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Biomedical subjects

M Danhof

Publications and source records attributed to M Danhof.

At least 181 records · Page 10Linked to original sources

Pharmacokinetic modeling of the anticonvulsant action of phenobarbital in rats.

The aim of this study was to develop a model for the relationship between concentration and anticonvulsant effect of phenobarbital in the rat. The method of quantitating the anticonvulsant response on the basis of plasma pentylenetetrazol threshold concentrations, was optimized by application of a longitudinal study design. The pharmacokinetics of phenobarbital were studied in a separate set of rats (elimination half-life 11 +/- 2 hr). The anticonvulsant effect was measured 1 hr after i.v. administration. Concentration-effect relationships were assessed for serum (total and free), cerebrospinal fluid and brain concentrations on the basis of the sigmoid maximum effect model. The EC50 for total serum was 76 +/- 9 mg/l and for free serum, cerebrospinal fluid and brain 44 +/- 5, 43 +/- 7 and 50 +/- 8 mg/l and mg/kg, respectively (means +/- S.E.). The maximum effect was about 120 mg/l of pentylenetrazol. The respective EC50 ratios corresponded closely with the concentration ratios between the different compartments as determined by orthogonal regression analysis. For the greater part of the concentration range the concentration-effect relationship also could be fitted accurately to a simple linear model. Such relationships were not perturbed by the occurrence of seizures as these did not alter the distribution profile of phenobarbital. The pharmacokinetics and pharmacodynamics of p-hydroxyphenobarbital, the main metabolite of phenobarbital, also were investigated. This compound is eliminated very rapidly and has neither anticonvulsant activity of its own nor influences the anticonvulsant effect of phenobarbital at serum concentrations up to 30 mg/l. The described experimental strategies allow the study of factors influencing the concentration-anticonvulsant effect relationship of phenobarbital.

Animals↗

Transport of vasopressin fragments across the blood-brain barrier: in vitro studies using monolayer cultures of bovine brain endothelial cells.

A well established in vitro blood-brain barrier (BBB) model, consisting of bovine cerebrovascular endothelial monolayers from primary cultures, was used to study the transport profile of vasopressin and its fragments across the BBB and to assess the metabolic properties of the BBB for the behaviorally active vasopressin fragment arginine vasopressin (AVP)1-8 (desglycinamide-AVP). All vasopressin fragments crossed the in vitro BBB to a measurable extent. Endothelial permeabilities were (in 10(-3) cm/min): AVP1-6, 3.0 +/- 0.2; AVP1-7, 4.6 +/- 0.4; AVP1-8, 2.0 +/- 0.5 and AVP1-9, 2.4 +/- 0.4. A significant effect of molecular size on endothelial permeability was seen. Transport rate of AVP1-8, expressed as BBB-clearance, was not affected by luminal concentration change and proved to be symmetrical. These findings suggest that, in the concentration range studied, vasopressin-like peptides can cross the BBB mainly by paracellular transport and that no relevant carrier mediation is involved. AVP1-8 was metabolized slowly (half-life, 6.5 hr) by a 60 cm2 confluent monolayer to AVP1-7, which was not broken down further, suggesting that carboxypeptidases are responsible for AVP1-8 metabolism in the BBB.

Animals↗

Pharmacokinetic modeling of the anticonvulsant response of oxazepam in rats using the pentylenetetrazol threshold concentration as pharmacodynamic measure.

This investigation developed strategies along which the anticonvulsant effect of oxazepam in the rat could be pharmacokinetically modeled. After determination of the pharmacokinetics of oxazepam, which could be described with a two-compartment model (half-lives of distribution and elimination 6 and 52 min, respectively), the drug was administered iv to groups of animals to achieve a serum concentration range of 0.1-2.5 mg/L at 10, 45, and 120 min after administration. At these time points pentylenetetrazol (PTZ) was infused slowly until the first myoclonic jerk occurred. The anticonvulsant response, expressed as the elevation of the serum or brain threshold concentration of PTZ, was modeled versus the serum (both total and free) and brain oxazepam concentration, according to the sigmoid Emax model. The total serum and brain oxazepam EC50 values are about 0.5 mg/L and 1.1 mg/kg, respectively, and Emax 120 mg/L PTZ. No marked differences in pharmacodynamic parameters between the three time groups were found, which indicates that serum and brain are pharmacokinetically indistinguishable from the effect compartment, that there is no (inter)activity of oxazepam metabolites and absence of development of acute tolerance during the investigated time frame. An interfering role of metabolites was also excluded by a direct radioreceptor assay of oxazepam, yielding very similar results as the specific chromatographic assay. It is concluded that the conception-anticonvulsant effect relationship of oxazepam can satisfactorily be described by the sigmoid Emax model, when utilizing the employed experimental strategies.

