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Results for “Sodium Channel Blockers”

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PubMed1991

[Clinical efficacy of combined therapy with verapamil and fast sodium channel blockers for refractory atrial fibrillation].

A total of 70 patients aged 38-73 years who suffered from various circulatory disorders and refractory atrial fibrillation were examined. The majority of patients with refractory atrial fibrillation displayed normalized cardiac rhythm after the combined therapy with verapamil plus one of the fast sodium channel blockers (novocainamide, ethmozine, ethacizine, kinilentin). If the therapy failed, electric cardioversion was applied.

Adult↗
PubMedDate not supplied

Sodium channel blockers are vasodilator as well as natriuretic and diuretic agents.

Amiloride (100-400 micrograms) injected intra-arterially into the dog forelimb perfused at constant flow produced a prompt but transient dose-dependent decrease in perfusion pressure. Intravenous injection lowered systemic arterial pressure, but effects were small and transient except in doses exceeding 10 mg. We tested 11 analogues of amiloride, 3 other diuretics, and a hypotensive imidazopyrazine for vasodilator activity in the dog forelimb and found one analogue, 6-iodo-amiloride, with twice the activity of amiloride. Intravenous injection of 3 mg of 6-iodo-amiloride promptly decreased systemic arterial pressure and forelimb perfusion pressure 65 and 47 mm Hg respectively. The decreases with 3 mg of amiloride were only 5 and 23 mm Hg respectively. Intravenous infusion of 17 to 77 mg of 6-iodo-amiloride produced diuresis, natriuresis, and antikaliuresis and, with the higher doses, hypotension. The latter occurred promptly on starting the infusion and was sustained for the duration of the infusion. Wistar rats responded to an intravenous infusion of 0.38 mg/100 g in 11 minutes in the same manner. In the spontaneously hypertensive rat, this same dose produced a large, sustained antihypertensive effect with little change in the urinary parameters. These studies indicate that 6-iodo-amiloride is a vasodilator and a vasodepressor as well as natriuretic and diuretic in the normal dog and rat and that it produces a sustained, large fall in blood pressure, independently of urinary effects, in the spontaneously hypertensive rat. These results suggest that 6-iodo-amiloride and other sodium channel blockers might be useful as vasodilatory antihypertensive agents, particularly in those types of hypertension characterized by increased vascular smooth muscle cell permeability to sodium.

Amiloride↗
PubMed2002

Synthesis and structure-activity relationships of 6,7-benzomorphan derivatives as use-dependent sodium channel blockers for the treatment of stroke.

We have synthesized a series of 6,7-benzomorphan derivatives and determined their ability to bind to voltage-dependent sodium channels. We have also compared the functional consequences of this blockade in vitro and in vivo. The ability of the compounds to displace [(3)H]batrachotoxin from voltage-dependent sodium channels was compared with their ability to inhibit [(3)H]glutamate release in rat brain slices and block convulsions in the maximal electroshock test in mice. We found that the hydroxyl function in the 4'-position is crucial for improving the sodium channel blocking properties. Moreover, the stereochemistry and the topology of the N-linked side chain also influence this interaction. Indeed, the affinity is improved by an aromatic substitution in the side chain. By modifying the N substituent and the substitution pattern of the hydroxyl function, we were able to discover (2R)-[2alpha,3(S),6alpha]-1,2,3,4,5,6-hexahydro-6,11,11-tri-methyl-3-[2-(phenylmethoxy)propyl]-2,6-methano-3-benzazocin-10-ol hydrochloride. This compound was chosen as the best candidate for further pharmacological investigations.

Animals↗
PubMed1995

A comparison of the effects of a sodium channel blocker and an NMDA antagonist upon extracellular glutamate in rat focal cerebral ischemia.

