[Mechanism of the effect of the alpha-adrenoblockader phentolamine on gastric secretion in dogs].
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This study prospectively assessed the use, effectiveness, and sexual and psychosocial impact of self-injection treatment in 15 men with psychogenic impotence. Sixty percent dropped out of self-injection treatment by 6 months. Those who remained used self-injections about four times monthly with a 94% success rate. Frequency of intercourse and sexual satisfaction increased. Anxiety decreased, and trends toward improvement in depression and self-esteem were evident. Qualitative data indicated that performance anxiety was not alleviated, dependence upon injections for intercourse remained, symptom substitution did not occur, and capacity for intimacy was not improved.
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In human kidney, we found unique prazosin-binding sites that were insensitive to phentolamine and were thus unlikely to be alpha(1)-adrenoceptors. As the binding of [(3)H]prazosin to phentolamine-insensitive sites was prevented by 100 microM guanabenz, the insensitive sites were evaluated by subtracting [(3)H]prazosin binding in the presence of 100 microM guanabenz from that in the presence of 10 microM phentolamine. [(3)H]Prazosin bound to the phentolamine-insensitive sites monophasically with a high affinity (pK(d); 9.1+/-0.08, n=8), and the B(max) value (814+/-204 fmol mg(-1) protein, n=8) was more than ten times that of the phentolamine-sensitive alpha(1)-adrenoceptor (pK(d)=9.9+/-0.13, B(max)=66+/-23 fmol mg(-1) protein, n=7). The phentolamine-insensitive sites in human kidney were highly sensitive to other quinazoline derivatives such as terazosin and doxazosin. However, other alpha(1)-adrenoceptor antagonists (tamsulosin, WB4101 and corynanthine) did not inhibit the binding at a range of concentrations that generally exhibit alpha(1)-adrenoceptor antagonism, and noradrenaline, rauwolscine and propranolol were without effect on the [(3)H]prazosin binding. On the other hand, ligands for the renal Na(+)-transporter (amiloride and triamterene) and for imidazoline recognition sites (guanabenz, guanfacine and agmatine) displaced the binding of [(3)H]prazosin to phentolamine-insensitive sites at micromolar concentrations. Photoaffinity labeling with [(125)I]iodoarylazidoprazosin showed phentolamine-insensitive labeling at around 100 kDa, a molecular size larger than that of human alpha(1a)- and alpha(1b)-adrenoceptors expressed in 293 cells (50-60 and 70-80 kDa, respectively) on electrophoresis. In contrast, there was no detectable phentolamine-insensitive binding site but were phentolamine-sensitive alpha(1)-adrenoceptors in human liver (pK(d)=10.0+/-0.06, B(max)=44+/-6 fmol mg(-1) protein, n=3). Phentolamine-insensitive prazosin binding sites were also detected in rabbit kidney (approximately 50% of specific binding sites) but were minor in rat kidney (less than 20%). In conclusion, there are unique prazosin-binding sites in human kidney, the pharmacological profiles of which were distinct from those of known adrenoceptors.
Clearance experiments were performed in conscious rats in order to investigate whether intravenous infusion of the non-selective alpha-adrenoceptor antagonist phentolamine could block compensatory sodium reabsorption during furosemide-induced volume contraction. By measuring inulin clearance, urinary excretion rates of sodium and water, and lithium clearance, the effects on proximal and distal nephron segments were dissociated. The renal effect of intravenous infusion of 0.3 mg/kg/hr phentolamine (n = 6) was compared with time control animals (n = 9). Furosemide was administered as constant intravenous infusion (7.5 mg/kg/hr) with simultaneous phentolamine infusion at four dose levels: 0 (n = 9), 0.3 (n = 6), 1.0 (n = 7) and 3.0 mg/kg/hr (n = 6). Phentolamine infusion reduced norepinephrine-induced increase in blood pressure at all three dose levels (n = 5). Phentolamine infusion induced transient antidiuresis and a prolonged antinatriuretic response. Compared with rats given furosemide only, phentolamine attenuated dose-dependently the diuretic and natriuretic peak response to furosemide. This effect was associated with dose-dependent reductions in mean arterial pressure. The reduced natriuretic response was due to a reduced fractional sodium excretion in the distal nephron segment (at all doses of phentolamine) and a reduction of the glomerular filtration rate (1.0 and 3.0 mg/kg/hr phentolamine). The fractional lithium excretion (FELi) increased to 65 +/- 3% at 0.3 mg/kg/hr phentolamine during the natriuretic peak response of furosemide, while it only increased to 52 +/- 3% during furosemide alone. At steady-state conditions (120-180 min. after start of furosemide infusion) after infusion with furosemide plus 0.3 mg/kg/hr phentolamine the animals were still volume-depleted, but the compensatory tubular Na reabsorption in the proximal tubules was inhibited (FELi = 48 +/- 2% versus 39 +/- 1% in rats given furosemide alone). During furosemide infusion plasma epinephrine increased 700% and plasma norepinephrine increased 50%. These results are compatible with increased systemic sympathetic nervous activity and a contributory role of proximal tubular alpha-adrenoceptors in mediating compensatory sodium reabsorption during acute furosemide-induced volume contraction.
