Mechanism of action of βadrenergic receptor blocking agents in angina pectoris: Comparison of action of propranolol with dexpropranolol and practolol

The effect on exercise tolerance of racemic propranolol has been assessed in eight angina pectoris patients and compared with that of dexpropranolol (the dextro isomer of propranolol), practolol (I.C.I. 50172), and saline. Dexpropranolol has the same local anaesthetic action as propranolol with negligible β-adrenergic receptor blocking activity, while practolol is a cardio-selective β-adrenergic blocking agent which does not have local anaesthetic activity.Saline and dexpropranolol had no significant effect on exercise time; racemic propranolol and practolol improved exercise tolerance in six subjects, the response to the two drugs being very similar in individual patients. It was concluded that the beneficial effect of propranolol in angina pectoris results from its action as a β-adrenergic receptor blocking agent and is not due to its local anaesthetic, or quinidine-like, activity.     

The interaction between spontaneous convulsions and tolerance to hexobarbital in the abstinence after chronic barbital treatments in the rat.

An earlier study had shown a decreased tolerance to hexobarbital after electrically induced convulsions in the abstinence after chronic barbital treatments in the rat. The effect of spontaneous convulsions was investigated in the present study.In two experiments tolerance was induced by treatment with barbital in the drinking water. Two treatment periods with a total duration of about 55 weeks were given in each experiment. The average consumption of barbital was approximately 200 mg/kg/day during the last part of the treatments. In the abstinence after the second treatment period tolerance was measured with a hexobarbital threshold method. Convulsions were recorded with a jiggle cage. Records were obtained from all barbital treated animals during the first three days of abstinence.In both experiments the hexobarbital thresholds were reduced in barbital treated animals if a convulsion had occurred within the 25 hour period prior to a threshold determination performed on the third abstinent day. If no convulsion had occurred there was a more marked tolerance to hexobarbital.The convulsion which is regarded as a sign of physical dependence can thus reduce the tolerance to hexobarbital in the abstinence after chronic barbital treatments. The convulsion could not only be the sign but also the means to at least temporarily decrease physical dependence.     

Differences between the tolerance characteristics of two anticonvulsant benzodiazepines in the amygdaloid-kindled rat

The characteristics of the development of tolerance to the anticonvulsant effects of chronic treatment by dipotassium clorazepate and diazepam using amygdaloid-kindled rats were investigated. Dipotassium clorazepate (5 mg/kg) or diazepam (5 mg/kg) were intraperitoneally administered for 10 consecutive days. Tolerance to the anticonvulsant effect of dipotassium clorazepate developed in seizure stage on day 6, after-discharge duration on day 7 and seizure latency on day 4. In contrast, tolerance to the effects of diazepam developed more rapidly in seizure stage on day 4, after-discharge duration on day 4 and seizure latency on day 3. Thus tolerance to the anticonvulsive effect of dipotassium clorazepate developed relatively slower than that to diazepam. All rats had stage 5 convulsions 24 hr after cessation of the administration of dipotassium clorazepate and diazepam. Concomitant determinations of plasma concentrations of the main metabolite of dipotassium clorazepate and diazepam, desmethyldiazepam, showed no statistical difference during treatment, suggesting that the developed tolerance was not metabolic but functional.     

The effects of cyclic 3'5' adenosine monophosphate on the acute tolerance induced by ethanol in male rats.

The effect of cyclic 3′5′ adenosine monophosphate (cAMP) on the acute tolerance induced by ethanol was studied in male rats. The acute tolerance was measured with a hexobarbital anesthesia method, where the dose of hexobarbital needed to obtain a burst suppression of 1 second or more in EEG is determined. Ethanol 2.0 g/kg was given ip 0.25 or 3 h prior to the threshold determination. cAMP 10 mg/kg or saline was given iv 6 h prior to the threshold determination.After saline pre-treatment less hexobarbital was needed 0.25 h after ethanol administration compared to 3 h after ethanol administration, although the blood levels were similar. An acute tolerance had developed. Pre-treatment with cAMP had no effect on the dose of hexobarbital needed without ethanol nor on the dose needed 3.0 h after ethanol administration. 0.25 h after ethanol more hexobarbital was needed in the animals pre-treated with cAMP compared with the corresponding saline treated animals. The dose of hexobarbital was as large as the one needed 3.0 h after ethanol. Thus cAMP seems to facilitate the induction of acute tolerance to ethanol while the hexobarbital threshold as such is uninfluenced.     