Agents such as 619C89 decrease extracellular glutamate concentrations by a primary action at voltage sensitive sodium channels, but NMDA antagonists also have been shown to decrease extracellular glutamate concentration after ischemia. To address the question as to whether 619C89's effect upon extracellular glutamate concentrations is any different than the effect of the NMDA antagonist dextrorphan, 24 rats were given either optimally neuroprotective doses of these drugs or saline prior to middle cerebral artery occlusion. In caudate, the 619C89-treated, but not dextrorphan-treated rats had less microdialysate glutamate than ischemic controls. In cortex, both 619C89- and dextrorphan-treated groups had significantly decreased glutamate compared with ischemic controls. These results support a specific effect of 619C89 upon glutamate release in caudate but not cortex.

Animals↗
PubMed1999

The novel anticonvulsant AWD 140-190 acts as a highly use-dependent sodium channel blocker in neuronal cell preparations.

The effect of the new anticonvulsant drug AWD 140-190 (4-(p-bromophenyl)-3-morpholino-1H-pyrrole-2-carboxylic acid methyl ester) on neuronal sodium channels was evaluated in differentiated NG 108-15 cells using the patch clamp technique. AWD 140-190 blocked neuronal sodium channels more potently than phenytoin in a dose-dependent manner (1-30 microM). As with phenytoin, the blocking effect was voltage and frequency dependent. However, comparing equi-effective doses of AWD 140-190 and phenytoin, the frequency dependence was two to three times stronger. This pronounced use dependent effect of AWD 140-190 may be the reason for the superior tolerability and anticonvulsant activity in experimental models of epilepsy.

Animals↗
PubMed1998

Synthesis and pharmacological evaluation of N,N'-diarylguanidines as potent sodium channel blockers and anticonvulsant agents.

Synthesis and structure-activity relationships (SAR) are described for a series of N,N'-diarylguanidines related to N-acenaphth-5-yl-N'-(4-methoxynaphth-1-yl)guanidine (3) as anticonvulsants through blockade of sodium channels. SAR studies on compound 3 led to several simpler diphenylguanidines with improved in vitro and in vivo activity. Compounds were screened for blockade of sodium channels in a veratridine-induced [14C]guanidinium influx assay (type IIA sodium channels) and for anticonvulsant activity in the audiogenic DBA/2 mouse model. Results indicated that N, N'-diphenylguanidines substituted with flexible and moderate size lipophilic groups were preferred over aryl and/or hydrophilic groups for biological activity. Among the compounds studied, n-butyl- and/or n-butoxy-containing guanidines showed superior biological activity. A possible relationship between in vitro and in vivo activity of this compound series and their measured/calculated lipophilicities was investigated. Compounds of this series showed only weak NMDA ion channel-blocking activity indicating that the anticonvulsant activity of these compounds is unlikely to be mediated by NMDA ion channels but, more likely, by acting at voltage-gated sodium channels.

Acoustic Stimulation↗
PubMed2006

Potent analgesic effects of a putative sodium channel blocker M58373 on formalin-induced and neuropathic pain in rats.

M58373, 4-[2-(4-hydroxy-4-{[N-(4-isopropoxyphenyl)-N-methylamino]methyl}piperidin-1-yl)ethyl]benzonitrile monohydrochloride, is a novel compound, which has an inhibitory activity on neurotoxin binding to the site 2 of voltage-gated sodium channels. In this study, we investigated the effects of M58373 on substance P release from sensory neurons in vitro and pain behaviors/responses in rats, compared with mexiletine. M58373 (1-10 microM) inhibited veratridine-induced release of substance P from dorsal root ganglion cells. In the formalin test, oral M58373 (0.3-10 mg/kg) reduced the time spent in nociceptive behaviors only in the late phase. In the neuropathic pain model, oral M58373 (1-10 mg/kg) attenuated mechanical allodynia and heat hyperalgesia in the nerve-injured paw without affecting normal responses in the uninjured paw. In contrast, oral mexiletine (10-100 mg/kg) had a narrow therapeutic dose range in both models because of the adverse effects on the central nervous system. These results suggest that M58373 is a favorable prototype for novel anti-neuropathic pain agents.

