Comparison with Propranolol, Nadolol and Prazosin Mitsuo
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Card iohemodynamic Effects of Nipradilol (K-351) in the Dog: Comparison with Propranolol, Nadolol and Prazosin MitsuoKAWADA, Keisuke SATOH and NorioTAIRA* Departmentof Pharmacology, Tohoku University School of Medicine,Sendai 980, Japan AcceptedMay 17, 1986 Abstract-The cardiohemodynamic effects of nipradilol (K-351) were studied in comparison with those of propranolol, nadolol and prazosin in anesthetized, open chest dogs. All drugs were administered intravenously. Nipradilol produced dose dependent decreases in systemic blood pressure (BP), heart rate (HR), venous return (VR) and cardiac output (COP), but virtually no change in right atrial pressure (RAP). Propranolo! decreased HR, tended to decrease VR and COP and increased RAP, but produced no change in systemic BP. Nadolol also decreased HR, VR and COP and increased RAP, but did not change systemic BP. Prazosin decreased systemic BP, VR and COP and tended to decrease RAP, but scarcely affected HR. After propranolol or nadolol, nipradilol failed to reduce HR, but still produced definite decreases in systemic BP, VR and COP and a slight decrease in RAP. After prazosin, nipradilol still produced decreases in systemic BP, HR, VR and COP. These results suggest that nipradilol decreases VR and COP mainly by increasing venous capacitance through direct venodilator action and in part by increasing resistance to VR through beta-adrenoceptor blockade. This effect also appears to be responsible for its hypotensive effect. Nipradilol (K-351) is a unique beta pranolol in producing a non-selective beta adrenoceptor blocking agent because it adrenoceptor blocking effect in isolated possesses a nitroxy group in its chemical guinea-pig atria and trachea (1). Never structure (1). The nitroxy group was incor theless, nipradilol, unlike propranolol, pro porated into the chemical structure with the duces a definite hypotensive effect in spon aim of making the compound possess a taneously hypertensive and DOCA hyper nitroglycerin-like action in addition to a beta tensive rats after acute oral administration, adrenoceptor blocking action (1). In the suggesting that it possesses some types of treatmen': of patients with angina pectoris, vasodilator action (1, 2). The direct relaxant hypertension or both, such a beta action of nipradilol on vascular smooth adrenoceptor blocking agent would be muscle has been demonstrated in isolated superior to hitherto known beta-adrenoceptor arteries and veins (1, 3). However, these blocking agents that block beta-adre findings are unable to settle the question of noceptors alone. This is because increases in whether the hypotensive and vascular relaxant coronary arterial resistance and total peri action of nipradilol can be ascribed to its pheral resistance by beta-adrenoceptor nitroglycerin-like action. The following blocking agents, particularly seen in the findings are highly suggestive of the nitro acute phase, are their main drawbacks. If the glycerin-like action of nipradilol: Unlike pro drug reduces the preload as nitroglycerin pranolol, nipradilol decreased left ventricular does, this property is also favorable as an end-diastolic pressure (LVEDP) in anes antianginal agent. Nipradilol has been shown thetized dogs (4). This is remarkable in view to be only about 2 times as potent as pro of the fact that nipradilol has a certain degree of negative inotropic and non-specific mem * To whom correspondence should be addressed . brane stabilizing actions (1, 5). Nipradilol also decreased central venous pressure zero base line reference for the RAP was set previously raised with dihydroergotamine in equal to the level of the tricuspid valve. These pithed rats, suggesting the reduced venous 4 variables were recorded on a 4-channel return (VR) through its dilator effect on rectilinear recorder (Watanabe Sokki, Linear capacitance vessels (6). However, so far no Corder Mark 3). The systemic blood pressure experimental data are available about was measured at the femoral artery with a whether nipradilol really produces a pressure transducer (Statham, P-50). The reduction of VR and consequently a reduction heart rate was measured with a cardio of cardiac output (COP). The present study tachometer (Sanei, type 2140) which was was carried out to elucidate whether triggered by the R wave of lead II electro nipradilol mimics nitroglycerin or other cardiograms. These two variables were nitrates in cardiohemodynamic effects par recorded on a 6-channel rectilinear recorder ticularly in its effects on VR and right atrial (Sanei, 8S). The zero flow level in each probe pressure (RAP) in anesthetized, open-chest was simultaneously determined at the end dogs. The effects of propranolol, nadolol and of the experiment when the cardiac arrest was prazosin were also investigated in order to abruptly produced by a rapid