Modification of the anticonvulsant efficacy of diazepam by Ro-15-1788 in the kindled amygdaloid seizure model

The effects of various doses of diazepam and the new central benzodiazepine antagonist Ro-15-1788 were investigated in fully amygdaloid kindled rats. Diazepam had a pronounced dose-dependent anticonvulsant effect in this model. Ro-15-1788 dose-dependently reduced the behavioral ranks of the elicited kindled seizures to a maximum of 60% of control without consistently modifying the afterdischarge duration. No prestimulation convulsant effects were seen with Ro-15-1788. When 2 mg/kg i.p. of Ro-15-1788 was given after various doses of diazepam, the prestimulation sedation and ataxia anticonvulsant effects of diazepam (0.5-2.0 mg/kg) were attenuated by treatment with 2 mg/kg dose of Ro-15-1788. At the low dose of diazepam (0.25 mg/kg), increased reduction of behavioral rank and after discharge duration was seen after the 2 mg/kg dose of Ro-15-1788. Thus, Ro-15-1788 appears not to have proconvulsant properties in the kindled amygdaloid seizure model. Further, Ro-15-1788 appears to have some anticonvulsant properties of its own. Mixed agonist and antagonist effects were seen with Ro-15-1788 when given after various doses of diazepam in this model.     

Selective inhibition of brain Na,K-ATPase by drugs

The effect of drugs from the class of cardiac (methyldigoxin, verapamil, propranolol), antiepileptic (carbamazepine), sedative (diazepam) and antihistaminic (promethazine) drugs on Na,K-ATPase activity of plasma membranes was studied in rat brain synaptosomes. Methyldigoxin in a concentration of 0.1 mmol/l inhibits enzyme activity by 80 %. Verapamil, propranolol and promethazine in concentrations of 20, 20 and 2 mmol/l respectively, entirely inhibit the ATPase activity. Carbamazepine and diazepam in concentrations of 0.02-60 mmol/l have no effect on the activity of this enzyme. According to the drug concentrations that inhibit 50 % of enzyme activity (IC(50)), the potency can be listed in the following order: methyldigoxin promethazine verapamil ? propranolol. From the inhibition of commercially available purified Na,K-ATPase isolated from porcine cerebral cortex in the presence of chosen drugs, as well as from kinetic studies on synaptosomal plasma membranes, it may be concluded that the drugs inhibit enzyme activity, partly by acting directly on the enzyme proteins. Propranolol, verapamil and promethazine inhibitions acted in an uncompetitive manner. The results suggest that these three drugs may contribute to neurological dysfunctions and indicate the necessity to take into consideration the side effects of the investigated drugs during the treatment of various pathological conditions.     

Mechanisms of the effect of diazepam on paroxysmal electrical activity of an isolated cortical slab in cats

The effect of diazepam on paroxysmal global electrical activity of a neuronally isolated slab of auditory cortex and on inhibitory responses of its neurons due to intracortical electrical stimulation was investigated in cats. Diazepam (2 mg/kg, intravenously) caused inhibition of paroxysmal electrical activity and increased the number of inhibited neurons in both the acutely isolated slab and three weeks after isolation, compared with the intact cortex. However, the number of disynaptic responses was reduced under these circumstances, especially in the long-isolated slab. It is postulated that diazepam exerts its action through activation of GABA-ergic inhibitory neurons, by synchronizing inhibition and increasing the duration of the IPSPs. The action of diazepam is manifested first, probably, in the initial links of cortical neuron chains.I. I. Mechnikov Odessa State University. Translated from Neirofiziologiya, Vol. 17, No. 1, pp. 3–10, January–February, 1985.     

