Enhancement of local anaesthesia action by organic acid salts. (I): Possible change of excitability in nerve fibre membrane

Measurements of action potentials recorded from giant nerve fibres of the crayfish abdomen showed that by addition of an organic acid salt to a local anaesthetic solution, the onset of anaesthetic action became more rapid and the duration of action was prolonged. Similar results were also obtained in rat vagal nerves. The chemical structure of compounds having these enhancing effects was found to have, in common, a carboxyl group connected with either a benzene ring or an aliphatic hydrocarbon. Topical application of anaesthetic solutions to the skin of flexor side of the forearm in humans revealed that the duration of anaesthesia evaluated by the apparent decrease of the number of pain points was significantly prolonged by the addition of salicylate. The use of local anaesthetics combined with organic acid salts would be promising in clinical practice to enhance their action greatly.     

Ventricular fibrillation and rhabdomyolysis after administration of succinylcholine

Succinylcholine is a depolarising muscle relaxant. Because of its quick onset of action, it is particularly used in situations which require urgent intubation. However, there have been several reports of cardiac arrest after administration of succinylcholine. We describe the case of a young woman who developed ventricular fibrillation and rhabdomyolysis following succinylcholine administration. Possible mechanisms and treatment are discussed.     

Relative potencies of two phenylalkylamines found in the abused plant Catha edulis, khat

Cathinone and d-norpseudoephedrine are closely related phenylalkylamines isolated from $\text{Catha edulis}$ (khat), a plant much abused for its stimulant properties. We have compared the potency of these two compounds on an operant behavioral procedure in rats. Both suppress fixed ratio 20 responding for food in a dose related manner. Cathinone was 7–10 times more potent and had a more rapid onset of action than d-norpseudoephedrine, although the duration of action of cathinone was shorter. The ability of these two compounds to produce amphetamine-like stereotyped movements was in concordance with this same relative potency and difference in duration of action. Comparison of the behavioral effects in rats with the pattern of stimulation reported for khat use by man suggests that cathinone may be the major CNS active component of $\text{Catha edulis}$.     

Long-acting beta-agonists in the management of chronic obstructive pulmonary disease: current and future agents

Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow limitation and debilitating symptoms. For patients with moderate-to-severe COPD, long-acting bronchodilators are the mainstay of therapy; as symptoms progress, guidelines recommend combining bronchodilators from different classes to improve efficacy. Inhaled long-acting β₂-agonists (LABAs) have been licensed for the treatment of COPD since the late 1990s and include formoterol and salmeterol. They improve lung function, symptoms of breathlessness and exercise limitation, health-related quality of life, and may reduce the rate of exacerbations, although not all patients achieve clinically meaningful improvements in symptoms or health related quality of life. In addition, LABAs have an acceptable safety profile, and are not associated with an increased risk of respiratory mortality, although adverse effects such as palpitations and tremor may limit the dose that can be tolerated.Formoterol and salmeterol have 12-hour durations of action; however, sustained bronchodilation is desirable in COPD. A LABA with a 24-hour duration of action could provide improvements in efficacy, compared with twice-daily LABAs, and the once-daily dosing regimen could help improve compliance. It is also desirable that a new LABA should demonstrate fast onset of action, and a safety profile at least comparable to existing LABAs.A number of novel LABAs with once-daily profiles are in development which may be judged against these criteria. Indacaterol, a LABA with a 24-hour duration of bronchodilation and fast onset of action, is the most advanced of these. Preliminary results from large clinical trials suggest indacaterol improves lung function compared with placebo and other long-acting bronchodilators. Other LABAs with a 24-hour duration of bronchodilation include carmoterol, vilanterol trifenatate and oldaterol, with early results indicating potential for once-daily dosing in humans.The introduction of once-daily LABAs also provides the opportunity to develop combination inhalers of two or more classes of once-daily long-acting bronchodilators, which may be advantageous for COPD patients through simplification of treatment regimens as well as improvements in efficacy. Once-daily LABAs used both alone and in combination with long-acting muscarinic antagonists represent a promising advance in the treatment of COPD, and are likely to further improve outcomes for patients.     

Anaesthetic-induced Malignant Hyperpyrexia: A Suggested Method of Treatment

Experiments in susceptible Landrace pigs have shown that procaine blocks the initiation of anaesthetic-induced malignant hyperpyrexia by both halothane and succinylcholine. Pretreatment with curare prevents only the trigger action of succinylcholine. In a preliminary study procaine was used to treat the established syndrome in five pigs, two of which survived. On the basis of these findings a treatment regimen can be suggested for patients who develop malignant hyperpyrexia.     