injection of estimate the possible contribution of alpha saturated KCI solution. or beta-adrenoceptor blocking action to the The drugs used were as follows: Nipradilol cardiohemodynamic effects of nipradilol, (Kowa), (+)-propranolol hydrochloride because nipradilol has also been shown to (Kowa), (±)-nadolol (Squibb) and prazosin possess a weak alpha-adrenoceptor blocking hydrochloride (Pfizer Taito). Nipradilol and action (1). nadolol were dissolved in 0.1 N HCI to give a concentration of 30 mg/ml, and propranolol Materials and Methods was dissolved in 0.9% saline at a concen Experiments were performed on young tration of 10 mg/ml. These drug solutions mongrel dogs of both sexes weighing 7 to were diluted with 0.9% saline to the desired 11 kg which were free from filarial infection. concentrations. Prazosin was dissolved in The preparation was essentially the same as distilled water to give a concentration of 0.5 had been used by Kokubun et al. (7) and mg/ml and then diluted with distilled water. Imai et al. (8). The animals were anesthetized All the drugs were injected into the femoral with sodium pentobarbital initially at a dose vein in doses of 1, 2, 7, 20, 70, 200 and 700 of 30 mg/kg, i.v., and hourly at a main iig/kg at 10 min intervals. These doses cor tenance dose of 4 to 5 mg/kg, i.v. Under respond to the cummulative doses of 1, 3, 10, artificial respiration with room air in a tidal 30, 100, 300 and 1000 /,,g/kg, respectively. volume of 20 ml/kg at a rate of 18 breaths/ Doses of drugs refer to their bases. min by the use of a dog respirator (Harvard Values of changes in cardiohemodynamic Apparatus, Model 607), the chest was variables used for construction of dose opened by mid-sternal incision. The azygos response curves refer to those just before vein was ligated and both phrenic nerves administration of the next dose. were cut. The heart was kept in position by Statistical significance of difference the pericardial cradle. Non-cannulating between mean values was evaluated by probes of a 2-channel electromagnetic Student's paired t-test. A P value of less flowmeter (Nihon Kohden, MF-27) were than 0.05 was considered to be significant. fitted to the superior and inferior vena cavae to measure the mean blood flow through the Results two vessels. The mean blood flow through the Control values of 9 cardiohemodynamic pulmonary trunk was also measured with variables: The control values of 9 cardio another non-cannulating probe of a 1 hemodynamic variables in 20 dogs are channel electromagnetic flowmeter (Nihon presented in Table 1. The pulmonary arterial Kohden, MFV-1200). The mean right atrial blood flow (PAF) which represents the total pressure was measured with a pressure COP was within a range from 600 to 1000 transducer (Nihon Kohden, LPU-0.1). The ml/min. The blood flow through the inferior Table 1. Control values of card iohemodvnamic variables in 20 dogs Body weight was 9.4±1.1 (mean±S.D.) kg. SBP, DBP and MBP: systolic, diastolic and mean blood pressure, respectively; PAF, IVCF and SVCF: blood flow through the pulmonary artery, inferior vena cava and superior vena cava, respectively; VR: venous return: RAP: right atrial pressure; HR: heart rate. Fig. 1. Cardiohemodynamic effects of nipradilol in an anesthetized, open-chest dog. SBP: systemic blood pressure; PAF, IVCF and SVCF: blood flow through the pulmonary artery, inferior vena cava and superior vena cava, respectively; RAP: right atrial pressure; HR: heart rate. vena cava (IVCF) and the superior vena cava tively. (SVCF) ranged from 400 to 700 and 100 to Effects of nipradilol on cardiohemodyn 300 ml/min, respectively. The VR which is amics: The effects of cumulative intravenous the sum of the IVCF and SVCF was within the injections of nipradilol (1-1000 iig/kg) were same range as the PAF. The RAP and the studied in 5 dogs. A typical experiment is heart rate (HR) ranged from 1 5 to 30 mmH2O shown in Fig. 1, and changes in cardio and 100 to 170 beats/min, respectively. The hemodynamic variables are summarized in systolic (SBP), diastolic (DBP) and mean Fig. 2. Nipradilol significantly decreased the blood pressure (MBP) ranged from 100 to SBP in doses of 10-1000 fig/kg in a dose 170, 60 to 120 and 80 to 130 mmHg, respec dependent manner. In doses larger than 30 /cg/kg, the DBP and MBP also decreased; decreased after a slight and transient increase. however, the decrease was more pronounced At the largest dose (1000 ,ag/kg), the PAF in SBP than in DBP or MBP; at 1000 !tg/kg decreased down to about 56% of the control the decrease was 59±14 mmHg in SBP as values. The IVCF decreased in doses larger against 26±10 mmHg and 37±11 mmHg in than 30 /€g/kg, but the SVCF remained DBP and MBP, respectively. With doses of virtually unchanged in all the doses except 10-1000 iag/kg, the PAF significantly for 1000 ,ug/kg. The changes in VR are very similar to those in the PAF; at a dose of 1000 iig/kg, the VR decreased by 338±59 ml/min.