Search

Enhancement of both excitatory and inhibitory responses to adrenaline, noradrenaline and isoprenaline was demonstrated with bretylium both in vivo and in vitro. Excitatory responses studied included rise of blood pressure and contraction of the nictitating membrane in cats and the contraction of aortic strip in rabbits; the inhibitory responses studied were fall of cat blood pressure and relaxation of rat uterus and rabbit tracheal chain. Possible mechanisms of potentiation of the effects of catechol amines by bretylium are discussed. A sensitization of the peripheral effector cells is suggested as a likely mechanism of potentiation.

Bretylium and guanethidine blocked the pressor effect of physostigmine and potentiated the responses to adrenaline and noradrenaline on the blood pressure of the rat. Morphine and atropine in small doses blocked the pressor effect of physostigmine without interfering with the actions of adrenaline and noradrenaline. Chlorpromazine in small doses (0.5 to 2.5 mg/kg) blocked the pressor effect of physostigmine and potentiated the responses to noradrenaline whilst those to adrenaline remained unaltered. 3,6-Di(3-diethylaminopropoxy)pyridazine di(methiodide) (Win 4981) blocked the pressor effect of physostigmine and, in its early stages, this block was partially reversed by choline chloride. N-Diethylaminoethyl-N-isopentyl-N'N'-diisopropylurea (P-286), in a dose that reduced the effect of dimethylphenylpiperazinium, had no effect on the pressor response to physostigmine or on the responses to adrenaline and noradrenaline. Hexamethonium, even in large doses (100 mg/kg), only blocked partially the effect of physostigmine while mecamylamine produced a complete block; the responses to adrenaline and noradrenaline were potentiated in both instances.

Treatment with phenoxybenzamine and dichloroisoprenaline prevented the rise of blood pressure, contraction of the nictitating membrane and increase in cardiac contractile force produced by intravenous injections of bretylium and guanethidine in anaesthetized or spinal cats. Treatment with cocaine, imipramine or reserpine reduced the sensitivity to bretylium and guanethidine of the spinal cat. In the spinal cat treated with reserpine, sensitivity to the drugs could be restored by an infusion of noradrenaline. Chlorpromazine also blocked the pressor and nictitating membrane responses to bretylium and guanethidine. The drug effects were unaltered 1 hr after bilateral adrenalectomy. During the intravenous infusion of noradrenaline into spinal cats the pressor responses to bretylium and guanethidine were increased, whilst those to adrenaline and to noradrenaline were decreased. Guanethidine (3 to 5 mg/kg) injected intravenously into the cat caused a sudden relaxation of the rat isolated stomach-strip bathed in blood. In seven similar experiments bretylium (3 to 5 mg/kg) relaxed the strip only once; in the other six experiments there was either no effect (four experiments) or an increase in the tone of the strip (two experiments). It is concluded that the initial adrenergic effects of bretylium and guanethidine are mediated, at least in part, through a release of catechol amines from stores in the effector organ.

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.