[Clinico-experimental study on a new psycho-muscle relaxant: chloromethazanone].
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A concentration-dependent relaxant effect of phentolamine was demonstrated in guinea-pig isolated trachea and was probably unrelated to its alpha-adrenoceptor blocking action. The maximal effect of phentolamine against spontaneous tracheal tone was in the 24-100% range. However, phentolamine produced 100% relaxation when the tone was induced by histamine, carbachol, 30 mM K+ or 124 mM K+. Relaxant EC50 values ranged from 8 to 50 microM with the highest potency found against histamine-induced contractions. Phentolamine caused no suppression of contractions elicited by prostaglandin F2 alpha (PGF2 alpha) or leukotriene C4 (LTC4). At a concentration of 100 microM the alpha 2-adrenoceptor blocker, yohimbine, produced minor inhibition of spasmogen-induced tone, whereas the alpha 1-adrenoceptor blocker prazosin (up to 10 microM) had no inhibitory effects in the trachealis. Propranolol (1 microM), prazosin (1 microM), yohimbine (100 microM), tetrodotoxin (3 microM), glibenclamide (10 microM), tetraethylammonium (8 mM), 4-aminopyridine (5 mM), procaine (100 microM), dipyridamole (3 microM) or methylene blue (100 microM) did not influence the relaxant responses to phentolamine. In tracheal preparations contracted by PGF2 alpha or LTC4, phentolamine (1, 10 and 100 microM) antagonized the relaxant action of the K+ channel openers, pinacidil and cromakalim. The concentration-relaxation curves for pinacidil were shifted 30-fold to the right without change in the maximal effects, whereas the maximal cromakalim-induced relaxant responses were markedly suppressed by phentolamine.
Osteoarthritis (OA) is a common, chronic condition that affects most older adults. Adults with OA must deal with pain that leads to limited mobility and may lead to disability and difficulty maintaining independence. A longitudinal, randomized clinical trial pilot study was conducted to determine whether Guided Imagery (GI) with Progressive Muscle Relaxation (PMR) would reduce pain and mobility difficulties of women with OA. Twenty-eight older women with OA were randomly assigned to either the treatment or the control group. The treatment consisted of listening twice a day to a 10-to-15-minute audiotaped script that guided the women in GI with PMR. Repeated-measures ANOVA revealed a significant difference between the two groups in the amount of change in pain and mobility difficulties they experienced over 12 weeks. The treatment group reported a significant reduction in pain and mobility difficulties at week 12 compared to the control group. Members of the control group reported no differences in pain and non-significant increases in mobility difficulties. The results of this pilot study justify further investigation of the effectiveness of GI with PMR as a self-management intervention to reduce pain and mobility difficulties associated with OA.
The introduction of curare improved surgical relaxation and encouraged anaesthetists to enlarge their vision. They became interested in the pharmacologic properties of their drugs and the physiologic changes associated with paralysis, and this led naturally to their involvement in intensive care and respiratory physiology. Since 1942, more than 50 muscle relaxants have been introduced: the current emphasis is on the short- to intermediate-duration agents that allow rapid recovery and avoid the problems associated with residual curarization, but we still await a nondepolarizing replacement for suxamethonium.
The objective of this study was to ascertain whether endothelium-dependent relaxation and guanosine 3',5'-cyclic monophosphate (cGMP) formation in bovine pulmonary artery are dependent on L-arginine. Arterial rings responded to acetylcholine and A23187 with increased cGMP accumulation and relaxation and showed resting L-arginine levels of approximately 300 microM. Addition of L-arginine failed to cause relaxation or cGMP accumulation. Arterial rings incubated under tension at 37 degree C for 24 h showed a three- to fourfold decline in L-arginine levels, and this decline was accompanied by a similar decline in resting cGMP levels as well as complete refractoriness to endothelium-dependent relaxation and cGMP formation in response to acetylcholine and A23187, without alteration of responsiveness to nitric oxide, s-nitrosothiols, or nitroglycerin. The endothelium in 24-h incubated arterial rings was normal morphologically, as assessed by scanning electron microscopy. L-Arginine caused endothelial-dependent relaxation and cGMP formation in L-arginine-depleted rings, which was antagonized by oxyhemoglobin and methylene blue. Bovine aortic endothelial cells grown in L-arginine-deficient medium supplemented with D-arginine during the final 24 h of growth failed to generate endothelium-derived nitric oxide, as assessed by bioassay cascade. L-Canavanine, but not L-lysine or L-ornithine, protected against the decline in L-arginine and cGMP levels and loss of endothelium-dependent relaxation that was characteristic of 24-h incubated arterial rings. The pharmacological properties of L-arginine were shared by L-arginine ethyl ester, L-arginine methyl ester, and L-homoarginine but not N-alpha-benzoyl-L-arginine ethyl ester or L-canavanine. These observations indicate that L-arginine or a structural analogue may be obligatory for endothelium-dependent relaxation and cGMP formation.
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Since the advent of surgical anesthesia, one of the single greatest challenges to providers and researchers has been to develop, test, and promote drugs and techniques to facilitate rapid intubation and security of the airway to diminish risk of regurgitation and gastric aspiration. This article provides a comprehensive, historical perspective of such efforts, including the efficacy of various techniques and muscle relaxant drugs that have been used to further the ideal situation in which airway control would obviate the all-too-common morbidity statistics of gastric aspiration. Special emphasis is given to the review of succinylcholine and vecuronium relative to their roles in rapid sequence induction.
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The effects of theophylline, proxyphylline and diprophylline on cAMP-phosphodiesterase (PDE), tracheal smooth muscle tone and cAMP-levels were studied in guinea-pig tracheal preparations, and on contractile force in guinea-pig atria. Theophylline and proxyphylline inhibited tracheal PDE-activity to similar extents (I50 approximately 40 micrograms/ml) whereas diprophylline was about 5 times less effective. Half-maximum relaxation of tracheal smooth muscle was obtained with 25 micrograms/ml theophylline, 100 micrograms/ml proxyphylline and 250 micrograms/ml diprophylline. Marked rises in cAMP-levels were obtained with theophylline and, to a lesser extent with proxyphylline whereas diprophylline was almost ineffective. In combination, the relaxant effect of theophylline was over-additively enhanced by diprophylline plus proxyphylline (combination product of these three methylxanthines: Neobiphyllin) but its cAMP-increasing effect (at lower doses) was not, indicating that the potentiated relaxing action was not due to higher levels of cAMP. Diprophylline in contrast to theophylline or proxyphylline had almost no positive inotropic effect in guinea-pig atria which supports the assumption that the mechanism of tracheal smooth muscle relaxation of diprophylline is different from that of theophylline and proxyphylline and unrelated to cAMP. These findings agree with and explain the favourable anti-asthmatic effects obtained with a combination of theophylline, proxphylline and diprophylline.
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