Actions of bretylium and guanethidine on the uptake and release of [3H]-noradrenaline

The effect of bretylium and guanethidine has been studied on the uptake and the spontaneous and reserpine-induced release of [(3)H]-noradrenaline in the rat heart and in the splenic nerve endings of the cat. Bretylium and guanethidine inhibited the uptake by the heart of circulating [(3)H]-noradrenaline. Bretylium blocked spontaneous and reserpine-induced release of [(3)H]-noradrenaline, while guanethidine caused release and partially antagonized the reserpine-induced release. Both compounds produced a transient liberation of [(3)H]-noradrenaline from splenic nerves, but blocked the release of the [(3)H]-catechol amine following stimulation of the splenic nerve.

Action of bretylium and guanethidine at the neuromuscular junction

Bretylium and guanethidine produced a block of neuromuscular transmission in the rat phrenic nerve diaphragm and cat sciatic gastrocnemius preparations, but had a potentiating effect on acetylcholine-induced contracture of the frog rectus. On the sciatic gastrocnemius preparation of the cat the compounds had a twofold action, consisting of an initial transient, and a delayed but more sustained, block of neuromuscular transmission. Bretylium and guanethidine had no immediate effect on the response of the muscle to direct stimulation, though a weak delayed depressant effect was observed. Intravenous injection of these compounds produced a flaccid paralysis in pigeons. Possible mechanisms of the neuromuscular blocking action of bretylium and guanethidine are discussed. Inhibition of acetylcholine release from motor nerve endings resulting from local anaesthesia by these compounds is suggested as a possible mechanism of their neuromuscular blocking action.

Some cocaine-like actions of 3-phenoxypro-pylguanidine

In anaesthetized cats 3-phenoxypropylguanidine caused a contracture of the nictitating membrane, a dilatation of the pupil and a fall followed by a rise in the arterial blood pressure. In spinal preparations of cats the initial fall in blood pressure was usually absent and the rise in blood pressure subsided to a steady level, which was about 10 mm Hg above the initial pressure. The pressor action and the contracture of the nictitating membrane were inhibited by phenoxybenzamine and by previous treatment with reserpine, but were not abolished by adrenalectomy and bretylium. 3-Phenoxypropylguanidine potentiated the actions of adrenaline and noradrenaline, increased the blood glucose concentration of the rabbit and decreased the appetite of the cat. The action of tyramine on the cardiovascular system was inhibited by 3-phenoxypropylguanidine, but the stimulant action of tyramine on the nictitating membrane of the cat was not abolished by this substance. Although 3-phenoxypropylguanidine produced a local anaesthesia of long duration in guinea-pig skin, it failed to anaesthetize the rabbit cornea. The responses to stimulation of the preganglionic cervical sympathetic nerve of the cat and the great auricular nerve of the rabbit ear were not abolished by 3-phenoxypropylguanidine; neither did this substance abolish the nicotinic action of acetylcholine in atropinized cats. Contractions of the rat fundus to tryptamine and 5-hydroxytryptamine were antagonized by 3-phenoxypropylguanidine, but were potentiated by cocaine.

Effect of guanethidine in revealing cholinergic sympathetic fibres

Guanethidine abolished the inhibitory response of segments of rabbit intestine to stimulation of the sympathetic nerves which accompany the mesenteric arteries. In the majority of experiments a motor response of the intestinal segment was then revealed; it was more readily observed in intestinal segments from young than from adult rabbits. The motor response of the intestine to sympathetic stimulation after guanethidine was blocked by atropine. It was not blocked by hexamethonium and was present in rabbits in which the vagal innervation to the small intestine had been sectioned. In the cat isolated atria, guanethidine blocked the accelerator response to sympathetic nerve stimulation and revealed a response resembling that to stimulation of the vagus. It was concluded that guanethidine blocked the release of noradrenaline and thus revealed the response to the direct action of acetylcholine released from cholinergic sympathetic nerves.

