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泮库溴铵及其代谢产物、维库溴铵(Org NC45)及其潜在代谢产物在麻醉猫体内的神经肌肉和迷走神经阻滞作用。

Neuromuscular and vagal blocking actions of pancuronium bromide, its metabolites, and vecuronium bromide (Org NC45) and its potential metabolites in the anaesthetized cat.

作者信息

Marshall I G, Gibb A J, Durant N N

出版信息

Br J Anaesth. 1983 Aug;55(8):703-14. doi: 10.1093/bja/55.8.703.

Abstract

The neuromuscular and cardiac vagus blocking actions of pancuronium, vecuronium (Org NC45) and their respective potential hydroxy metabolites have been studied in the chloralose-anaesthetized cat. Pancuronium was three times more potent as a neuromuscular blocker than its 3-hydroxy derivative, 20 times more potent than the 17-hydroxy derivative and 45 times more potent than the 3,17-dihydroxy derivative. The vagal:neuromuscular block ratios measured at 50% inhibition for these compounds were pancuronium 3.0, 3-hydroxy derivative 6.4, 17-hydroxy derivative 1.1 and 3,17-dihydroxy derivative 0.36 (a value greater than unity indicated greater potency at the neuromuscular junction). Vecuronium was 1.4 times more potent than its 3-hydroxy derivative, 24 times more potent than the 17-hydroxy derivative and 72 times more potent than the 3,17-dihydroxy derivative as a neuromuscular blocker. The vagal:neuromuscular block ratios were vecuronium 79.8, 3-hydroxy derivative 40.4, 17-hydroxy derivative 0.85 and 3,17-dihydroxy derivative 0.15. The 3-hydroxy derivative of vecuronium, the most likely first metabolite of vecuronium, thus possessed only slightly less neuromuscular blocking potency than vecuronium, coupled with a high safety margin between neuromuscular and vagal blocking doses. In addition, the time-course of its action was not different from that of vecuronium. Thus, it is concluded that this potential metabolite is unlikely to give rise to tachycardia in man. It is unlikely that the 17-hydroxy and 3,17-dihydroxy derivatives of vecuronium would be produced in sufficiently great quantities by metabolism from vecuronium to result in either tachycardia or residual neuromuscular blockade.

摘要

在氯醛糖麻醉的猫身上研究了泮库溴铵、维库溴铵(Org NC45)及其各自潜在的羟基代谢产物的神经肌肉和心脏迷走神经阻滞作用。泮库溴铵作为神经肌肉阻滞剂的效力是其3-羟基衍生物的3倍,是17-羟基衍生物的20倍,是3,17-二羟基衍生物的45倍。这些化合物在50%抑制率时测得的迷走神经:神经肌肉阻滞比值,泮库溴铵为3.0,3-羟基衍生物为6.4,17-羟基衍生物为1.1,3,17-二羟基衍生物为0.36(大于1的值表明在神经肌肉接头处效力更强)。维库溴铵作为神经肌肉阻滞剂的效力比其3-羟基衍生物高1.4倍,比17-羟基衍生物高24倍,比3,17-二羟基衍生物高72倍。迷走神经:神经肌肉阻滞比值分别为维库溴铵79.8,3-羟基衍生物40.4,17-羟基衍生物0.85,3,17-二羟基衍生物0.15。维库溴铵最可能的首代代谢产物3-羟基衍生物,其神经肌肉阻滞效力仅略低于维库溴铵,同时在神经肌肉和迷走神经阻滞剂量之间有较高的安全 margin。此外,其作用的时间过程与维库溴铵无异。因此,得出结论,这种潜在的代谢产物在人体内不太可能引起心动过速。维库溴铵的17-羟基和3,17-二羟基衍生物不太可能通过维库溴铵的代谢大量产生,从而导致心动过速或残留的神经肌肉阻滞。

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