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.     

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.     

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 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.     

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.     

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.     

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.     

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^–])     

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.     

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.     

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.     

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.     

Improved cardiac performance by salbutamol, a selective beta 2-agonist, in chronic cor pulmonale

The effects of salbutamol, a relative specific beta 2-agonist, on hemodynamics and arterial blood oxygenation, were studied in 12 patients with chronic cor pulmonale. The studies were done during heart catheterization at rest (n = 12) and during arm bicycle exercise (n = 7) before and during salbutamol infusion of 0.2 microgram/kg/min. At rest, salbutamol significantly increased cardiac index on average by 31%, stroke volume index by 11%, and heart rate by 12 beats/min. Mean pulmonary artery pressure was not changed by salbutamol, whereas a small reduction in mean arterial pressure was observed. The vascular resistance was reduced by 15% in pulmonary and 24% in systemic circulation. Similar hemodynamic changes by salbutamol were observed during exercise. Arterial oxygen tension and saturation were not changed by salbutamol, but a significant rise in mixed venous oxygen saturation and oxygen delivery were observed both at rest and during exercise. Thus, salbutamol infusion improves the cardiac performance in patients with chronic cor pulmonale through a chronotropic effect combined with vasodilation in both the systemic and pulmonary circulation and thereby increased stroke volume. No deleterious effects on arterial blood oxygenation by salbutamol infusion were observed.     

The in vivo effects of cyanide and its antidotes on rat brain cytochrome oxidase activity.

The in vivo effects of sodium cyanide and its antidotes, sodium nitrite, sodium thiosulfate and 4-dimethylaminophenol (DMAP), as well as the alpha-adrenergic blocking agent phentolamine, on rat brain cytochrome oxidase were studied. The course of inhibition was time-dependent and a peak of 40% was attained between 15 and 20 min after the s.c. injection of 1.3 LD50 (12 mg/kg) of cyanide. Pronounced dose-dependence was observed in the inhibition of the enzyme, at this relatively low, but lethal dose. Further observation was impossible because of rapidly lethal effects of cyanide. In animals artificially ventilated with room air, observation was possible up to 60 min. However, maximum inhibition was also 40%. When antidotes were applied 30 min after 20 mg/kg of cyanide, marked reactivation of cytochrome oxidase activity was observed with all antidotes (particularly with thiosulfate) except for phentolamine which had no effect. Prevention of methemoglobin forming with toluidine blue did not affect the reactivating ability of nitrite or DMAP, thus suggesting more complex protective mechanisms then simple methemoglobin formation. The high efficacy of thiosulfate may be attributed to its rhodanese catalyzed, direct binding to free blood cyanide, leading thus to its dissociation from cytochrome oxidase. The theory that cytochrome oxidase inhibition is a basic mechanism of cyanide toxicity could not be disproved.     

对二甲氨基酚治疗急性失血合并氰中毒对血液动力学及血液内环境的影响

本实验用犬制备了轻(10％)、中(15％)、重度(20％)急性失血合并ⅳ NaCN 2.5 mg/kg中毒的动物模型,观察了ⅳ DMAP 2.5mg/kg治疗时血液动力学及血液内环境的变化。结果发现,DMAP治疗轻度急性失血合并氰中毒能使心血管功能迅速恢复正常并维持稳定,随失血程度加重DMAP对心血管功能兴奋作用减弱;血气分析及HbFe~(3+)测定结果表明,DMAP治疗急性失血合并氰中毒可造成机体严重缺氧及代谢性酸中毒,并随失血程度的加重而加剧。     