Effects of prenatal X-irradiation: studies on the mechanism of X-irradiation-induced inhibition of microsomal enzyme development in rat liver

Exposure of pregnant rats to 25 R of x-irradiation on the fourteenth gestation day has produced in the male offspring an impairment of the development of the hepatic microsomal enzyme system which metabolizes hexobarbital. However, irradiation did not suppress the increase of enzyme activity brought about by the administration of chemical inducers (pheno-barbital). Actinomycin, on the other hand, inhibited to varying degrees both the ontogenic and phenobarbital-induced increases in enzyme activity. The effects on the enzyme system have been supported by in vivo measurements of the duration of hexobarbital hypnosis. The ontogenic increase in enzyme activity is hormone-dependent, while that following phenobarbital administration is independent of hormonal regulation as evidenced by the response in hypophysectomized or sexually immature animals. It is concluded from these results that the inhibitory effect of x-irradiation on the hepatic enzyme system is mediated through an action on the hormonal regulation of enzyme activity. Evidence for this hypothesis is discussed.     

Inhibition of rat brain ecto-atpase activity by various drugs

The in vitro effect of digoxin, verapamil, propranolol, carbamazepine, diazepam and promethazine were investigated on the ecto-ATPase activity of synaptosomal plasma membranes from the rat brain. ATP hydrolyzing activities of the enzyme were not affected by digoxin while the use of all other drugs resulted in significant and dose-dependent ihibition in ATP hydrolysis. According to values of IC(50) and K(iapp), the order of inhibitory potency of the drugs applied was: diazepam > promethazine > verapamil > propranolol > carbamazepine. Kinetic analysis of the nature of the ATPase inhibition revealed that it resulted from a direct action of drugs on the enzyme protein. The aim of the present study was to determine the potential neuromodulatory side effects of the drugs investigated. The results achieved indicated that all investigated drugs, except digoxin, may modulate neuronal activities via the purinergic receptors P2 by increasing extracellular concentrations of ATP as a consequence of inhibition of the ecto-ATPase activity. Our findings indicate that it may be useful to take into consideration the possible side effects of the investigated drugs, when they are used in treatment of different pathologies, particularly in the treatment of epilepsy by carbamazepine and diazepam.     

Effect of psychotropic drugs on somatosensory evoked cortical potentials]

The effects of some typical clinically tested psychotropic drugs were studied in acute experiments on awake rats. Potentials in somatosensory cortex were evoked by peripheral stimulation. Haloperidol, diazepam, medazepam, desipramin and a new substance, the MPP-sulton, caused significant modification in latency and amplitude of some components of the potentials. Between the effects of psychotropic drugs exist differences which, in turn, were clearly distinguishable from the modification of these evoked responses by unspecific narcotic effects of hexobarbital.     

Response to Propranolol and Diazepam in Somatic and Psychic Anxiety

A total of 12 chronically anxious psychiatric outpatients were treated with racemic propranolol (Inderal), diazepam (Valium), and placebo for one week each, using a balanced cross-over experimental design. Six patients had predominantly somatic anxiety, complaining mostly of bodily symptoms, and six had mainly psychic anxiety, complaining primarily of psychological symptoms. Clinical ratings of anxiety were made by patient and psychiatrist after each treatment. Though diazepam was in general more effective than propranolol or placebo in relieving anxiety, propranolol was more effective than placebo in patients with somatic anxiety but not in those with psychic anxiety. We suggest that propranolol should be reserved for patients whose anxiety symptoms are mainly somatic.     

Effect of diazepam on the Na, K-ATPase state in a penicillin--induced hyperactivity focus in the cerebral cortex]

Intramuscular injection of diazepam to rats at doses of 0.01 and 2 mg/kg 25-30 min after penicillin application to the rat brain cortex leads to alteration of periodic appearance of epileptic seizures (ES), to changes in the seizure pattern, and to emergence of periodic acceleration of epileptiform discharges (ED). Injection of diazepam at a dose of 2 mg/kg 20 min before penicillin application results in the reduction of ED latency in the epileptogenic focus and in a decrease in their frequency before seizures as compared to the control animals without diazepam injection. ES appear irregularly, their quantity is markedly reduced while duration is increased. Diazepam injection leads to disappearance of the rat moving reaction during ER and ES. In vivo experiments diazepam (2 mg/kg) does not influence brain cortex Na, K-ATPase of crude synaptosomes. However, diazepam leads to an increase in Na, K-ATPase activity both in the primary and dependent secondary epileptogenic foci. It is suggested that the anticonvulsant action of diazepam may be underlain by its activating effect on Na, K-ATPase of neuronal membranes in the epileptogenic focus.     

