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Effects of the putative antidepressant, ABT 200, on the clearance of exogenous norepinephrine in rat cerebellum.

ABT 200 [(RR,SS)-3-phenyl-1-[1',2',3',4'-tetrahydro-5',6'-methylenedioxy- 1'-naphthalenyl-methyl]-pyrrolidine methanesulfonate] is a potent alpha 2-adrenoceptor antagonist (Ki = 1.2 nM) with modest norepinephrine uptake-blocking activity (IC50 = 841 nM) that is currently under clinical evaluation as an antidepressant. The effects of ABT 200, nomifensine (an inhibitor of catecholamine uptake), and rauwolscine (a selective alpha 2-adrenoceptor antagonist) on the clearance of exogenous norepinephrine in the cerebellum of urethane-anesthetized rats was investigated using a vivo electrochemistry. Chronoamperometric recordings were continuously made at 5 Hz using Nafion-coated, single carbon fiber electrodes. When a calibrated amount of norepinephrine was pressure-ejected at 5-min intervals from a micropipette adjacent (290-330 microM) to the electrode, transient and reproducible norepinephrine signals were detected. In response to systemic ABT 200 (30 mg/kg i.p.) or nomifensine (30 mg/kg i.p.), the signals increased in both amplitude and time course, indicating significant inhibition of the norepinephrine transporter. A lower dose (15 mg/kg i.p.) of either ABT 200 or nomifensine had no effect in this paradigm. Local application of ABT 200 (400 microM) or nomifensine (400 microM) prior to pressure-ejection of norepinephrine also significantly increased the amplitude and time course of the norepinephrine signals. In contrast, systemic administration of rauwolscine (30 mg/kg i.p.) or vehicle solution, and local application of vehicle solution, had no effect on the norepinephrine signals. These data indicate that at the higher dose evaluated, both ABT 200 and nomifensine inhibit cerebellar norepinephrine uptake in vivo.

Animals↗

Effects of exposure to simulated microgravity on neuronal catecholamine release and blood pressure responses to norepinephrine and angiotensin.

We tested the hypothesis that exposure to microgravity reduces the neuronal release of catecholamines and blood pressure responses to norepinephrine and angiotensin. Eight men underwent 30 days of 6 degrees head-down tilt (HDT) bedrest to simulate exposure to microgravity. Plasma norepinephrine and mean arterial blood pressure (MAP) were measured before and after a cold pressor test (CPT) and graded norepinephrine infusion (8, 16 and 32 ng/kg/min) on day 6 of a baseline control period (C6) and on days 14 and 27 of HDT. MAP and plasma angiotensin II (Ang-II) were measured during graded Ang-II infusion (1, 2 and 4 ng/kg/min) on C8 and days 16 and 29 of HDT. Baseline total circulating norepinephrine was reduced from 1017ng during the baseline control period to 610 ng at day 14 and 673ng at day 27 of HDT, confirming a hypoadrenergic state. An elevation of norepinephrine (+178 ng) to the CPT during the baseline control period was eliminated by HDT days 14 and 27. During norepinephrine infusion, similar elevations in plasma norepinephrine (7.7 pg/ml/ng/kg/min) caused similar elevations in MAP (0.12 mmHg/ng/kg/min) across all test days. Ang-II infusion produced higher levels of plasma Ang-II during HDT (47.3 pg/ml) than during baseline control (35.5 pg/ml), while producing similar corresponding elevations in blood pressure. While vascular responsiveness to norepinephrine appears unaffected, impaired neuronal release of norepinephrine and reduced vascular responsiveness to Ang-II might contribute to the lessened capacity to vasoconstrict after spaceflight. The time course of alterations indicates effects that occur within two weeks of exposure.

Adult↗

The effects of morphine and halothane anaesthesia on urine norepinephrine during surgery for congenital heart disease.