Animals↗

Application of serial sampling of cerebrospinal fluid in pharmacodynamic studies with a drug active in the CNS: heptabarbital concentrations at onset and offset of loss of righting reflex in rats.

As cerebrospinal fluid (CSF) possesses unique characteristics in order to explore concentration-pharmacological response relationships of drugs active in the CNS, the practicability of serial sampling of CSF was tested in a study with heptabarbital. Concentrations in CSF and plasma were measured simultaneously in individual rats during and after an intravenous infusion for 30 min. At the end of the infusion, the distribution equilibrium was attained with a CSF/plasma concentration ratio of 0.38, roughly equal to the fraction unbound to protein. When concentrations in blood and CSF were determined at the onset and offset of loss of righting reflex concentrations in blood were significantly greater at onset (146 +/- 19 mg/l) than at offset (108 +/- 16 mg/l, n = 6), whereas concentrations in CSF were identical (39 +/- 5 and 38 +/- 5 mg/l, respectively). This confirmed the earlier observation that the CSF is pharmacokinetically indistinguishable from the site of action. When the duration of the loss of righting reflex was varied, concentrations of heptabarbital in CSF at onset and offset were similar, independent of the duration of the loss of righting reflex (1-5 hr). These findings demonstrate the absence of the development of acute tolerance and confirmed that no (inter)active metabolites interfered with the pharmacological response. In a total number of 26 rats the concentrations in CSF at onset and offset of loss of the righting reflex were compared. The interindividual variation was 13-15% and the intra-individual variation was only 4-6%. The results demonstrate the usefulness of serial sampling of CSF in pharmacodynamic studies with centrally acting drugs.

Animals↗

Pharmacokinetic-pharmacodynamic modeling of midazolam effects on the human central nervous system.

The effect of midazolam on alpha-activity of the EEG and latency of the P-100 of the visual evoked response (VER) was studied in six healthy subjects. Drug concentration was related to effect with the Emax model that was used with either a threshold drug concentration or a sigmoid exponent. An effect compartment was included in the pharmacokinetic-pharmacodynamic model. Four subjects showed hysteresis, and mean values of half-lives-k(eo) ranged from 0.26 to 0.60 hour. Mean values of EC50 ranged from 42.0 to 48.1 ng/ml. Goodness of fit did not differ significantly between the sigmoid Emax model and the threshold Emax model. The sigmoid exponent estimated was 3.7 +/- 1.8 (EEG, mean +/- SD) and 2.9 +/- 1.4 (VER); the threshold concentration was estimated at 15.7 +/- 11.1 ng/ml (EEG) and 11.3 +/- 7.0 ng/ml (VER). We conclude that the Emax model adequately describes the relationship between midazolam concentration and effect and that the sigmoid exponent can be substituted by a threshold drug concentration, with a comparable fit of the model to the data.

Central Nervous System↗

Pharmacokinetics and hemodynamic effects of nisoldipine and its interaction with cimetidine.

Pharmacokinetics, diastolic blood pressure, and heart rate after oral and intravenous nisoldipine were studied in eight healthy subjects without and with cotreatment of cimetidine in a four-way crossover design. After intravenous infusion, elimination half-life (t1/2) was 4.0 +/- 2.3 hours, systemic clearance (CL) was 0.83 +/- 0.17 L/min, and volume of distribution was 1.6 +/- 0.6 L/kg. After oral nisoldipine, t1/2 was 3.8 +/- 1.3 hours and systemic availability was 3.9% +/- 3.5%. During cimetidine, t1/2 and CL were not different. Systemic availability increased to 5.7% +/- 2.8%. After all nisoldipine treatments a significant decrease in supine diastolic blood pressure (mean 10% to 16%) and increase in heart rate (mean 22% to 44%) were observed. Hemodynamic effects until 2 hours after nisoldipine administration could be fitted to a sigmoidal Emax model. At times after 2 hours a second effect peak was observed. Cimetidine inhibits the metabolism of nisoldipine but has no significant influence on hemodynamic parameters.

Administration, Oral↗

Relationship between the metabolism of antipyrine, hexobarbitone and theophylline in man as assessed by a 'cocktail' approach.