Long-term therapy of essential tremor with propranolol.

In a double-blind crossover study 12 patients with essential tremor were treated with propranolol and a placebo; 8 improved with propranolol and 3 with the placebo; the degree of improvement with propranolol was greater. In a similar study with diazepam 5 of 12 improved with diazepam and 4 of 12 with the placebo; the degree of improvement was less than that achieved with propranolol. Response in 21 patients to treatment with propranolol for 2 to 4 years was excellent in 4, good in 4 and fair in 10; the condition of 1 was unchanged and that of 2, worse. Excellent response was maintained for as long as 4 years, but response tended to deteriorate with time if initially it was less than excellent. Response decreased with increasing age. No patient 60 years of age or older had an excellent response, and the four with an excellent response were under age 55, three being under age 35; all four had had their tremor less than 12 years. Patients with essential tremor should be given a 3-month trial of propranolol at 120 mg/d; if no significant response is seen the dose should be decreased, then the drug discontinued.     

Effect of beta-blockers on sodium and potassium content of human erythrocytes.

Recently, hyperpotassemia was reported in patients treated with propranolol, but the mechanism has not yet been delineated. We have investigated the effects of various beta-adrenergic blockers and of D-propranolol on the Na+ and K+ distribution intra- and extracellularly in human erythrocytes. K+ loss and Na+ gain by cells was demonstrated at drug concentrations of 10(-4) M or greater. D-Propranolol was more effective than L-propranolol, whereas pindolol was ineffective. Practolol increased Na+ content but did not influence K+. The results suggest that electrolyte redistribution across cell membranes is not a likely explanation for hyperpotassemia in patients treated with propranolol, or for the local anaesthetic effect of this drug.     

Actions of pentobarbitone and derivatives with modified 5-butyl substituents on GABA and diazepam binding to rat brain synaptosomal membranes

The effects of a variety of factors known to influence the enhancement of GABA binding by diazepam, were studied upon pentobarbitone stimulation of GABA binding to washed synaptosomal membranes prepared from whole rat brains. The differential kinetics of, and effects of temperature, chloride ions, a benzodiazepine receptor antagonist (Ro15-1788) and picrotoxinin upon pentobarbitone and diazepam enhancement of GABA binding, suggest that these drugs exert their actions upon GABA binding at different loci. The degree of enhancement of diazepam binding and of high affinity GABA binding in chloride-containing media at 25 degrees C by members of a series of twelve side chain methyl substituted and/or unsaturated derivatives of 5-butyl-5-ethyl-barbituric acid (pentobarbitone analogs) correlated significantly. For the sedative members of the series, enhancement of high affinity GABA binding correlated with their anaesthetic but not their anticonvulsant activities. It appears likely that the anaesthetic and anticonvulsant activities of barbiturates arise from different molecular actions.     

The beta-adrenoceptor is precoupled to Gs in chicken erythrocyte membranes

In this study we seek to elucidate the mechanism of hormone-independent adenylate cyclase stimulation by Gpp(NH)p in chicken erythrocyte membranes, and the inhibition of this stimulation by propranolol. Membrane treatment with isoprenaline + GMP increased Gpp(NH)p stimulation to near maximal levels [obtainable with isoprenaline + Gpp(NH)p], but reduced stimulation by NaF. The stimulation by Gpp(NH)p was stereoselectively inhibited by propranolol, but not by equal concentrations of the local anaesthetic lignocaine. Propranolol's inhibitory action was abolished following membrane treatment with isoprenaline/GMP. In contrast to its inhibition of Gpp(NH)p stimulation, propranolol did not alter Gpp(NH)p-mediated 3H-GDP release from membranes. The polyene antibiotic filipin, which uncouples receptor (R) from Gs, also abolished Gpp(NH)p stimulation and this effect was partly overcome by membrane treatment. These results are consistent with a model in which free R exists in equilibrium with precoupled R.Gs complexes in the absence of hormone. These complexes are activated by Gpp(NH)p and dissociated by antagonists. The existence of such complexes is a prerequisite for Gpp(NH)p stimulatory action.     

Enantiospecific quantification of hexobarbital and its metabolites in biological fluids by gas chromatography/electron capture negative ion chemical ionization mass spectrometry.

