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Microbial transformation of the antihistamine pyrilamine maleate. Formation of potential mammalian metabolites.

Fourteen fungi were found to metabolize pyrilamine (2-[(2-dimethylaminoethyl)(p-methoxybenzyl)amino]pyridine). Two Cunninghamella elegans strains transformed essentially all of the pyrilamine added after 144 hr. After 48 hr of incubation, C. elegans ATCC 9245 metabolized 76% of the antihistamine into methylene chloride-extractable pyrilamine metabolites. These organic-soluble metabolites were isolated by HPLC and the major metabolites were characterized by comparison of their chromatographic, mass, and 1H-NMR spectral properties with those of authentic compounds. The major metabolite was identified as 2-[(2-dimethyloxyaminoethyl)(p-methoxybenzyl)amino]pyridine (N-oxide derivative of pyrilamine). Other metabolites identified were 2-[(2-dimethylaminoethyl)(p-hydroxybenzyl)amino]pyridine, 2-[(2-methylaminoethyl)(p-methoxybenzyl)amino]pyridine, and 2-[(2-methylaminoethyl)(p-hydroxybenzyl)amino]pyridine. These metabolites represent O-demethylated, N-demethylated, and O- and N-demethylated derivatives of pyrilamine, respectively. The mutagenic activities of the N-oxide and the N- and O-dealkylated pyrilamine derivatives, and pyrilamine maleate were measured by reversion of Salmonella typhimurium strains TA97, TA98, TA100, and TA102. Pyrilamine maleate and the three microbial metabolites showed no appreciable mutagenic activity in any of the S. typhimurium tester strains. The metabolism of pyrilamine by 12 other filamentous fungi and yeast strains was much less when compared to C. elegans and ranged from 3.8% to 12.2%. The fungal metabolism of pyrilamine may be useful in predicting results of mammalian metabolism and in readily providing sufficient quantities of metabolites for further toxicological studies.

Aminopyridines↗

The metabolism and elimination of pyrilamine maleate in the rat.

The metabolism and elimination of pyrilamine (2-[(2-dimethylamino-ethyl)(p-methoxybenzyl)amino]pyridine) were characterized after the iv administration of 7.0 mg/kg or 0.7 mg/kg pyrilamine maleate plus [14C]pyrilamine maleate to adult male Fischer-344 rats. Approximately 29% and 38% of the administered dose was excreted in the urine in the first 24 hr in the high and low dose groups, respectively, as determined by liquid scintillation spectrometry. Fecal excretion accounted for 27% and 30% of the administered dose in the first 24 hr in the high and low dose groups, respectively, as confirmed via combustion analysis. The 24-hr urinary metabolic products consisted of one major and four minor radiolabeled compounds. The major metabolite was isolated by reversed-phase high performance liquid chromatography and identified as the O-glucuronic acid conjugate of O-demethyl pyrilamine. This was accomplished by comparison of the chromatographic characteristics of this metabolite's aglycon with that of an authentic standard of O-demethyl pyrilamine and fast atom bombardment mass spectrometry of the unhydrolyzed conjugate. Pyrilamine and its N-oxide and O-demethyl derivatives were also identified after isolation by reversed-phase high performance liquid chromatography and comparison of their mass spectral and/or chromatographic properties with those of authentic compounds. The plasma metabolic profile was essentially the same as the urinary profile except for the absence of O-demethyl pyrilamine. The plasma elimination of pyrilamine fit a one-compartment open model and was first order. The terminal plasma elimination half-life of pyrilamine did not increase with increasing doses (2.3 hr, 0.7 mg/kg; 1.5 hr, 7.0 mg/kg) and thus pyrilamine does not exhibit dose-dependent elimination.(ABSTRACT TRUNCATED AT 250 WORDS)

Aminopyridines↗

Nomifensine maleate: a new second-generation antidepressant.

The pharmacology, pharmacokinetics, clinical efficacy, adverse effects, drug interactions, dosage, and formulary recommendations for nomifensine maleate are reviewed. Nomifensine is a potent inhibitor of norepinephrine but has little effect on serotonin. It is unique in that it is a potent reuptake inhibitor of dopamine. Nomifensine is rapidly and completely absorbed and is widely distributed throughout the body. The major route of elimination is through the kidneys. Because of its short half-life and resultant lack of accumulation, nomifensine is usually given in divided doses. Nomifensine is approved for the treatment of depression. In clinical trials with imipramine, amitriptyline, nortriptyline, maprotiline, and various investigational antidepressant drugs, it has been found to be as effective as the standard antidepressant agents. In general, nomifensine has been well tolerated by patients and has caused few side effects. It also has not been associated with serious toxic effects in overdose situations. The usual effective dose of nomifensine maleate is 100-200 mg daily given in divided doses. It appears to be a good choice for patients with profoundly retarded depression and for those who cannot tolerate the side effects of traditional antidepressant drugs. Nomifensine should not be used alone in patients with schizoaffective disorders or in patients with agitated depression. Nomifensine is a safe and effective antidepressant with a fairly unique pharmacological profile. Because the drug is relatively safe and causes little sedation, it may offer substantial advantages over the more traditional antidepressants and should be considered for formulary addition.

