Summary
Several experimental and clinical studies have suggested that histamine is released following the administration of neuromuscular blocking agents, and that the histamine release is an important aspect in the hemodynamic response to the drug. We have measured plasma histamine following the administration of a series of neuromuscular blocking agents in man. Our data suggests that members of this class of drugs can cause a dose dependent release histamine release in man and that this release is hemodynamically significant. We have also evaluated the roles of rate of administration, of pretreatment with H1 and H2 antagonists and alterations in drug design as clinical strategies in attenuating the adverse reactions.
The data obtained in humans can be shown to validate the cat model as a means of screening novel neuromuscular blocking agents.
Zusammenfassung
Mehrere experimentelle und klinische Studien haben angedeutet, daß Histamin bei Gabe von neuromuskulär blockierenden Agentien freigesetzt wird und diese Histaminfreisetzung ein wichtiger Aspekt in der hämodynamischen Reaktion auf dieses Arzneimittel ist. Wir haben Plasmahistaminbestimmungen nach Gabe von einer Reihe neuromuskulär blockierender Agentien beim Menschen durchgeführt. Unsere Daten weisen darauf hin, daß einige Mittel dieser Arzneimittelklasse eine dosisabhängige Histaminfreisetzung bei Menschen bewirken und diese Freisetzung von hämodynamischer Bedeutung ist. Wir haben ebenfalls die Rolle der Art der Verabreichung, der Vorbehandlung mit H1- und H2-Rezeptorantagonisten und die Veränderungen im Arzneimitteldesign als klinische Strategien zur Verminderung der Nebenwirkungen geprüft.
Die erhaltenen Daten beim Menschen können zur Validierung des Modells bei Katzen als eine Art Screeningmodell von neuromuskulär blockierenden Agentien angesehen werden.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Antonio RP, Philbin DM, Savarese JJ (1979) Comparative hemodynamic effects of d-tubocurarine and metocurine in the dog. Br J Anesthesiol 51:1007–1010
Basta SJ, Moss J, Savarese JJ, Ali HH, Sunder N, Gionfriddo BA, Lineberry CG (1981) Cardiovascular effects of BWA444U: Correlation with plasma histamine levels. Anesthesiology 50:A 198
Beaven MA (1978) Histamine: its role in physiological and pathological processes. Monographs in allergy, vol 13. Karger, Basel
Comroe JH, Dripps RD (1946) The histamine-like action of curare and tubocurarine injected intracutaneously and intraarterially in man. Anesthesiology 7:260–262
Ellis HV, Johnson AR, Moran NC (1970) Selective release of histamine from rat mast cells by several drugs. J Pharm Exp Therap 175:627–631
Fahey MR, Morris RB, Miller RD, Sohn YJ, Cronnelly R, Gencarelli P (1981) Clinical pharmacology of ORG NC45 (Norcuron™): A new nondepolarizing relaxant. Anesthesiology 55:6–11
Ginsberg R, Bristow MR, Stinson EB, Harrison DC (1980) Histamine receptors in human heart. Life Sci 26:2245–2249
Hughes R, Chapple DJ (1981) The pharmacology of atracurium, a new competitive neuromuscular blocking agent. Br J Anaesthesiol 53:31–44
Lim H, Churchill-Davison HC (1981) Adverse effects of neuromuscular blocking drugs. In: Thornton JA (ed) Adverse reactions of anesthetic drugs. Elsevier, Amsterdam
Lee-Son S, Waud BE, Waud DR (1981) A comparison of the neuromuscular blocking and vagolytic effects of ORG NC45 and pancuronium. Anesthesiology 55:12–18
Lorenz W, Doenicke A (1978) Anaphylactoid reactions and histamine release by intravenous drugs used in surgery and anesthesia. In: Watkins J, Ward A (eds) Adverse response to intravenous drugs. Academic Press, London, pp 83–112
Lorenz W, Doenicke A (1978) Histamine release in clinical conditions. Mt Sinai J Med MY 45:357–386
Lorenz W, Doenicke A, Schoning B, Mamorski J, Weber D, Hinterlang E, Schwarz B, Neugebauer E (1980) Histamine Release: H1 and H2-receptor antagonists for premedication in anaesthesia and surgery: A critical view based on randomized clinical trials with haemaccel and various antiallergic drugs. Agents Actions 10:114–124
Moss J, Rosow CE, Savarese JJ, Philbin DM, Kniffen K (1981) Role of histamine in the hypotensive action of d-tubocurarine in humans. Anesthesiology 55:19–25
Payne J, Hughes R (1981) The evaluation of atracurium in anesthetized man. Br J Anaesthesiol 53:45–54
Philbin DM, Moss J, Rosow CE, Akins C, Kono K, Savarese JJ, Schneider RC, VerLee T, Emerson C (1980) The use of H1 and H2 histamine blockers with morphine: A double blind study. Anesthesiology 53:S67
Philbin DM, Moss J, Akins CW, Rosow CE, Kono K, Schneider RC, VerLee TR, Savarese JJ (1981) The use of H1 and H2 histamine blockers with high dose morphine anesthesia: A double blind study. Anesthesiology 55:292–296
Rosow CW, Basta SJ, Savarese JJ, Ali HH, Kniffen KJ, Moss J (1980) BW785U: Correlation of cardiovascular effects with increases in plasma histamine. Anesthesiology 53:S270
Savarese JJ (1979) The autonomic margins of safety of metucurine and d-tubocurarine in the cat. Anesthesiology 50:40–46
Savarese JJ, Wastila WB (1971) BWA444U: An intermediateduration nondepolarizing neuromuscular blocking agent with significant lack of cardiovascular and autonomic effect. Anesthesiology 52:S279
Shaff RE, Beaven MA (1979) Increased sensitivity of the enzymatic isotopic assay of histamine: Measurement of histamine in plasma and serum. Anal Biochem 94:425–530
Taylor P (1980) Neuromuscular blocking agents. In: Gilman AG, Goodman LS, Gilman AG (eds) The pharmacological basis of therapeutics. Macmillan, New York, pp 228–229
Zavecz JH, Levi R (1977) Separation of primary and secondary cardiovascular events in systemic anaphylaxis. Circ Res 40:15–19
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Moss, J., Philbin, D.M., Rosow, C.E. et al. Histamine release by neuromuscular blocking agents in man. Klin Wochenschr 60, 891–895 (1982). https://doi.org/10.1007/BF01716945
Issue Date:
DOI: https://doi.org/10.1007/BF01716945