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Food-induced changes in theophylline absorption from controlled-release formulations. Part II. Importance of meal composition and dosing time relative to meal intake in assessing changes in absorption.

Theo-24 (G. D. Searle & Co.) is an ultra-slow-absorbing formulation of theophylline suitable for once-a-day dosing in slow and normal metabolizers of theophylline. Relative to fasting conditions, increased rate and extent of theophylline absorption occur when this product is administered immediately after a breakfast with a high fat content. Our study demonstrated that factors such as meal composition (fat content) or dosing time relative to meal intake can modify the high fat-induced changes in absorption. For consistent, slow absorption, patients taking high doses (greater than or equal to 900 mg) of Theo-24 once a day should take this product in the morning under fasting conditions or with a breakfast containing less than or equal to 10 gm fat. If a high-fat breakfast (greater than 55 gm fat) is taken, then Theo-24 should be administered at least 1 hour before the meal.

Absorption↗

[The absorption of cholecystographic contrast media, following intraduodenal application; reasons for improved absorption due to sodium bicarbonate (author's transl)].

Three different cholecystographic contrast media in six dilutions were administered through a duodenal tube to six groups of five patients each. Blood samples were obtained up to five hours following the introduction of the contrast, in order to determine serum iodine levels as a measure of contrast concentration in the blood. At one, two, four and five hours, radiographs of the abdomen were obtained in order to evaluate the biliary passages and non-absorbed contrast. 1. The known effect of increased absorption of a microcrystalline suspension of Iosumet acid caused by sodium bicarbonate was enhanced by intra-duodenal application. 2. Following intra-duodenal application, there was no definite effect on the blood level of Iosumet acid microsuspension due to the addition of sodium bicarbonate. Thus there was no evidence of increased absorption. It therefore seems that the effect of sodium bicarbonate is due to accelerated transport of the contrast medium from the stomach into the duodenum. 3. The micro-suspension is very rapidly dissolved in the duodenum. Ingestion of an acid solution does not improve absorption. 4. Micro-crystalline suspensions of iopodinic acid and particularly iopanic acid are absorbed relatively slowly and incompletely. The sodium salt of iopodinic acid is absorbed much better than the free acid.

Adult↗

Studies on digestion and absorption in the intestines of growing pigs. 4. Effects of dietary cellulose and sodium levels on mineral absorption.

1. Seven pigs of 30 kg initial live weight were fitted with re-entrant cannulas in the terminal ileum. Each was fed, in succession, four purified diets having cellulose and sodium levels (g/kg) of 30 and 2.7, 30 and 0.9, 90 and 2.7 or 90 and 0.9, respectively. Collections of digesta (24 h) and 3 or 4 d collections of faeces were made. 2. There was a greater throughput of ileal digesta with the high-cellulose diets than with the low-cellulose diets, mainly due to increased water content, and there was a concomitant reduction in the net absorption of Na from the small intestine. The immediate response to reduced Na intake was increased secretion of Na into the gut lumen anterior to the terminal ileum; this was more pronounced with the high-cellulose diet. Na concentrations in ileal digesta were very similar for all four diets. 3. The apparent absorptions of calcium, phosphorus, magnesium, potassium and zinc were reduced by the high-cellulose diets. In each instance this was due to reduced absorption posterior to the terminal ileum.

Animals↗

Absorption enhancing effect of labrasol on the intestinal absorption of insulin in rats.

The oral absorption enhancing effect of Labrasol has been studied in rats using insulin as a model peptide/protein drug. Insulin solution was prepared by dissolving insulin in pH 7.4 buffer followed by the addition of Labrasol. The insulin concentration was 50.0 IU/ml. The test insulin/Labrasol solution was administered to the jejunum, ileum and ascending colon of rats at 10.0 IU/kg. After administration, blood samples were collected for 5 h and serum glucose levels and insulin levels were measured. In another group of rats, insulin solution was injected intravenously at 1.0 IU/kg, and both serum glucose and insulin levels were measured. The pharmacological availability of insulin from Labrasol solution was found to be 3.9, 8.9 and 9.1% following jejunal, ileal and colonic administrations, respectively, by comparing the serum glucose level vs. time profiles obtained after intestinal and i.v. administrations. By comparing the serum insulin levels vs. time profiles, the bioavailability of insulin was found to be 0.25 and 0.20% for intra-ileum and colonic administrations, respectively. The hypoglycemic effect of insulin after intra-ileum administration showed a dose-dependency in the insulin dose range from 10.0 to 1.0 IU/kg. These results suggest the absorption enhancing effect of Labrasol on the intestinal absorption of insulin in rats.

