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维拉帕米对大鼠缺血性心律失常的抗心律失常作用。

Antiarrhythmic actions of verapamil against ischaemic arrhythmias in the rat.

作者信息

Curtis M J, MacLeod B A, Walker M J

出版信息

Br J Pharmacol. 1984 Oct;83(2):373-85. doi: 10.1111/j.1476-5381.1984.tb16497.x.

Abstract

The actions of intravenous verapamil against arrhythmias induced by occlusion of a coronary artery were investigated in conscious rats. Verapamil (2-20 mg kg-1, i.v. given pre-occlusion) dose-dependently reduced arrhythmias in rats with either large or small occluded zones at an ED50 of 6 mg kg-1. This dose was effective when given immediately post-occlusion. Severe arrhythmias, as opposed to PVC, were preferentially reduced. In conscious, and pentobarbitone-anaesthetized rats, verapamil (6 mg kg-1) had different effects on electrically-induced arrhythmias, and the ECG, from an equi-effective anti-arrhythmic dose of quinidine (20 mg kg-1, i.v.). Quinidine decreased following frequency, but increased threshold current and pulse width, whereas verapamil did not. Both drugs increased P-R interval, but only quinidine increased QRS and Q-T intervals. Thirty minutes post-occlusion, the verapamil content of tissue and blood was determined after a 6 mg kg-1 dose given pre- or post-occlusion. Measurable levels of verapamil were found in both normal and ischaemic myocardium. Plasma and plasma water concentrations were 3.6 +/- 0.8 mumol l-1 and 0.6 +/- 0.1 mumol l-1 (mean +/- s.e. mean), respectively following post-occlusion administration vs. 2.7 +/- 1.2 and 0.24 +/- 0.04 for pre-occlusion administration. Plasma water concentrations were close to IC50 values for inhibition of contractility in rat atria and ventricles. Similar concentrations depressed slow action potentials induced in rat ventricles by raised K+ We suggest that the ability of verapamil to prevent severe ventricular arrhythmias following myocardial ischaemia in the conscious rat is largely due to the calcium antagonist effects of the drug.

摘要

在清醒大鼠中研究了静脉注射维拉帕米对冠状动脉闭塞诱发的心律失常的作用。维拉帕米(2 - 20毫克/千克,静脉注射,闭塞前给药)剂量依赖性地减少了闭塞区域大或小的大鼠的心律失常,其半数有效剂量(ED50)为6毫克/千克。该剂量在闭塞后立即给药时有效。与室性早搏相反,严重心律失常得到优先减少。在清醒和戊巴比妥麻醉的大鼠中,维拉帕米(6毫克/千克)对电诱发的心律失常和心电图的影响与等效抗心律失常剂量的奎尼丁(20毫克/千克,静脉注射)不同。奎尼丁降低了后续频率,但增加了阈电流和脉冲宽度,而维拉帕米则没有。两种药物均增加了P - R间期,但只有奎尼丁增加了QRS和Q - T间期。闭塞后30分钟,在闭塞前或闭塞后给予6毫克/千克剂量后测定组织和血液中的维拉帕米含量。在正常和缺血心肌中均发现了可测量水平的维拉帕米。闭塞后给药后,血浆和血浆水浓度分别为3.6±0.8微摩尔/升和0.6±0.1微摩尔/升(平均值±标准误平均值),而闭塞前给药分别为2.7±1.2和0.24±0.04。血浆水浓度接近抑制大鼠心房和心室收缩力的半数抑制浓度(IC50)值。类似浓度可抑制高钾诱导的大鼠心室慢动作电位。我们认为,维拉帕米预防清醒大鼠心肌缺血后严重室性心律失常的能力很大程度上归因于该药物的钙拮抗剂作用。

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