Reactions of 4-halogeno-N,N-dimethylaniline-N-Oxide with hemoglobin

Summary Incubation with ferrihemoglobin or ferricytochrome c transforms 4-bromo-N,N-dimethylaniline-N-oxide (BrDANO) into 4-bromo-N,N-dimethylaniline, 4-bromo-N-methylaniline, and 2-dimethylamino-5-bromo-phenol. In a secondary reaction 4-bromo-N-(4-bromophenyl)-6-hydroxy-N,N,N-trimethyl-1,3-phenylenediamine (U) was formed from 2-dimethylamino-5-bromo-phenol and 4-bromo-N-methylaniline. The products were isolated and identified, the structure of (U) was elucidated.It has been found that the formation of ferrihemoglobin by BrDANO is an autocatalytic reaction, ferrihemoglobin being the catalyst. BrDANO reacts with the catalyst resulting in the named products. 2-Dimethylamino-5-bromo-phenol oxidizes hemoglobin in the presence of oxygen. Thereby the catalyst ferrihemoglobin increases, which in turn increases the transformation of BrDANO to ferrihemoglobin forming derivates, This cycle explains the autocatalytic character of the production of ferrihemoglobin by BrDANO. The primary products of the reaction between 4-fluoro-N,N-dimethylaniline-N-oxide (FDANO) or 4-chloro-N,N-dimethylaniline-N-oxide (ClDANO) with cytochrome c, 4-fluoro- and 4-chloro-N,N-dimethylaniline, 4-fluoro- and 4-chloro-N-methylaniline, 2-dimethylamino-5-fluorophenol, and 2-dimethylamino-5-chloro-phenol were isolated and identified. The reactions between N,N-dimethylaniline-N-oxide (DANO), BrDANO, ClDANO, FDANO, and hemoglobin from blood of various species were studied. BrDANO and ClDANO accelerate the formation of ferrihemoglobin in solutions of hemoglobin from beef and dog blood much more effectively than DANO and FDANO.Abbreviations BrDANO 4-bromo-N,N-dimethylaniline-N-oxide - ClDANO 4-chloro-N,N-dimethylaniline-N-oxide - FDANO 4-fluoro-N,N-dimethylaniline-N-oxide - DANO N,N-dimethylaniline-N-oxide - BrMA 4-bromo-N-methylaniline - BrDMA 4-bromo-N,N-dimethylaniline - DMABrP 2-dimethylamino-5-bromo-phenol - DMAClP 2-dimethylamino-5-chloro-phenol - DMAFP 2-dimethylamino-5-fluoro-phenol - U 4-bromo-N-(4-bromophenyl)-6-hydroxy-N,N,N-trimethyl-1,3-phenylenediamine     

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.     

Coronary blood flow during exercise following nonselective and selective alpha 1-adrenergic blockade with indoramin

Studies were performed to compare the effects of alpha 1-adrenergic blockade with indoramin and nonselective alpha-adrenergic blockade with phentolamine on coronary blood flow and myocardial oxygen consumption during exercise. Nine dogs trained to run on a motor-driven treadmill were instrumented with electromagnetic flowmeter probes on the left circumflex coronary artery, and aortic and coronary sinus catheters for determination of myocardial arteriovenous oxygen difference. During control conditions, myocardial oxygen consumption and coronary blood flow increased as a direct function of heart rate during exercise. Phentolamine caused a significant decrease in blood pressure, while heart rate, coronary blood flow, and myocardial oxygen consumption were significantly increased at rest and during all exercise stages. Although alpha 1-adrenergic blockade with indoramin caused a similar reduction of arterial pressure, heart rate was unaltered both at rest and during exercise. Coronary blood flow and myocardial oxygen consumption were unchanged by alpha 1-adrenergic blockade at rest and during light exercise: however, during the heaviest exercise stages alpha 1-blockade caused a significant decrease in myocardial oxygen consumption. These findings are in agreement with the concept that phentolamine, by blocking presynaptic alpha 2-adrenoceptors which normally modulate norepinephrine release, increases sympathetic activity during exercise while indoramin, by acting as a selective alpha 1-adrenergic blocker, does not produce this effect.     

Zur Beurteilung der Blausäure-Antidote

The effect of various antidotes on the exhalation of hydrocyanic acid has been measured in guinea pigs and cats poisoned with cyanide. This procedure permits evaluation of both the speed of action and the capacity of the agents tested to detoxify hydrocyanic acid, and therefore allows an exact judgement as to therapeutic value of various antidotes to cyanide poisoning. The results were as follows:

1. Cobaltous histidine at a dose of 20 mg/kg was distinguished among the compounds tested by its rapid action in both species. Its detoxifying capacity was not adequate however. Treatment of severe cyanide poisoning in man with Co (his)₂ would appear to be reasonable, but only when combined with sodium thiosulfate.
2. The same rapid action as with cobaltous histidine was achieved in cats by intravenous injection of 2.25 mg/kg p-dimethylaminophenole (DMAP) leading to a methemoglobin formation of 30%. A dose of 0.75 mg/kg DMAP forming 10% methemoglobin reduced HCN-exhalation by an equivalent amount only after a 2.4 min delay. The capacity of DMAP to detoxify hydrocyanic acid was considerably greater than that of cobaltous histidine but still was far inferior to that of sodium thiosulfate.
3. The high capacity of sodium thiosulfate to detoxify hydrocyanic acid was likewise demonstrated by the new method employed here in both animal species. However, the onset of its effect was always very delayed. In clinical practice, this agent should never be omitted, but in treatment of severe poisonings it will only be successful when combined with a more rapid-acting antidote such as cobaltous histidine or DMAP.
4. Sodium nitrite, even when applied in relatively high doses, did not act rapidly enough nor did it demonstrate a satisfactory capacity to detoxify hydrocyanic acid. Therefore, it no longer fulfills the requirements that presently should be demanded of an antidote to hydrocyanic acid.