Animals↗

Digestion, absorption and effects on cholesterol absorption of menhaden oil, fish oil concentrate and corn oil by rats.

Adult male rats were surgically provided with a drainage catheter in the left thoracic lymphatic channel and an indwelling duodenal catheter for constant infusion of physiological saline-5% glucose. After an overnight fast, animals were given a single duodenal dose of an aqueous emulsion containing one of the following: oleic acid, corn oil, menhaden oil or a fish oil concentrate (FOC) and [1,2-3H]cholesterol. Digestion and absorption were estimated by recovering the total fatty acids in the thoracic duct lymph over a 24-h collection period (after subtraction of the "baseline" endogenous fatty acids in the lymph). Cholesterol absorption in the thoracic duct lymph was significantly reduced (P less than 0.05) in the presence of menhaden oil or FOC compared to that in the presence of corn oil. With various fat feedings, the major increases in lymph fatty acids were directly related to the dietary fatty acid content. The relative amounts of eicosapentaenoic acid (EPA) and arachidonic acid (AA) in the thoracic lymph were influenced by the lipid content of the emulsion. The EPA/AA ratio in control, oleic acid and corn oil feedings ranged from 0.12 to 0.25. When marine oil was administered, the EPA/AA ratio was 0.78-0.98. The total amount of fatty acids found in the lymph after marine oil feeding was significantly less (P less than 0.01) than that found after corn oil feeding. The results suggested that the digestion and absorption of menhaden oil and FOC were decreased as compared with corn oil. The EPA/AA ratio was increased in the thoracic lymph after dietary fish oil feeding.

Animals↗

Investigation of drug absorption from the gastrointestinal tract of man. IV. Influence of food and digestive secretions on metoprolol jejunal absorption.

The influence of nutrients and digestive secretions on the intestinal absorption and bioavailability of the beta-adrenoceptor antagonist, metoprolol, was investigated in an isolated segment of jejunum using an intestinal perfusion technique. Two solutions containing metoprolol, one with, and one without nutrients, were perfused into the jejunum with an occluding balloon inflated or deflated. Jejunal fluid, blood and urine samples were then collected for drug or metabolite estimation. In the segment studied, metoprolol absorption from the nutrient solution was four times that observed during perfusion of the saline solution. Bile salts did not enhance drug absorption. Both in the presence and absence of nutrients, a linear relationship was observed between the computed cumulative amount of drug absorbed from the gastrointestinal tract and the resulting plasma concentration at each sampling time, indicating that first-pass loss was not saturated. This result was also reflected in the similarity of the AUC:dose ratios, and in the lack of effect of nutrients on the metabolism of the drug.

Adult↗

Jejunal and ileal absorption of oxprenolol in man: influence of nutrients and digestive secretions on jejunal absorption and systemic availability.

1 Study I evaluated the absorption of oxprenolol in the ileum, compared to jejunum, in healthy volunteers by an intestinal perfusion technique. Around 80 mg of drug were delivered as a saline solution directly in the small bowel. 2 Samples taken 30 cm distally to the site of perfusion showed that 63% of perfused oxprenolol was absorbed in the jejunum and 48% in the ileum; the differences were significant. 3 The plasma concentration-time profiles were similar for the two perfusions. The AUC and Cmax values of free and conjugated oxprenolol for the jejunal perfusion were significantly lower than those of ileum. They showed large but consistent intersubject variations in the two treatments. 4 Study II investigated, using the same technique, the influence of nutrients and digestive secretions on jejunal absorption and systemic availability of this drug. A saline (in treatments A and B) or a nutrient (in treatment C) solution containing oxprenolol was perfused into the jejunum below a balloon either inflated (A) or deflated (B and C). 5 The disappearance rate of oxprenolol from the jejunum was unaffected by endogenous secretions. The mean amount of drug absorbed along a 30-cm jejunal segment accounted for 52 (A) and 57% (B) of the total amount perfused. The intestinal absorption rate was markedly increased in the presence of nutrients (mean amount absorbed 96% for C). 6 The change in the rate of disappearance from the intestine had no effect on the systemic availability of oxprenolol (mean AUC values 8740, 8250 and 8020 nmol l-1 h for A, B and C, respectively) or its elimination from plasma.(ABSTRACT TRUNCATED AT 250 WORDS)

Biological Availability↗

Immunological control of drug absorption from the gastrointestinal tract: the mechanism whereby intestinal anaphylaxis interferes with the intestinal absorption of bromthymol blue in the rat.

