Action of bretylium and guanethidine at the neuromuscular junction

The action of substances which block sympathetic postganglionic nervous transmission

The substances which block sympathetic postganglionic transmission, xylocholine, bretylium and guanethidine, also block neuromuscular and sympathetic ganglionic transmission. To see if these last properties were related to the sympathetic blocking property, phenyltrimethylammonium, which blocks the neuromuscular junction (Riker, 1953), was used. It blocked the inhibition of the rabbit ileum produced by stimulating the periarterial nerves in the mesentery, though with higher concentrations the effect of stimulation was initially increased. The action was not modified by the presence of hyoscine. The blocking action was exerted on the response to stimulation of the highest frequency first, and on the response to stimulation of the lowest frequency last. This relation of block to stimulus frequency is similar to that at the neuromuscular junction when tubocurarine is used. Nine compounds have now been shown to block responses to sympathetic postganglionic stimulation, and seven of these are onium compounds. They are, however, mon-onium compounds, and not bis-onium compounds like hexamethonium and decamethonium, so that they can probably enter the postganglionic fibre, which bis-onium compounds (having a charged group at each end of the molecule) may not be able to do. Since these mon-onium compounds have some blocking action at neuromuscular junctions and at sympathetic ganglia, their block of postganglionic transmission may be essentially similar to that by hexamethonium at ganglia and to that by decamethonium at neuromuscular junctions. It is known that acetylcholine releases noradrenaline from sympathetic postganglionic terminations, and xylocholine and bretylium block this release in the vessels of the rabbit ear and in the rabbit isolated atria.

THE ADRENERGIC-NEURONE BLOCKING ACTION OF SOME COUMARAN COMPOUNDS

Ethyldimethyl(7-methylcoumaran-3-yl)ammonium iodide (SK&F 90,109) and its guanidine analogue [N-(7-methylcoumaran-3-yl)guanidine nitrate] (SK&F 90,238) abolish the effects of adrenergic nerve stimulation in cats, as do xylocholine and bretylium. SK&F 90,109 has slight sympathomimetic actions; these are less marked than in SK&F 90,238. Large doses of SK&F 90,109 have an action, dependent on local noradrenaline stores, that delays the appearance of adrenergic-neurone blockade in conscious cats. Responses to adrenaline are, in general, enhanced by each drug, but SK&F 90,238 transiently antagonizes tachycardia induced by adrenaline and isoprenaline. Both drugs inhibit the release of noradrenaline from the spleen during splenic nerve stimulation, but the release of catechol amines from the adrenal glands, in response to electrical or chemical stimulation, is unimpaired. In contrast to the prolonged adrenergic-neurone blocking action, any inhibition of the effects of cholinergic nerve stimulation is transient. Large intravenous doses produce neuromuscular blockade. The compounds have a slight central depressant action. In contrast to reserpine and guanethidine the noradrenaline content of rat hearts is not appreciably lowered 24 hr after a single dose of either drug. Unlike xylocholine they are not local anaesthetics. Related compounds also block the effects of adrenergic-nerve stimulation. The possible modes of action of these drugs are discussed.

THE SYMPATHETIC POSTGANGLIONIC FIBRE AND THE BLOCK BY BRETYLIUM; THE BLOCK PREVENTED BY HEXAMETHONIUM AND IMITATED BY MECAMYLAMINE

Acetylcholine, in the presence of atropine, has an action like that of sympathetic stimulation. When injected into the splenic artery it causes contraction of the spleen, but this action is blocked by hexamethonium; stimulation of the splenic nerves, however, is still effective. Thus hexamethonium distinguishes between sympathetic nerve stimulation and the action of acetylcholine. If bretylium is used instead of hexamethonium, there is no such distinction, for bretylium blocks the response to nerve stimulation as well as that to acetylcholine. It appeared that hexamethonium might block the action of acetylcholine by preventing its entry into the sympathetic fibre. Acetylcholine has some structural similarity to bretylium, since acetylcholine is a derivative of trimethylammonium and bretylium is a derivative of dimethylethylammonium. It has been found that hexamethonium, pentolinium and hemicholinium (HC-3), which are all bis-quaternary compounds, block the action of bretylium, presumably by preventing its entry into the fibre. Consistent with the view that ability to enter the fibre is important is the observation that mecamylamine and pempidine, which are ganglion-blocking agents, but not either mono- or bis-quaternary compounds, often abolish the response to stimulation of the sympathetic postganglionic fibre.

