Cardiopulmonary Effects of the Novel Neuromuscular Blocking Drug GW280430A (AV430A) in Dogs

2004 ◽  
Vol 100 (4) ◽  
pp. 846-851 ◽  
Author(s):  
Paul M. Heerdt ◽  
Richard Kang ◽  
Andrew The’ ◽  
Mir Hashim ◽  
Robert J. Mook ◽  
...  

Background This investigation determined the cardiopulmonary side effects of a novel nondepolarizing neuromuscular blocking drug with an ultrashort duration of action in anesthetized male beagles. Methods The ED95 for GW280430A was first determined in four animals. These data were then used to guide bolus dosing in multiples of ED95 in six dogs instrumented for hemodynamic measurements as well as inspiratory pressure and pulmonary compliance. Cardiopulmonary data were compared before and after the conclusion of a 60- to 90-min GW280430A infusion and in response to subsequent incremental bolus dosing starting with 3.125 x ED95. An adverse response was regarded as an alteration of 10% or greater in any variable. Arterial blood was obtained for histamine analysis before and 1 min after each dose. Results The ED95 of GW280430A was 0.064 +/- 0.01 mg/kg, and stable neuromuscular blockade was maintained with infusion of 0.012 +/- 0.002 mg.kg(-1).min(-1). With the exception of a late 14% increase in heart rate, there were no cardiopulmonary changes during infusion. Bolus dosing produced no cardiopulmonary change until a decrease in mean arterial pressure was elicited in four of six dogs at 25 x ED95. This response was modest, transient, and associated with a concomitant increase in plasma histamine concentration. There were no accompanying changes indicative of direct myocardial depression, pulmonary vasoconstriction, or bronchospasm. Conclusions These data indicate that GW280430 does not produce demonstrable cardiovascular effects in the anesthetized dog until doses far in excess of the ED95 are administered as a bolus.

1987 ◽  
Vol 25 (5) ◽  
pp. 19-20

Vecuronium bromide (Norcuron - Organon) is a neuromuscular blocking drug introduced in the UK shortly after atracurium besylate. The manufacturer claims it is free from significant unwanted cardiovascular effects, causes minimal histamine release and has low renal elimination and so does not cumulate.


2010 ◽  
Vol 112 (4) ◽  
pp. 900-909 ◽  
Author(s):  
Hiroshi Sunaga ◽  
Jaideep K. Malhotra ◽  
Edward Yoon ◽  
John J. Savarese ◽  
Paul M. Heerdt

Background CW002 is a neuromuscular blocking drug that is inactivated by endogenous L-cysteine. This study determined the exogenous L-cysteine dose-response relationship for CW002 reversal along with acute cardiovascular effects and organ toxicity in dogs. Methods Six dogs were each studied four times during isoflurane-nitrous oxide anesthesia and recording of muscle twitch, arterial pressure, and heart rate. CW002 (0.08 mg/kg or 9 x ED95) was injected, and the time to spontaneous muscle recovery was determined. CW002 was then administered again followed 1 min later by 10, 20, 50, or 100 mg/kg L-cysteine (1 dose/experiment). After twitch recovery, CW002 was given a third time to determine whether residual L-cysteine influenced duration. Preliminary toxicology was performed in an additional group of dogs that received CW002 followed by vehicle (n = 8) or 200 mg/kg L-cysteine (n = 8). Animals were awakened and observed for 2 or 14 days before sacrificing and anatomic, biochemical, and histopathologic analyses. Results L-cysteine at all doses accelerated recovery from CW002, with both 50 and 100 mg/kg decreasing median duration from more than 70 min to less than 5 min. After reversal, duration of a subsequent CW002 dose was also decreased in a dose-dependent manner. Over the studied dose range, L-cysteine had less than 10% effect on blood pressure and heart rate. Animals receiving a single 200-mg/kg dose of L-cysteine showed no clinical, anatomic, biochemical, or histologic evidence of organ toxicity. Conclusion The optimal L-cysteine dose for rapidly reversing the neuromuscular blockade produced by a large dose of CW002 in dogs is approximately 50 mg/kg, which has no concomitant hemodynamic effect. A dose of 200 mg/kg had no evident organ toxicity.


2016 ◽  
Vol 125 (6) ◽  
pp. 1136-1143 ◽  
Author(s):  
Paul M. Heerdt ◽  
Hiroshi Sunaga ◽  
Joel S. Owen ◽  
Matthew T. Murrell ◽  
Jaideep K. Malhotra ◽  
...  

Abstract Background CW002 is a benzylisoquinolinium nondepolarizing neuromuscular-blocking drug found to be inactivated by cysteine in preclinical studies. The current study represents a dose escalation clinical trial designed to describe CW002 potency, duration, cardiopulmonary side effects, and histamine release. Methods Healthy subjects anesthetized with sevoflurane/nitrous oxide were divided into five groups (n = 6), each receiving a fixed CW002 dose (0.02, 0.04, 0.06, 0.08, or 0.10 mg/kg), and one group (n = 4) receiving 0.14 mg/kg. Blood pressure and heart rate were continuously recorded along with airway dynamic compliance. Neuromuscular blockade was assessed with mechanomyography at the adductor pollicis. Arterial blood was obtained before and after CW002 injection for analysis of plasma histamine concentration. Potency was estimated from a baseline sigmoid Emax model. Results ED50 was found to be 0.036 mg/kg (95% CI, 0.020 to 0.053 mg/kg) and ED95 0.077 mg/kg (95% CI, 0.044 to 0.114 mg/kg). At 0.14 mg/kg (1.8 × ED95), 80% twitch depression occurred in 94 ± 18 s with complete block in 200 ± 87 s. Clinical recovery (25% of maximum twitch) occurred in 34 ± 3.4 min, with a 5 to 95% recovery interval of 35.0 ± 2.7 min. The time to a train-of-four ratio greater than 0.9 ranged from 59 to 86 min. CW002 did not elicit histamine release or significant (greater than 10%) changes in blood pressure, heart rate, or dynamic airway compliance. Conclusions In healthy subjects receiving sevoflurane/nitrous oxide, CW002 at 1.8 × estimated ED95 produces a clinical duration less than 40 min, elicits no histamine release, and has minimal cardiopulmonary side effects.


1979 ◽  
Vol 47 (5) ◽  
pp. 917-922 ◽  
Author(s):  
A. Wanner ◽  
R. J. Mezey ◽  
M. E. Reinhart ◽  
P. Eyre

In 10 conscious ewes with cutaneous sensitivity to Ascaris suum, measurements of pulmonary resistance (RL), static lung compliance (Cst), functional residual capacity (FRC), and arterial blood gas composition along with arterial plasma histamine concentration (H) were obtained before and after inhalation challenge with A. suum extract. Five animals showed no changes in respiratory mechanics after A. suum challenge; in these H did not change. The remaining five animals responded to A. suum challenge with bronchospasm reflected by the following maximum changes in mean values that were significant 15 and 30 min after beginning of challenge, respectively: RL 248% , FRC 126%, specific pulmonary conductance 33%, and arterial PO2 63% of base line. These parameters returned towards base line by 120 min. No changes occurred in Cst, arterial PCO2, and pH. Five minutes after beginning of A. suum challenge, mean H was increased to 423% of base line with a return to base line 10 min later. In the same 5 animals, no changes were observed in pulmonary function or H after inhalation of ragweed extract (control). These results suggest that antigen-induced bronchospasm in sensitized conscious sheep represents an anaphylactic airway response and shares distinct physiological features with human bronchial asthma including pulmonary hyperinflation.


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