Urine excretion rates of norepinephrine were measured in 15 children with Tetralogy of Fallot and 25 with atrial septal secundum defects anaesthetized with halothane or morphine before, during and for two hours after surgical correction of their cardiac defects. All patients were paralyzed with d-tubocurarine, the tracheae were intubated and respiration was controlled. Urine was obtained for 90 minutes before induction, during induction, before, during and after bypass and postoperative. Patients with TF had significantly higher pre-operative urine norepinephrine excretion rates than patients with ASD. In TF children anaesthetized with halothane norepinephrine excretion was significantly decreased during induction and during operation but increased post-operatively. Children with ASD and anaesthetized with halothane did not have urine norepinephrine excretion rates that were significantly different from post-operative values until the postoperative period. ASD children anaesthetized with morphine had marked elevations in norepinephrine excretion during induction and all subsequent study periods. On the other hand, morphine anaesthetized TF children did not have a significant increase in urine norepinephrine excretion until bypass had been established. Increased norepinephrine excretion was maintained in these patients during all subsequent study periods. These data, when combined with our results in patients with acquired heart disease, demonstrate that disease can alter norepinephrine responses to morphine anaesthesia. In addition our results suggest that dosage of morphine and morphine blood levels might also modify norepinephrine excretion.

Anesthesia, Inhalation↗

Norepinephrine and metaraminol in septic shock: a comparison of the hemodynamic effects.

OBJECTIVE: To compare the effects of norepinephrine and metaraminol on hemodynamics in septic shock patients. DESIGN AND SETTING: Open-label, controlled clinical trial in the general intensive care unit of a university-affiliated hospital. PATIENTS AND PARTICIPANTS: Ten consecutive septic shock patients receiving norepinephrine to maintain the mean arterial pressure higher than 65 mmHg. INTERVENTIONS: Patients were monitored with pulmonary artery catheter and indirect calorimetry. At the baseline hemodynamic variables were obtained during norepinephrine infusion. Subsequently norepinephrine was replaced by metaraminol infusion in a dose sufficient to keep mean arterial pressure constant. After 20 min of stable arterial pressure a new set of measurement was repeated. MEASUREMENTS AND RESULTS: Mean arterial pressure did not differ significantly with norepinephrine or metaraminol; there was no relationship between the norepinephrine and metaraminol doses. Replacement norepinephrine with metaraminol did not modify hemodynamic variables; in particular there were no changes in heart rate, stroke volume index, pulmonary artery occlusion pressure, or oxygen consumption index. CONCLUSIONS: This study shows that metaraminol increases arterial pressure as does norepinephrine in septic shock patients. Despite similar effects of norepinephrine and metaraminol, there was no relationship between the dose of the two drugs.

Dose-Response Relationship, Drug↗

Plasma norepinephrine as an indicator of sympathetic neural activity in clinical cardiology.

This review summarizes the available medical literature about plasma norepinephrine, which as been used as an indicator of sympathetic neural activity in clinical cardiology. Plasma norepinephrine levels are elevated myocardial infarction and congestive heart failure, and the norepinephrine concentration varies with severity of disease. Patients with ischemic heart disease at rest show essentially normal plasma norepinephrine, but no studies have assessed norepinephrine levels during spontaneously occurring typical angina pectoris. Plasma norepinephrine also is increased during hypertension occurring after coronary bypass surgery or repair of aortic coarctation. Propranolol increases plasma norepinephrine, and acute withdrawal of propranolol does not. Sodium restriction increases plasma norepinephrine in healthy persons, but no information is available about its effect on patients with congestive heart failure. Insufficient data are available to make strong inferences about sympathetic activity in cardiomyopathy, essential hypertension or pulmonary hypertension, and little or no information is available about plasma norepinephrine in ventricular fibrillation without myocardial infarction, the mitral valve prolapse syndrome, digoxin effect, syndromes associated with prolonged electrocardiographic Q-T interval and the hyperkinetic heart syndrome.

Angina Pectoris↗

Characterization of norepinephrine sensitivity in the maternal splanchnic circulation during pregnancy.

