The effects of beta 1- and beta 2-adrenergic blockade and calcium channel blockade on postresuscitation electrolyte changes.
We have previously reported in dogs after ventricular fibrillation that (1) potassium and calcium levels decrease and magnesium and glucose increase, (2) all values return to control levels by 3 hours, and (3) propranolol blocks the changes in potassium, magnesium, and glucose but not calcium. The purpose of this study was to evaluate the beta 1- and beta 2-selectivity of changes in potassium, magnesium, and glucose and assess the response of the change in calcium to calcium channel blockade. Before initiating ventricular fibrillation, we pretreated dogs with an intravenous solution of either normal saline, metoprolol, ICI 118551 (two doses), or diltiazem. After a 2-minute episode of ventricular fibrillation, dogs were resuscitated. Baseline electrolyte measurements were obtained before ventricular fibrillation and sequentially for 3 hours after fibrillation. The saline-treated control group had a maximal decrease in the serum potassium level of 0.5 +/- 0.2 mEq/L. High-dose ICI 118551 reduced this decrease to 0.3 +/- 0.3 mEq/L (p = 0.055), but the other three groups showed no difference compared with the control group. Magnesium increased in the saline control group by 0.2 +/- 0.1 mEq/L. This increase was partially reduced by high-dose ICI 118551 to 0.1 +/- 0.1 (p = 0.055) but not by the other drugs. Glucose increased to 40 +/- 13 mg/dl in the saline control group. This increase was partially reduced by high-dose ICI 118551 to 23 +/- 6 mg/dl (p = 0.007) but not by the other drugs. Calcium showed a maximal decrease of 0.6 +/- 0.3 mg/dl in the control group. This decrease was not attenuated by any of the drugs.(ABSTRACT TRUNCATED AT 250 WORDS)
Salerno
D M
DM
Department of Medicine, Hennepin County Medical Center, University of Minnesota, Minneapolis, MN 55415.
Murakami
M M
MM
Johnston
R B
RB
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology*; D000818:Animals; D001786:Blood Glucose / Q000378:metabolism; D002118:Calcium / Q000097:blood; D002121:Calcium Channel Blockers / Q000494:pharmacology*; D004110:Diltiazem / Q000494:pharmacology; D004285:Dogs; D006439:Hemodynamics / Q000502:physiology; D008274:Magnesium / Q000097:blood; D008790:Metoprolol / Q000494:pharmacology; D011188:Potassium / Q000097:blood; D011292:Premedication; D011412:Propanolamines / Q000494:pharmacology; D012151:Resuscitation; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000097:blood* / Q000628:therapy; D014883:Water-Electrolyte Imbalance / Q000209:etiology*
D000319:Adrenergic beta-Antagonists; D001786:Blood Glucose; D002121:Calcium Channel Blockers; D011412:Propanolamines; C026777:ICI 118551; D004110:Diltiazem; D008790:Metoprolol; D008274:Magnesium; D011188:Potassium; D002118:Calcium