Circulation,respiration, and blood homeostasis in cyanide-poisoned dogs after treatment with 4-dimethylaminophenol or cobalt compounds

The effects of intravenously injected 4-dimethylaminophenol-HCl (DMAP), Co₂EDTA, and Co(histidine)₂ on the survival rate and several physiological parameters were studied on dogs after acute intravenous poisoning with the double lethal dose of potassium cyanide.All dogs survived when the antidotes were administered 1 min after poisoning. When the therapy began 4 min after poisoning more dogs were rescued in the DMAP group than in the cobalt groups. DMAP, Co₂EDTA, and Co(histidine)₂ restored circulation and respiration of the surviving animals in a similar manner.The increase in the plasma concentrations of glucose and lactate was much higher in the Co₂EDTA group than in the DMAP group. The injection of Co₂EDTA produced a sharp rise in the lactate-to-pyruvate ratio. The lactate-to-pyruvate ratio stayed unchanged for some 15 min after injection of DMAP before also rising. The total dose of KCN (4 mg/kg) was bound to the ferrihemoglobin formed by DMAP. The arterial pO₂ increase, caused by liberation of oxygen from oxyhemoglobin during the formation of ferrihemoglobin, was less when the cyanide could act on the tissues for a longer period of time before the therapy with DMAP began.DMAP is more appropriate for the therapy of cyanide poisoning than Co₂EDTA, since the latter adds its inhibitory effects on the metablism to those of cyanide.     

Effects of 4-dimethylaminophenol and Co2EDTA on circulation, respiration, and blood homeostasis in dogs.

The effects of intravenously injected 4-dimethylaminophenol and Co2EDTA on peripheral circulation, respiration, acid-base balance, and several other physiological and biochemical parameters were studied on dogs. DMAP increased the respiratory minute volume and mean arterial pressure, diminished the lactate-to-pyruvate ratio, and induced an increase in arterial oxygen pressure caused by liberation of oxygen from oxyhemoglobin during the formation of ferrihemoglobin. A study in vitro of the fate of the oxygen during the reaction between DMAP and oxyhemoglobin showed that only 30--40% of the oxygen released by the formation of ferrihemoglobin appeared in the gas phase. Co2EDTA caused circulatory depression, hyperventilation, and metabolic acidosis resulting in a decrease in base-excess and pH. The concentrations of lactate, pyruvate, potassium, and urea nitrogen and the hemoglobin content were increased by Co2EDTA. The side effects of Co2EDTA in therapeutic doses were more serious than those of DMAP. Thus the latter is superior in the therapy of cyanide poisoning, all the more since it detoxifies more cyanide.     

Effects of 4-dimethylaminophenol,Co2EDTA,or NaNO2 on cerebral blood flow and sinus blood homeostasis of dogs in connection with acute cyanide poisoning

The effects of the cyanide antidotes DMAP, Co₂EDTA, and NaNO₂ on cerebral blood flow (CBF) and cerebral blood gases were investigated in connection with acute poisoning of dogs by cyanide. The substances were injected intravenously. Local CBF as measured with thermocouples in the cingulum increased by 100–200% after a non-lethal dose of KCN (1 mg/kg) and by 50% after injection of NaNO₂ (15 mg/kg), that oxidized some 20% of the total hemoglobin to ferrihemoglobin. Co₂EDTA (10 mg/kg) induced a decrease in local CBF of 30% and in brain temperature of 0.5°C. The temperature diminished also after poisoning by KCN, but it rose by 0.15°C after the administration of NaNO₂. Local CBF and sinus sagittalis blood flow increased by 60–160% for about 15 min, and the brain temperature decreased by 0.4–0.5°C when DMAP (3.25 mg/kg) or Co₂EDTA (15 mg/kg) was injected 1 min after poisoning by cyanide (4 mg/kg), a dose that always caused respiratory arrest. Immediately after injection of DMAP the brain temperature rose transiently by 0.1–0.2°C. Co₂EDTA did not exert such an effect. In the sinus sagittalis blood of artificially ventilated animals pCO₂ decreased rapidly by 10–20 mmHg after poisoning and approached the initial level after treatment with DMAP or Co₂EDTA. The highest value of pO₂ was about 80 mmHg and 50 mmHg after injection of DMAP and Co₂EDTA, respectively; thereafter pO₂ declined to 20 mmHg or 40 mmHg at 20 min. The lactate concentration increased by 60–70% without tendency to return to normal.     