Effect of a zinc phosphate suspension of a long-acting somatostatin analog on postprandial plasma glucose, triglyceride and glucagon concentrations in alloxan diabetic dogs

The effects of a zinc phosphate suspension of a long-acting, reportedly selective somatostatin analog, Des-Ala1,Gly2 [His4,5,D-Try]-somatostatin (100 micrograms/kg) on postprandial plasma glucose, glucagon, xylose and triglyceride levels were evaluated in alloxan diabetic dogs. Compared to the analog in aqueous solution, the zinc phosphate suspension had a more gradual onset of action in suppressing plasma glucose and xylose levels but a similar onset of action on suppression of plasma triglyceride and glucagon responses. On all these responses, the zinc suspension had a duration of action (greater than 6 hrs) at least three times as long as the aqueous solution. We conclude that such a somatostatin analog in zinc phosphate suspension may have a sufficient duration of action to be useful as an adjunct to insulin in the treatment of diabetes mellitus.     

Animal models and studies of in utero endocrine disruptor effects

The rate of organ and system development in mammals, including humans, is most rapid during the prenatal period. Perturbations of the endocrine system during this period can have profound effects on later anatomy, physiology, behavior, and the onset of disease. Endocrine-disrupting compounds can cause perturbations during fetal development by mimicking or blocking natural hormones. In experimental studies, compounds that mimic estrogens and those that block androgen action have been shown to have a number of long-term effects. Among these effects are the acceleration of puberty onset, increased incidence of adult cancers such as vaginal and prostate cancers, and alterations in sexually dimorphic anatomy, physiology, and behavior. Laboratory animal models continue to play a crucial role in identifying endocrine disruptors, determining their mode of action, and demonstrating their consequences.     

New ultra-short acting hypnotic: synthesis, biological evaluation, and metabolic profile of ethyl 8-oxo-5,6,7,8-tetrahydro-thiazolo[3,2-a][1,3]diazepin-3-carboxylate (HIE-124)

Ethyl 8-oxo-5,6,7,8-tetrahydro-thiazolo[3,2-a][1,3]diazepin-3-carboxylate (HIE-124, 4) is a member of a new generation of ultra-short acting hypnotics. HIE-124 (4) exhibited potent in vivo activity with a rapid onset of action and a short duration of action, with no acute tolerance or noticeable side effects. The metabolic profile of 4 is also performed. HIE-124 (4) has the potential use as a preanesthetic medication, anesthesia inducer, and could be used with thiopental sodium to maintain anesthesia for longer duration.     

Interaction of Diazepam with the Muscle-relaxant Drugs

Diazepam has been found to increase the duration of the neuromuscular block produced by gallamine and to reduce that produced by succinylcholine. Preliminary studies suggest that the action is at the presynaptic site.     

The design of a novel series of muscarinic receptor antagonists leading to AZD8683, a potential inhaled treatment for COPD

A novel series of muscarinic receptor antagonists was developed, with the aim of identifying a compound with high M₃ receptor potency and a reduced risk of dose-limiting side effects with potential for the treatment of COPD.Initial compound modifications led to a novel cycloheptyl series, which was improved by focusing on a quinuclidine sub-series. A wide range of N-substituents was evaluated to determine the optimal substituent providing a high M₃ receptor potency, high intrinsic clearance and high human plasma protein binding. Compounds achieving in vitro study criteria were selected for in vivo evaluation. Pharmacokinetic half-lives, inhibition of bronchoconstriction and duration of action, as well as systemic side effects, induced by the compounds were assessed in guinea-pig models.Compounds with a long duration of action and good therapeutic index were identified and AZD8683 was selected for progression to the clinic.     

