Amitriptyline eliminates calculi through urinary tract smooth muscle relaxation

被引:16
作者
Achar, E
Achar, RAN
Paiva, TB
Campos, AH
Schor, N
机构
[1] Univ Fed Sao Paulo, Escola Paulista Med, Dept Med, Div Nephrol, BR-04023062 Sao Paulo, Brazil
[2] Sao Teodoro Vet Hosp, Sao Paulo, Brazil
[3] Univ Fed Sao Paulo, Escola Paulista Med, Dept Biophys, BR-04023062 Sao Paulo, Brazil
关键词
amitriptyline; urinary tract smooth muscle; voltage-dependent potassium channel; relaxation; obstructive acute renal failure; urolithiasis;
D O I
10.1046/j.1523-1755.2003.00222.x
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background. We investigated the effects of amitriptyline in the urinary tract smooth muscle and urolithiasis. Methods. Cats presenting with obstructive acute renal failure (ARF) received amitriptyline, and renal function and survival rates were analyzed. Isometric contractions and membrane potentials of rat, pig, or human isolated urinary tract smooth muscle were recorded in the presence or absence of amitriptyline. Results. Twenty cats with obstructive ARF caused by urethral plugs received amitriptyline. In all cases, plugs were completely eliminated, and renal function returned to normal, with a 100% survival rate in the follow-up. Amitriptyline produced potent relaxations in rat urethral strips, accompanied by significant reductions in urethral ring membrane potential. This effect was prevented by pretreatment of urethral rings with 4-aminopyridine (4-AP), a voltage-dependent potassium channel blocker. Amitriptyline abolished in a reversible manner acetylcholine-, bradykinin-, and KCl-induced contractions in rat isolated bladder, and this effect was also prevented by 4-AP. Of interest, spontaneous and KCl-induced contractions of pig and human isolated ureter were also blocked by amitriptyline. Conclusion. Our results indicate that amitriptyline is an effective and potent relaxant of urinary tract smooth muscle and this effect is mediated by opening of voltage dependent-potassium channels. We suggest that amitriptyline administration may help to promote elimination of urinary calculi.
引用
收藏
页码:1356 / 1364
页数:9
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