Rats were immunized intraperitoneally with ovalbumin and the disappearance of bromthymol blue (BTB) from the intestinal lumen, its accumulation in the tissue, and its net absorption were examined by means of an in-situ recirculation technique during local anaphylaxis. The disappearance of BTB from the intestinal lumen and its net absorption were significantly reduced, but there was no significant effect on its accumulation in the tissue. The pH value of the luminal solution and the perfusate volume were not influenced by intraluminal challenge with the antigen in ovalbumin-immunized rats. In addition, no significant effect was observed on intestinal permeability to BTB in the in-vitro everted sac technique. The intestinal blood flow, measured by a hydrogen clearance method, was not reduced significantly by the intraluminal exposure to antigen. There was enhanced Evans Blue leakage and mucus release in the perfusate after intraluminal challenge with ovalbumin in ovalbumin-immunized rats, but not in non-immunized rats. A significant increase of BTB binding with macromolecular substances in the perfusate was observed during the local anaphylaxis. These findings suggest that the decreased absorption of BTB is due to the interaction with the macromolecular substances in the perfusate during local anaphylaxis.

Anaphylaxis↗

Intestinal absorption of cephalosporin antibiotics: correlation between intestinal absorption and brush-border membrane transport.

The absorption of seven cephalosporin antibiotics from the in-situ intestinal loop at pH 7.4 and their transport by brush-border membrane vesicles in the presence of an inward H+ gradient ([pH]i = 7.5, [pH]o = 6.0) were examined. A good correlation was found between the intestinal absorption rate and the initial uptake rate by brush-border membrane vesicles. The data suggest that the transport study using intestinal brush-border membrane vesicles is useful as a model system for the intestinal absorption of beta-lactam antibiotics.

Animals↗

The reproducibility and use of the tritiated folic acid urinary excretion test as a measure of folate absorption in clinical practice: effect of methotrexate on absorption of folic acid.

Investigations into the standardization and reproducibility of the urinary excretion method for determining the absorption of tritiated folic acid were carried out. By proper timing of tissue-loading doses of folic acid a clear difference between the percentage excretion ranges of normal and coeliac subjects was obtained. In addition conditions were found whereby the procedure could be repeated on an individual up to four times with reproducible results. Methotrexate in pharmacological amounts was found to have no inhibitory effect on the human intestinal absorption of a small oral dose (300 mug) of folic acid as determined by this method. This indicates that reduction of folic acid is not necessary for its absorption in man.

Administration, Oral↗

Studies on the absorption and metabolism of folic acid. I. Folate absorption in the dog after exposure of isolated intestinal segments to synthetic pteroylpolyglutamates of various chain lengths.

Folic acid absorption was studied in anesthetized dogs by determining the amount and chemical nature of folate in venous blood emerging from isolated intestinal segments containing free folic acid and/or pteroylpolyglutamates of a known chain length. Chromatographically pure test materials placed in the lumen were prepared by unambiguous solid phase synthetic methods. This synthetic procedure not only yields compounds of known structure, it also provides a means by which glutamic acid residues at any given position in the gamma glutamyl chain can be made radioactive. For example, teropterin (pteroyltriglutamate) was synthesized in such a way that (14)C was present only in the middle glutamic acid unit. Suitable placement of label permitted assessment of the extent of peptide cleavage. The action of plasma conjugase was inhibited by copper chloride. Plasma samples were analyzed by Lactobacillus casei and Streptococcus faecalis assay, by column chromatography, and by quantitative measurement of pteridine-bound radioactivity. It was observed that biologically active folate appeared in the mesenteric vein with either pteroylmono-, di-, tri-, penta-, or heptaglutamate in the lumen. Generally speaking the absorption rate appeared to be inversely related to the length of the gamma glutamyl side chain. Roughly twice as much folic acid appeared in the circulation from (3)H-labeled pteroylmonoglutamate as from (14)C-labeled pteroylpentaglutamate when equimolar amounts of each were placed simultaneously in a single intestinal segment. Pteroylmonoglutamate appeared to be the predominant form entering the blood from each of the precursors tested. However, evidence was obtained that pteroyldiglutamate may enter the mesenteric vein soon after placing pteroyldi-, or triglutamate in the lumen, but not with the higher polyglutamates. Comparison of radioactivity and biological activity patterns suggests little conversion, if any, to reduced or methylated forms during the first 30 min of passage through the intestinal mucosa. We conclude that both pteroylmonoglutamates and pteroyldiglutamates may across the intestinal mucosa of the dog, and that reduction and methylation are not essential to the absorption process.

