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Interaction of the competitive AMPA receptor antagonist NBQX with hexobarbital.

IP administration of hexobarbital to rats caused a mean sleeping time of 93.6 min (SD 21.5). IV infusion of 2,3-dihydroxy-6-nitro-7-sulfamoyl-benzo(f)quinoxaline (NBQX) at a dose rate of 0.11 mg/kg/min starting 30 min after administration of hexobarbital prolonged the mean sleeping time to 132.2 min (SD 14.9). Dose rates of 0.33 and 1.10 mg/kg/min prolonged the mean sleeping times to 176.4 min (SD 33.3) and 444.1 min (SD 72.0), respectively. Measured 180 and 450 min after the start of the study, there were no differences in the plasma concentrations of hexobarbital in groups receiving hexobarbital alone compared to groups receiving the high-dose rate of NBQX starting 30 min after administration of hexobarbital. The present results demonstrate that by IV infusion NBQX dose dependently prolonged the sleeping time of hexobarbital. There were no indications of interactions on hexobarbital elimination of either isomer. It is therefore likely that NBQX acts synergistically with hexobarbital to depress the central nervous activity.

Animals↗

Hexobarbital blood levels and effects on EEG in the presence and absence of caffeine.

The interaction of caffeine and hexobarbital in the rat with spinal cord transection was studied. Duration of hexobarbital effect on the brain was taken as the time from the injection of hexobarbital (i.v.) to the return of pre-injection cortical voltage. Hexobarbital distribution and elimination was estimated by application of a two-compartmental model to values for blood hexobarbital concentration (determined by a direct gas chromatographic method after extraction). Caffeine caused a shift in the dose-response curve for hexobarbital but no changes in hexobarbital distribution and elimination. Results are interpreted on the basis of a central interaction of caffeine with hexobarbital at a brain receptor level.

Animals↗

[Mechanisms of hexobarbital anesthesia potentiation by hydrocortisone].

The authors carried out studies on white rats of Wistar strain and investigated some of the mechanisms, metabolic and central, by means of which hydrocortisone affected hexobartital sleep. They established that hydrocortisone in dose of 25 and 50 mg, administered singly, together with hexobarbital or after a 30-minute interval, potentiated hexobarbital sleep significantly. The concentrations of hexobarbital in blood serum and in brain on the 30th minute after its administration were higher in the experimental animals, treated with hexobarbital in comparison with the controls of both sexes. The experiments with determination of the activity of liver microsomal hexobarbital enzymic system showed convincingly a considerable inhibition of enzymic activity (with 53%) of hydrocortisone after 20 minutes after its application in vivo. Subthreshold sreep dose of hexobarbital, determined by the method of Lewy, was lowered than that of the experimental group and higher in the control rats. Hexobarbital concentrations in blood serum and in brain at the moment of waking were lower in experimental animals, treated with hydrocortisone, and higher in the control animals. The obtained results gave foundations to the authors to assume that metabolic and central nervous mechanisms participated in potentiation of hexobarbital sleep.

Anesthesia↗

Effects of aldehyde dehydrogenase inhibitors on hexobarbital sensitivity and neuroamine metabolism in rat brain.

Several authors have found that the aldehyde dehydrogenase (ALDH) inhibitor, disulfiram, prolongs hexobarbital-induced anaesthesia. It was suggested that this effect was caused by an alteration of the serotonergic system in brain, mediated by elevated levels of biogenic aldehydes. In the present study, disulfiram (300 mg/kg) was found to cause a 4-fold prolongation of hexobarbital-induced anaesthesia, while coprine (another potent ALDH-inhibitor) had no effect. This strongly suggested that biogenic aldehydes were not involved in this effect of disulfiram. The hexobarbital concentration in brain, at the electroencephalogram (EEG) criteria used for measuring hexobarbital sensitivity, was unaffected in rats given 75-300 mg/kg disulfiram, indicating that factors other than an increased brain hexobarbital sensitivity were responsible for the prolonged anaesthesia. Also 10-100 mg/kg coprine did not affect hexobarbital sensitivity measured this way. No alteration of the dopamine level in brain was found in rats given disulfiram, and in both disulfiram- and coprine-treated rats, similar changes in the serotonergic system were found. However, the level of norepinephrine was decreased in brains of disulfiram-treated rats, but it was unaffected by coprine. Thus, norepinephrine may have been involved in the prolongation of hexobarbital-induced anaesthesia caused by disulfiram.