Cerebral blood flow,circulation, and blood homeostasis of dogs during slow cyanide poisoning and after treatment with 4-dimethylaminophenol

The effects of 4-dimethylaminophenol · HCl (DMAP) and 100% oxygen on cerebral blood flow (CBF) and peripheral circulation, arterial and venous blood gases, and other parameters have been investigated in dogs in the course of slow cyanide infusion.The i.v. infusion of KCN increased the respiratory minute volume, accompanied by a rise in arterial pO₂ and pH and a decrease in arterial pCO₂ while the venous lactate concentration increased by about 500% and the hemoglobin content and hematocrit by about 30%. Heart rate and carotid artery blood flow decreased. Local CBF in the cingulum as measured with thermocouples rose steadily, and the brain and oesophagus temperature were lowered. The breathing of 100% oxygen raised the local CBF, the temperature, and the arterial pCO₂.During the infusion of KCN into the femoral artery of artificially ventilated dogs the femoral venous pO₂ increased continuously by some 40 mm Hg, attended with a decrease in pCO₂ of 15 mm Hg. The femoral blood flow, however, rose sharply within 3 min. 100% oxygen induced a rise in pCO₂ and a diminution of pH in the femoral vein and in the sinus sagittalis, and the femoral flow rose rapidly.After DMAP i.v. the values of most of the parameters returned to normal or finally stabilized below or above the initial level. The rise in the hemoglobin content, hematocrit, and lactate concentration was stopped, but the arterial and venous pH remained or were lowered. DMAP elicited a rapid, strong decrease in the pO₂ of the femoral vein and the sinus sagittalis with a concomitant marked increase in pCO₂.     

Pharmacokinetics of cyanide in poisoning of dogs,and the effect of 4-dimethylaminophenol or thiosulfate

Cyanide in blood, plasma, and urine of dogs after administration of K¹⁴CN was determined with the isotope dilution technique. The addition of large amounts of inactive KCN as soon as possible to a sample to be analyzed inhibited the decrease of the original cyanide concentration.After administration of several lethal doses of cyanide into the stomach or by slow intravenous infusion a concentration of about 40 M cyanide in plasma was found at the moment of respiratory arrest. Since 60% of the cyanide in plasma was bound to proteins the concentration of free cyanide which stopped respiration was about 16 M.Quick formation of ferrihemoglobin by i.v. injection of 4-dimethylaminophenol after plasma cyanide had risen to or above 40 M decreased the cyanide concentration in plasma and restored respiration, while cyanide was accumulated in red cells by formation of ferrihemoglobin cyanide.Equilibrium constants calculated for the reaction between ferrihemoglobin and cyanide in vivo indicated that the reaction approached equilibrium in a few minutes.Up to 60% of the radioactive cyanide absorbed was found as non-cyanide radioactivity in the urine.Abbreviations Used DMAP 4-Dimethylaminophenol hydrochloride - HbFe²⁺ Ferrohemoglobin - HbFe³⁺ Ferrihemoglobin - HbFe³⁺CN^– Ferrihemoglobin cyanide - C_a Molarity of all radioactive compounds calculated on the assumption that one mole cyanide yields one mole metabolite - NCR Molarity of non-cyanide radioactive compounds calculated on the assumption that one mole cyanide yields one mole of metabolite (C_a-[CN^–])     