Behavioural observations of Pieris brassicae larvae indicate multiple mechanisms of action of analogous drimane antifeedants

We tested 11 analogous synthetic drimane antifeedant compounds for their feeding inhibiting effects on larvae of the large white butterfly Pieris brassicae L. (Lepidoptera: Pieridae) in no-choice tests on the host plant Brassica oleracea L. Furthermore, we observed larval feeding behaviour in no-choice tests to analyze temporal effects of five drimanes. The results show that the five analogous antifeedants differentially influence feeding behaviour and locomotion activity. Warburganal and polygodial are most likely sensory mediated antifeedants. Habituation to these compounds occurs soon after the onset of the tests (i.e., within 0.5–1.5 h). Compound 5 and confertifolin are probably not direct, sensory mediated antifeedants. After 0.5–1.5 h of exposure, these compounds inhibit not only feeding, but also locomotion behaviour, indicating postingestive, toxic effects. Isodrimenin inhibits feeding from the onset of the test and is probably a sensory mediated antifeedant. No habituation occurs to this compound, indicating that isodrimenin is either a very strong antifeedant or that it additionally has postingestive, toxic effects. Topical application of the drimanes on the larval cuticle revealed feeding inhibiting effects, but these could not be related to the occurrence of postingestive feeding inhibiting effects, indicating that this method is inappropriate to show possible postingestive effects of drimanes in P. brassicae. In conclusion, the behavioural observations performed in this research indicate that analogous drimanes inhibit feeding by P. brassicae larvae through multiple mechanisms of action. The results show that, when developing a structure activity relationship (SAR) for a series of antifeedants, it is important to distinguish the mode of action which underlies inhibition of feeding.     

Synthesis and local anesthetic activity of fluoro-substituted imipramine and its analogues

A series of fluoro-substituted imipramines and its analogues, 6a-6e, were synthesized and evaluated for their in vitro local anesthetic activity. Compound 6b was found to have potency, onset, and duration of action comparable to those of lidocaine (lidocaine hydrochloride, CAS:6108-05-0). Dissociation constants (pK(a)) of these compounds have been determined to be 7.6-7.9.     

Quaternary derivatives of granatanol diesters: potent, ultrashort acting non-depolarizing neuromuscular relaxants

The purpose of this study was to explore the feasibility of utilizing the granatanol: N-methyl [9-azabicyclo (3.3.1) nonane] 3-alpha-ol as the terminal group in a series of new bisquaternary azabicycyclic diester-type neuromuscular blocking agents. Fifty two bisquaternary ammonium derivatives of several dicarboxylic acid esters of granatanol and three similar derivatives of pseudo granatanol have been investigated for neuromuscular blocking (NMB) potency (ED(50) s), onset and recovery of action and for cardiovascular side effects. All agents were studied first in anesthetized rats, and selected agents were subjected to further pharmacodynamic testing in rabbits, juvenile pigs, cats, dogs and monkeys. One agent was tested in continuous i.v. infusion mode in comparison with its corresponding tropine diester and the aminosteroid muscle relaxant, rocuronium. Several new and highly potent NMB granatanol derivatives are described, which are largely similar in NMB potency to the previously described tropine: N-methyl [8-azabicyclo (3.2.1)] 3-alpha-ol diester derivatives. The majority of the presently described granatanol derivatives displayed ultrashort onset and duration of actions. In that respect some of these agents proved to be the fastest and shortest acting non-depolarizing muscle relaxants described so far. On the negative side, many, but not all, granatanol derivatives produced cardiovascular side effects: e.g. changes in heart rate and blood pressure. Like with the similar tropinyl diester derivatives, cardiac vagal block was present with the majority of these agents as assessed in the rat, pig and cat. Few glutaryl, fumaryl and cyclobutane (trans) 1,2-dicarboxylyl granatanol diesters quaternized with disubstituted benzyl halides, bearing p-acyloxy radicals, showed excellent NMB profile. In these derivatives, however, the rapid decomposition of the p-acyloxy groups leads to formation of toxic quinone methene metabolites which precludes their further pharmaceutical development. The pseudo granatanol derivatives were less potent in the rat than the corresponding granatanols and were not further investigated. We conclude that the 9-azabicyclo (3.3.1) nonane (granatane) ring system can successfully replace the similar 8-azabicyclo (3.2.1) octane (tropane) ring system in building potent, utrashort acting NMB agents.     