Aldehyde Oxidoreductases↗

Oxidative metabolism of hexobarbital in human liver: relationship to polymorphic S-mephenytoin 4-hydroxylation.

The major route of hexobarbital metabolism in humans involves hydroxylation at the 3'-position followed by oxidation to a 3'-keto metabolite. Studies were performed to characterize the form of cytochrome P-450 responsible for the initial oxidation. In vitro studies indicated that P-450MP purified from human livers, involved in the 4-hydroxylation of S-mephenytoin, efficiently catalyzed the 3'-hydroxylation of hexobarbital; moreover, polyclonal antibodies raised to this enzyme extensively inhibited such activity in human liver microsomes. S-Mephenytoin 4- and hexobarbital 3'-hydroxylase activities in microsomes from different livers were significantly correlated, and both activities were essentially absent in fetal liver preparations. Hexobarbital was also found to inhibit S-mephenytoin 4-hydroxylation and vice versa, with Ki values similar to the Km values for the measured pathways. These data suggested that in vivo metabolism of hexobarbital would be determined by the same genetic factor(s) responsible for polymorphic 4-hydroxylation of S-mephenytoin. This prediction was confirmed by the finding that, after oral administration of a single dose of hexobarbital (300 mg), the 24-hr urinary excretion of 3'-hydroxy- and 3'-ketohexobarbital in a "poor-metabolizer" was only one third of that in a subject of the "extensive-metabolizer" phenotype. Also, the plasma level of metabolites at 6 hr after administration was reduced, and that of unchanged drug was increased in the poor metabolizer. Finally, a markedly enhanced sedative effect was associated with the impaired metabolism. Accordingly, several lines of in vitro evidence indicate that hexobarbital 3'-hydroxylation is catalyzed by P-450MP.(ABSTRACT TRUNCATED AT 250 WORDS)

Cytochrome P-450 Enzyme System↗

Hexobarbital pharmacokinetics in rats after ligation of the common bile duct.

Rats, with and without bile duct ligation (BDL), were injected with hexobarbital (i.p. and i.v.) and blood concentrations measured as a function of time. Analysis of these curves using a single-compartment model showed that BDL altered hexobarbital pharmacokinetics in a manner dependent upon the duration of BDL and the route of administration of hexobarbital. Clearance from the blood and the rate constant for elimination (K) were reduced after 72-hour BDL but not after 12-hour BDL. The absorption of hexobarbital after intraperitoneal injection was slowed by 12- and 72- hour BDL. Seventy-two-hour BDL also increased the volume of distribution of hexobarbital but only when the drug was administered intraperitoneally. These data are consistent with previously reported data showing impairment of hepatic microsomal drug metabolism after 72-hour BDL, but not after 12-hour BDL. We also confirmed earlier speculations that BDL decreased the absorption of intraperitoneally-administered hexobarbital, although this does not appear to be a significant factor in prolonging hexobarbital sleeping time.

Animals↗

[Metabolism of hexobarbital in patients with acute hepatitis and cirrhosis (author's transl)].

16 patients with acute hepatitis, 18 patients with cirrhosis and a total of 21 volunteers and patients with normal liver function received 7.32 mg/kg hexobarbital by linear intravenous infusion within 60 min. Hexobarbital was determined gaschromatographically in serial blood samples and the hexobarbital-clearance was calculated from the plasma concentration curve versus time. Additional experiments were performed in rats suffering from so called "galactosamine hepatitis". In half of the patients with acute hepatitis a normal hexobarbital clearance could be found. In the other patients this was distinctly reduced but not correlation was found to other liver function tests. Patients with cirrhosis were subdivided into two groups. The patients in group 1 were well compensated. The patients in group 2 had a decompensated state with ascites and oesophageal varices. In nearly all patients with cirrhosis the hexobarbital-clearance was diminished. This was more pronounced in group 2. Ketohexobarbital excretion in healthy subjects was in the range of 40-60% of dose. Patients with acute hepatitis excreted only 10-20% of dose and patients with liver cirrhosis only about 5% of dose. In rats with "galactosamine hepatitis" hexobarbital clearance in vivo was distinctly reduced and this could be explained by diminished microsomal cytochrome p 45- and hexobarbital oxidation rate.

Acute Disease↗

Effect of 2,4-dinitrophenol on the oxidative metabolism of hexobarbital by cytochrome P-450 in perfused rat liver.