对二甲氨基酚,依地酸二钴和亚硝酸钠对犬心脏血流动力学的影响

本文观察了DMAP,Co_2 EDTA和NaNO_2对犬心脏血流动力学的影响。iv DMAP 3.2mg/kg后LVP及其±dP/dtmax短暂轻度增加,CI,MAP,TPVR,LVWI和HR在30 min内基本稳定,至60 min时CI,LVWI和-dp/dtmax下降。iv Co_2EDTA 15mg/kg或NaNO_2 20 mg/kg后10 min MAP,CI,LVWI,LVP,±dP/dtmax及TPVR(Co_2EDTA组除外)降低最明显,60 min时NaNO_2组CI,MAP,TPVR,LVP和LVWI及Co+2EDTA组CI和LVWI仍然下降。Co_2EDTA组TPVR 1min时下降,5 min见恢复,60min上升。表明(1)DMAP能维持血压和外周血管张力平稳,使心脏舒缩性能短暂轻度增强;(2)Co_2EDTA初期降压系由其扩张血管和抑制心功能所致,后期降压主要由后者引起;(3)NaNO_2降压作用系通过扩张外周血管和抑制心功能所致。     

Effects and biotransformation of 4-dimethylaminophenol in man and dog

The cyanide antidote 4-dimethylaminophenol . HCl (DMAP) was administered orally, i.v., or i.m. to man and dog. Ferrihemoglobin formation and changes of several parameters in human blood were investigated to obtain information on damage to liver, kidney, muscle, and red blood cells; in addition, the metabolism of DMAP was studied. In dogs, the initial rate of ferrihemoglobin production (DMAP, 3.25 mg/kg i.v. or i.m., 15 mg/kg orally) amounted to 28%, 3.5%, and 2% of the total hemoglobin per min; the corresponding values for man were 9%, 2%, and 2% per min. The dogs behaved normally while CPK increased after i.m. injection. In man, only i.m. injection of DMAP (3.25 mg/kg) was followed by increases in LDH, GOT, and CPK of 110, 260, and 490%, resp.; while total bilirubin, conjugated bilirubin, and iron concentration rose by 270, 120, and 50%, respectively. Bilirubin and iron concentration increased also after DMAP i.v. (3.25 mg/kg) or when it was taken orally (600 or 900 mg). The lactate concentration was not influenced while the pyruvate concentration increased by 50%. DMAP produced hemolysis in vitro. Generally, the values determined in vivo approached the starting level within 1 week. Intramuscular injection of DMAP induced reversible subjective and objective symptoms, e.g., local pain, swollen buttock, fever reaction. The urine showed no pathological changes. About 54% of DMAP taken orally was excreted as metabolites in the urine, 41% as glucuronide, 7% as sulfate, and 6% as thioethers. After i.v. administration the total of metabolites was somewhat higher, and the thioether proportion was 15%. The results indicate that DMAP is readily absorbed after oral administration but undergoes significant first pass effect in the liver. Therefore, the 4-fold i.v. dose must be administered orally to achieve the same ferrihemoglobin formation.     

Formation of cyanide from o-chlorobenzylidene malononitrile and its toxicological significance

Mice received o-chlorobenzylidene malononitrile (CS) by i.p. injection (0.5 LD₅₀) or by aerosol exposure (20,000 mg min^–1 m^–3). Increased excretion of thiocyanate in the urine was observed, indicating a transformation of CS to cyanide in vivo. Determinations of cyanide in whole blood after i.p. administration of CS verified a rapid transformation of the agent to cyanide. A correlation between the time course of cyanide levels and symptoms was observed. Toxicity of injected CS was significantly reduced by pretreatment with thiosulfate, slightly reduced by nitrite and not affected by Co₂EDTA.Thiocyanate excretion, blood cyanide levels and protective effect of antidotes were also evaluated after administration of 0.5 LD₅₀ of malononitrile and potassium cyanide. The importance of cyanide formation for the toxicity of CS is discussed.     

