The role of the local anaesthetic properties of beta-adrenoceptor blocking agents in antagonizing CaCl2-induced arrhythmias in the rat

Effect of calcium chloride and 4-aminopyridine therapy on desipramine toxicity in rats

BACKGROUND

Hypotension is a major contributor to mortality in tricyclic antidepressant overdose. Recent data suggest that tricyclic antidepressants inhibit calcium influx in some tissues. This study addressed the potential role of calcium channel blockade in tricyclic antidepressant-induced hypotension.

METHODS

Two interventions were studied that have been shown previously to improve blood pressure with calcium channel blocker overdose. CaCl2 and 4-aminopyridine. Anesthetized rats received the tricyclic antidepressant desipramine IP to produce hypotension, QRS prolongation, and bradycardia. Fifteen min later, animals received CaCl2, NaHCO3, or saline. In a second experiment, rats received tricyclic antidepressant desipramine IP followed in 15 min by 4-aminopyridine or saline.

RESULTS

NaHCO3 briefly (5 min) reversed hypotension and QRS prolongation. CaCl2 and 4-aminopyridine failed to improve blood pressure. The incidence of ventricular arrhythmias (p = 0.004) and seizures (p = 0.03) in the CaCl2 group was higher than the other groups.

CONCLUSION

The administration of CaCl2 or 4-aminopyridine did not reverse tricyclic antidepressant-induced hypotension in rats. CaCl2 therapy may possibly worsen both cardiovascular and central nervous system toxicity. These findings do not support a role for calcium channel inhibition in the pathogenesis of tricyclic antidepressant-induced hypotension.

Selective beta 1 and beta 2 adrenoceptor blockade on epinephrine-induced arrhythmias in halothane anaesthetized dogs

Beta 2 as well as beta 1 adrenoceptors have been recognized in the heart of vertebrates. They mediate a positive chronotropic action of catecholamines. We compared the effect of selective beta 1 and beta 2 adrenoceptor antagonists on the genesis of halothane-epinephrine arrhythmias in dogs. The arrhythmogenic dose (AD) of epinephrine was increased in the presence of l-metoprolol, a selective beta 1 antagonist (8.40 +/- 1.13 micrograms.kg-1 x min-1; mean +/- SEM), compared with control value (2.62 +/- 0.56) (P < 0.05). In contrast, ICI-118,551, a selective beta 2 antagonist, did not change the AD (2.36 +/- 0.43). Adding ICI-118,551 to l-metoprolol did not affect the AD of epinephrine in the presence of l-metoprolol alone (6.34 +/- 0.74 vs 8.40 +/- 1.13). These results suggest that selective beta 1 blockade is effective in preventing halothane-epinephrine arrhythmias, but selective beta 2 blockade is not.

Comparison of verapamil and bepridil, two slow channel inhibitors, in protection against calcium-induced arrhythmias

Verapamil and bepridil share the common property of antagonizing the slow inward calcium-mediated current, but bepridil has some additional antiarrhythmic properties. The efficacy of these two compounds against CaCl2-induced arrhythmias has been compared in rats. CaCl2 was administered i.v. by continuous infusion until death (25 mg X kg-1 X min-1 or 40 mg X kg-1 X min-1) or by bolus injection (160 mg X kg-1). Bepridil (5, 10 mg X kg-1) or verapamil (2.5, 5 mg X kg-1) were injected 10 min before CaCl2. Bepridil (10 mg X kg-1) or verapamil (5 mg X kg-1) prolong the survival time during CaCl2 infusion. After pretreatment, the injection of 160 mg X kg-1 CaCl2 is less toxic: 25% of animals are protected by bepridil (5 mg X kg-1), 41% by bepridil (10 mg X kg-1) or verapamil (5 mg X kg-1). At death the myocardial Ca2+ level is not different in controls and pretreated animals, thus, the ratio myocardial Ca2+/total injected Ca2+ is significantly lowered by bepridil (10 mg X kg-1) or verapamil (5 mg X kg-1). The efficacy of the two drugs on this model appears related solely to inhibition of slow inward current despite the additional antiarrhythmic profile of bepridil.

In vitro and in vivo antiarrhythmic effects of prazosin in the rat

The possible antiarrhythmic action of prazosin was studied on two experimental models: a focus of ectopic automaticity in the rat isolated right ventricle and arrhythmias induced by i.v. CaCl2 in anaesthetized animals. In vitro, prazosin at 10(-5)M abolished the ectopic automaticity focus in 83% of cases (10/12). The effects of prazosin were not modified by reserpine pretreatment. In vivo, prazosin modified the range of CaCl2 arrhythmias, reduced the mean control sinus rate (by 21.7% at 1 mg/kg), reduced incidence and mortality by ventricular fibrillation and lengthened survival time of animals that eventually died. The results indicate that antagonism of postsynaptic alpha 1-adrenoreceptors may partly explain the efficacy of prazosin against some experimental cardiac arrhythmias.