The antimicrobial properties of some alpha-amino-oxy-acids, alpha-amino-oxy-hydrazides, alkoxyamines, alkoxydiguanides and their derivatives

A series of compounds containing an amino-oxy-group has been examined for antibacterial and antifungal activity. The amino-oxy-acids and the alkoxyamines showed little activity, but the hydrazides, notably the amino-oxydodecyl and the amino-oxytetradecyl compounds, had appreciable activity against Staphylococcus aureus. The alkoxydiguanides showed considerable bactericidal activity in vitro against Gram-positive and Gram-negative organisms and some activity against Mycobacterium tuberculosis. The most active compounds were those with a chain containing 10 to 14 carbon atoms, but the activity was considerably reduced in the presence of serum. They were also active against the few fungi tested. The most active compound, decyloxydiguanide, was moderately toxic when administered intraperitoneally to mice and no therapeutic activity could be demonstrated against an intraperitoneal injection of Streptococcus pyogenes administered 15 min. previously.

Mechanism of action of guanethidine

The early hypotensive action of intravenous guanethidine in rabbits, rats and cats anaesthetized with urethane is reversed after pretreatment with iproniazid. The fall in blood pressure following injection of guanethidine in rabbits is reduced after previous administration of reserpine. Reserpine, like adrenalectomy and splenectomy, suppresses the early pressor effect of guanethidine in cats anaesthetized with chloralose. Guanethidine inhibits the action of tyramine and nicotine, but potentiates the effect of noradrenaline on isolated rabbit atria. Guanethidine is also a weak inhibitor of monoamine oxidase activity. The results are discussed and compared with those shown by reserpine. It is concluded that the early effects of guanethidine are mainly due to the release of endogenous catechol amines.

Pharmacological properties of phenyldiguanide and other amidine derivatives in relation to those of 5-hydroxytryptamine

Cats in which the coronary and allied chemoreflexes could not be obtained with small intravenous doses of 5-hydroxytryptamine were insensitive also to phenyldiguanide. In cats which responded to phenyldiguanide with reflex falls of blood pressure and heart rate, abolished by vagotomy, the effects of graded doses (5 to 150 mug./kg.) of phenyldiguanide bore a striking resemblance to those produced initially by 5-hydroxytryptamine in somewhat smaller doses. Differences in the cardiovascular responses to the two drugs are attributed to additional (non-reflex) actions of 5-hydroxytryptamine. The reflex actions of both drugs were blocked reversibly also by 2-naphthylguanidine (500 mug.). Certain other drugs (bufotenine, procaine, S-decylisothiourea) antagonized the depressor action of phenyldiguanide as well as the reflex depressor action of 5-hydroxytryptamine. Like 5-hydroxytryptamine, phenyldiguanide and certain other amidine derivatives caused pain when applied to the base of blisters in human subjects. Unlike 5-hydroxytryptamine, phenyldiguanide did not constrict perfused rat blood vessels or increase the tone of the rat fundal strip preparation of Vane (1957). Phenyldiguanide did not affect the sensitivity of these smooth muscle preparations to 5-hydroxytryptamine, but other amidine derivatives proved to be moderately strong antagonists of the vasoconstrictor actions of 5-hydroxytryptamine and of adrenaline. Unlike 5-hydroxytryptamine, phenyldiguanide did not produce gastric haemorrhage in the mouse. Phenyldiguanide did not prolong chloral hydrate sleeping time in mice by the same mechanism as did 5-hydroxytryptamine. Phenyldiguanide was not highly toxic to mice (LD50 being 240 mg./kg.). It is concluded that phenyldiguanide and certain other amidine derivatives act on sensory receptors which respond to 5-hydroxytryptamine, but that they show little pharmacological resemblance to 5-hydroxytryptamine in other respects.

Effect of sympathomimetic amines on the blocking action of guanethidine, bretylium and xylocholine

Experiments were carried out in which the adrenergic neurone blocking activity of xylocholine, bretylium and guanethidine was studied by the use of the inhibitory responses of the isolated rabbit ileum to lumbar sympathetic nerve stimulation, and the contractions of the nictitating membrane of the anaesthetized cat in response to stimulation of the cervical sympathetic nerves. In both these preparations, after blockade of the effects of sympathetic nerve stimulation had been produced with xylocholine, bretylium or guanethicdine, the sympathomimetic amines, dexamphetamine, mephentermine, hydroxyamphetamine, ephedrine and phenethylamine, reversed the blockade; if these amines were given first, then the adrenergic neurone blocking agents were ineffective. Tyramine and dopamine were effective on the isolated rabbit ileum but not on the cat's nictitating membrane. Effective antagonism of the adrenergic neurone blocking drugs was also shown by some substances which inhibit mono-amine oxidase but only those which in addition possess sympathomimetic effects. Thus phenelzine, pheniprazine and tranylcypromine were effective whereas iproniazid and nialamide were not. Since xylocholine, bretylium and guanethidine were all antagonized by the same agents, it seems likely that they all produce sympathetic blockade by a similar mechanism. The possibility is discussed that the sympathomimetic amines which antagonize the adrenergic neurone blocking drugs are competing with these substances for the same receptor sites.

