McDonough J H, Shih T M
Biochemical Pharmacology Branch, U.S. Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, MD 21010-5425.
Neurosci Biobehav Rev. 1993 Summer;17(2):203-15. doi: 10.1016/s0149-7634(05)80151-4.
Anticholinergics, benzodiazepines and N-methyl-D-aspartate (NMDA) antagonists have been shown to modulate the expression of nerve agent-induced seizures. This study examined whether the anticonvulsant actions of these drugs varied depending on the duration of prior seizure activity. Rats implanted with electrodes to record electroencephalographic (EEG) activity were pretreated with the oxime HI-6 (125 mg/kg, IP) to prolong survival, and then challenged with a convulsant dose of the nerve agent soman (180 micrograms/kg, SC); treatment compounds (scopolamine, diazepam, MK-801, atropine, benactyzine, and trihexyphenidyl) were delivered IV at specific times after seizure onset. Both diazepam and MK-801 displayed a similar profile of activity: At both short or long times after seizure initiation the anticonvulsant efficacy of each drug remained the same. Diazepam, and especially MK-801, enhanced the lethal actions of soman by potentiating the respiratory depressant effects of the agent; scopolamine given prior to diazepam or MK-801 protected against the respiratory depression. Scopolamine and atropine showed a dose- and time-dependent effectiveness; the longer the seizure progressed the higher the dose of drug required to terminate the seizure, with eventual loss of anticonvulsant activity if the seizure had progressed for 40 min. In contrast, benactyzine and trihexyphenidyl showed a third profile of activity: There was a smaller increase in drug dosage required for anticonvulsant activity as seizure duration increased, and both drugs could terminate seizures that had progressed for 40 min. The early anticonvulsant action of anticholinergics is interpreted as a specific effect that blocks the primary cholinergic excitatory drive that initiates, and first maintains, nerve agent seizures. If allowed to progress, the seizure activity itself recruits excitatory neurotransmitter systems (i.e., NMDA) that eventually maintain the seizure independent of the initial cholinergic drive. This is indicated by the eventual ineffectiveness of scopolamine and atropine as the duration of the seizure progresses. Diazepam and MK-801 appear to act to moderate nerve agent seizures by enhancing inhibitory activity (diazepam) or dampening the secondarily activated noncholinergic excitatory system (MK-801). Benactyzine and trihexyphenidyl represent compounds that possibly have both anticholinergic and NMDA antagonistic properties.
抗胆碱能药物、苯二氮䓬类药物和N-甲基-D-天冬氨酸(NMDA)拮抗剂已被证明可调节神经毒剂诱发癫痫发作的表达。本研究考察了这些药物的抗惊厥作用是否因先前癫痫活动的持续时间而异。给植入电极以记录脑电图(EEG)活动的大鼠预先注射肟HI-6(125mg/kg,腹腔注射)以延长存活时间,然后用惊厥剂量的神经毒剂梭曼(180μg/kg,皮下注射)进行攻击;在癫痫发作开始后的特定时间静脉注射治疗化合物(东莨菪碱、地西泮、MK-801、阿托品、苯乃嗪和苯海索)。地西泮和MK-801表现出相似的活性特征:在癫痫发作开始后的短时间和长时间,每种药物的抗惊厥效力均保持不变。地西泮,尤其是MK-801,通过增强该药物的呼吸抑制作用增强了梭曼的致死作用;在给予地西泮或MK-801之前给予东莨菪碱可预防呼吸抑制。东莨菪碱和阿托品表现出剂量和时间依赖性疗效;癫痫发作持续的时间越长,终止癫痫发作所需的药物剂量越高,如果癫痫发作持续40分钟,最终会失去抗惊厥活性。相比之下,苯乃嗪和苯海索表现出第三种活性特征:随着癫痫发作持续时间的增加,抗惊厥活性所需的药物剂量增加较小,并且两种药物均可终止持续40分钟的癫痫发作。抗胆碱能药物的早期抗惊厥作用被解释为一种特异性效应,即阻断引发并首先维持神经毒剂癫痫发作的主要胆碱能兴奋驱动。如果任其发展,癫痫发作活动本身会募集兴奋性神经递质系统(即NMDA),最终维持癫痫发作而不依赖于最初的胆碱能驱动。随着癫痫发作持续时间的延长,东莨菪碱和阿托品最终无效就表明了这一点。地西泮和MK-801似乎通过增强抑制活性(地西泮)或抑制继发激活的非胆碱能兴奋系统(MK-801)来减轻神经毒剂癫痫发作。苯乃嗪和苯海索代表可能同时具有抗胆碱能和NMDA拮抗特性的化合物。