Artemisinins act through at least two targets in a yeast model

Artemisinin and related compounds are potent and widely used antimalarial drugs but their biochemical mode of action is not clear. There is strong evidence that ATP-dependent calcium transporters are a key target in the malarial parasite. However, work using Saccharomyces cerevisiae suggests that disruption of mitochondrial function is critical in the cell killing activity of these compounds. Here it is shown that, in the absence of reducing agents, artemisinin and artesunate targeted the S. cerevisiae calcium channels Pmr1p and Pmc1p. Both compounds affected the growth of yeast on fermentable and nonfermentable media. This growth inhibition was not seen in a yeast strain in which the genes encoding both calcium channels were deleted. In the presence of reducing agents, which break the endoperoxide bridge in the drugs, growth inhibition was only observed in nonfermentable media. This inhibition could be partially relieved by the addition of a free radical scavenger. These results suggest that the drugs have two biochemical modes of action - one acting by specific binding to calcium channels and one involving free radical production in the mitochondria.     

Cutaneous erythema and blood pressure lowering effects of topically applied 16-vinylprostaglandins

Topically applied 16-vinylprostaglandis demonstrate the property of rapid transit through the skin and a profound effect on the cutaneous vasculature. At low concentrations in the guinea pig and rabbit, 15-deoxy-16-hydroxy-16-vinyl-PGE₂ (DHV-PGE₂) and its methyl ester (DHV-PGE₂Me) elicit a distinct and persistent erythema which is restricted to the area of application and is not associated with a wheal. Skin temperatures are elevated for several hours following application. Accordingly, these compounds may have therapeutic utility in conditions where local blood flow is compromised or where an enhanced blood flow is desired. In the spontaneously hypertensive rat, topically applied DHV-PGE₂ and DHV-PGE₂Me produce a dramatic and persistent lowering of blood pressure. The maximal effects are comparable to those obtained with equal oral or intravenous doses and are maintained for a longer period of time. Moreover, with the topical route, there is no prolongation in the time required for onset of action (3–5 minutes). It appears that while the skin presents only a minimal diffusion barrier to these compounds, a sufficient depot is maintained to give sustained release and prolonged duration. Transdermal delivery of 16-vinyl prostaglandins may offer a convenient means of achieving a clinical antihypertensive effect without the characteristics effects generally asociated with oral or intravascular prostaglandins.     

The modes of action of long chain alkyl compounds on the respiratory chain-linked energy transducing system in submitochondrial particles

The interactions of long chain (greater than C7), alkyl compounds with tightly coupled, beef heart submitochondrial particles (SMP) have been investigated with respect to their effects upon respiratory chain-linked electron transfer and energy coupling capacity. Long chain alkyl alcohols, amines, free fatty acids, and methyl esters exhibit a general uncoupling effect, with stimulation of the succinate oxidase activity but inhibition of the NADH oxidase, in SMP. The degree of effectiveness is dependent on the nature of the functional group and the length of the alkyl chain. Submitochondrial particles depleted of F1 and the F1-inhibitor protein are similarly affected. Subsequent treatment with bovine serum albumin reverses the effects of free fatty acids and results in partial recovery of activity with alkyl amines, alcohols, and methyl esters. Differences between the effects of these alkyl compounds and those of sodium dodecyl sulfate, deoxycholate, palmitoyl carnitine, and palmitoyl CoA rule out detergent-like action as the explanation for these observations. These data suggest that specific lipophilic interactions with the membrane, modulated by the nature of the functional group, are responsible for the effects of these compounds on the energy transducing system of SMP. Analyses of the reduction kinetics of the cytochromes indicate that the sites of interaction of these compounds with the inner mitochondrial membrane are associated with the primary dehydrogenase of complex I and energy coupling site 2; alkyl amines possess an additional site of interaction in the region of complex III.     

Organophosphorus pesticide‐induced butyrylcholinesterase inhibition and potentiation of succinylcholine toxicity in mice

Succinylcholine is the most important rapid‐acting depolarizing muscle relaxant during anesthesia. Its desirable short duration of action is controlled by butyrylcholinesterase, the detoxifying enzyme. There are two reported cases of prolonged paralysis from succinylcholine in patients poisoned with the organophosphorus insecticides parathion and chlorpyrifos. The present study examines the possibility that other organophosphorus and methylcarbamate pesticides might also prolong succinylcholine action by inhibiting butyrylcholinesterase using mice treated intraperitoneally as a model and relating inhibition of blood serum hydrolysis of butyrylthiocholine to potentiated toxicity (mouse mortality). The organophosphorus plant defoliant tribufos (4 h pretreatment, 160 mg/kg) and organophosphorus plant growth regulator ethephon (1 h pretreatment, 200 mg/kg) potentiate the toxicity of succinylcholine by seven‐ and fourfold, respectively. Some other pesticides or analogs are more potent sensitizers for succinylcholine toxicity with threshold levels of 0.5, 1.0, 1.7, 8, 10, and 67 mg/kg for phenyl saligenin cyclic phosphonate, profenofos, methamidophos, tribufos, chlorpyrifos, and ethephon, respectively. Enhanced mortality from succinylcholine is generally observed when serum butyrylcholinesterase is inhibited 55–94%. Mivacurium, a related nondepolarizing muscle relaxant also detoxified by butyrylcholinesterase, is likewise potentiated by at least threefold on 4 hour pretreatment with tribufos (25 mg/kg) or profenofos (10 mg/kg). © 1998 John Wiley & Sons, Inc. J Biochem Toxicol 13: 113–118, 1999     

