Creese R, Maclagan J
Br J Pharmacol. 1976 Sep;58(1):141-8. doi: 10.1111/j.1476-5381.1976.tb07703.x.
1 Tritium-labelled decamethonium was infused intravenously in 12 cats at final rates of 1.3-4.2 nmol kg-1 min-1 to produce a steady plasma concentration which ranged between 0.21-1.3 mumol/l in different experiments. Muscle contractions were elicited by nerve stimulation and the potential at the end-plate regions of superficial fibres was recorded by extracellular electrodes. 2 Under these conditions, it was not possible to obtain a steady degree of neuromuscular block. The initial decrease in muscle contractions was followed by recovery towards the original value although the concentration of decamethonium in the plasma remained constant, or in some cases rose. The initial depolarization of the end-plate region also waned during the constant infusion of the drug. 3 Once the twitch tension had returned to control values during infusion of the drug, prolongation of the infusion for a total of four hours did not produce a secondary neuromuscular block. 4 Scintillation counting showed that during infusion of labelled decamethonium the radioactivity of the muscles increased progressively with time. The uptake was less in the soleus muscle than in the fast-contracting flexor longus digitorum and extensor longus digitorum muscles. Muscles which had been denervated 12-13 days previously showed a greater uptake of labelled drug than control muscles from the contralateral limb. 5 The labelled drug was localized by autoradiography of frozen sections of leg muscles following intra-arterial injection of decamethonium. Grain counts in individual fibres showed that small amounts of decamethonium had entered the muscle fibres along their entire length, and there was increased uptake of the drug into the cell in the region of the end-plate. 6 The mechanisms underlying the waning of the pharmacological response during constant application of depolarizing drugs are discussed.
以1.3 - 4.2纳摩尔/千克·分钟的终末速率给12只猫静脉输注氚标记的十烃季铵,以产生稳定的血浆浓度,在不同实验中该浓度范围为0.21 - 1.3微摩尔/升。通过神经刺激引发肌肉收缩,并用细胞外电极记录浅表纤维终板区域的电位。
在这些条件下,无法获得稳定程度的神经肌肉阻滞。尽管血浆中十烃季铵的浓度保持恒定,或在某些情况下升高,但肌肉收缩的最初下降之后是恢复到原始值。在持续输注药物期间,终板区域的初始去极化也逐渐减弱。
在药物输注期间,一旦抽搐张力恢复到对照值,将输注延长总共4小时并未产生继发性神经肌肉阻滞。
闪烁计数表明,在输注标记的十烃季铵期间,肌肉的放射性随时间逐渐增加。比目鱼肌的摄取量低于快速收缩的趾长屈肌和趾长伸肌。先前已去神经12 - 13天的肌肉比来自对侧肢体的对照肌肉摄取更多的标记药物。
在动脉内注射十烃季铵后,通过腿部肌肉冰冻切片的放射自显影对标记药物进行定位。单个纤维中的颗粒计数表明,少量十烃季铵沿其全长进入肌肉纤维,并且在终板区域药物进入细胞的摄取增加。
讨论了在持续应用去极化药物期间药理反应减弱的潜在机制。