The effect of 2,4-dinitrophenol (2,4-DNP) on the oxidative metabolism of hexobarbital by cytochrome P-450 was investigated in perfused rat liver. In the livers from fed, phenobarbital (PB)-treated rats, 2,4-DNP (50 microM) had no effect on the redox state of cytochrome P-450 or on oxygen uptake during mixed-function oxidation of hexobarbital. In the livers from fasted, PB-treated rats, 2,4-DNP (50 microM) significantly decreased the amount of reduced (oxygenated) cytochrome P-450 and the drug-induced oxygen uptake by about 50%. 2,4-DNP caused a decrease of metabolites of hexobarbital in perfusate, in the fasted but not in the fed state. These results suggest that in fed, PB-treated rats NADPH for mixed-function oxidation of hexobarbital can be predominantly supplied from an extramitochondrial source (most probably via the cytosolic pentose phosphate shunt), but in fasted, PB-treated rats, about 50% of the NADPH required for the mixed-function oxidation is supplied from an intramitochondrial source. In the livers from PB-treated rats, infusion of sorbitol (4 mM), a glycogenic substrate in fasted rats, stimulated the rate of drug-induced oxygen uptake and the steady-state level of reduced (oxygenated) cytochrome P-450 increased during mixed-function oxidation of hexobarbital. These effects of sorbitol were almost completely abolished in the presence of 2,4-DNP. Complete inhibition of gluconeogenesis was also observed in the livers from fasted, PB-treated rats in the presence of 2,4-DNP (50 microM). The amount of metabolites of hexobarbital in the perfusate was increased by the addition of sorbitol in the fasted but not in the fed state. The effect of sorbitol on drug metabolism was inhibited by 2,4-DNP. These data may be explained by assuming that ATP is required for the conversion of sorbitol to metabolites (e.g. glucose-6-phosphate) which can produce NADPH in the cytosol.

2,4-Dinitrophenol↗

Polymorphism in stereoselective hydroxylations of mephenytoin and hexobarbital by Japanese liver samples in relation to cytochrome P-450 human-2 (IIC9).

1. Stereoselective 4'-hydroxylations of R-(--)-mephenytoin and S-(+)-mephenytoin were determined in liver microsomes of 19 Japanese subjects. 2. The content of P-450 human-2 assessed by Western-blots correlated with microsomal S-(+)-mephenytoin 4'-hydroxylation. Antibody raised against P-450 human-2 effectively inhibited microsomal S-(+)-mephenytoin 4'-hydroxylation, but was less efficient for inhibition of R-(--)-mephenytoin 4'-hydroxylation in extensive metabolizers, and 4'-hydroxylation of both mephenytoin enantiomers in poor metabolizers. 3. Similar results were observed on the stereoselective hydroxylations of R-(--)- and S-(+)-hexobarbital. Clear correlations were observed for the content of P-450 human-2 and microsomal R-(--)-hexobarbital 3'alpha-hydroxylation and S-(+)-hexobarbital 3'beta-hydroxylation. 4. Moreover, yeast microsomes expressing P-450 human-2 cDNA showed high stereoselectivities for hydroxylations of mephenytoin and hexobarbital similar to those observed in human liver. 5. Two other cytochromes P-450(IIC 9/10) expressed in yeast, whose cDNA were synthesized by site-directed mutagenesis from human-2 cDNA, showed no stereoselectivity for the hydroxylations of mephenytoin and hexobarbital, in spite of the modification of only two amino acid substitutions or deletions in the whole sequence. 6. Only a cytochrome derived from P-450 human cDNA corresponding to P-450 human-2 was expressed in human livers, the two cytochromes of the three related IIC9/10 forms were not expressed. 7. These findings indicate that P-450 human-2 is the major cytochrome P-450 responsible for the polymorphisms in stereoselective hydroxylations of mephenytoin and hexobarbital.

Cytochrome P-450 Enzyme System↗

Disposition of hexobarbital in the rat. Estimation of "first-pass" elimination and influence of ether anesthesia.