Differences in the reactions of isomeric ortho- and para-aminophenols with hemoglobin

The metabolites of phenacetin, 2-hydroxyphenetidine and 4-nitrosophenetol, rapidly produced ferrihemoglobin both in vivo (dogs) and in vitro. At low concns, 2-hydroxyphenetidine was superior to 4-nitrosophenetol in ferrihemoglobin formation. The kinetics of ferrihemoglobin formation by 2-hydroxyphenetidine in solutions of purified human hemoglobin was biphasic and exhibited an unusual dose response. Similar to p-aminophenols, 2-hydroxyphenetidine was oxidized by oxyhemoglobin, and the oxidation product(s) were reduced by ferrohemoglobin with the formation of ferrihemoglobin. In addition, these oxidation products condensed to 2-amino-7-ethoxy-3H-phenoxazine-3-one (u.v., i.r., ¹H-NMR and mass spectroscopy). This metabolite produced ferrihemoglobin by itself and was responsible for the slow phase of ferrihemoglobin formation observed with 2-hydroxyphenetidine. This condensation reaction, which was also observed with 2-aminophenol, prevented thioether formation of the transient o-quinonimines with the cysteine residues of hemoglobin and reduced glutathione as observed with 4-aminophenol and 4-dimethylaminophenol. Phenoxazone formation, which depends on the square of the o-quinonimine concn, was negligible at micromolar concns. At similar concns addition reactions to thiols prevailed also with 2-hydroxyphenetidine and 2-aminophenol. Other electrophilic reactions, e.g. with primary amino groups of amino acids, were insignificant. These dose-dependent differences in the reactions of isomeric aminophenols may explain the low nephrotoxicity of those o-aminophenols capable of forming phenoxazones when given in a single dose. This self-detoxication of some o-quinonimines, however, should not function during long-term exposure to repetitive low doses of such o-aminophenols.     

Ferrihemoglobin and kidney lesions in rats produced by 4-aminophenol or 4-dimethylaminophenol

4-Dimethylaminophenol hydrochloride (DMAP), 20 mg/kg i.V., was found to oxidize in rats as much as 50% of the hemoglobin to ferrihemoglobin but did not cause kidney lesions. 4-Aminophenol hydrochloride, 400mg/kg i.V., oxidized only 25% of the hemoglobin and produced large tubular necroses. In highly toxic doses only, e.g., twice the LD₅₀, DMAP also produced tubular necroses.

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Abbreviations Used DMAP 4-Dimethylaminophenol hydrochloride - AP 4-Aminophenol hydrochloride     

Comparison of hydroxylamine, 4-dimethylaminophenol and nitrite protection against cyanide poisoning in mice

Intraperitoneal doses of 4-dimethylaminophenol hydrochloride (DMAP), hydroxylamine hydrochloride (H₂NOH) and sodium nitrite (NaNO₂) were found where each converted a maximum of about 37% of the total circulating hemoglobin in mice to methemoglobin. Those doses in mmol/kg were: 0.29 for DMAP, 1.1 for H₂NOH, and 1.1 for NaNO₂. For DMAP and H₂NOH the peak was sharp and at about 7 min after injection whereas for NaNO₂ the peak was much broader and at about 40 min. The i.p. LD₅₀'s in mmol/kg were: 0.48 for DMAP, 1.8 for H₂NOH and 2.3 for NaNO₂. When mice pretreated with each of the methemoglobin-generating agents were challenged with sodium cyanide, the ratios of the LD₅₀'s in protected mice to those in control mice (protection index, PI) were 1.5 for H₂NOH, 2.0 for DMAP and 3.1 for NaNO₂. When sodium thiosulfate was also given in combination with each of the three methemoglobin-generating agents, the protective effect was at least additive. The PI against sodium sulfide was also significantly greater in mice pretreated with NaNO₂ than in mice given H₂NOH. Methemoglobins generated from human and mouse hemoglobins by either NaNO₂ or by H₂NOH had identical binding affinities (dissociation constants) for cyanide. When human red cells containing methemoglobin generated by exposure to either NaNO₂ or H₂NOH were injected into the peritoneal cavity of mice and then followed by cyanide challenges, there was no difference in the PI for the two kinds of methemoglobin. Not only was the PI the same in each case with human cells, but it was also identical with that in mice given NaNO₂ systemically to generate the same total amount of methemoglobin. The difference in PI between NaNO₂ and H₂NOH (or DMAP) in mice appears to be related to the high rate of methemoglobin reductase activity in mouse RBC. It appears likely that cyanmethemoglobin is a substrate for mouse methemoglobin reductase activity, and that NaNO₂ is an inhibitor of mouse methemoglobin reductase. No differences in cyanide antagonism between NaNO₂ and H₂NOH would be anticipated in humans because of the slow rates of methemoglobin reduction in human red cells.     

