Rigel D F, Katona P G
J Pharmacol Exp Ther. 1986 Jul;238(1):367-71.
Atropine produces cardioacceleration in conscious dogs partly by reversing the pre-existing parasympathetic cardioinhibition and partly by inducing "excess tachycardia" (ET). Because ET occurs independently of adrenergic mechanisms, the present study sought to determine whether ET is generated by a positive chronotropic action of endogenous histamine on pacemaker cell H1 receptors. ET was antagonized in conscious dogs by the H1-receptor antagonists pyrilamine, diphenhydramine, chlorpheniramine and promethazine (1-5 mg/kg i.v.), but not the H2-receptor antagonist cimetidine (2-10 mg/kg i.v.). Pyrilamine (0.1 mg/kg i.v.), but not cimetidine (4 mg/kg i.v.), also eliminated a histamine tachycardia (31 +/- 4.1 beats/min) produced by injecting histamine (22 +/- 14.2 micrograms) into the sinus node artery after pharmacological autonomic blockade. The 30-fold greater dose of pyrilamine required to antagonize ET than histamine tachycardia suggests a nonantihistaminic, and possibly a local anesthetic mechanism of action on ET. Indeed, lidocaine, procaine, propranolol and pyrilamine antagonized ET in doses corresponding to the known relative local anesthetic potencies of these agents. The same doses of pyrilamine, lidocaine and procaine had significantly less effects on a comparable beta adrenergic tachycardia produced by intravenous isoproterenol infusion (0.1-0.5 micrograms/kg/min i.v.) after hexamethonium (10 mg/kg i.v.). The results indicate that H1-receptor blockers antagonize ET because of their local anesthetic effects and not their antihistaminic properties. The results also suggest that the ionic pacemaker mechanisms generating ET and beta adrenergic tachycardia are different.
阿托品可使清醒犬心率加快,部分原因是逆转先前存在的副交感神经对心脏的抑制作用,部分原因是诱导“过度心动过速”(ET)。由于ET的发生独立于肾上腺素能机制,本研究旨在确定ET是否由内源性组胺对起搏细胞H1受体的正性变时作用所产生。在清醒犬中,H1受体拮抗剂吡苄明、苯海拉明、氯苯那敏和异丙嗪(静脉注射1 - 5 mg/kg)可拮抗ET,但H2受体拮抗剂西咪替丁(静脉注射2 - 10 mg/kg)则不能。静脉注射吡苄明(0.1 mg/kg)可消除在药理学自主神经阻滞后向窦房结动脉注射组胺(22 ± 14.2微克)所产生的组胺性心动过速(31 ± 4.1次/分钟),而西咪替丁(4 mg/kg静脉注射)则无此作用。拮抗ET所需的吡苄明剂量比拮抗组胺性心动过速所需剂量大30倍,这表明其对ET的作用机制并非抗组胺作用,可能是局部麻醉作用机制。事实上,利多卡因、普鲁卡因、普萘洛尔和吡苄明以与这些药物已知相对局部麻醉效能相当的剂量拮抗ET。相同剂量的吡苄明、利多卡因和普鲁卡因对六甲铵(静脉注射10 mg/kg)后静脉输注异丙肾上腺素(0.1 - 0.5微克/千克/分钟静脉注射)所产生的类似β肾上腺素能心动过速的影响明显较小。结果表明,H1受体阻滞剂拮抗ET是由于其局部麻醉作用而非抗组胺特性。结果还提示,产生ET和β肾上腺素能心动过速的离子起搏机制不同。