An electropharmacological analyses of the effects of some drugs on neuromuscular transmission in the vas deferens of the guinea-pig

1 The effects of several drugs upon the excitatory junction potential (e.j.p.) in the guinea-pig vas deferens have been investigated. 2 Amiodarone, a noradrenergic neurone blocker which also blocks both alpha and beta-adrenoreceptors, did not reduce the e.j.p. 3 The alpha-adrenoreceptor antagonists, azapetine, piperoxan and prazosin, only enhanced the e.j.p. irrespective of their relative potencies at alpha 1 and alpha 2-adrenoreceptors. 4 Sotalol, a beta-adrenoreceptor antagonist, was without effect upon the e.j.p. 5 Clonidine and lysergic acid diethylamide, alpha-adrenoreceptor agonists, produced a dose dependent inhibition of the e.j.p. without apparently affecting the frequency or size of spontaneous junction potentials. 6 The effects of clonidine were antagonized by piperoxan in a competitive reversible manner. 7 It is argued that these results confirm the presence of alpha-adrenoreceptors prejunctionally upon the sympathetic excitatory innervation of the vas deferens but that although an endogenous alpha-adrenoreceptor agonist is released by nerve stimulation either the transmitter that is responsible for the e.j.p. is not noradrenaline or that the postjunctional receptors responsible for the generation of the e.j.p. are not adrenoreceptors.

An analysis of the anatomical basis for the mechanical response to motor nerve stimulation of the rat vas deferens

1. An anatomical basis was sought for the biphasic motor nerve response of the rat vas deferens. The motor nerve pathway to the tissue was stimulated at different points between the vertebral outflow and the intramural fibres, in the pithed rat and in isolated tissues, to examine the possibility of two anatomically separate groups of neurones. Different preparations of the isolated tissue were devised to detect whether different groups of smooth muscle fibres contributed to the two phases.2. The fibres mediating both phases of the response arose from the upper lumbar vertebral outflows. Both phases were elicited by pre- or post-ganglionic stimulation and could be depressed by hexamethonium. In the pithed rat or with hypogastric nerve stimulation in the isolated tissue, however, the initial ;twitch' phase was relatively resistant to such blockade.3. When the rat vas deferens was perfused through the lumen in situ or in vitro, the perfusion pressure response to motor nerve stimulation exhibited two phases similar to those of the longitudinal contractile response.4. Isolated rat vasa were bisected into portions, each of which was stimulated and longitudinal tension was recorded. The proportions of the two phases of the response varied along the length of the tissue. At the prostatic end the total response was relatively weak with a dominant ;twitch' and at the epididymal end the two phases were comparable in magnitude. The distribution of adrenergic nerve terminals within the muscle layers also varied along the length of the rat vas deferens.5. The effects of drugs were investigated on the motor responses of the above preparations. The ;twitch' phase was relatively susceptible to blockade by reserpine and lysergic acid diethylamide and the ;secondary' phase to phentolamine with both equally sensitive to guanethidine. Each phase had similar susceptibilities to blockade irrespective of which part of the tissue was involved.6. It was concluded that two types of nerve-muscle transmission may be involved in the rat vas deferens with the proportion of each varying along the length of the tissue but both displaying pharmacological characteristics of adrenergic fibres.