Mechanism of the autocatalytic formation of ferrihemoglobin by N,N-dimethylaniline-N-oxide

Summary Incubation with ferrihemoglobin or ferricytochrome c transforms N,N-dimethylaniline-N-oxide into N-methylaniline, formaldehyde, N,N-dimethylaniline, 2-dimethylaminophenol, 4-dimethylaminophenol, and a violet dye. The amines and aminophenols were isolated and identified; the structure of the dye is not yet known. Deoxygenated ferrohemoglobin was found to decompose N,N-dimethylaniline-N-oxide much more slowly than ferrihemoglobin. This explains the autocatalytic course of the formation of ferrihemoglobin by N,N-dimethylaniline-N-oxide. The ferrihemoglobin forming derivatives of N,N-dimethylaniline-N-oxide, i.e. 4-dimethylaminophenol, 2-dimethylaminophenol, and the dye, are produced more rapidly when the ferrihemoglobin concentration increases. Ferricytochrome c accelerates the formation of ferrihemoglobin by N,N-dimethylaniline-N-oxide, because it produces the ferrihemoglobin forming derivatives more rapidly than ferrihemoglobin itself. Oxygen is needed for the formation of ferrihemoglobin by N,N-dimethylaniline-N-oxide, since it is not the N-oxide itself that oxidizes hemoglobin, but the dimethylaminophenols and the dye which transfer electrons from ferrohemoglobin to molecular oxygen. The kinetics of these reactions was studied.The skilled technical assistance of Miss Ursula Franz, Mrs. Renate Malangré and Miss Krystyna Pioro is gratefully acknowledged.     

Structure-activity relationships of putative primaquine metabolites causing methemoglobin formation in canine hemolysates

A rapid and reproducible in vitro test system was developed to measure the methemoglobin (MHb)-forming properties of various 8-aminoquinoline derivatives. Initial rates and extents of reaction were measured spectrophotometrically with either canine hemolysates from which ferrihemoglobin reductase was removed, or with purified human oxyhemoglobin (Hb). The results demonstrate that primaquine derivatives that can be oxidized to quinones or iminoquinones (5-hydroxy,6-desmethyl primaquine; 5-hydroxyprimaquine; 5,6-dihydroxy-8-aminoquinoline; and 5-hydroxy, 6-methoxy-8-aminoquinoline) are potent MHb-forming compounds. Studies on the extent of reaction in hemolysates and purified oxyhemoglobin suggest that the extent of MHb formation may be limited by the rate at which the corresponding iminoquinones or quinones arylate nucleophiles. The effects of glutathione, mannitol, ascorbate, and superoxide dismutase on the rate and extent of hemoglobin oxidation by 5,6-dihydroxy-8-aminoquinoline suggest that these compounds oxidize Hb similar to the mechanism known for dimethylaminophenol (DMAP), in which Hb oxidizes the quinoline to semiquinone radical and quinone species which are the oxidizing and arylating agents.     