1. Three model substrates for the characterization of drug oxidation activity, antipyrine (AP), hexobarbitone (HB) and theophylline (TH), were administered to 26 healthy volunteers on two different occasions: in the first experiment a combination of AP (250 mg) and HB (250 mg) was given and in the second experiment TH (150 mg) was added to the former combination. 2. Plasma concentrations of AP, HB and TH and urinary excretion of TH and the three main metabolites of AP (3-hydroxymethylantipyrine: HMA, norantipyrine: NORA and 4-hydroxyantipyrine: OHA) were determined and the intrinsic clearance (CLint) of the three substrates and the clearance to the formation of AP metabolites were calculated. 3. The correlation coefficients between CLHB and CL-greater than metabolites of AP were highest for CL-greater than HMA and CL-greater than NORA (greater than 0.80) and lowest for CL-greater than OHA (0.63). High correlation coefficients also were found between CLTH and CL-greater than OHA (0.89) and CL-greater than HMA (0.80). 4. Ideal relationships, defined by a slope of the orthogonal regression line equal to unity, did exist between CLHB and CL-greater than HMA as well as CL-greater than NORA and between CLTH and CLAP as well as CL-greater than OHA. 5. Based on the results of correlation and regression analysis it can be concluded that isozymes of the cytochrome P-450 system responsible for the oxidation of HB and formation of HMA and NORA are very closely related and also that isozymes responsible for the oxidation of TH and formation of OHA show a very close relation. 6. With this strategy of simultaneous administration of substrates ('cocktail' approach) it seems possible to characterize and correlate activities of different P-450 isozymes and to investigate their in vivo substrate selectivity without the disturbing influence of intra-individual variation in drug oxidation.

Adult↗

The influence of infusion rate on the pharmacokinetics and haemodynamic effects of nisoldipine in man.

1. The pharmacokinetics and haemodynamic effects of nisoldipine on long term i.v. infusion of 2.40 mg and 9.59 mg in 25 h were studied in six healthy subjects. Liver blood flow at 0.8 and 24 h was assessed by measuring indocyanine green (ICG) clearance. 2. After high-dose nisoldipine, systemic clearance was 0.99 +/- 0.16 1 min-1, volume of distribution was 5.8 +/- 1.5 1 kg-1 and elimination half-life was 10.7 +/- 2.4 h. The pharmacokinetic parameters were similar after low-dose nisoldipine. 3. No significant changes in apparent liver blood flow were observed after either high-dose or low-dose nisoldipine. 4. Systolic blood pressure did not change, whereas diastolic blood pressure decreased by approximately 10% during both treatments. Maximal increase in heart rate was approximately 37% at high-dose infusion, whereas this was one half lower during the low-dose regimen. 5. Increased infusion rate results in an unfavourable shift in the haemodynamic effect profile of nisoldipine.

Adsorption↗

Strategy to assess the role of (inter)active metabolites in pharmacodynamic studies in-vivo: a model study with heptabarbital.

The purpose of this investigation was to develop a universal experimental strategy by which the role of (inter)active metabolites in in-vivo pharmacodynamic studies can be examined. Heptabarbital was chosen as a model drug and several pharmacokinetic variables which may affect in-vivo concentration-pharmacological response relationships were examined. Adult female rats received an i.v. infusion of the drug at one of three different rates (0.225-1.50 mg min-1) until the animals lost their righting reflex (after 11 +/- 1 to 88 +/- 8 min of infusion). The serum concentration of the drug at onset of loss of righting reflex (LRR) increased slightly with increasing infusion rate. The drug concentrations in brain tissue and cerebrospinal fluid (CSF), (mean +/- s.d.: 67 +/- 5 mg kg-1 and 24 +/- 4 mg L-1, respectively, for the lowest infusion rate) were not affected by the infusion rate. The possible contribution of (inter)active metabolites to the pharmacological response of heptabarbital was determined by administration of different i.v. bolus doses (14.1-22.5 mg) resulting in widely differing sleeping-times (7 +/- 3 to 119 +/- 20 min). The concentrations of heptabarbital in serum, brain tissue and CSF at offset of LRR (mean +/- s.d.: 77 +/- 8 mg L-1, 76 +/- 7 mg kg-1 and 29 +/- 5 mg L-1, respectively, for the highest dose) were not affected by the administered dose.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Altered pharmacokinetic-pharmacodynamic relationship of heptabarbital in experimental renal failure in rats.