The disposition of hexobarbital was studied in rats after i.v. and i.a. administration. In addition to sleeping times, plasma concentration profiles were measured. No significant differences were found in sleeping times, volumes of distribution, elimination half-lives or systemic clearances between these different routes. The average elimination half-lives were 13.5 +/- 0.8 (n = 17) and 11.6 +/- 1.9 min (n = 21) (means +/- S.E.M.), respectively, whereas the systemic whole blood clearance values were 75.4 +/- 3.4 (n = 17) and 85.8 +/- 3.5 ml/min/kg (n = 21) (means +/- S.E.M.). The values of the latter parameter approach hepatic blood flow in the rat (i.e., 100 ml/min/kg) and therefore the oral availability of hexobarbital was established by comparing areas under plasma concentration time curves, after i.v. and oral administration to the same rat. Oral availability was found to be only 36%, which corresponds to an extraction ratio of 64%. The consequences of such a "first-pass" effect are discussed in view of the use of hexobarbital as a model substrate for measuring drug-metabolizing enzyme activity. Furthermore, it was found that anesthesia as induced by diethylether during the experiments resulted in a very significant inhibition of the rate of hepatic metabolism of hexobarbital; the elimination half-life increased by about 50% due to a similar decrease in the systemic clearance. The protein binding of hexobarbital in rat plasma amounted to 51.4 +/- 1.2% (mean +/- S.E.M., n = 15) and it was found not to be dependent on the plasma concentration of hexobarbital in the range encountered in vivo.

Absorption↗

Stereoselective disposition of hexobarbital and its metabolites: relationship to the S-mephenytoin polymorphism in Caucasian and Chinese subjects.

In vitro studies with human liver preparations suggest that the metabolism of hexobarbital involves CYP2CMP--the determinant of the S-mephenytoin 4'-hydroxylation polymorphism, but no in vivo evidence of interphenotypic differences exist. The pharmacokinetics and urinary excretion of hexobarbital and its metabolites were, therefore, investigated following oral administration of a differentially labelled pseudoracemate that allowed determination of the fate of the individual enantiomers. Studies were undertaken in 10 Caucasian and nine Chinese healthy subjects known to be either extensive (EM) or poor (PM), metabolizers of mephenytoin. No inter-racial differences were observed in any of the measured parameters within a given phenotype. However, pronounced stereoselectivity in disposition was noted in EMs with R-(-)-hexobarbital's oral clearance being five- to six-fold greater than that for the S-(+)-enantiomer. By contrast, the S-(+)-isomer was eliminated twice as fast as R-(-) hexobarbital in PMs and, in addition, the oral clearances of both enantiomers were significantly reduced compared with their values in EMs. Formation of 3'-hydroxy- and 3'-ketohexobarbital and 1,5-dimethylbarbituric acid were the major identified routes of metabolism for each enantiomer in both phenotypes. Furthermore, these pathways were found to co-segregate with the mephenytoin polymorphism and in EMs they were primarily responsible for the observed stereoselectivity in disposition. These findings, therefore, confirm the stereoselectivity in hexobarbital's disposition in humans and identify the major pathways of metabolism involved. Additionally, the results indicate that CYP2CMP is a major determinant of the in vivo metabolism of both of hexobarbital's enantiomers but especially that of the R-(-)-enantiomer.

Administration, Oral↗

The binding of hexobarbital and aniline to cytochrome P-450 of liver microsomes from control and phenobarbital-treated rats of different ages.

The spectral changes due to the binding of hexobarbital and aniline to cytochrome P-450 of rat liver microsomes were investigated in 10-day- to 15-month-old rats. The Ks values for both substances and consequently the affinity for cytochrome P-450 do not change during ageing. Phenobarbital treatment does not alter the affinity of hexobarbital, but enhances the Ks value for aniline. The maximal spectral changes (delta A max) due to aniline are nearly equal in all age groups whereas delta A max due to hexobarbital is very small in young rats and increases considerably during ageing. The age-dependence of the hexobarbital-induced delta A max is similar to the development of drug-metabolizing reactions. delta A max due to hexobarbital and aniline is enhanced by phenobarbital treatment of the rats. The addition of aniline to microsomes enhances the Ks value and diminishes delta A max for hexobarbital.

Aniline Compounds↗

Pharmacokinetics of hexobarbital in acute hepatitis and after apparent recovery.

The pharmacokinetics of hexobarbital were studied in 13 patients with acute hepatitis. Hexobarbital sodium was administered by zero order intravenous (iv) infusion, and plasma concentrations were determined regularly by gas chromatography. For each patient the data were fitted according to 2-compartment kinetics. The results were compared to those obtained for 14 healthy volunteers. The elimination half-life of hexobarbital was 490 +/- 186 min in the hepatitis patients and 261 +/- 69 min in the control group. Clearance was significantly reduced in the hepatitis group, whereas the volume of distribution at steady state was not significantly altered. For some patients the initial distribution volume was reduced. In 6 patients the experiment with hexobarbital was repeated after apparent recovery from hepatitis as judged by normal transaminase and bilirubin levels. Generally the half-life of hexobarbital was shorter and the clearance value was higher than during the acute illness, but the values had not yet returned to normal. Clinical recovery from liver disease is not accompanied by corresponding recovery of drug-metabolizing capability.

