Simultaneous microsomal monooxygenase enzyme system induction and inhibition, and the influence of the pharmacogenetic background: potential hazards in multi-drug therapy?
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Biomedical subjects
Publications and source records attributed to A Vas.
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The authors studied the effect of a 0.5 mg intravenous bolus injection of digoxin on human red blood cell glucose-6-phosphate activity under in vivo circumstances. Digoxin administration resulted in a small but statistically significant rise in the enzyme activity. This effect of digoxin seems to support the hypothesis that the circulating sodium transport inhibitor substance or natriuretic hormone found in a group of patients with essential hypertension may be an endogenous digitalis because the two substances act similarly in this respect.
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The polypeptide hormones insulin, glucagon, thyrotropin (TSH), pregnant mare serum gonadotropin (PMSG) and adrenocorticotropin (ACTH) stimulated the growth of the Tetrahymena, and the non-hormone polypeptides (bovine serum albumin (BSA), protamine) had a similar effect. Re-exposure after 24 h accounted for a greater growth stimulation than pre-exposure alone in cultures treated with TSH and PMSG, and re-exposure after 7 days had such effect in all polypeptide-treated cultures. It follows that the non-hormone polypeptides had a similar imprinting potential to the polypeptide hormone. The non-hormone polypeptides were also able to cross-imprint for one another, i.e. pre-exposure to one enhanced the binding capacity of the cells for the other on re-exposure, and vice versa. A single treatment with a polypeptide hormone or a non-hormone polypeptide did in itself stimulate the growth of the Tetrahymena for as long as 1 week.
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The distribution of acetylator phenotypes in a Hungarian population of 253 Caucasian was studied. The patients were divided into two age groups - the elderly over 60 years, and young below that age. The individuals below the age of 60 years contained an equal proportion of the two acetylator phenotypes. The same distribution was observed in the population as a whole. In the elderly subjects the slow acetylator phenotype was predominant. The finding supports the hypothesis that age has an influence on hepatic drug acetylation rate.
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Results of animal experiments indicate that indomethacin has a marked inhibitory effect on the activity of the hepatic microsomal mixed function monooxygenase (MFO) enzyme system. In order to verify this effect of indomethacin in humans, the authors studied antipyrine kinetics and D-glucaric acid excretion in 14 patients before and after 7 days treatment with two different doses of the drug. In contrast to the results obtained from animal experiments, there was no change in the activity of MFO in man. This can possibly be explained by species difference.
Based on previous studies with alpha-methyldopa (inhibitor of hepatic mixed-function monooxygenase system) and m-trifluoromethyl-alpha-ethylbenzhydrol, a new enzyme inducer Zixoryn, the authors studied the effect of the combined treatment of the two compounds on the hepatic drug-metabolizing enzyme activity in ten patients. There was no change in antipyrine half-life and its apparent volume of distribution (aVd) in the amount of D-glucaric acid excreted in the urine (indirect parameters of the mixed-function monooxygenase system's activity) after 1-week administration of 1000 mg alpha-methyldopa together with 300 mg Zixoryn per day. The two compounds counteracted each other's effects in the applied doses.
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Alphamethyldopa has been found to prolong the biological half-lives of Antipyrine and Tolbutamide and to decrease D-glucaric acid excretion in man. These observations suggest that the liver microsomal enzyme system metabolizing drug in man is inhibited by alphamethyldopa. No side effects were found during treatment with alphamethyldopa at the dose levels used in this study.