking effect was slowly reversible. On the other hand, verapamil (3 X 10(-4) M) failed to antagonize the secretory response evoked by the substitution of NaCl by sucrose in the perfusion fluid. A similar lack of inhibitory effect of verapamil on catecholamine output produced by NaCl-omission was observed in the absence of extra-cellular Ca2+. These results suggest that Ca2+ influx might not be involved in adreno-medullary secretion induced by the substitution of NaCl by sucrose in the perfusion medium.

Comparative effects of abrupt withdrawal of propranolol and verapamil in angina pectoris

The potential hazards of abrupt withdrawal of propranolol have been described in patients with angina pectoris; however, the effects of abrupt withdrawal from long-term therapy with verapamil have not previously been investigated. The comparative effects of withdrawal from long-term treatment with propranolol and verapamil were assessed in a placebo-controlled double-blind randomized crossover study of 20 patients received placebo for 2 weeks, then increasing doses of propranolol (60 to 320 mg/day) or verapamil (240 to 480 mg/day) for 3 weeks. Patients were then abruptly withdrawn from drug onto placebo for 1 week, followed by crossover to the other drug treatment and a second withdrawal period. All 20 patients were withdrawn from verapamil without evidence of a rebound increase in frequency of anginal attacks, blood pressure, heart rate, or rate-pressure product and without a rebound deterioration in exercise tolerance. In contrast, with propranolol withdrawal, 2 patients (with the highest baseline angina attack rate) had a severe exacerbation of their anginal syndrome and could not undergo formal exercise testing; the other 18 patients were withdrawn from propranolol without incident. Plasma catecholamines were increased during exercise compared with rest during all treatments; however, the levels of catecholamines during exercise were significantly higher with propranolol than with verapamil and placebo (p less than 0.05). Levels of exercise catecholamines returned to placebo baseline values after withdrawal of propranolol.

Stimulus-secretion coupling in isolated adrenal chromaffin cells: calcium channel activation and possible role of cytoskeletal elements

The catecholamine secretory function of a preparation of isolated bovine adrenal chromaffin cells has been further characterized under conditions designed to elucidate the mechanism of calcium channel activation and the possible role of cytoskeletal elements in stimulus-secretion coupling. Three related sets of data were obtained: (1) Differences in kinetics, Ca dependence, strength, and additivity of the secretory response to acetylcholine (ACh) versus excess K; (2) the effects on secretion of the Ca channel-blocking agents, Ni, Mg, and verapamil; and (3) the Ca dependence of vinblastine action on ACh- and K-evoked secretion. The results suggest that a major portion of the Ca influx required for catecholamine release enters the cell via voltage-dependent Ca channels with some additional Ca influx via the ACh receptor channel. Comparison of the present secretion data with corresponding known electrophysiological properties of isolated chromaffin cells provides added evidence for a role of chromaffin cell action potentials in regulation of Ca influx and the secretory response. Elevated Ca concentrations enhanced K-evoked secretion to levels comparable to that of Ach but did not induce a vinblastine block of K-evoked release. This provides further evidence against a role of microtubules in the common exocytosis event per se. However, a role of cytoskeletal elements in directing the movement of secretory granules, or an action of vinblastine at cholinergic receptors, remain distinct possibilities.

Dantrolene and the effect of temperature on the spontaneous release of transmitter at the frog neuromuscular junction

The characteristic effect of temperature on m.e.p.p. frequency at the amphibian neuromuscular junction is unaltered by the presence of Dantrolene (an agent that is believed to reduce the efflux of Ca2+ from intracellular stores) or by changes in [Ca2+)o. It is concluded that temperature affects the release system directly, with a transition temperature at about 16 degrees C.