Ward A, Chaffman M O, Sorkin E M
Drugs. 1986 Aug;32(2):130-68. doi: 10.2165/00003495-198632020-00003.
Dantrolene sodium acts primarily by affecting calcium flux across the sarcoplasmic reticulum of skeletal muscle. Recently, dantrolene has been used very successfully in the treatment of several rare hypercatabolic syndromes which have previously been associated with high mortality rates. In malignant hyperthermia, where early diagnosis and treatment usually with intravenous dantrolene in association with other supportive measures (and often subsequent dantrolene therapy) is performed, recovery is seen in virtually 100% of patients. There is a rapid resolution of hyperthermia, dysrhythmias, muscle rigidity, tachycardia, hypercapnia, mottled or cyanotic skin, and metabolic acidosis, and a slower normalisation of myoglobinuria and elevated serum creatine phosphokinase levels. In patients with family history or previous episodes of malignant hyperthermia, prophylactic treatment with dantrolene prior to anaesthesia prevents the syndrome occurring in most cases. Where malignant hyperthermia has developed patients have been successfully treated with further dantrolene therapy. Dantrolene has also been used successfully in the treatment of a few cases of heat stroke and the neuroleptic malignant syndrome--both of which have many similarities to malignant hyperthermia. Dantrolene is well established in the treatment of patients with muscle spasticity where it generally improves at least some of the components of spasticity (i.e. hyper/hypotonia, clonus, muscle cramps and spasms, resistance to stretch and flexor reflexes, articular movement, neurological and motor functions and urinary control). However, in some patients, particularly those with multiple sclerosis, dantrolene may not be effective, and in many cases muscular strength may diminish. Long term dantrolene therapy has been associated with hepatic toxicity and may cause problems in patients treated for disorders of muscle spasticity. Thus, dantrolene offers a unique advance in the therapy available for the treatment of hypercatabolic disorders and is also useful in the treatment of muscle spasticity of various aetiology.
丹曲林钠主要通过影响骨骼肌肌浆网的钙通量发挥作用。最近，丹曲林已非常成功地用于治疗几种罕见的高分解代谢综合征，这些综合征以前与高死亡率相关。在恶性高热中，早期诊断并通常通过静脉注射丹曲林并结合其他支持措施（且常常随后进行丹曲林治疗），几乎100%的患者可康复。高热、心律失常、肌肉强直、心动过速、高碳酸血症、皮肤斑驳或发绀以及代谢性酸中毒可迅速缓解，肌红蛋白尿和血清肌酸磷酸激酶水平升高则较缓慢恢复正常。对于有恶性高热家族史或既往有恶性高热发作的患者，麻醉前用丹曲林进行预防性治疗可在大多数情况下预防该综合征的发生。当发生恶性高热时，患者通过进一步的丹曲林治疗已成功治愈。丹曲林还成功用于治疗少数中暑和抗精神病药恶性综合征病例——这两种情况都与恶性高热有许多相似之处。丹曲林在治疗肌肉痉挛患者方面已得到充分确立，它通常至少能改善痉挛的一些成分（即张力亢进/减退、阵挛、肌肉痉挛和抽搐、对伸展和屈肌反射的抵抗、关节活动、神经和运动功能以及排尿控制）。然而，在一些患者中，尤其是患有多发性硬化症的患者，丹曲林可能无效，而且在许多情况下肌肉力量可能会减弱。长期丹曲林治疗与肝毒性有关，可能给治疗肌肉痉挛性疾病的患者带来问题。因此，丹曲林在治疗高分解代谢疾病的可用疗法方面取得了独特进展，也可用于治疗各种病因的肌肉痉挛。