Evidence against adrenergic motor transmission in the guinea-pig vas deferens

1. Field stimulation of desheathed preparations of guinea-pig vas deferens, treated with a ganglion-blocking agent, has revealed the presence of two tetrodotoxin-susceptible components in the motor response, suggesting the existence of two sets of post-ganglionic motor nerve fibres of different excitability: one set responding maximally to pulses of 0.1-0.4 msec; the other, to pulses of 2 msec. No distinction could be made pharmacologically between the two components.2. Cooling potentiated that component in the twitch-responses which was due to stimulation of the more excitable fibres.3. The sensitivity of the longitudinal muscle to the motor action of noradrenaline was low and was subject to considerable animal variation. But normal responses to post-ganglionic field stimulation were elicited in noradrenaline-insensitive preparations, in which the twitches elicited by 5 pulses could not be matched with noradrenaline, even 100-125 mug/ml.4. In some forty experiments, small doses of noradrenaline inhibited the twitch-responses evoked by either set of motor fibres. This inhibition differed from that produced by isoprenaline in two respects. Firstly, propranolol did not antagonize the noradrenaline inhibition, thus excluding an action on beta-adrenoceptors; and secondly, noradrenaline did not depress contractions elicited by muscarine or by 5-methylfurmethide.5. Phenoxybenzamine, 10(-6) g/ml., produced a thousandfold reduction in the sensitivity of the muscle to the motor action of noradrenaline, without any decrease in the height of the twitches elicited by 0.1 or 1 msec pulses.6. The twitch-responses were not affected by combined alpha + beta adrenoceptor blockade with phentolamine and propranolol.7. Tyramine, amphetamine, tranylcypromine and prostaglandin E(2) inhibited the twitches but potentiated the contractile effect of noradrenaline.8. The twitch-responses and their inhibition by noradrenaline were present in preparations taken from reserpinized animals.9. Although the twitch-responses could be paralysed by bretylium or guanethidine, the foregoing results excluded adrenergic transmission at the motor endings. Cholinergic transmission was also excluded by negative findings with anticholinesterases, atropine, nicotine and (+)-tubocurarine.10. Motor transmission by histamine, 5-hydroxytryptamine, gamma-aminobutyric acid or ATP was also excluded.

Actions of bretylium tosylate at the neuromuscular junction

1. The actions of bretylium tosylate on neuromuscular transmission in the rat phrenic nerve diaphragm preparation have been investigated by electrophysiological methods. Additional experiments have been made on the effect of the drug on the frog rectus preparation and on the acetylcholinesterase of erythrocytes.2. After bretylium, there was a reduction in the amplitudes of miniature end-plate potentials (mepps), endplate potentials (epps) and acetylcholine potentials recorded in the diaphragm, and also in the contractures of the rectus in response to acetylcholine (ACh) and to carbachol.3. After bretylium, there was a prolongation of the time courses of epps and ACh potentials. Under certain circumstances there was enhancement of the amplitudes of epps and ACh potentials and of the contractile responses to ACh but not to carbachol.4. Bretylium reduced the velocity of hydrolysis of ACh by erythrocyte ghosts. This inhibition was competitive and the Ki of bretylium was 0.053 mM.5. Bretylium did not cause a reduction in the mean quantal content of the epp in junctions blocked with Mg(++).6. It is concluded that bretylium exerts both facilitatory and inhibitory influences on neuromuscular transmission, which, exerted simultaneously, may give the false appearance that the drug has little action at this synapse.

Pharmacological actions of phosphocholine 2,6-xylyl ether bromide (phospho-TM10; PTM10)

PPP-Trimethyl-2-(2,6-xylyloxy)ethylphosphonium bromide (PTM10; phospho-TM10), the phosphorus analogue of xylocholine (TM10), has been found to possess local anaesthetic, α-adrenoceptor and ganglion blocking properties. It also shows a blocking action at the neuromuscular junction but has no detectable adrenergic neuron blocking properties. The relation of these results to the ‘cholinergic link” hypothesis of Burn and Rand is discussed.

Effects of adrenergic neurone blocking agents on voluntary muscle stimulated at different frequencies

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