E. Lazartigues et al., Pressor and bradycardic effects of tacrine and other acetylcholinesterase inhibitors in the rat, EUR J PHARM, 361(1), 1998, pp. 61-71
The cardiovascular effects of three different acetylcholinesterase inhibito
rs: physostigmine, tacrine and rivastigmine injected by intravenous (i.v.)
route were compared in freely moving Wistar rats. The three drugs significa
ntly increased both systolic and diastolic blood pressure and decreased hea
rt rate. Compared to physostigmine, a 20-fold higher dose of tacrine and a
40-fold higher dose of rivastigmine was necessary to induce a comparable pr
esser effect. Tacrine was chosen as a model to study the mechanisms underly
ing the cardiovascular effects of i.v. cholinesterase inhibitors. Atropine
totally abolished while methylatropine did not affect tacrine presser effec
ts. Conversely, both drugs abolished tacrine-induced bradycardia. The alpha
(1)-adrenoceptor antagonist prazosin or the vasopressin V-1 receptor antago
nist, [beta-mercapto-beta,beta-cyclopenta-methylenepropionyl(1), O-Me-Tyr(2
), Arg(8)] vasopressin partially but significantly reduced tacrine presser
effect and mostly abolished it when administered concomitantly. The tacrine
presser response was inhibited in a dose-dependent manner by the i.c.v. ad
ministration of the non-selective muscarinic receptor antagonist atropine (
ID50 = 1.45 mu g), the muscarinic M-1 receptor antagonist pirenzepine (ID50
= 4.33 mu g), the muscarinic M-2 receptor antagonist methoctramine (ID50 =
1.39 mu g) and the muscarinic M-3 receptor antagonist para-fluoro-hexahydr
o-sila-difenidol (ID50 = 31.19 mu g). Central injection of such muscarinic
receptor antagonists did not affect tacrine-induced bradycardia. Our result
s show that acetylcholinesterase inhibitors induce significant cardiovascul
ar effects with a presser response mediated mainly by the stimulation of ce
ntral muscarinic M-2 receptors inducing a secondary increase in sympathetic
outflow and vasopressin release. Conversely, aretylcholinesterase inhibito
r-induced bradycardia appears to be mediated by peripheral muscarinic mecha
nisms. (C) 1998 Elsevier Science B.V. All rights reserved.