Adolescent↗

Chronopharmacologic aspects of hexobarbital oxidation rate in rats.

Circadian variations of hexobarbital oxidation rate in rat liver and the relationship to serum corticosterone levels were determined in 324 animals subjected to different lighting regimen and feeding schedules.--Rats maintained under standard light/dark conditions and with free access to food showed a significant circadian hexobarbital oxidase rhythmicity. Inversion of the light/dark cycle and time feeding was followed by significant changes of the 24-h means of hexobarbital oxidation rate as well as of the shape and phasing of the circadian pattern. The animals' response to the experimentally altered environmental conditions did not reveal a predictable relationship between the shape and phasing of the rhythmic patterns of liver hexobarbital oxidase activity and of corticosterone levels in blood serum; the rats subjected to timed feeding showed decreased levels of corticosterone whereas the hexobarbital oxidation rate of the liver was increased.

Alcohol Oxidoreductases↗

Induction of microsomal drug-metabolizing enzymes caused by hexobarbital.

Hexobarbital was given to anaesthetized mice for a period of 7 h by repeated i. p. injection, first of 100 mg/kg,then several times of 50 mg/kg. A high level of hexobarbital was maintained in the liver. The activity of microsomal drug-metabolizing enzymes was induced by this treatment with hexobarbital. 30 min after a single i. p. injection of 100 mg/kg of hexobarbital, there was a significant inhibition of aminopyrine N-demethylase but none of cytochrome c and neotetrazolium reductases. Hexobarbital in vitro inhibits aminopyrine N-demethylase but not cytochrome c reductase.

Aminopyrine N-Demethylase↗

Interaction between flumazenil and the anesthetic effects of hexobarbital in the rat.

Interaction between flumazenil, a substance regarded mainly as a benzodiazepine antagonist, and an intravenous anesthetic barbiturate, hexobarbital, was investigated by using an electroencephalography threshold test in male rats. Flumazenil 10 mg/kg given as pretreatment reduced the threshold dose of hexobarbital approximately 20% indicating a synergistic interaction. Similar effects were obtained with the agonists, diazepam 20 mg/kg and lorazepam 2 mg/kg. Dose-response curve for flumazenil (2.5-10 mg/kg) was determined with the same technique and hexobarbital concentrations were analysed in serum and several brain regions at the threshold by high pressure liquid chromatography. Flumazenil 10 mg/kg pretreated group showed a different pattern of distribution of hexobarbital into the tested brain regions indicating a pharmacokinetic interaction. Low concentrations of hexobarbital in the brainstem which were negatively correlated with the dose of flumazenil indicate a pharmacodynamic interaction which could be due to partial agonistic intrinsic activity of flumazenil, usually seen at much higher doses.

Analysis of Variance↗

Pharmacokinetics of hexobarbital in young and old rats.

Hexobarbital is a drug widely used to study the capacity of the liver to metabolize drugs. The pharmacokinetics of hexobarbital in 3- and 30-month-old male BN/BiRij rats were studied. The half-life of hexobarbital in 30-month-old rats (39.9 +/- 4.1 min) was significantly higher than that of 3-month-old ones (21.3 +/- 3.8 min). The volume of distribution (ml.kg-1 body weight) did not change with age. The intrinsic clearance, expressed as ml.min-1.kg-1 body weight, of hexobarbital in 30-month-old rats (20.2 +/- 6.6) was half that of the 3-month-old ones (39.5 +/- 7.6). Further studies will be performed to investigate the effect of age on the intrinsic clearance of S(+)- and R(-)- hexobarbital.

Age Factors↗

Metabolic and psychophysiologic studies of cannabidiol-hexobarbital interaction.

Cannabidiol (CBD), 600 mg/day orally for 5 to 12 days, inhibited hexobarbital metabolism in ten subjects. Hexobarbital oral clearance was 36% lower and apparent volume of distribution was 35% smaller, with no change in half-life during CBD. In four subjects who received intravenous and oral hexobarbital, systemic clearance was 36% lower while bioavailability was 10% greater during CBD. Hexobarbital increased fatigue and tremor, impaired eye-tracking performance, and altered the electroencephalogram. Hexobarbital effects were not affected by CBD. Inhibition of metabolism of other drugs should be considered when large amounts of CBD are taken or when CBD is used for therapy.

Absorption↗