Chemical Phenomena↗

[Synthesis of C14-flupirtine maleate].

Starting from 14C-p-fluorobenzoic acid the synthesis of 14C-labelled 2-amino-3-ethoxycarbonylamino-6-(p-fluorobenzylamino)-pyridi ne maleate (flupiritine maleate, D 9998) is described.

Aminopyridines↗

Physical parameters of chlorphenamine maleate suppositories and its release as a function of particle size, concentration and nature of the base.

Suppositories of chlorphenamine maleate were formulated. The influence of particle size and percentage concentration of chlorphenamine maleate on the physical standards of its suppositories as well as the release of the drug from oily base (cacao butter), water-soluble base (carbowax) and emulsifying base (Witepsol) has been investigated.

Chemistry, Pharmaceutical↗

Double-blind comparison of the efficacy and safety of nomifensine maleate vs. placebo in depressed outpatients.

Nomifensine maleate in doses of 100-200 mg/day was compared to placebo in a double-blind study of 50 moderately to severely depressed outpatients seen in a private practice. Efficacy ratings over the 28-day treatment period revealed significant improvement in the nomifensine group on the Hamilton Depression Rating Scale and Clinical Global Impressions, as well as the Self-Rating Symptom Scale, Brief Psychiatric Rating Scale, and Hamilton Anxiety Scale. These differences in favor of nomifensine were seen as early as Day 7 of treatment and were generally consistent throughout the trial. No clinically meaningful changes in vital signs or laboratory values were found over the course of treatment. Only one side effect, a pruritic rash in one patient, was directly attributable to active drug treatment. The CGI Therapeutic Index revealed a very favorable ratio of clinical benefit to side effects for nomifensine maleate.

Adolescent↗

[Polyneuritis after use of perhexiline maleate: quantimetric and ultrastructural study (author's transl)].

The authors record a new case of polynevritis through a prolonged use of perhexiline maleate. The acute neurological episode occurred 14 months after the beginning of the treatment when the daily doses had been raised to 600 mg for 2 months. The biopsy of the peripheral nerve was carried out only 27 months later as the posology was brought down to 200 mg and the clinical symptomatology had almost completely diminished. This probably accounts for the unusual aspects observed on semi-thin and ultrathin sections: a very remarkable reduction of the number of myelinated fibers and the severity of the phenomena of Wallerian degeneration, contrasting with the rarity of intra-cytoplasmic multilamellar schwannian inclusions, classically observed in the course of polynevritis caused by perhexiline maleate. The direct toxic action of the drug upon the neuron has been discussed.

Humans↗

Effects of sodium repletion and timolol maleate administration on the zona glomerulosa of the rat adrenal cortex: an electron microscopic morphometric study.

The effects of long-term sodium repletion and timolol maleate treatment on the zona glomerulosa of dexamethasone- and ACTH-administered rats were investigated. Morphometry showed that both treatments induced a noticeable atrophy of the zona glomerulosa and its parenchymal cells, which is mainly due to the decrease in the smooth endoplasmic reticulum and the mitochondrial compartment. Radio-immunological studies indicated that in the treated rats the plasma aldosterone concentration was significantly decreased. Combined sodium repletion and timolol maleate administration provoked more intense effects than the single treatments. These data confirm the contention that both Na/K balance and the renin-angiotensin system are involved in the maintenance of the growth and steroidogenic capacity of the rat zona glomerulosa, with interfering without the hypothalamo-hypophyseal-adrenal axis.

Adrenal Cortex↗

[Study of thesaurismosis induced by perhexiline maleate. Confirmation of experimental data].

Perhexiline maleate is an amphiphilic molecule. Along with many other drugs it is responsible for experimental and, in some instances, clinical lipidoses. Sphingomyelinase deficiency has been evidenced in cell cultures incubated with perhexiline maleate. We describe the occurrence of a similar defect in a patient. The disturbances in the phospholipid turnover which are responsible for the thesaurismosis may originate in the sphingomyelinase deficiency.