Vascular sensitivity to exogenous norepinephrine and transmural nerve stimulation was studied in the splanchnic bed of nonpregnant, early pregnant, and late pregnant rats. Resistance-size mesenteric arteries were removed from late pregnant (18 to 20 days), early pregnant (7 days), and nonpregnant cycling rats and mounted in a myograph system, which permits the precise setting of vessel circumference for the determination of norepinephrine sensitivity. Norepinephrine dose-response curves and frequency-response curves for transmural nerve stimulation were obtained in the presence and absence of cocaine, a specific inhibitor of neuronal reuptake. The mesenteric arteries of late pregnant rats were 1.5 times less sensitive to exogenous norepinephrine than arteries of both early pregnant and nonpregnant rats. Sensitivity to transmural nerve stimulation was decreased in both early and late pregnant rats compared with nonpregnant controls. Cocaine potentiated the response to both exogenous norepinephrine and transmural nerve stimulation in the pregnant rats so that responses between nonpregnant, early pregnant, and late pregnant rats were no longer different. This suggests a greater reuptake activity from pregnant rats. In conclusion, pregnancy is associated with a reduction in splanchnic norepinephrine sensitivity, which may be due partly to an increase in neuronal deactivation of norepinephrine. The maximum contractile response to norepinephrine also was decreased in late pregnancy, which suggests additional mechanisms for changes in norepinephrine vascular sensitivity.

Animals↗

Elevated platelet norepinephrine concentration in patients with pheochromocytomas.

With a radioenzymatic method of analysis we determined the concentration of plasma and platelet norepinephrine in simultaneously drawn blood samples from six patients with pheochromocytomas. All six subjects had elevated platelet norepinephrine concentrations in the preoperative or intraoperative period. Three of the six patients had a normal plasma norepinephrine concentration in their sample. After resection of benign pheochromocytomas the platelet and plasma norepinephrine of five patients returned to normal. The platelet and plasma norepinephrine concentration of a patient with a malignant, non-resectable pheochromocytoma remained elevated. Eight of 30 patients (27%) with hypertension, not thought to be due to pheochromocytoma, had elevated platelet norepinephrine concentrations, All 8 of these patients had diastolic blood pressures of 120 mm Hg or greater at the time the blood samples were drawn. In contrast, the six patients with pheochromocytomas had elevated platelet norepinephrine concentrations while normotensive. Only five of 60 "sick" patients (8%) without a history of hypertension had elevated platelet norepinephrine concentration. Platelet norepinephrine concentration is an excellent test to screen patients, with a history of spells of hypertension but presently normotensive, for pheochromocytomas. An elevated value should be followed up with measurement of vanillylmandelic acid (VMA) and/or catecholamines in a 24-h urine collection.

Adrenal Gland Neoplasms↗

Interactions of catecholamine uptake inhibitors and norepinephrine on autonomic ganglia.

The effect of catecholamine uptake inhibitors on blockade by norepinephrine was observed in the isolated stellate ganglion of the hamster. The preganglionic nerve was stimulated, supramaximally, at 0.2 Hz and compound action potentials were recorded from the postganglionic nerve. Norepinephrine blocked ganglionic transmission. The sensitivity of the ganglion to norepinephrine was increased by the catecholamine uptake inhibitors, desipramine (3 X 10(-7) M), d-amphetamine (10(-6) and 10(-5) M) and tyramine (10(-4) M). Ouabain (10(-5) and 3 X 10(-5) M) did not change the sensitivity of the ganglion to norepinephrine. All the drugs reduced the uptake by the [3H]norepinephrine into the ganglion. The inhibition of [3H]norepinephrine uptake by the drugs could be correlated with the increase in sensitivity of the ganglion to norepinephrine. These results support the hypothesis that catecholamine uptake is important in terminating the actions of exogenously applied norepinephrine, and that inhibition of the catecholamine uptake increases the sensitivity of the ganglion to norepinephrine.

Animals↗

Dopamine accumulation after dopamine beta-hydroxylase inhibition in rat heart as an index of norepinephrine turnover.

