Abstract
Newborn swine have an increased sensitivity to verapamil induced cardiac depression. This connelates with the profound hypotension induced by verapamil in some infants, Glucagon has positive inotropic and chronotropic actions and affects cellular calcium channels. Therefore, glucagon's ability to reverse verapamil-induced hypotension in newborn swine was investigated.
Fourteen piglets (<24 hrs old, mean wt 1.5 kg) had aortic catheters placed one day prior to study. Mean Aortic Pressure (MAP) was measured continuously during the study. Ionized calcium levels were drawn on all animals and then a bolus infusion of 300 ug/kg of verapamil was administered. Five control animals received no further therapy. Nine animals were given 1 mg glucagon boluses one minute following verapamil.
Ionized calcium was 4.9 mg% or greater prior to the study (n1 = 4.1-5.1) in all animals. Verapamil induced hypotension in both groups. The average MAP fell from 66 to 56 mm Hg (17%) in the treatment group and from 70 to 61 (13%) the control. Heart rate (HR) also slowed both in the treatment group from a mean of 220 to 200 and in the controls from 200 to 180. Glucagon failed to reverse the hypotension in the nine treated animals (MAP 54 Treated, 63 Control). HR did not return to baseline (HR 190 Treated, 180 Control). Neither difference was statistically significant by analysis of convariance.
Glucagon's cardiac effects peak at five minutes and the 1 mg dose fully saturates its receptors. Thus glucagon apparently lacks antagonism in the newborn swine for verapamil induced hypotension.
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McKinley, D., Zaritsky, A. GLUCAGON TRIAL FOR PIGLET VERAPAMIL TOXICITY. Pediatr Res 21 (Suppl 4), 239 (1987). https://doi.org/10.1203/00006450-198704010-00429
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DOI: https://doi.org/10.1203/00006450-198704010-00429