Cerebellar Ataxia↗

[Reproducibility of the clinical, electrocardiographic and coronarographic aspects of spontaneous coronary spasm with the use of ergonovine maleate].

Five patients affected by angina pectoris showed a spontaneous attack of myocardial ischemia in the course of coronary arteriography examination. During the ischemic episode it was shown a severe coronary arterial spasm promptly relieved by nitroglycerin. In these patients the administration of ergonovine maleate induced the same clinical, electrocardiographic and coronariographic patterns of spontaneous ischemic episodes. These data support the hypotesis that the ergonovine maleate administration is a suitable test for detection of the vasospastic pathogenesis in acute myocardial ischemia.

Adult↗

Effect of atropine sulfate on tear production in the cat when used with ketamine hydrochloride and acetylpromazine maleate.

Schirmer I tear tests were done on 10 cats before and during anesthesia induced with ketamine hydrochloride in combination with acetylpromazine maleate, with and without atropine sulfate as a preanesthetic agent. Use of atropine sulfate alone decreased tear production from a mean base-line value of 16.9 +/- 3.7 mm/min to 8.2 +/- 4.9 mm/min, 10 minutes after its subcutaneous administration. Tear production continued to decrease from 8.2 +/- 4.9 mm/min to a mean of 2.3 +/- 2.5 mm/min at 30 minutes after the administration of the ketamine hydrochloride and acetylpromazine maleate combination.

Acepromazine↗

Changes in the lysosomes and mitochondria isolated from the liver, kidney and heart of rats treated with perhexiline maleate.

A seven-days treatment, with Perhexilline Maleate induces changes in the structural latency of lysosomes isolated from liver or kidney and of the respiratory activity of mitochondria isolated from liver, kidney or heart. While the effect on lysosomal structural latency appears very similar in the liver and kidney lysosomes, the oxidative properties of liver mitochondria appears clearly more disturbed than those of the heart or kidney. It is concluded that liver mitochondria might be strongly involved in the mechanism of Perhexiline Maleate hepatotoxicity.

Acetylglucosaminidase↗

Cardiorespiratory effects of acepromazine maleate and buprenorphine hydrochloride in clinically normal dogs.

Cardiorespiratory effects of the combination of acepromazine maleate (ACP) and buprenorphine hydrochloride (BPN) were studied in 11 healthy, conscious dogs. Values for systemic and pulmonary artery blood pressure, cardiac output, arterial and venous pH and blood gas tensions, and invasive and noninvasive estimates of ventricular systolic function, preload, and afterload were obtained before sedation and after administration of each drug. Acepromazine maleate (0.1 mg/kg, IV) depressed cardiac function, compared with baseline values for unsedated dogs. Cardiac output decreased from a mean (+/- SD) value of 4.2 (+/- 1.5) L/min to 3.1 (+/- 0.8) L/min (P < 0.001), a change not attributed to heart rate. Pulmonary capillary wedge pressure decreased from 8.3 (+/- 4.2) mm of Hg to 6.5 (+/- 4.3) mm of Hg (P < 0.01), but mean right atrial pressure did not change. Left ventricular measurement of the maximal positive rate of pressure change (dP/dtmax) decreased from 2,668 (+/- 356)/mm of Hg/s to 2,145 (+/- 463) mm of Hg/s (P < 0.001), and ventricular stroke volume decreased from 43.2 (+/- 15.2) ml/beat to 32.3 (+/- 8.6) ml/beat. Noninvasive indices of left ventricular function, ventricular shortening fraction, peak aortic velocity, and aortic average acceleration were decreased after ACP administration, but were not statistically different from baseline values. Mean systemic arterial blood pressure decreased from 121 +/- 12 mm of Hg to 96 +/- 13 mm of Hg 15 minutes after ACP administration (P < 0.001). Total systemic vascular resistance was not significantly different from the baseline value.(ABSTRACT TRUNCATED AT 250 WORDS)

Acepromazine↗

Effects of dimethindene maleate on psychomotor performance in the oculodynamic test compared with placebo and loratadine.

The effects of dimethindene maleate (CAS 3614-69-5) on the central nervous system-as sustained release pellets (Fenistil OAD; OAD = once a day) and sustained release tablets (Fenistil retard) with an immediate release fraction-were investigated by means of the oculodynamic test (ODT) and visual analogue scales and compared to loratadine (CAS 79794-75-5) and placebo. In the confirmatory part of the study 18 healthy volunteers were included in a single-blind, randomised, 3-way change-over design with Fenistil OAD, loratadine, and placebo. An additional, fourth exploratory arm with Fenistil retard was run in 6 (out of the 18) subjects after completing the main part of the study. The ODT includes electro-oculography, choice reaction task, and cardiologic parameters under workload. Visual analogue scales were used for subjective ratings on well-being and drug effects concerning wakefulness (sedation), excitation, dizziness, performance, effort, and dry mouth. The results show no relevant differences between either of the active drugs and placebo. Therefore it can be stated that after a single dose there is no sedating effect of dimethindene maleate compared to loratadine or placebo.