Effects of urea and guanidine hydrochloride on peptide and nonpolar groups

The free energy transfer of several N-acetyl(glycine)n ethyl esters (n = 1-3) and side chain derivatives (Ala, Val, Nva, Leu, Nle, and Phe) from water to urea and guanidine hydrochloride solutions has been determined from the solubility and distribution coefficients of these compounds between aqueous and nonaqueous phases. These uncharged model peptides, unlike the amino acids used for a similar study, avoid complication due to charge effects for the transfer process. The compounds with an increase in the number of glycyl groups show additivity of the group free energy toward the transfer from water to urea solution but not to guanidine hydrochloride solution. The derivatives with a side chain show that the principle of group additivity does not hold true for the aliphatic side chains for the transfer to either urea or guanidine hydrochloride solutions. In fact, the free energy of transfer of the side chains, viz., aliphatic ones, is found to be energetically unfavorable in moderately high denaturant concentration. Phenylalanyl, the only aromatic side chain studied here, showed a favorable free energy of transfer to the denaturant solutions. In addition, the values of the favorable free energy obtained in this study are much smaller than the values obtained from the study of the amino acids. The transfer of the glycyl group to the denaturant solutions is exothermic whereas the transfer of the side chains is endothermic in nature.(ABSTRACT TRUNCATED AT 250 WORDS)     

MUSCARINIC REGULATION OF cAMP IN MOUSE NEUROBLASTOMA

The neurotransmitter acetylcholine regulates cAMP concentrations in mouse neuroblastoma cells (clone NS20). In these cells, the action of acetylcholine appears to be specific: it does not alter basal concentrations of cAMP, but prevents the elevation of cAMP which is mediated by either adenosine or prostaglandin E₁. The receptor for acetylcholine which is involved in this phenomenon has been identified as muscarinic. Pilocarpine and carbamylcholine, but not acetate or choline, will substitute for acetylcholine. Furthermore, the action of 10 μM-carbbamylcholine is blocked by ≥ nM concentrations of atropine, isopropamide or 3-quinuclidinylbenzilate, but not by mM concentrations of d-tubocurarine or hexamethonium. Of eight cholinergic antagonists tested, decamethonium and succinylcholine were the only two which were able to substitute for acetylcholine. These two antagonists are known to cause depolarization of post-synaptic cells. Decamethonium and succinylcholine appear to interact with the same muscarinic receptor, as their actions are also blockèd by low concentrations of 3-quinuclidinylbenzilate. In addition to these two depolarizing antagonists, the ionophores, valinomycin, A23187 and X537A, were also found to prevent elevation of cAMP concentrations. The involvement of specific membrane depolarization as being the active agent by which acetylcholine inhibits elevation of cAMP concentrations is discussed.     

New drugs in hypertension.

Clonidine, propranolol, bethanidine and debrisoquine effectively decrease blood pressure by suppressing renin secretion or interfering with function of the sympathetic nervous system. In man these compounds exert an antihypertensive effect within several hours or days and their duration of action is sufficient to permit administration twice or thrice daily. Clonidine and propranolol are especially useful if sexual dysfunction or postural hypotension is undesirable. Although bethanidine and debrisoquine may produce these adverse effects, they are beneficial in severe hypertension and produce fewer side effects than guanethidine. Clonidine frequently causes sedation, and rebound hypertension may occur with sudden cessation of therapy. Injudicious use of propranolol may provoke heart failure or asthma in susceptible individuals. The combination of a thiazide diuretic with propranolol and one of hydralazine, bethanidine and debrisoquine may be used to treat severe or complicated hypertension.