A highly sensitive and specific assay based on gas chromatography/electron capture negative ion chemical ionization mass spectrometry has been developed for the analysis of the enantiomers of hexobarbital and its major metabolites in human urine and plasma. S-(+)-(5-2H3)hexobarbital and R-(-)-(5-2H3)hexobarbital were synthesized for clinical studies along with (+/-)-(1,5-2H6)hexobarbital and the deuterated major metabolites for use as internal and reference standards. Hexobarbital enantiomers and their metabolites were analyzed after pentafluorobenzyl and trimethylsilyl derivatization, following solid-phase extraction from plasma and urine. Intense negative ion spectra were observed for all of the derivatives. The base peak in the spectra corresponded to the M-pentafluorobenzyl anion [M-PFB]- except for 1,5-dimethylbarbituric acid, where M-. was the most abundant ion. The applicability of the method was demonstrated by following the plasma concentration-time profiles and urinary excretion in a male extensive metabolizer of mephenytoin who was given a pseudoracemic oral dose of hexobarbital containing equal 50 mg amounts of S-(+)-2(H0)hexobarbital and R-(-)-(2H3)hexobarbital. Marked stereoselective disposition was observed, with the R-(-)-enantiomer being more efficiently metabolized, primarily by alicyclic oxidation and ring cleavage.     

Interactions of some anaesthetic,convulsant, and anticonvulsant drugs at GABA-benzodiazepine receptor-ionophore complexes in rat brain synaptosomal membranes

The effects of several anaesthetic, convulsant and anticonvulsant drugs were studied upon high affinity [3H]GABA and [3H]diazepam binding to rat brain synaptosomal membranes in chloride-containing incubation buffers at 25 degrees C, conditions under which pentobarbitone extensively enhanced binding of both ligands to GABA-benzodiazepine-receptor-ionophore complexes. Of the compounds studied, only (+)-etomidate enhanced both GABA and diazepam binding; the sedative-hypnotic glutethimide weakly enhanced GABA binding while inhibiting diazepam binding. Several drugs, including beta-butyl-beta-methyl-glutarimide, phenobarbitone, pentylenetetrazole, and ketamine reversed the enhancement of GABA binding by pentobarbitone (500 microM) while not altering basal GABA or diazepam binding. Enhancement of high affinity GABA binding does not appear to be a general property of sedative or anticonvulsant drugs.     

Diazepam sensitive mice: differential sensitivity to the depressant and anticonvulsant effects of diazepam

A mouse line was developed by selecting for increased sensitivity to the hypnotic effect of diazepam. These "diazepam sensitive" mice showed a mean duration of loss of righting reflex (LORR) of approximately 150 min at a dose of 20 mg/kg diazepam, this dose failed to induce LORR in the control outbred mice. Rotarod treading times of the diazepam sensitive mice were significantly shorter than that of the control mice over the same dose range indicating that these mice are also more sensitive to the sedative/muscle relaxant effects of diazepam. On the contrary, the ability of diazepam to protect against pentylenetetrazole-induced convulsion was found to be the same in the sensitive and control mice. These observations strongly suggest that the heightened sensitivity to the sedative-hypnotic effects of diazepam in the sensitive mice is unlikely to be due entirely to changes in drug disposition.     

Enhancement of hexobarbital-induced sleep by lysine and its metabolites

Lysine has been shown to be metabolized in the rat brain to pipecolic acid which is a precursor of piperidine. Lysine and its proposed metabolites in this pathway were studied for the first time for their effect on the sleeping time induced by hexobarbital in the rat. Only $\text{L}$-lysine and $\text{D}$-lysine were found to prolong sleeping time significantly without toxic effect. A 3-day pretreatment with $\text{L}$-lysine produced an even more profound sleep prolongation. In most cases sleep enhancement was accompanied by a significant shortening of the time of sleep onset. Quantification of brain hexobarbital levels in the control and treated rats indicates that prolongation of sleeping time was not produced by inhibition of hexobarbital metabolism. The sleep prolonging effect of lysine, therefore, may be a direct action of lysine, or the metabolite(s) derived $\text{in}$$\text{vivo}$ from lysine, on the central nervous system.