Toet A E, van de Kuil A, Vleeming W, Wemer J, Bode W, Meulenbelt J, de Wildt D J
National Poison Control Center, National Institute of Public Health and Environmental Protection, Bilthoven, The Netherlands.
Chirality. 1996;8(6):411-7. doi: 10.1002/(SICI)1520-636X(1996)8:6<411::AID-CHIR1>3.0.CO;2-F.
The contribution of the individual enantiomers ([+]-[R]- and [-]-[S]-propranolol) to rac-propranolol intoxication was studied in anaesthetized, spontaneously breathing (SB) rats and artificially ventilated (AV) rats and rabbits. In the SB rat, propranolol (30 mg.kg-1.h-1 i.v.) decreased heart rate and mean arterial blood pressure and caused hypoventilation, serious hypoxaemia, respiratory acidosis, and death by respiratory arrest. Survival time (ST) in the (+)-(R)-propranolol group (ST 91 +/- 5 min) was significantly longer than in the rac-propranolol group (ST. 68 +/- 6 min). In AV rats and rabbits toxic doses of rac-, (-)-(S)- and (+)-(R)-propranolol, 30 mg.kg-1.h-1 and 15 mg.kg-1.h-1 i.v., respectively, induced comparable effects on haemodynamic variables as in the SB rat. Artificial ventilation lengthened ST by a factor of three to four in rats. In the AV rat, ST's were not significantly different between the rac-, (-)-(S)- and (+)-(R)-propranolol groups. In the rabbit, as in the SB rat, ST in the (+)-(R)-propranolol group was significantly longer than ST's in the rac- and (-)-(S)-propranolol groups. The acute respiratory acidosis in SB rats and the prolonged ST in AV rats suggest that respiratory failure is the primary and cardiovascular failure the secondary cause of death in propranolol intoxication. The potentiation of the toxic effect of the enantiomers observed after dosing the racemate instead of the pure enantiomers could not be explained by a stereoselective difference in plasma propranolol concentration.
在麻醉状态下自主呼吸(SB)的大鼠以及人工通气(AV)的大鼠和兔子中,研究了左旋和右旋普萘洛尔对消旋普萘洛尔中毒的作用。在自主呼吸的大鼠中,普萘洛尔(静脉注射30毫克·千克⁻¹·小时⁻¹)可降低心率和平均动脉血压,并导致通气不足、严重低氧血症、呼吸性酸中毒以及呼吸骤停死亡。(+)-(R)-普萘洛尔组的存活时间(ST为91±5分钟)显著长于消旋普萘洛尔组(ST为68±6分钟)。在人工通气的大鼠和兔子中,分别静脉注射30毫克·千克⁻¹·小时⁻¹和15毫克·千克⁻¹·小时⁻¹的消旋、(-)-(S)-和(+)-(R)-普萘洛尔的中毒剂量,对血流动力学变量产生的影响与自主呼吸的大鼠相当。人工通气使大鼠的存活时间延长了三到四倍。在人工通气的大鼠中,消旋、(-)-(S)-和(+)-(R)-普萘洛尔组的存活时间无显著差异。在兔子中,与自主呼吸的大鼠一样,(+)-(R)-普萘洛尔组的存活时间显著长于消旋和(-)-(S)-普萘洛尔组。自主呼吸大鼠中的急性呼吸性酸中毒以及人工通气大鼠中延长的存活时间表明,呼吸衰竭是普萘洛尔中毒死亡的主要原因,而心血管衰竭是次要原因。给予外消旋体而非纯对映体后观察到的对映体毒性作用增强,无法用血浆普萘洛尔浓度的立体选择性差异来解释。