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Methantheline improves the reactivation by HI 6 of human erythrocyte acetylcholinesterase inhibited by soman in vitro.

The effect of methantheline, a quaternary ammonium compound, on the reactivation by HI 6 of soman-inhibited human erythrocyte acetylcholinesterase (AChE) was investigated in vitro using purified human erythrocyte AChE or washed human erythrocytes. Methantheline itself was found to be a mixed competitive/non-competitive inhibitor of AChE (Kii 360 +/- 70 mumol/l; Ki 240 +/- 10 mumol/l). In all experiments the enzyme was first inhibited by soman for 30 min under conditions preventing ageing (pH 10.0 degrees C) and then ageing was allowed by changing the pH to 7.3 and the temperature to 37 degrees C. Methantheline addition (0.36 or 3.6 mmol/l) at the start of ageing increased the portion of AChE which could be reactivated by HI 6 (0.32 mmol/l) added 5 min later, from 24.6 +/- 1.0% (mean +/- SEM) of the original activity to 42.1 +/- 1.8% or 45 +/- 2.9%, respectively. With HI 6 alone, the portion of AChE activity which could be reactivated 25 min after the start of ageing decreased rapidly with the delay of the oxime addition (100% of the original activity at immediate addition), the half-life being approximately 2.5 min. With methantheline alone (0.36 mmol/l) the AChE activity was lower after immediate addition (37% of the original value), but the loss of activity due to the increasing delay of methantheline addition exhibited a similar half-life as with HI 6. Finally, when methantheline (0.36 mmol/l) was added at the start of ageing and HI 6 at various intervals thereafter the half-life of AChE activity loss due to the delay of HI 6 addition at least doubled, compared to incubations without methantheline.

Acetylcholinesterase↗

The effect of ion pair formation on the antimuscarinic activity of methantheline.

The quaternary ammonium compound, methantheline, was found to antagonize acetylcholine induced contractions in isolated guinea pig ileum by a mechanism which did not conform to the criteria for either competitive or non-competitive inhibition. Enhancement of the lipid solubility of methantheline by formation of an ion pair with trichloracetate failed to influence its cholinergic inhibitory activity. The results suggest that in the guinea pig ileum a) an intracellular site of action does not exist for methantheline and b) the membrane receptors for methantheline most likely are located in an aqueous environment.

Acetylcholine↗

Treatment of detrusor hyperreflexia in multiple sclerosis: a double-blind, crossover clinical trial comparing methantheline bromide (Banthine), flavoxate chloride (Urispas) and meladrazine tartrate (Lisidonil).

34 patients suffering from detrusor hyperreflexia due to multiple sclerosis entered the trial and 32 patients accomplished. The patients received each drug for a period of 14 days. The patients made records of relevant symptoms, urgency and urge incontinence and compared the treatment periods according to these symptoms. Registration of the number of micturitions was also made. Furthermore, the patients underwent cystometric studies. The following parameters were recorded and compared: residual urine, volume at the first bladder contraction, effective volume and amplitude of the first bladder contraction. The study showed that the patients preferred methantheline bromide. The entire cystometric pattern changed statistically significant with methantheline bromide, but only with concordance to the patients preferences in 60%. Decrease in number of micturitions and volume at the first bladder contraction were the only parameters showing accordance with the preferences. The drugs caused many various side effects. 12 treatment periods were discontinued due to side effects of meladrazine tartrate. The cystometric recordings seem to be of little use in evaluation of a drugs therapeutic effect, and it is difficult to find parameters which reflect the patients preference of the drugs.

Adult↗