Dopamine concentration in rat heart is normally very low, only a few percent of the concentration of norepinephrine. After treatment of rats with a dopamine beta-hydroxylase inhibitor, 1-cyclohexyl-2-mercapto-imidazole (CHMI), there was a rapid increase in dopamine concentration even before norepinephrine concentration had decreased perceptibility. This accumulation of dopamine was readily measured by liquid chromatography with electrochemical detection. Since the percentage change in dopamine was much greater than the percentage change in norepinephrine, especially at early times, measurement of dopamine accumulation rather than norepinephrine decline was considered as a useful measure of norepinephrine turnover. Drugs that act on noradrenergic receptors and are known to alter norepinephrine turnover were found to alter the rate of dopamine accumulation. Clonidine and guanabenz decreased dopamine accumulation after CHMI, whereas piperoxan (but not prazosin) increased dopamine accumulation after CHMI. Pergolide, a dopamine agonist whose lowering of blood pressure and cardiac rate has been suggested to be due to suppression of neurogenic release or norepinephrine, also decreased dopamine accumulation after CHMI. The results suggest that measuring dopamine accumulation may have advantages over measuring norepinephrine disappearance after dopamine beta-hydroxylase inhibition as an indicator of norepinephrine turnover in heart.

Animals↗

Increase in myocardial interstitial norepinephrine during a short period of coronary occlusion.

The neurally intact in vivo beating hearts of cats were used to examine the influence of a short period of coronary occlusion on regional myocardial norepinephrine levels. Using a cardiac dialysis technique, dialysate norepinephrine levels were measured as an index of myocardial interstitial norepinephrine levels, and the left anterior descending coronary artery was occluded for 10 min. In anesthetized cats, 10 min occlusion increased the dialysate norepinephrine level in the ischemic region but not in the non-ischemic region. To investigate the influence of neuronal norepinephrine uptake on occlusion-induced dialysate norepinephrine response, a neuronal uptake inhibitor (desipramine) was locally administered to both regions with the dialysis perfusate. In the ischemic region, 10 min occlusion significantly increased the dialysate norepinephrine level from the control level in the presence of desipramine. We concluded that 10 min coronary occlusion was associated with an increase in the myocardial interstitial norepinephrine level in the ischemic region. This increase in the early phase of ischemia was not attributed to attenuation of neuronal norepinephrine uptake function.

Animals↗

Total norepinephrine spillover, muscle sympathetic nerve activity and heart-rate spectral analysis in a patient with dopamine beta-hydroxylase deficiency.

Dopamine-beta-hydroxylase (D beta H) is the enzyme responsible for intraneural conversion of dopamine to norepinephrine. Its deficiency results in failure of norepinephrine synthesis, excessive dopamine release and orthostatic hypotension. We studied a young patient with this deficiency using the currently available methods to assess sympathetic function namely measurement of norepinephrine kinetics, microneurography to assess muscle sympathetic nerve activity (MSNA), and heart-rate spectral analysis. We compared these findings with those in 24 young healthy controls, and 4 patients with peripheral autonomic failure (PAF). Recordings were made in our subject before and after 5 months of treatment with L-threo-3,4-dihydroxyphenylserine (DOPS) (which is converted directly into L-norepinephrine bypassing the D beta H enzymatic step); measurements were made at rest in the supine position and after 15 min of 30 degrees head-up tilt. Our subject with D beta H deficiency had a high resting nerve firing rate (40.3 bursts/min) compared with the mean value in normal controls (19.3 bursts/min), and an appropriate increase in nerve firing rate during tilt. Total body norepinephrine spillover at rest was very low, 38 ng/min, compared with age-matched normals (519 +/- 43.3 ng/min, mean +/- SEM), and epinephrine secretion was undetectable. Conversely, the plasma concentrations of dopamine, DOPAC, HVA and DOPA were raised. At rest, low-frequency heart-rate variability (0.1 Hz) was absent with preservation of the respiratory-related high-frequency peak. In contrast, the PAF subjects had no detectable muscle sympathetic nerve activity, very low levels of norepinephrine spillover and epinephrine secretion and a reduction in heart rate variability at all frequencies. After 5 months treatment with L-threo-3,4-dihydroxyphenylserine (DOPS) in the D beta H deficiency patient there was a dramatic clinical improvement with resolution of the orthostatic symptoms, dramatic reduction in MSNA activity at rest, and return of plasma norepinephrine, norepinephrine spillover, DHPG and MHPG to within the normal range, indicating intraneuronal production of norepinephrine.