Analgesics↗
PubMed1990

Sodium channel blockers: the size/solubility hypothesis revisited.

The influence that drug size has on the rate of recovery of sodium channels in heart tissue has been reexamined. A drug dimension that looks at the end-on view of the molecule provides a substantially better explanation for the size dependence of repriming kinetics than does molecular weight. A quantitative model for the recovery time is provided that couples proton exchange kinetics with a drug size-dependent process that is related to recovery from inactivation. Drugs having a wider span at their aromatic end produce more slowing of the rate of recovery from inactivation.

Adrenergic beta-Antagonists↗
PubMed2001

Evaluation of the neuroprotective effects of sodium channel blockers after spinal cord injury: improved behavioral and neuroanatomical recovery with riluzole.

OBJECT: Persistent activation of voltage-sensitive Na+ channels is associated with cellular toxicity and may contribute to the degeneration of neural tissue following traumatic brain and spinal cord injury (SCI). Pharmacological blockade of these channels can attenuate secondary pathophysiology and reduce functional deficits acutely. METHODS: To determine the therapeutic effects of Na+ channel blockers on long-term tissue sparing and functional neurological recovery after traumatic SCI, the authors injected Wistar rats intraperitoneally with riluzole (5 mg/kg), phenytoin (30 mg/kg), CNS5546A, a novel Na+ channel blocker (15 mg/kg), or vehicle (2-HP3CD; 5 mg/kg) 15 minutes after induction of compressive SCI at C7-T1. Functional neurological recovery of coordinated hindlimb function and strength, assessed 1 week postinjury and weekly thereafter for 6 weeks, was significantly enhanced in animals treated with riluzole compared with the other treatment groups. Seven weeks postinjury the preservation of residual tissue and integrity of descending axons were determined with digital morphometrical and fluorescent histochemical analysis. All three Na+ channel blockers significantly enhanced residual tissue area at the injury epicenter compared with control. Riluzole significantly reduced tissue loss in rostrocaudal regions surrounding the epicenter, with overall sparing of gray matter and selective sparing of white matter. Also, counts of red nuclei neurons retrogradely labeled with fluorogold introduced caudal to the injury site were significantly increased in the riluzole group. CONCLUSIONS: Systemic Na+ channel blockers, in particular riluzole, can confer significant neuroprotection after in vivo SCI and result in behavioral recovery and sparing of both gray and white matter.

Animals↗
PubMed1999

Positive symptoms in multiple sclerosis: their treatment with sodium channel blockers, lidocaine and mexiletine.

Patients with multiple sclerosis (MS) often show positive symptoms of painful tonic seizure and dysesthesia as well as negative symptoms of paralysis and hypesthesia. Positive manifestation is paroxysmal and/or persistent. These are considered to be mediated by ectopic impulses generated at the site of demyelination, whereas negative symptoms are caused by conduction block. Conduction block at a demyelinated segment should reduce positive symptoms, but worsen negative ones. As reported previously, lidocaine, an Na channel blocker unmasks silent negative symptoms presumably by further reducing the action current in demyelinated portions and blocking conduction. Furthermore, because it blocks Na channels in a voltage- and frequency dependent manner, fibers that mediate positive symptoms are preferentially blocked. We administered lidocaine to 30 MS patients with positive symptoms. Lidocaine (mean plasma level, 2.4 pg/ml) almost completely abolished the paroxysmal manifestation of painful tonic seizures, neuralgic attacks, paroxysmal itching, and Lhermitte's sign. It also markedly alleviated persistent symptoms, but less so than paroxysmal symptoms. Similar effects were obtained with orally-administered mexiletine (300-400 mg/day), a derivative of lidocaine, but to a lesser extent. Na channel blockers have a dual effect on symptoms in MS, depending on whether symptoms are positive or negative. The mechanism that produces positive symptoms and the effects of the drugs on these symptoms are discussed.

Adult↗
PubMed1995

Sodium channel blockers reduce oxygen-glucose deprivation-induced cortical neuronal injury when combined with glutamate receptor antagonists.