The purpose of this investigation was to determine whether renal dysfunction is associated with an alteration in the concentration-anesthetic effect relationship of heptabarbital (HB). Adult female rats were pretreated with uranyl nitrate (5 mg/kg i.v.) to produce renal dysfunction. Saline-injected rats served as controls. The concentration-effect relationship of HB was determined both at onset of loss of righting reflex (LRR) during an i.v. infusion (0.563 mg/min) and at offset of LRR after administration of a bolus dose (82 and 111 mg/kg in renal failure and controls, respectively, inducing similar durations of effect). In renal failure HB concentrations in serum (total and free) and in brain and cerebrospinal fluid (CSF) both at onset and offset of LRR were reduced significantly. When HB was infused at different rates (0.225, 0.563 and 1.50 mg/min) rats with renal impairment had slightly increasing HB concentrations at onset of LRR with increasing infusion rate, not only in serum and brain but also in CSF. When HB was administered in different bolus doses (71, 77, 80 and 96 mg/kg i.v.) the duration of effect increased linearly with the logarithm of the dose, but HB concentrations in serum (both total and free), brain and CSF at offset of LRR were similar, indicating the absence of (inter)active metabolites. The results indicate that renal dysfunction is associated with an increased sensitivity of the brain to HB, which is unrelated to changes in the disposition of HB.

Acute Kidney Injury↗

Characterization of an "in vitro" blood-brain barrier: effects of molecular size and lipophilicity on cerebrovascular endothelial transport rates of drugs.

The in vitro blood-brain barrier model described consisted of confluent monolayers of bovine cerebrovascular cells in primary cultures. Aim of the study was to investigate whether this type of model exhibits transport characteristics comparable to the in vivo blood-brain barrier and whether the cells in the cultured monolayers were able to form tight junctions, the most typical feature of the in vivo blood-brain barrier. Endothelial permeability of fluorescein-conjugated dextrans with increasing molecular size was correlated to monolayer pore shape, size and abundance by means of a mathematical model. Results showed that the in vitro pores had a longitudinal appearance with an effective pore size of 81 A and fractional pore area of 0.04%. These data indicate that the properties of the in vitro pores and in vivo tight junctions are comparable. The monolayer model was applied successfully to establish a relationship between endothelial permeability and drug lipophilicity, using several beta blocking agents and nonsteroidal anti-inflammatory drugs as model drugs. Results showed a sigmoidal relationship between these parameters, indicating the existence of a threshold lipophilicity for passive transendothelial transport.

Animals↗

Negligible sublingual absorption of nifedipine.

The sublingual absorption of nifedipine was investigated in 11 healthy volunteers. After the subjects bit a capsule containing 10 mg nifedipine in solution and did not swallow for 20 min (at which time the mouth was washed out), absorption was slow and led to low plasma levels (median 10 ng/ml). After the same subjects bit and swallowed a capsule, absorption was faster and higher plasma levels were achieved 982 ng/ml). Biting a capsule and swallowing its contents is recommended in cardiovascular emergencies.

Absorption↗

Rate of increase in the plasma concentration of nifedipine as a major determinant of its hemodynamic effects in humans.

The relevance of the rate of increase in the plasma concentration of nifedipine for the drug's hemodynamic effect was investigated in healthy volunteers. Nifedipine was given intravenously according to two regimens, each designed to produce the same steady-state concentration, but attained gradually (within 5 to 7 hours) with one regimen and rapidly (within 3 minutes) with the other. The mean steady-state concentrations obtained were 31.7 +/- 5.2 (SD) ng/ml and 29.4 +/- 9.8 ng/ml, respectively (not significant). With the gradual regimen, heart rate was unchanged and diastolic blood pressure was lowered gradually by approximately 10 mm Hg. With the rapid regimen, heart rate increased immediately and remained elevated for the duration of the infusion, whereas diastolic blood pressure did not change significantly. At the end of the gradual-rise regimen, the infusion rate was increased tenfold for 10 minutes, promptly resulting in tachycardia and a paradoxical rise in diastolic blood pressure. These divergent hemodynamic responses of the gradual- and rapid-rise regimens could well be related to differences in baroreceptor activation. It is concluded that the hemodynamic response to nifedipine is influenced by the rate of increase of its concentration in plasma.

Adult↗

The disposition of antipyrine and its metabolites in young and elderly healthy volunteers.