Animals↗

The effects of absorption enhancers on the pulmonary absorption of recombinant human granulocyte colony-stimulating factor (rhG-CSF) in rats.

Pulmonary absorption of recombinant human granulocyte colony-stimulating factor (rhG-CSF) with various surfactants and protease inhibitors were examined in rats. The relative bioavailabilities of rhG-CSF with surfactants, such as polyoxyethylene 9-lauryl ether (Laureth-9) and sodium glycocholate (SGC), after intratracheal (i.t.) administration by intravenous (i.v.) and subcutaneous (s.c.) means were 37% (i.v.), 88% (s.c.), 84% (i.v.) and 197% (s.c.), respectively. These values were evaluated from the ratio of the area under the curve (AUC) of the plasma rhG-CSF concentration versus time for 8 h. In the presence of various kinds of protease inhibitors, such as (p-amidinophenyl) methanesulfonyl fluoride x HCl (p-APMSF), aprotinin and bestatin, an increase in the plasma rhG-CSF concentration was observed, and the effect with p-APMSF was maximal. The relative bioavailabilities of rhG-CSF with p-APMSF after i.t. administration by i.v. and s.c. means were increased about 2-fold. To clarify the absorption mechanism of rhG-CSF, rhG-CSF was intratracheally administered with both Laureth-9 and p-APMSF. The AUC of rhG-CSF increased with both agents, and was approximately equal to that with SGC, which has both an enhancing effect on membrane permeation and an inhibitory effect on enzymatic degradation after i.t. administration. Consequently, it was considered that permeation and enzymatic degradation were rate-determining steps in the pulmonary absorption of rhG-CSF after i.t. administration.

Absorption↗

Solvent drag effect in drug intestinal absorption. I. Studies on drug and D2O absorption clearances.

It was shown that the intestinal absorption clearance of D2O (CLD2O) could be a more appropriate index to study the solvent drag effect than water volume flow which was the difference between water influx and outflux in the intestinal lumen. Then, the correlation between the intestinal absorption clearances of drugs (CLdrug) and CLD2O were studied using the in situ recirculating method in the rat small intestine. The drugs used were low molecular drugs, that is, benzoic acid, salicylic acid, p-hydroxybenzoic acid and antipyrine, and comparably high molecular drugs, that is, cephalexin (CEX), cefroxadine (CXD) and cephalothin (CET). CLdrug and CLD2O were obtained in hypertonic, isotonic and hypotonic perfused solution adjusted with sodium chloride. Consequently, the correlations for all drugs except CET were significant and high solvent drag effects were observed. CLdrug of benzoic acid, salicylic acid and antipyrine were approximately equal to CLD2O, suggesting that the intestinal mucosa could not distinguish these lower molecular drugs from water. For the high molecular drugs such as cephalosporins, however, some extent of reflection from the membrane was certainly found in CEX and CXD, and the extent in CET was assumed much larger than CEX and CXD, resulting that the contribution of solvent drag in CET could not be found. Consequently, it was suggested that the solvent drag had some important role in the intestinal absorption of cephalosporins.

Animals↗

Intestinal absorption of several beta-lactam antibiotics. IV. Binding to the various components in the intestinal mucosa of rat and role in absorption process.

The binding characteristics of zwitterionic and monobasic beta-lactam antibiotics to the components in the intestinal mucosa of rat was investigated. From the binding experiments using the brush border membrane preparation and the insoluble cellular fractions, there was no correlation between the binding behavior and the absorption characteristics. However, there was a highly significant correlation between the affinity to the soluble F1 fraction and the absorption characteristics of these antibiotics. It was also found that the binding of these antibiotics to the other soluble protein fractions were significantly smaller than that to F1 fraction. It was postulated that the binding properties of these antibiotics to soluble F1 fraction play an important role in the absorption process.

