Sato S, Tsuji M H, Okubo N, Nishimoto C, Naito H
Department of Anesthesiology, University of Tsukuba, Ibaraki, Japan.
J Toxicol Clin Toxicol. 1995;33(4):337-42. doi: 10.3109/15563659509028919.
In a previous study of propranolol poisoning, glucagon and milrinone significantly increased cardiac output, but the improvement caused by glucagon was almost entirely due to the chronotropic effect. This study investigates the combined effect of glucagon, in a dose not inducing tachycardia, and milrinone on beta-blocker poisoning. Following the administration of 10 mg/kg propranolol IV over ten minutes, dogs (N = 20) were divided into four treatment groups, group S (saline), group G (glucagon 2.5 micrograms/kg), group M (milrinone 100 micrograms/kg), and group G + M (glucagon 2.5 micrograms/kg plus milrinone 100 micrograms/kg). Hemodynamic parameters were observed over the next thirty minutes. Heart rate, cardiac output, and mean arterial pressure were decreased in all groups after the administration of propranolol. Heart rate, mean arterial pressure, cardiac output, and stroke volume recovered to the baseline values in group G + M. However, heart rate in group G + M showed a significant increase versus the other three groups. In a canine model of severe propranolol poisoning, the combined effect of glucagon 2.5 micrograms/kg and milrinone 100 micrograms/kg brought about a significant hemodynamic improvement, but it was accompanied by an excessive increase of heart rate. Combined therapy of milrinone and glucagon may not be preferable therapy in beta-blocker poisoning in the canine model.
在先前一项关于普萘洛尔中毒的研究中，胰高血糖素和米力农可显著增加心输出量，但胰高血糖素所带来的改善几乎完全归因于变时效应。本研究调查了在不引起心动过速的剂量下，胰高血糖素与米力农联合使用对β受体阻滞剂中毒的影响。在十分钟内静脉注射10mg/kg普萘洛尔后，将犬类（N = 20）分为四个治疗组，S组（生理盐水）、G组（胰高血糖素2.5微克/千克）、M组（米力农100微克/千克）和G + M组（胰高血糖素2.5微克/千克加米力农100微克/千克）。在接下来的三十分钟内观察血流动力学参数。注射普萘洛尔后，所有组的心率、心输出量和平均动脉压均下降。G + M组的心率、平均动脉压、心输出量和每搏输出量恢复到基线值。然而，G + M组的心率与其他三组相比显著增加。在严重普萘洛尔中毒的犬类模型中，2.5微克/千克胰高血糖素和100微克/千克米力农联合使用带来了显著的血流动力学改善，但同时伴有心率过度增加。在犬类模型中，米力农和胰高血糖素联合治疗可能不是β受体阻滞剂中毒的优选治疗方法。
