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Histamine antagonists and d‐tubocurarine‐induced hypotension in cardiac surgical patients
Author(s) -
Inada Eiichi,
Philbin Daniel M,
Machaj Vincent,
Moss Jonathan,
D'Ambra Michael N,
Rosow Carl E,
Akins Cary W
Publication year - 1986
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.1986.226
Subject(s) - d tubocurarine , histamine , medicine , anesthesia , pharmacology
Hemodynamic effects and histamine release by bolus injection of 0.35 mg/kg of d‐tubocurarine were studied in 24 patients. H 1 ‐ and H 2 ‐histamine antagonists or placebo were given before dosing with d‐tubocurarine in a randomized double‐blind fashion to four groups: group 1—placebo; group 2— cimetidine, 4 mg/kg, plus placebo; group 3—chlorpheniramine, 0.1 mg/kg, plus placebo; and group 4— cimetidine plus chlorpheniramine. Histamine release occurred in most patients, the highest level 2 minutes after d‐tubocurarine dosing. Group 1 had a moderate negative correlation between plasma histamine change and systemic vascular resistance (r = 0.58; P < 0.05) not present in group 4. Prior dosing with antagonists partially prevented the fall in systemic vascular resistance. These data demonstrate that the hemodynamic changes associated with d‐tubocurarine dosing are only partially explained by histamine release. Thus prior dosing with H 1 ‐ and H 2 ‐antagonists provides only partial protection. Clinical Pharmacology and Therapeutics (1986) 40, 575–580; doi: 10.1038/clpt.1986.226