Adult↗

[Efficacy of pilocarpine and timolol maleate combination in therapy of glaucoma].

The authors assessed the effects of a single instillation and prolonged use of pilocarpine, thymolol maleate, fotyl, and fotyl-forte on the ophthalmic tone and some ocular functions in 118 patients (202 eyes) with glaucoma. The duration of pilocarpine effect is 6-8 h, that of thymolol maleate, fotyl, and fotyl-forte more than 24 h. The most expressed reduction of intraocular pressure was observed after fotyl and fotyl-forte (32-40% of initial level). Moreover, these agents showed the highest hypotensive activity upon prolonged (up to 6 months) use. Intraocular pressure normalized in about 70% patients. The hypotensive effect of fotyl-forte is somewhat higher than that of fotyl, but patients complain of pain after instillation of fotyl-forte 2-3 times more frequently than after fotyl.

Administration, Topical↗

Dimethindene maleate in the treatment of pruritus caused by varizella zoster virus infection in children.

The efficacy and tolerability of dimethindene maleate (CAS 3614-69-5, DMM, Fenistil) as drops in the treatment of pruritus in children suffering from chicken-pox were investigated in a study with two different doses of dimethindene maleate and placebo. 128 children, 1 to 6 years of age, were included in a double blind, randomized, placebo controlled, multi-center clinical trial. Patients received either a dosage of DMM of 0.1 mg/kg x d, or 0.05 mg/kg x d, or placebo, respectively. All patients received a commercially available astringent lotion for topical treatment of skin lesions. The primary efficacy criterion which was the change in the itching severity score from baseline to the end of the treatment assessed as area under the baseline (AUB) showed for both treatments with DMM a statistically significant superiority versus placebo in reducing the severity of itching. There was no statistically proven difference between the two verum groups.

Appetite↗

Discoidal niosome based controlled ocular delivery of timolol maleate.

Non-ionic surface active agents based discoidal vesicles (discomes) bearing timolol maleate were prepared. Niosomes were incorporated with Solulan C24 in order to effect vesicle to discome transition. The discomes were relatively large in size, 12-60 microm. They were found to entrap a relatively high quantity of timolol maleate. The prepared system characterized for size, shape and drug release profile in vitro. They were found to release the contents following biphasic profile particularly in the case where the drug was loaded using a pH gradient technique. The prepared system could produce or sustain a suitable activity profile upon administration into the ocular cavity; however, systemic absorption was minimized to a negliable level. The discomes were found to be promising and of potential for controlled ocular administration of water-soluble drugs.

Administration, Topical↗

Redox manipulation using the thiol-oxidizing agent diethyl maleate prevents hepatocellular necrosis and apoptosis in a rodent endotoxemia model.

Manipulation of the intracellular redox state has been shown to alter cell activation pathways with resultant changes in cellular function. Previous studies have suggested that thiol oxidation, using the glutathione-depleting agent diethyl maleate (DEM), was able to inhibit endothelial cell activation. We hypothesized that this agent might exert beneficial effects following endotoxemia in the rat, a model in which transendothelial migration of neutrophils is central to the development of hepatocellular injury. Sprague-Dawley rats treated intraperitoneally with lipopolysaccharide (LPS) (200 microg/kg) plus D-galactosamine (GalN) (600 mg/kg) developed hepatocellular necrosis, as evidenced by liver enzyme release and morphological changes. Pretreatment with DEM abrogated this injury in a dose-dependent fashion. Histology revealed reduced neutrophil accumulation in both the parenchyma and sinusoids, consistent with reduced neutrophil sequestration and transendothelial migration. This effect appeared to be related to the ability of DEM to prevent LPS-induced up-regulation of both vascular cell adhesion molecule-1 (VCAM-1) mRNA and intercellular adhesion molecule-1 (ICAM-1) mRNA in the liver, as well as reducing tumor necrosis factor (TNF) mRNA expression. In addition, DEM prevented hepatocyte apoptosis following LPS treatment. The effect was reproduced when TNF was used as an inflammatory stimulus, suggesting a direct protective effect on the hepatocyte. Taken together, these studies show that redox manipulation through thiol oxidation may represent a novel approach to preventing liver necrosis and apoptosis in inflammatory conditions.

Alanine Transaminase↗