Radical formation during autoxidation of 4-dimethylaminophenol and some properties of the reaction products

4-Dimethylaminophenol (DMAP), after intravenous injection, rapidly forms ferrihaemoglobin and has been successfully used in the treatment of cyanide poisoning. Since DMAP produces many equivalents of ferrihaemoglobin, it was of interest to obtain further insight into this catalytic process. DMAP autoxidizes readily at pH regions above neutrality, a process which is markedly accelerated by oxyhaemoglobin. The resulting red-coloured product was identified as the N-N,-dimethylamino) phenoxyl radical by EPR spectroscopy. The same radical was also produced by pulse radiolysis and oxidation with ferricyanide. The 4-(N-N-dimethylamino)phenoxyl radical is quite unstable and decays in a pseudo-first order reaction (k = 0.4 sec^?1 at pH 8.5,22°) with the formation of p-benzoquinone and dimethylamine. This observed decay rate is identical with the rate of hydrolysis of N,N-dimethylquinonimine. When a solution containing the phenoxyl radical was extracted with ether, half the stoichiometric amount of DMAP was recovered. Hence it is apparent that the phenoxyl radical decays by disproportionation yielding DMAP and N,N-dimethylquinomine. The latter product then quickly hydrolyses. The equilibrium of this disproportionation reaction is far towards the radical side, and the pseudo-first order hydrolysis controls the radical decay rate. p-Benzoquinone rapidly reacts with DMAP (k₂ = 2 × 10⁴M^?1sec^?1) with the formation of the 4-N,N-dimethylamino)phenoxyl and the semiquinone radicals. This reaction explains the autocatalytic phenoxyl radical formation during the autoxidation of DMAP. DMAP is not oxidized by H₂O₂ or O₁₂^? but the 4-(N-N-dimethylamino)phenoxyl radical is very rapidly reduced by O₂^? (k₂ = 2 × 10⁸M^?1 sec^?1. In addition, the phenoxyl radical is quickly reduced by NAD(P)H or GSH with the formation of NAD(P)⁺ or GSSG. Since DMAP is also able to reduce two equivalents of ferrihaemoglobin (provided that the ferrohaemoglobin produced is trapped by carbon monoxide), electrophilic addition reactions of the phenoxyl radical seem unimportant in contrast to N,N-dimethylquinonimine. Hence, during the catalytic ferrihaemoglobin formation, DMAP is oxidized by oxygen which is activated by haemoglobin, and the phenoxyl radical oxidizes ferrohaemoglobin. This catalytic process is terminated by covalent binding of N,N-dimethylquinonimine to SH groups of haemoglobin (and GSH in red cells).     

Acute effects of the heavy metal antidotes DMPS and DMSA on circulation,respiration, and blood homoeostasis in dogs

The heavy metal antidotes sodium-2,3-dimercaptopropane-1-sulfonate (DMPS) and meso-2,3-dimercaptosuccinic acid (DMSA) were investigated in anaesthetized dogs for their effects on a variety of physiological variables and parameters. In addition, the influence of both dithiols on oxygen consumption and ferrihaemoglobin production was studied in blood and red blood cells in vitro. DMPS (15 and 75 mg/kg i.v.) did not affect respiration, central venous pressure, left ventricular pressure or cardiac output and showed only marginal, statistically non-significant effects on aortic and effective perfusion pressure. In contrast to the slight, non-significant changes due to DMPS (15 mg/kg i.v.), an equimolar dose of DMSA (12 mg/kg i. v.) led to a slight transient decrease in femoral blood pressure with strong reflex tachycardia and increase in blood flow. The higher DMPS dose (75 mg/kg i.v.), however, caused marked decreases in femoral blood pressure and blood flow, strong changes in blood gases and pH, and lactacidosis. Most of the physiological variables and parameters did not return to the initial level by 60 min. The R-spike of the electrocardiogram decreased, and the T-wave increased. Experiments on the denervated hind leg indicate that DMPS may be a direct vasodilator. The fall of blood pressure due to DMPS was markedly reduced when 30% ferrihaemoglobin had been formed by 4-dimethylaminophenol. HCl (DMAP). The highest DMPS dose (150 mg/kg i.v.) provoked circulatory failure and respiratory arrest. Artificial ventilation with room air restored spontaneous respiration, but one of three animals did not survive this dose for more than 90 min. DMPS and DMSA reacted with oxygen. In phosphate buffer, pH 7.4,1 mol O₂ appears to be taken up by 2 mol DMPS. The consumption of O₂ by DMPS was less in samples of human and canine blood or erythrocyte suspensions than in buffer solution. DMPS caused a greater loss of oxygen than DMSA. DMPS and DMSA alone did not produce ferrihaemoglobin, but the ferrihaemoglobin content of erythrocyte suspensions increased over the time when DMPS was added in the presence of 30% ferrihaemoglobin. Such an action was not observed at the same ferrihaemoglobin content in vivo.     

