Chlorpromazine is a synthetic alkyl amino derivative of phenothiazine, with a chemical structure very similar to that of promethazine. It has, however, less antihistaminic activity and is a more powerful central depressant. Antagonism to adrenaline has been described in animals (Courvoisier, Fournel, Ducrot, Kolsky, and Koetschet, 1953), and in man (Foster, O'Mullane, Gaskell, and Churchill-Davidson, 1954), but the nature of this action has not been fully elucidated.The present study is a quantitative assessment of the antagonism between chlorpromazine and adrenaline in the blood vessels of the hands of healthy human subjects. METHODS Twenty-two tests were performed on nine male medical students and colleagues aged from 21 to 50 years. Each subject lay at rest on a comfortable couch in the laboratory for at least half an hour before the start of the test. The blood flow in both hands was measured regularly at half minute intervals by venous occlusion plethysmography under standard conditions: the laboratory temperature was maintained at 22-24°C., and the metal plethysmographs were filled with water (Barcroft and Edholm, 1943) kept at 32-34°C. (Duff, 1952). Blood flow was calculated and expressed as ml./100 ml. hand volume/min.After anaesthetizing the overlying skin, a unilateral intra-arterial infusion of saline (0.9% w/v NaCl soln.) was given through a needle inserted into the brachial artery on one side just above its bifurcation at the elbow. Saline was delivered at the rate of 3 ml./min. by an electric infusion machine from one or other of two 50 ml. syringes, connected to the intra-arterial needle by a polythene tube and adaptor. Intravenous infusions were similarly given into a superficial vein of the opposite arm, using a second machine. Solutions of adrenaline (synthetic (-)-adrenaline tartrate, B.D.H.) and chlorpromazine (" Largactil," M. & B.) were prepared by serial dilution with saline. The potency of the adrenaline was maintained by adding 0.1 mg. ascorbic acid to each pint of saline used in the infusions (Gaddum, Peart, and Vogt, 1949).The effect of chlorpromazine on the peripheral constriction caused by adrenaline was studied in two series of experiments. In the first of these the effect of intra-arterial chlorpromazine on the vasoconstriction produced by intra-arterial and by intravenous adrenaline was measured; this study also enabled the direct action of chlorpromazine alone on the calibre of the vessels to be assessed. In the second series of experiments, the effect of intravenous chlorpromazine on the constriction produced by intra-arterial adrenaline was studied.
Action of Intra-arterial Chlorpromazine on the Effects of Intra-arterial and Intravenous AdrenalineThe course of a typical experiment is illustrated in Fig. 1. After a control period of approximately 10 min. during which saline alone was given, three 4-min. infusions of adrenaline were alternated with control saline infusions for at least 4 min. Two infusions of adrenaline in a concentration of 0.5 pg./min. were given intra-arteria...