Adolescent↗

Increased dopamine and norepinephrine release in medial prefrontal cortex induced by acute and chronic stress: effects of diazepam.

We have examined the effects of diazepam on the stress-induced increase in extracellular dopamine and norepinephrine in the medial prefrontal cortex using in vivo microdialysis. In naive rats, acute tail pressure (30 min) elicited an increase in the concentrations of dopamine and norepinephrine in extracellular fluid of medial prefrontal cortex (+54 and +50%, respectively). Diazepam (2.5 mg/kg, i.p.) decreased the basal concentration of extracellular dopamine and norepinephrine. Diazepam also attenuated the stress-evoked increase in the absolute concentrations of extracellular dopamine (+17%), but did not alter the stress-induced increase in norepinephrine (+41%). However, when the drug-induced decrease in basal dopamine and norepinephrine concentration was taken into account, the stress-induced net increase in dopamine above the new baseline was equivalent to that obtained in vehicle pretreated rats, whereas the net increase in norepinephrine was almost twice that obtained in control subjects. In rats previously exposed to chronic cold (three to four weeks at 5 degrees C), tail pressure again produced an increase in the concentrations of dopamine and norepinephrine in the medial prefrontal cortex (+42% and +92%, respectively). However, in these chronically stressed rats, diazepam no longer decreased basal dopamine or norepinephrine in extracellular fluid, nor did it affect the stress-induced increase in the concentrations of these catecholamines. These data indicate that diazepam has complex effects on the extracellular concentrations of dopamine and norepinephrine which vary depending upon whether the rat is undisturbed or stressed during the period of drug exposure as well as the rat's prior history of exposure to stress. Moreover, these data raise questions regarding the role of catecholamines in the mechanism by which diazepam exerts its anxiolytic properties.

3,4-Dihydroxyphenylacetic Acid↗

Measurement of overall and cardiac norepinephrine release into plasma during cognitive challenge.

Measurements of plasma norepinephrine concentrations and norepinephrine spillover into plasma were used to gauge sympathetic nervous system activation during cognitive challenge (forced mental arithmetic) in 12 human subjects. Norepinephrine levels were influenced by the sampling site, with the fractional increase being greatest for norepinephrine spillover from the heart (where norepinephrine release almost trebled), intermediate for the arterial plasma norepinephrine concentration and total body norepinephrine spillover (50-70% increase), and inconsequential for antecubital venous plasma norepinephrine levels (less than 20% increase). These findings are explained by patterning of the sympathetic response, which only minimally involves the sympathetic outflow to the skeletal muscle of the forearm but preferentially involves the heart. Antecubital venous plasma norepinephrine levels are not sufficiently sensitive to allow satisfactory monitoring of the sympathetic neural outflow to organs, such as the heart, which are selectively activated in the response to mental challenge.

Adult↗

Effect of digitalis on norepinephrine kinetics in congestive heart failure.