Animals↗

Solvent drag effect in drug intestinal absorption. II. Studies on drug absorption clearance and water influx.

In order to study the solvent drag effect, it was shown that back flux of absorbed drug from blood to intestinal lumen can be ignored but the back flux of water cannot. Then, apparent water influx was calculated as a new measure of solvent drag based on the model in which the back flux of D2O from blood to lumen was considered during absorption. Consequently, the correlation between drug absorption clearance (CLdrug) and apparent water influx was highly significant for benzoic acid, salicylic acid, p-hydroxybenzoic acid, antipyrine, cephalexin (CEX) and cefroxadine (CXD), resulting the high solvent drag effects were detected. The mean values of the slopes in the regression lines of CLdrug versus apparent water influx, i.e., sieving coefficients, were smaller than one for benzoic acid and salicylic acid, but the values were not significantly different from one. The sieving coefficients of the other drugs were significantly smaller than one. From these results, the molecular size dependence in the reflection from the intestinal membrane during absorption was clearly shown. And the intercepts of the regression lines including diffusive permeabilities were found to be significantly different from zero in CEX and CXD. On the basis of the sieving coefficients and intercept values obtained in such ways, the appropriateness of this model was discussed.

Animals↗

Promoting mechanism by bile salt related to water absorption in drug rectal absorption.

The promoting mechanism by bile salts in rat rectal absorption of antipyrine was studied by the in situ recirculating perfusion. The significant correlation between rectal absorption clearance (CLAP) of antipyrine (AP) and apparent water influx (influx') was found in the control without promoters, indicating the existence of solvent drag in the AP rectal absorption. Sieving coefficient of AP (bAP), i.e. the slope of the regression line between CLAP and influx', was 0.6 approximately equal to that in small intestine reported previously. The relation between the promoting effects and solvent drag was further studied, resulting that both CLAP and influx' were significantly enhanced by sodium taurocholate (TC-Na), sodium glycocholate (GC-Na) and sodium cholate (C-Na). Accordingly the promoting effects of bile salts might be due to the increase in solvent drag. However TC-Na did not produce the significant change in bAP. From these results, the enhancing mechanism in the epithelial cell membrane transport was discussed.

Animals↗

Absorption of copper(II) by creosote bush (Larrea tridentata): use of atomic and x-ray absorption spectroscopy.

Larrea tridentata (creosote bush), a common North American native desert shrub, exhibits the ability to take up copper(II) ions rapidly from solution. Following hydroponic studies, U.S. Environmental Protection Agency method 200.3 was used to digest the plant samples, and flame atomic absorption spectroscopy (FAAS) was used to determine the amount of copper taken up in different parts of the plant. The amount of copper(II) found within the roots, stems, and leaves was 13.8, 1.1, and 0.6 mg/g, respectively, after the creosote bush was exposed to a 63.5-ppm copper(II) solution for 48 h. When the plant was exposed to a 635-ppm copper(II) solution, the roots, stems, and leaves contained 35.0, 10.5, and 3.8 mg/g, respectively. In addition to FAAS analysis, x-ray microfluorescence (XRMF) analysis of the plant samples provided further confirmation of copper absorption by the various plant parts. X-ray absorption spectroscopy (XAS) elucidated the oxidation state of the copper absorbed by the plants. The copper(II) absorbed from solution remained as copper(II) bound to oxygen-containing ligands within the plant samples. The results of this study indicate that creosote bush may provide a useful and novel method of removing copper(II) from contaminated soils in an environmentally friendly manner.

Absorption↗

[Intestinal absorption of fats in children using serum turbidity and triglyceride absorption tests].

Intestinal fat absorption was studied, using serum turbidity and serum triglyceride levels, which were determined before and after a test meal of 2 g neutral fat per kg b.w. in 33 children: 25 controls, four with cystic fibrosis, and four with celiac disease. The results proved that the easy-to-perform serum turbidity test was superior to the triglyceride absorption test in characterizing fat digestion and absorption. The most substantial increase in both tests occurred about three hours after the oral fat load.

Celiac Disease↗