The effect of prior treatment with 4-dimethylaminophenol (DMAP) on animals experimentally poisoned with hydrogen cyanide

Six dogs were given sufficient oral 4-dimethylaminophenol (DMAP) to produce a peak methaemoglobin level of 12–15%. Five out of the six dogs then survived an intravenous injection of approximately 2 LD₅₀'s of hydrogen cyanide given when the methaemoglobin had reached 8–10%. The sixth dog died after 44 min. When the same dose of hydrogen cyanide was given to dogs, not previously given DMAP, all three died within 11/2 min. It was concluded that prior treatment with oral DMAP provided a large measure of protection against cyanide poisoning. Comparison of cyanide levels in whole blood and plasma in the two groups of dogs lent support to the hypothesis that methaemoglobin complexed with cyanide in the erythrocytes causing the plasma cyanide to remain lower than it did in unprotected animals.     

Examination of the effects of some 5-HT2 receptor antagonists on central sympathetic outflow and blood pressure in anaesthetised cats

Summary Thoracic preganglionic sympathetic nerve activity, blood pressure, heart rate and femoral arterial conductance were recorded in anaesthetised, paralysed cats. Cumulative dose response curves were constructed for the 5-HT₂ antagonists cinanserin, ritanserin, cyproheptadine, methiothepin, metergoline and ICI 169,369. These antagonists showed differing effects on the above parameters. Methiothepin and cyproheptadine caused hypotension and sympathoinhibition at low and high doses, whilst metergoline and ritanserin caused these effects at high doses, above 1 mg kg^–1. Cinanserin and ICI 169,369 did cause large transient changes in heart rate, blood pressure and sympathetic outflow. However, all the antagonists except ICI 169,369 and methiothepin caused an increase in femoral arterial conductance which was not associated with hypotension. It was therefore concluded that using the above antagonists it was difficult to attribute changes in blood pressure and central sympathetic outflow to blockade of 5-HT₂ receptors. However, it is suggested that 5-HT₂ receptors may be involved in the control of skeletal muscle and/or skin vascular beds.     

Effects of 4-dimethylaminophenol in rat kidneys,isolated rat kidney tubules and hepatocytes

1. Addition of 4-dimethylaminophenol (DMAP) to suspensions of isolated rat kidney tubules increased extracellular lactate dehydrogenase (LDH) at concn. which did not markedly affect gluconeogenesis. ATP content was also decreased by DMAP but this did not occur until the membrane became permeable to LDH. There was no similar leakage of the mitochondrial enzyme glutamate dehydrogenase.

2. After i.v. injection of DMAP to rats in doses which did not inhibit gluconeogenesis, kidney glutathione was decreased and the urinary LDH was increased. DMAP was irreversibly bound to tissue in rat, with the highest binding in the kidney. The highest binding occurs in those tissues in which DMAP causes necrosis.