OBJECTIVE: The aim of this study was to test the hypothesis that digitalis glycosides would reduce sympathetic activity as reflected by forearm venous norepinephrine kinetics in patients with congestive heart failure. BACKGROUND: Digitalis glycosides have been reported to decrease sympathetic nervous system activity with baroreceptor sensitization in experimental animals. Such effects could be of therapeutic importance in congestive heart failure. METHODS: Double-blind randomized assessment was made of the effects of low dose intravenous deslanoside (Cedilanid-D, 0.002 mg/kg body weight) and vehicle on heart rate, arterial pressure, forearm blood flow, plasma norepinephrine, norepinephrine clearance and norepinephrine spillover in nine patients with stable congestive heart failure, New York Heart Association functional class II or III. Open label assessment of the responses to 0.6 mg of deslanoside was made in an overlapping group of seven patients. All measurements were made 30 and 60 min after intravenous injection of drug or vehicle and after 15 min of 30 degrees head-down tilt as a test of the sympathetic response to baroreceptor loading. RESULTS: Heart rate, arterial pressure and forearm blood flow were unchanged by low dose deslanoside. Heart rate decreased slightly with the 0.6 mg dose with the patients in the supine position. Norepinephrine spillover and clearance decreased with time on each study day in the supine position, but no effect was attributable to digitalis. Plasma norepinephrine and norepinephrine clearance and spillover all remained unchanged during head-down tilt on each study day. CONCLUSIONS: Nonpressor doses of deslanoside do not suppress sympathetic activity as reflected by venous norepinephrine and norepinephrine spillover in patients with congestive heart failure. Further, deslanoside did not normalize the sympathetic response to mild baroreceptor loading produced by head-down tilt. These data do not support sympathoinhibition through baroreceptor sensitization as a likely effect of digitalis in congestive heart failure.

Deslanoside↗

Norepinephrine inhibits a Ca2+ current in rat sympathetic neurons via a G-protein.

The effects of norepinephrine on a Ca2+ current from acutely isolated and short-term (24 h) cultured adult rat superior cervical ganglion neurons were studied using the whole-cell variant of the patch-clamp technique. Norepinephrine produced a rapid, reversible and concentration-dependent reduction of the Ca2+ current. Accurately timed applications of norepinephrine (3 microM) showed that the development of Ca2+ current inhibition was delayed by up to 11 s after application of norepinephrine. Internal 500 microM guanylyl-imidodiphosphate (Gpp(NH)p) or guanosine-5'-O-(3-thiotriphosphate) (GTP-gamma-S) decreased the Ca2+ current amplitude and induced a biphasic rising phase of the Ca2+ current. Under these conditions, the reduction of Ca2+ current amplitude by 3 microM norepinephrine was virtually abolished when compared with cells dialysed with GTP-containing internal solutions. Internal dialysis with solutions containing 2 mM guanosine-5'-O-(2-thiodiphosphate) (GDP-beta-S) increased the Ca2+ current amplitude and reduced the inhibition produced by 3 microM norepinephrine compared to cells dialysed with control internal solution. Treatment with 200 ng/ml pertussis toxin for 12-16 h greatly reduced the norepinephrine-induced Ca2+ current inhibition. Internal dialysis with solutions containing 500 microM cyclic adenosine 3',5'-monophosphate (cyclic AMP) and 3-isobutyl-1-methylxanthine had no significant effect on either the Ca2+ current inhibition by norepinephrine or the Ca2+ current amplitude. These results suggest that norepinephrine blocks a Ca2+ current in adult rat superior cervical ganglion neurons via a pertussis toxin-sensitive G-protein which is independent of intracellular cyclic AMP.

1-Methyl-3-isobutylxanthine↗

Supraclinical concentrations of dexmedetomidine evoke norepinephrine release from rat cerebrocortical slices possible involvement of the orexin-1 receptor.

Dexmedetomidine is a highly selective alpha(2)-agonist and reduces norepinephrine release from several neuronal tissues. However, supraclinical concentrations of dexmedetomidine have been reported to increase norepinephrine release from cardiac stores. In addition, some report using microdialysis shows that intrathecal clonidine increased norepinephrine release from the dorsal horn in mid-thoracic spinal cord but dexmedetomidine did not. Thus, in the present study we have studied effects of dexmedetomidine on norepinephrine release from rat cerebrocortical slices and compared this with clonidine. We have also used a selective alpha(2)-antagonist yohimbine and an orexin-1 receptor antagonist SB-334867 to examine whether the effects of dexmedetomidine on norepinephrine release are mediated via alpha(2)-adrenergic or orexin (OX) receptors. In addition, concentrations of orexin A in the evoked sample were also measured. Dexmedetomidine significantly increased norepinephrine release (basal=100%) from rat cerebrocortical slices in a concentration-dependent manner with E(max) 377.3+/-8.6% and pEC(50) 6.12+/-0.07, whereas clonidine significantly reduced the release with E(max) 62.1+/-6.8% and pEC(50) 4.55+/-0.25. Yohimbine (10(-5)M) did not affect the concentration-response curve of dexmedetomidine for norepinephrine release. However, SB-334867 concentration-dependently antagonized dexmedetomidine-evoked norepinephrine release with I(max) 91.0+/-9.4% and pIC(50) 5.99+/-0.18. Orexin A concentrations did not differ between the samples. Thus, supraclinical concentrations of dexmedetomidine increase norepinephrine release from rat cerebrocortical slices, and this release may be mediated via OX(1) but not alpha(2)-adrenoceptors.

