Abstract
The drug 4-aminopyridine (4-AP) at a dose of 0.2 mg kg-1 body weight intravenously is an effective antagonist of non-depolarizing neuromuscular blockade. We studied its cardiovascular effects in the canine heart using a right-heart bypass with extracorporeal circulation in seven dogs. This study demonstrates that 4-aminopyridine significantly augments arterial blood pressure, left ventricular dp/dt maximum, as well as left ventricular pressure at dp/dt mx. The highest values were obtained between two and 20 minutes after administration of 4-AP. Left ventricular end-diastolic pressure diminished slightly, but this was not statistically significant. Although the exact mechanism of action of 4-AP is not known, its positive inotropic effects may be of value in the reversal of non-depolarizing neuromuscular blockade in patients with impaired myocardial function of diverse aetiologies and it would be contraindicated in patients with arterial hypertension and/or coronary artery disease.
RéSUMé
En administration intraveineuse à la dose de 0.2 mg kg-1, la 4-aminopyridine (4-AP) est un antagoniste efficace du bloc neuromusculaire produit par les relaxants de type non-dépolarisant. Nous avons é tudié ses effets cardiaques chez sept chiens sous circulation extracorporelle avec dérivation du cœ ur droit. Cette é tude a montré que la 4-aminopyridine é lève de façon significative la pression arté rielle et la dp/dt maximale du ventricule gauche, les valeurs maximales é tant obtenues entre deux et vingt minutes après l’injection du mé dicamment. La pression de fin de diastole du ventricule gauche diminuait lé gèrement, mais de façon non significative. Bien que le mé canisme d’action de la 4-AP ne soit pas connu de façon pré cise, ses effets inotropes positifs peuvent s’avé rer utiles lorsqu’il est né cessaire de renverser un bloc musculaire de type non dé polarisant chez des malades pré sentant une atteinte de la fonction myocardique de diverses étiologies. Cet agent serait contreindiqué chez des malades présentant une hypertension arté rielle et/ou une atteinte coronarienne.
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This study was performed at the Myocardial Contractility Laboratory, Experimental Surgery Institute of the Central University of Venezuela, School of Medicine and supported, in part, by CONICIT, grant No S-1-0690, grant from the Council for Scientific and Humanistic Development (CDCH), and a grant from the Vollmer Foundation.
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Martínez-Aguirre, É., Wikinski, J.A., Bello, A. et al. Effect of 4-aminopyridine on cardiovascular functions in the dog. Canad. Anaesth. Soc. J. 28, 114–120 (1981). https://doi.org/10.1007/BF03007253
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DOI: https://doi.org/10.1007/BF03007253