1 Oxidative metabolism of antipyrine (AP) was compared in 11 elderly (greater than 65 years) and 12 young (less than 40 years) volunteers. All subjects were non-smokers, consumed little if any alcohol and were in good health. 2 After a single dose of AP 500 mg, its clearance from saliva and profiles of the parent drug and its major metabolites in urine were determined using high-performance liquid chromatography. 3 Mean total AP clearance from saliva was lower in the elderly (P less than 0.05). Mean weight-normalised volume of distribution was also smaller (P less than 0.01) so that elimination half-life in the elderly was not significantly different from that in the young. 4 The percentage dose excreted in 48 h urine as norantipyrine (NORA) and its clearance for production were lower in the elderly (P less than 0.001 and P less than 0.01 respectively). Urinary 3-hydroxymethylantipyrine (HMA) and free antipyrine were present in greater quantities in 48 h urine in the elderly (P less than 0.001 and P less than 0.05) while the amounts of 4-hydroxyantipyrine (OHA) were almost identical in the two age groups. 5 The findings suggest that there is a selective impairment of N-demethylation in the elderly which may have important implications for dosage of elderly patients with drugs metabolised by this route.

Adult↗

Nifedipine: kinetics and hemodynamic effects in patients with liver cirrhosis after intravenous and oral administration.

The pharmacokinetics and hemodynamic effects of nifedipine were studied in patients with liver cirrhosis and in age-matched healthy control subjects. In a randomized order each subject received nifedipine by intravenous infusion (4.5 mg in 45 minutes) and as a tablet (20 mg). After intravenous nifedipine patients had a longer elimination t1/2 (420 +/- 254 vs. 111 +/- 22 minutes; P less than 0.01), a greater volume of distribution (1.29 +/- 0.60 vs. 0.97 +/- 0.42 L/kg), and a lower systemic clearance (233 +/- 109 vs. 588 +/- 140 ml/min; P less than 0.001). Plasma protein binding of nifedipine was lower in the patients (P less than 0.001). After oral nifedipine systemic availability was much higher in patients (90.5% +/- 26.2% vs. 51.1% +/- 17.1%; P less than 0.01) and maximal in patients with a portacaval shunt. Blood pressure decreased and heart rate increased after intravenous nifedipine and these effects could be fitted to plasma concentrations by a sigmoidal model. Maximal effects on heart rate and diastolic blood pressure were not different in liver cirrhosis. When free drug levels were considered, the concentrations corresponding to half the maximal effect were also not different. Blood pressure changes with oral nifedipine were comparable with those after intravenous infusion. We conclude that in patients with liver cirrhosis the pharmacokinetics of nifedipine are considerably altered; dose reduction is recommended when such patients need oral nifedipine.

Absorption↗

Progesterone in saliva: pitfalls and consequent implications for accuracy of the determination.

The concentration of steroid hormones in saliva is believed to reflect the concentration of free hormone in blood. Because the assay for progesterone in saliva has not been rigorously validated, we investigated some of the analytical variables involved. Saliva samples were divided into two portions. One was centrifuged and the supernate used for extraction; the other was homogenized by sonication and used as such for extraction. Progesterone concentrations in homogenized whole saliva were double or triple those in supernates. By equilibrium dialysis we established that 85% of progesterone was in the free form in supernates but only 60 to 70% in homogenized whole saliva, depending upon the phase of the cycle of the subjects. Salivary flow was stimulated by crystals of citric acid; unstimulated and stimulated saliva samples were obtained from the same person. Progesterone concentrations were significantly (p less than 0.02) higher in stimulated samples than in unstimulated ones, particularly in samples collected during the luteal phase.

Body Fluids↗

Kinetics of drug action in disease states XII: Effect of experimental liver diseases on the pharmacodynamics of phenobarbital and ethanol in rats.

This investigation was designed to determine if liver diseases can modify the pharmacodynamics of the central nervous system depressants phenobarbital and ethanol. Two experimental models of liver diseases in rats were used: extrahepatic cholestasis produced by bile duct ligation and hepatic necrosis induced by carbon tetrachloride administration. Phenobarbital (both models) or ethanol (cholestasis model only) was infused slowly intravenously until the rats lost their righting reflex. Drug concentrations in serum, brain, and cerebrospinal fluid at that time were determined in the diseased animals as well as in sham-operated or solvent-treated controls. Phenobarbital concentrations at the onset of action were not significantly different between controls and either 5-d or 12-d cholestatic rats, except for total serum concentrations which were lower in the cholestatic groups due to reduced protein binding. Ethanol concentrations were slightly but statistically significantly lower in 12-d cholestatic rats as compared with controls. Neither 5-d nor 12-d carbon tetrachloride-induced hepatic dysfunction had any significant effect on phenobarbital concentrations at the onset of loss of righting reflex, except for a marginal decrease in the cerebrospinal fluid concentration of rats that had been treated for 5 d with the hepatotoxin. It was concluded that, under the experimental conditions, the hepatic diseases investigated did not have appreciable effects on the central nervous system response to the hypnotic action of phenobarbital and ethanol.

Animals↗