Blockers of voltage-gated Na+ channels can protect central neuronal axons from hypoxic injury in vitro but have shown limited neuroprotective effects on neurons, where substantial injury is mediated by glutamate receptors. We explored the ability of several voltage-gated Na+ channel blockers to protect murine cultured cortical neurons from injury induced by oxygen-glucose deprivation. Whole-cell recordings from neurons revealed two types of Na+ currents activated by membrane depolarization: one rapidly inactivating and the other noninactivating. Both currents were blocked by tetrodotoxin (TTX) and 5,5-diphenylhydantoin (phenytoin). Fluorescent imaging using the Na(+)-selective dye SBFI confirmed that TTX attenuated the increase in intracellular free Na+ induced by oxygen-glucose deprivation. Addition of TTX (1 microM) but not phenytoin (10-100 microM) produced a small and variable reduction in neuronal death subsequent to oxygen-glucose deprivation for 40 to 50 min. Blockade of glutamate neurotoxicity by combined addition of MK-801, 7-chlorokynurenate and 6-cyano-7-nitroquinoxaline-2,3-dione markedly reduced injury such that prolonged deprivation times (75-100 min) were needed to induce widespread neuronal death. In this setting of glutamate receptor blockade, addition of TTX, phenytoin or one of several other Na+ channel blockers--lidocaine (100 microM), QX-314 (1 mM), quinidine (100 microM) or lorcainide (10 or 100 microM)--all further reduced neuronal death. Present results raise the possibility that Na+ channel blockers may be useful in protecting gray matter from hypoxic-ischemic injury, especially when combined with antiexcitotoxic approaches.

6-Cyano-7-nitroquinoxaline-2,3-dione↗
PubMed2006

Pharmacology of 2-[4-(4-chloro-2-fluorophenoxy)phenyl]-pyrimidine-4-carboxamide: a potent, broad-spectrum state-dependent sodium channel blocker for treating pain states.

Voltage-gated Na(+) channels may play important roles in establishing pathological neuronal hyperexcitability associated with chronic pain in humans. Na(+) channel blockers, such as carbamazepine (CBZ) and lamotrigine (LTG), are efficacious in treating neuropathic pain; however, their therapeutic utility is compromised by central nervous system side effects. We reasoned that it may be possible to gain superior control over pain states and, in particular, a better therapeutic index, by designing broad-spectrum Na(+) channel blockers with higher potency, faster onset kinetics, and greater levels of state dependence than existing drugs. 2-[4-(4-Chloro-2-fluorophenoxy)phenyl]-pyrimidine-4-carboxamide (PPPA) is a novel structural analog of the state-dependent Na(+) channel blocker V102862 [4-(4-fluorophenoxy)benzaldehyde semicarbazone]. Tested on recombinant rat Na(v)1.2 channels and native Na(+) currents in cultured rat dorsal root ganglion neurons, PPPA was approximately 1000 times more potent, had 2000-fold faster binding kinetics, and > or =10-fold higher levels of state dependence than CBZ and LTG. Tested in rat pain models against mechanical endpoints, PPPA had minimal effective doses of 1 to 3 mg/kg p.o. in partial sciatic nerve ligation, Freund's complete adjuvant, and postincisional pain. In all cases, efficacy was similar to clinically relevant comparators. Importantly, PPPA did not produce motor deficits in the accelerating Rotarod assay of ataxia at doses up to 30 mg/kg p.o., indicating a therapeutic index >10, which was superior to CBZ and LTG. Our experiments suggest that high-potency, broad-spectrum, state-dependent Na(+) channel blockers will have clinical utility for treating neuropathic, inflammatory, and postsurgical pain. Optimizing the biophysical parameters of broad-spectrum voltage-gated Na(+) channel blockers may lead to improved pain therapeutics.

Animals↗
PubMed1997

The effect of the sodium channel blocker QX-314 on recovery after acute spinal cord injury.

