Wirguin I, Brenner T, Sicsic C, Argov Z
Department of Neurology, Hadassah University Hospital, Jerusalem, Israel.
Muscle Nerve. 1994 May;17(5):523-7. doi: 10.1002/mus.880170509.
We tested the effect of intravenous administration of verapamil and nimodipine on the decremental response in rabbits with experimental autoimmune myasthenia. Nimodipine produced an immediate augmentation of the decremental response to 3-Hz nerve stimulation, which lasted about 30 min. In contrast, verapamil caused marked amelioration of the decrement beginning 30 min after injection. Our findings are consistent with previous reports suggesting that verapamil has a presynaptic effect of enhanced acetylcholine release at the neuromuscular junction. Since evaluation of a drug effect in vivo in animals with experimental autoimmune myasthenia gravis may be more pertinent to its effect on patients with myasthenia gravis (MG), verapamil might prove to be safer in MG than nimodipine. However, due to the additional effects of calcium channel blockers, the safety of their use in myasthenia gravis cannot be inferred from the experimental results.
我们测试了静脉注射维拉帕米和尼莫地平对实验性自身免疫性重症肌无力家兔递减反应的影响。尼莫地平使对3Hz神经刺激的递减反应立即增强，持续约30分钟。相比之下，维拉帕米在注射后30分钟开始使递减反应明显改善。我们的研究结果与之前的报告一致，表明维拉帕米在神经肌肉接头处具有增强乙酰胆碱释放的突触前效应。由于在实验性自身免疫性重症肌无力动物体内评估药物效果可能与其对重症肌无力（MG）患者的效果更相关，维拉帕米在MG中可能比尼莫地平更安全。然而，由于钙通道阻滞剂的其他作用，不能从实验结果推断它们在重症肌无力中使用的安全性。