3. In isolated rat hepatocytes, DMAP caused toxic effects which were similar but less extensive than occur on addition of DMAP to kidney tubules. The formation of acid-soluble metabolites was higher in isolated rat hepatocytes (20 nmol/mg protein) than in rat kidney tubules (4 nmol/mg protein). DMAP-glucuronide and DMAP-sulphate comprised the major acid-soluble metabolites in both preparations; conjugates of DMAP with glutathione or cysteine were also found.     

Depletion of mitochondrial coenzyme A and glutathione by 4-dimethylaminophenol and formation of mixed thioethers

4-Dimethylaminophenol (DMAP), an antidote in cyanide poisoning, has been shown to produce kidney lesions in rats, to damage isolated rat kidney tubules and to impair mitochondrial functions as already described for 4-aminophenol. Since DMAP upon oxidation forms bis- and tris-substituted thioethers with GSH, it was anticipated that mitochondrial toxicity of DMAP might result from CoA depletion. In a model reaction DMAP was oxidized by oxyhemoglobin in the presence of CoA and GSH resulting in formation of tris-(CoA-S-yl)-DMAP, tris-(GSH-S-yl)-DMAP and two mixed thioethers, namely, (CoA-S-yl)-bis-(GSH-S-yl)-DMAP and (GSH-S-yl)-bis-(CoA-S-yl)-DMAP. The compounds were isolated by HPLC and identified spectroscopically, by amino acid analysis and Raney-Nickel desulfuration. Rat liver mitochondria (5 mg protein/ml) incubated under state IV conditions with 20 and 50 microM DMAP were depleted of GSH and total coenzyme A with formation of GSSG and the above-mentioned thioethers which were quantified by isotope dilution techniques using [14C]-labelled DMAP and the isolated, inactive thioethers. The results confirm earlier suggestions that part of the cytotoxicity of DMAP may result from depletion of vital mitochondrial thiols, particularly CoA. Since 4-aminophenol reacts analogously, similar cytotoxic effects can be expected from compounds which on (aut)oxidation form quinoid systems capable of 1.4-addition reactions with nucleophilic thiols.     

Effect of increased cardiac output on liver blood flow,oxygen exchange and metabolic rate during longterm endotoxin-induced shock in pigs

1. We investigated hepatic blood flow, O₂ exchange and metabolism in porcine endotoxic shock (Control, n=8; Endotoxin, n=10) with administration of hydroxyethylstarch to maintain arterial pressure (MAP)>60 mmHg.
2. Before and 12, 18 and 24 h after starting continuous i.v. endotoxin we measured portal venous and hepatic arterial blood flow, intracapillary haemoglobin O₂ saturation (Hb-O₂%) of the liver surface and arterial, portal and hepatic venous lactate, pyruvate, glyercol and alanine concentrations. Glucose production rate was derived from the plasma isotope enrichment during infusion of [6,6-²H₂]-glucose.
3. Despite a sustained 50% increase in cardiac output endotoxin caused a progressive, significant fall in MAP. Liver blood flow significantly increased, but endotoxin affected neither hepatic O₂ delivery and uptake nor mean intracapillary Hb-O₂% and Hb-O₂% frequency distributions.
4. Endotoxin nearly doubled endogenous glucose production rate while hepatic lactate, alanine and glycerol uptake rates progressively decreased significantly. The lactate uptake rate even became negative (P<0.05 vs Control). Endotoxin caused portal and hepatic venous pH to fall significantly concomitant with significantly increased arterial, portal and hepatic venous lactate/pyruvate ratios.
5. During endotoxic shock increased cardiac output achieved by colloid infusion maintained elevated liver blood flow and thereby macro- and microcirculatory O₂ supply. Glucose production rate nearly doubled with complete dissociation of hepatic uptake of glucogenic precursors and glucose release. Despite well-preserved capillary oxygenation increased lactate/pyruvate ratios reflecting impaired cytosolic redox state suggested deranged liver energy balance, possibly due to the O₂ requirements of gluconeogenesis.