Adrenergic alpha-Agonists↗

Effect of the attention deficit/hyperactivity disorder drug atomoxetine on extracellular concentrations of norepinephrine and dopamine in several brain regions of the rat.

Atomoxetine is a selective inhibitor of norepinephrine transporters and is currently being used in the pharmacotherapy of attention deficit/hyperactivity disorder (ADHD). We have previously shown that atomoxetine increased extracellular (EX) concentrations of norepinephrine and dopamine in prefrontal cortex, but unlike the psychostimulant methylphenidate, did not alter dopamine(EX) in nucleus accumbens or striatum. Using the in vivo microdialysis technique in rat, we investigated the effects of atomoxetine on norepinephrine(EX) and dopamine(EX) concentrations in several other brain regions and also evaluated the role of inhibitory autoreceptors on atomoxetine-induced increases of norepinephrine(EX) concentrations. Atomoxetine (3mg/kg i.p.) increased norepinephrine(EX) robustly in prefrontal cortex, occipital cortex, lateral hypothalamus, dorsal hippocampus and cerebellum, suggesting that norepinephrine(EX) is increased throughout the brain by atomoxetine. In lateral hypothalamus and occipital cortex where dopamine(EX) was quantifiable, atomoxetine did not increase dopamine(EX) concentrations, in contrast to parallel increases of norepinephrine(EX) and dopamine(EX) in prefrontal cortex, indicating a unique effect in prefrontal cortex. Administration of the alpha(2)-adrenergic antagonist idazoxan 1h after atomoxetine resulted in increases in prefrontal cortical norepinephrine efflux greater than either compound alone, indicating an attenuating effect of the adrenergic autoreceptors on norepinephrine efflux.

Adrenergic Uptake Inhibitors↗

Depression of pulmonary metabolic function by cardiopulmonary bypass procedures increases levels of circulating norepinephrine.

We measured plasma levels of endogenous norepinephrine radioenzymatically in mixed venous and arterial blood simultaneously sampled from anesthetized dogs before, during, and after 1 to 4 hours of total cardiopulmonary bypass (CPB) or 2 hours of left heart bypass. Prior to bypass, arterial levels of norepinephrine were 0.41 +/- 0.04 ng/ml and pulmonary extraction of norepinephrine was 25 +/- 3% (N = 20). During bypass, norepinephrine levels significantly increased from control to 1.41 +/- 0.15 (1 or 2 hours of CPB; N = 8) and 1.97 +/- 0.30 (3 or 4 hours of CPB; N = 8) or 0.97 +/- 0.29 (2 hours of left heart bypass) ng/ml. Restoration of normal pulmonary blood flow was associated with a rapid and significant decrease in arterial levels of norepinephrine, which, after 1 or 2 hours of CPB or 2 hours of left heart bypass, returned to levels obtained before bypass. However, arterial levels of norepinephrine remained higher than 1 ng/ml in the 3-hour recovery period after prolonged bypass. In these animals, pulmonary extraction of norepinephrine was significantly less than control. These data suggest that the lung's ability to remove norepinephrine is altered by CPB and that the severity of the alterations is directly related to pump time. The impairment in extraction allows higher than normal concentrations of norepinephrine to enter the arterial circulation and may contribute to systemic hypertension after bypass.

Animals↗