Stimulus-dependent blockade of node of Ranvier sodium channels by ethmozine

The effect of antiarrhythmic drug ethmozine on sodium channels in Ranvier node was studied by the voltage clamp technique. Both outside and inside application of ethmozine induced a decrease of sodium current I Na, the time course of I Na and the sodium inactivation being unchanged. The ethmozine-induced Na channel blockade induced tonic (stationary) and phasic (transient stimulus-dependent) components. The tonic blockade of I Na developed slowly and could be accelerated by frequent electric stimulation of the membrane. The phase dependent blockade became more profound with an increase in the pulse rate or amplitude of depolarizing pulses. The prolonged (1 s) membrane depolarization did not bring about an additional blockade of I Na. It is concluded that the phasic blockade is due to the interaction of ethmozine with open Na channels. The noninactivating batrachotoxin-modified Na channels were insensitive to ethmozine. It is found that the increase in outside potassium concentration from 2.5 to 20mM induced both a decrease of the tonic blockade and an increase of the phasic one. The possible nature of the ionic blockade is discussed. The effect of ethmozine is compared with that of tertiary and quaternary local anesthetics.