[Cardiac adverse effects following an intravenous injection of pirenzepine are an expression of deficient receptor sensitivity].
Under the aspect of life-threatening pneumonias in long-term ventilated patients receiving ant-acids or H2-antagonists the prophylaxis of stress ulcer with pirenzepine gains new importance. This study was aimed at detecting cardiac side effects of pirenzepine due to low receptor specificity. Pirenzepine (10 mg) was given via the peripheral or central venous route at an injection velocity of 5 or 30 seconds as well as a control of 2 ml normal saline solution via the central venous route for 5 seconds, 20 times each. Heart rate and blood pressure were determined before and after the injection. Independent of the injection site or velocity, an increase in the heart rate was found after the injection of pirenzepine. The increase was more marked if the central venous route was used. The percentage rise in heart rate was up to the thirteenth minute highly significant when comparing pirenzepine to normal saline solution. There were no changes in blood pressure. If M1-cholinoceptors are blocked, a reduction of the heart rate is seen. Blocking M2-cholinoceptors causes a rise in the heart rate. Injecting 10 mg of the M1-antagonist pirenzepine results in a significant increase in the heart rate, independent of site or velocity of injection which can be explained by blocking M2-cholinoceptors at the same time. To prevent this probably dose-dependent effect, pirenzepine should be given slowly over a couple of minutes.
Probst
S
S
Zentrum der Anästhesiologie und Wiederbelebung, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt.
Lischke
V
V
Wiederspahn
T
T
Klein
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000209:etiology / Q000517:prevention & control; D010890:Pirenzepine / Q000008:administration & dosage / Q000009:adverse effects*; D011950:Receptors, Cholinergic / Q000502:physiology*; D013268:Stimulation, Chemical; D013312:Stress, Physiological / Q000150:complications
D011950:Receptors, Cholinergic; D010890:Pirenzepine
Kardiale Nebenwirkungen nach intravenöser Injektion von Pirenzepin sind Ausdruck mangelnder Rezeptorspezifität.