There is evidence that elevated intracellular sodium ([Na+]i) activity potentiates spinal cord injury (SCI) and the hypoxic/ischemic cell death. In this study, we examined the effect of QX-314, a potent Na+ channel blocker, on recovery after SCI in vivo. QX-314 (2.0 and 10 nmol) or vehicle was microinjected (2 microL) into the injury site 15 min after SCI. Injury was performed by compression of the spinal cord at C7-T1 for 1 min with a modified aneurysm clip exerting a closing force of 35 g. Neurological function was assessed 1 day after injury and weekly thereafter until 6 weeks by the inclined plane method and by the modified Tarlov technique. After 6 weeks of injury, the origin of descending axons at the injury site was determined by retrograde labeling with fluorogold (FG), and a computer-assisted morphometric assessment of the injury site was performed. There was a significant improvement in counts of retrogradely labeled neurons in the red nucleus and rostral ventrolateral medulla (RVLM) in rats treated with either 2 nM (1338 +/- 366 and 28.8 +/- 16) or 10 nM (1390 +/- 511 and 46.3 +/- 31) QX-314 as compared to vehicle (902 +/- 403 and 13.8 +/- 8). There was a trend to increased neuronal counts in the sensorimotor cortex (170.8 +/- 226.8) and vestibular nuclei (1096.2 +/- 970.2) with QX-314 (10 nM) as compared to the vehicle-treated group. There was no significant difference in the extent of neurological recovery between the control and treated groups. Our results suggest that the Na+ channel blocker QX-314 partially preserves the integrity of descending motor axons after SCI. However, in this study, the effects were insufficient to result in sustained improvements in behavioral neurological function.

Anesthetics, Local↗
PubMedDate not supplied

Stimulus-dependent effects in the actions of sodium channel blockers on sensory C-units.

Stimulus-dependent inhibition of discharges from cutaneous C fibers from mechanothermo-sensitive (MTS) units (nociceptive sensors) can explain the paradoxical analgesic effect of local anesthetics at low concentrations, insufficient to block axonal conduction of nerve impulses. Three types of experiments are proposed which could detect the stimulus-dependent inhibition of the terminal section of sensory C units: a method involving repeated series of stimuli, the increasing stimulus method, and the spike encounter method. The applications of these methods to assessing the magnitudes of the neuroleptic effects of local anesthetics and cardiac antiarrhythmics is discussed.

Anesthetics, Local↗
PubMed2000

Effect of a neuronal sodium channel blocker on magnetic resonance derived indices of brain water content during global cerebral ischemia.

Diffusion-weighted magnetic resonance imaging (DWI) with calculation of the apparent diffusion coefficient (ADC) of water is a widely used noninvasive method to measure movement of water from the extracellular to the intracellular compartment during cerebral ischemia. Lamotrigine, a neuronal Na(+) channel blocker, has been shown to attenuate the increase in extracellular concentrations of excitatory amino acids (EAA) during ischemia and to improve neurological and histological outcome. Because of its proven ability to reduce EAA levels during ischemia, lamotrigine should also minimize excitotoxic-induced increases in intracellular water content and therefore attenuate changes in the ADC. In this study, we sought to determine the effect of lamotrigine on intra- and extracellular water shifts during transient global cerebral ischemia. Fifteen New Zealand white rabbits were anesthetized and randomized to one of three groups: a control group, a lamotrigine-treated group, or a sham group. After being positioned in the bore of the magnet, a 12-min 50-s period of global cerebral ischemia was induced by inflating a neck tourniquet. During ischemia and early reperfusion there was a similar and significant decrease of the ADC in both the lamotrigine and control group. The ADC in the sham ischemia group remained at baseline throughout the experiment. Lamotrigine-mediated blockade of voltage-gated sodium channels did not prevent the intracellular movement of water during 12 min 50 s of global ischemia, as measured by the ADC, suggesting that the ADC decline may not be mediated by voltage-gated sodium influx and glutamate release.

Animals↗