1 Compared with the response of preparations incubated in solutions without clonidine, a three to four fold increase in the magnitude of the contracture of the longitudinal muscle to challenge with phentolamine (1.0 mum) was induced by incubating the guinea-pig isolated ileum at 22 degrees C for 24 h with clonidine (1.0 mum) in Krebs solution containing hexamethonium (70 mum). Incubation of the ileum with clondine (1.0 mum) for 0.5 h at 37 degrees C did not increase responsiveness to phentolamine.2 The increase in responsiveness to phentolamine was directly related to the clonidine concentration in the incubation fluid over the range 0.01 to 1.0 mum.3 The magnitude of the contracture to phentolamine of ilea incubated with clonidine (1.0 mum) (withdrawal contracture) was directly related to the challenge dose of phentolamine over the range 0.3 to 1.0 mum.4 Yohimbine (1.0 mum) or piperoxane (1.0 mum) elicited a response comparable to that elicited by phentolamine but propranolol (1.0 mum) was inactive.5 Addition of phentolamine (1.0 mum) to clonidine (1.0 mum) in the incubation fluid abolished the increased response of the preparation to subsequent challenge with phentolamine.6 Addition of hyoscine (0.5 mum) immediately after challenge with phentolamine restored the tension of the withdrawal contracture to its resting level.7 Tetrodotoxin (3.0 mum) given before challenge, prevented phentolamine from eliciting a withdrawal contracture.8 Ileal segments incubated with clonidine (1.0 mum) were unresponsive to challenge with naloxone (100 nm); and segments incubated with normorphine (1.0 mum) were unresponsive to phentolamine (1.0 mum), although responsive to naloxone.9 Normorphine (1.0 mum) restored to resting level the tension of the clonidine withdrawal contracture; and clonidine (0.1 mum) restored to resting level the tension of the contracture to naloxone in ileal segments incubated with normorphine.10 These experiments indicate that incubation with clonidine induces, in the final cholinergic motor neurones of the myenteric plexus of the isolated ileum, a dependence the withdrawal from which is expressed as a contracture in response to alpha-adrenoceptor antagonists.11 Although opiate receptors are not involved in clonidine dependence nor alpha-adrenoceptors in opiate dependence, the findings that normorphine suppresses the clonidine withdrawal-contracture and that clonidine suppresses the contracture of opiate-dependent ileum to naloxone, suggest that the withdrawal effect studied in both clonidine and normorphine dependence in this preparation is mediated by release of acetylcholine from the final motor neurone.
In anaesthetized rats, ventilatory stimulation induced by phentolamine, an alpha sympatholytic agent, emphasizes the role of some adrenergic mechanisms in the control of the respiratory centres activity. Phentolamine (5 and 10 mg.kg-1, iv) stimulates ventilation after a 4 s latency, tidal volume and respiratory rate being both increased. A same response can also be provoked 10 min later, by a second identical iv administration, systemic blood pressure remaining then stable at its previous low level. Hyperventilation is also observed when phentolamine is injected in totally denervated rats, without any remaining baro- or chemosensitivity. Stimulation is thus due to a central activity in relation with the release of inhibitory influences. Phentolamine also causes hyperventilation after prazosin pretreatment indicating that the alpha 1 adrenergic blockade is not involved in the post-phentolamine stimulation. This is an alpha 2 adrenergic transmission dependent mechanism. Variation of the systemic blood pressure is not the main mechanism involved in the hyperventilation induced by phentolamine. Meanwhile, baroreceptor activity modulates the central response to the drug, as shown by the negative influence of the post-vasopressin arterial hypertension. Hyperoxia is also a modulating factor acting by two ways: an inhibition of the peripheral chemoreceptors activity is added to an arterial hypertension. On the other side, activation of these chemoreceptors by almitrine bismesilate increases the respiratory responses to phentolamine. As already shown by one of us (Lagneuax, 1986), phentolamine pretreated rats are more responsive to hypoxia and to almitrine. Moreover, these phentolamine pretreated rats are protected against cardiovascular collapses and against apnea, frequently observed during hypoxia without CO2 compensation.
Selective alpha and beta 1 and beta 2 adrenergic antagonists were used with electrical stimulation of the sympathetic innervation to parotid and submandibular glands of rats in order to delineate the role of the beta 1 and beta 2 adrenoceptors in regulation of salivary flow rate, Na reabsorption and K secretion from these glands. In parotid gland, [Na] of sympathetically evoked saliva in the presence of phentolamine (3 mg/kg, i.p.) was not different from that of nerve-evoked saliva in the presence of phentolamine and butoxamine (3 mg/kg, i.p.), except for the last 20 min of stimulation when [Na] of nerve-elicited saliva was higher. [K] of saliva with sympathetically evoked stimulation was the same in the presence of phentolamine alone as it was or in the presence of phentolamine and butoxamine. Again, there was no difference in salivary flow rate induced by either kind of stimulation, except for the first 10 min of stimulation, during which salivary flow rate of nerve-evoked saliva in the presence of phentolamine was lower than under the other conditions indicated. On the other hand, with submandibular gland, [Na] and [K] of nerve-elicited saliva in the presence of phentolamine were generally higher than levels of sympathetically evoked saliva in the presence of phentolamine and butoxamine. However, salivary flow rate of nerve-evoked saliva in the presence of phentolamine was generally lower than that of sympathetically evoked saliva in the presence of phentolamine and butoxamine.(ABSTRACT TRUNCATED AT 250 WORDS)