Comparison of bretylium and guanethidine: tolerance, and effects on adrenergic nerve function and responses to sympathomimetic amines

Bretylium depresses the slope of regression lines relating frequency of sympathetic nerve stimulation to magnitude of contractions of the cat nictitating membrane. In contrast, guanethidine and reserpine preferentially abolish responses to low rates of nerve stimulation and cause a roughly parallel shift of the regression lines. The hypersensitivity of the nictitating membranes of cats to intravenous adrenaline or noradrenaline is far greater after a series of small daily doses of bretylium or guanethidine than after single large doses. The maximal sensitivity produced was similar to that after postganglionic sympathetic nerve section and exceeded that produced by ganglion blockade. The development of hypersensitivity to catechol amines is accompanied by some return of responses of the nictitating membranes to sympathetic nerve stimulation despite continued daily administration of bretylium or guanethidine. In cats given bretylium daily, responses to low rates of nerve stimulation become greater than in controls unless the dose of bretylium given subcutaneously is 50 mg/kg or more. When marked hypersensitivity to catechol amines has been produced by giving bretylium or guanethidine daily for 7 or 14 days, the sympathomimetic effects of these compounds are greater. Responses to intravenous dimethylphenylpiperazinium are also increased and the results suggest that even large daily doses of adrenergic neurone blocking agents do not appreciably impair the functioning of the adrenal medulla. The pressor effects of intravenous adrenaline, noradrenaline and dimethylphenylpiperazinium iodide increase less than the corresponding nictitating membrane responses. These results are discussed in relation to tolerance to adrenergic neurone blockade, and differences between the effects of bretylium and guanethidine found in man. Bretylium and guanethidine depress the slopes of the dose-response curves for the pressor and nictitating membrane contracting effects of tyramine. When single doses or a short series of daily doses were given, guanethidine caused more depression of the slopes than did bretylium, but nevertheless large depressions of slope were found after giving bretylium daily for several weeks. The magnitude of the responses can be greater or less than in controls depending on the dose of the sympathomimetic amine, the dose of the adrenergic neurone blocking agent and the duration of its administration. The results suggest that injection of tyramine produces a progressively smaller release of adrenaline or noradrenaline during the daily administration of bretylium (or guanethidine) but that in some test situations this is more than compensated for by the development of hypersensitivity to the catechol amine released. Some corresponding changes in responses to amphetamine and ephedrine are also described.

Supersensitivity of salivary glands following treatment with bretylium or guanethidine

The sensitivity of the submaxillary glands to noradrenaline was estimated once a week in cats anaesthetized with hexobarbitone. Daily subcutaneous injections of bretylium or guanethidine were found to produce a supersensitivity of the glands, similar to that caused by extirpation of the superior cervical ganglion.

Tissue amine levels and sympathetic blockade after guanethidine and bretylium

A single dose of guanethidine produces a substantial, long-lasting depletion of tissue catecholamines in the rat, whereas a similar dose of bretylium has no effect. Both drugs produce block of the eserine-induced sympathetic pressor effect. Block by guanethidine is induced more rapidly than is amine depletion. When amine depletion is maximal, a noradrenaline infusion is capable of restoring the response to eserine, but no restoration of the response to eserine occurs after noradrenaline infusion into bretylium-treated rats. Catecholamine levels in isolated tissues are not reduced when complete block of sympathetic nerve stimulation has been produced by guanethidine. It is suggested that guanethidine possesses a primary bretylium-like, and a secondary reserpine-like, blocking action. Guanethidine produces a transient lowering of intestinal 5-hydroxytryptamine, and this coincides with increased intestinal motility.