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Metabolism of chlorpromazine and promazine in vitro: isolation and characterization of N-oxidation products.

1. The syntheses of the secondary hydroxylamines of nor1chlorpromazine and nor1promazine via their corresponding primary hydroxylamines and oximes are described. 2. The N-oxidation products are unstable to analysis by g.l.c. without prior derivatization; the decomposition products and the structures of the trimethylsilyl (TMS) and trifluoroacetyl (TFA) derivatives were characterized by g.l.c.-mass spectrometry. 3. Chlorpromazine, promazine and their demethylated products were shown to undergo metabolic N- and alpha-C-oxidation, to yield hydroxylamines and carboxylic acids, on incubation with fortified 9000 g liver homogenates of male New Zealand white rabbits. 4. A condensation product, an artifact formed by reaction of the metabolically derived primary hydroxylamines with acetaldehyde, an impurity in the extraction solvent, diethyl ether, was identified. 5. N-hydroxynor1- and N-hydroxynor2chlorpromazine undergo metabolic reduction to the parent amines, and the secondary hydroxylamine undergoes N-demethylation to yield the corresponding primary hydroxylamine.

Animals↗

Anxiety/depression in elderly patients. A double-blind comparative study of fluphenazine/nortriptyline and promazine.

A double-blind study involving sixty-two patients, aged 65 years or over, treated for twenty-eight days, showed that fluphenazine 0-5 mg/nortriptyline 10 mg three times daily was superior to promazine 50 mg three times daily in relieving symptoms of anxiety and was associated with a lower incidence of side-effects. The results are discussed in the light of the nature of anxiety/depression syndromes in the elderly and it is suggested that since symptoms of anxiety in these disorders are often manifestations of an underlying depressive illness, the antidepressant effect of the nortriptyline may have enhanced the 'anxiolytic' advantage of fluphenazine/nortriptyline.

Age Factors↗

Promazine and neonatal hyperbilirubinaemia.

An increased incidence of jaundice in mature, healthy newborn babies was noticed in 1970-1971. This coincided with the increased used of the drug promazine. A decrease in the incidence of jaundice was noted three months after total withdrawal of this drug from the hospital.

Analgesia↗

Severe ischemia of the hand following intra-arterial promazine injection: effects of vasodilation, anticoagulation, and local thrombolysis with tissue-type plasminogen activator.

Promazine hydrochloride was injected accidentally in the antecubital artery of a 42-year-old woman, resulting in severe ischemia of the second and third fingers of her right hand which lasted for four days before she was hospitalized. Vasodilation by combining axillary plexus block and intravenous sodium nitroprusside did not improve ischemia and local thrombolysis was performed using recombinant tissue-type plasminogen activator (50 mg over 8 hours), resulting in normalization of digital pressure in one of the two affected fingers. The outcome was favourable and amputation could be avoided.

Adult↗

Promazine. A major plasma metabolite of chlorpromazine in a population of chronic schizophrenics.

N-Demethylation and dehalogenation of chlorpromazine (CPZ) were compared in six psychotic inpatients and in rats orally treated for 4 weeks with a daily CPZ dose of 5.4 (mean value) and 20 mg X kg-1 body weight, respectively, by measuring drug and metabolite plasma levels by means of a gas-liquid chromatography-nitrogen/phosphorus detector method. In patients the major plasma metabolite was found to be promazine (PZ), as identified by capillary GC-MS analysis. In rats, on the contrary, PZ represented only a small proportion of the compounds detected in plasma. The mean [PZ]/[CPZ] ratio after 4 weeks of treatment was 1.64 in patients and 0.08 in rats. The relative frequency of the N-demethyl metabolites in plasma, however, was similar in the two species. The mean [N-monodemethylated CPZ]/[CPZ] and [N-didemethylated CPZ]/[CPZ] ratios after 4 weeks of treatment were 0.45 and 0.24 in patients and 0.56 and 0.25 in rats, respectively. These findings suggest that dechlorination of CPZ in psychotic patients represents an important metabolic pathway.

Adult↗

Liquid chromatographic determination of identity, content, and content uniformity of desipramine, fluphenazine, and promazine.

A liquid chromatographic procedure has been developed for the assay, content uniformity, and identification of single active ingredient formulations of desipramine, fluphenazine, and promazine. The drugs are extracted from formulations with methanol or dilute hydrochloric acid and quantitated against an internal standard (norephedrine). The drugs are identified by comparison of retention times with those of the reference standards.

Chromatography, Liquid↗

[Voluntary description of drug effects as a method in clinical trials. Presented using the example of pentobarbital, promazine and their combination].

Free description of drug effects is suggested as a method in which subjects or patients describe spontaneously the effects of psychotropic drugs from their own experience with their own verbal concepts. The method is exposed in detail and examplified by examination of pentobarbitone, promazine and their combination (Norkotral). The results of the free description method have psychological as well as psychopharmacological plausibility. It is suggested to implement the method as a new means of clinical research in psychopharmacology.

Clinical Trials as Topic↗

Antibiotic cross-resistance patterns of ambodryl and promazine resistant mutants.

The antihistaminic drug ambodryl (Am) and the tranquillizer promazine (Pr), which had previously shown significant antimicrobial activities, were used to select bacterial mutants representing different levels of resistance to their action. These Am and Pr mutants were found to have simultaneously developed cross-resistance to penicillin (Pe), streptomycin (Sm), chloramphenicol (Cm), tetracycline (Tc) and kanamycin (Km). Certain first-step Am mutants of sensitive wild-type bacteria which were also sensitive to these antibiotics developed resistance to Pe and Sm as well as to Pr and the antihistamine benadryl (Bn). The next-step mutant of Am resistance not only doubled its resistance to these antibiotics and chemotherapeutics, but broadened its resistance-spectrum to cover Tc and Cm. These observations on cross-resistances seem to be best explained on the basis of a reduction in cell-membrane permeability acting in a nonspecific manner. The role of such cross-resistance in accounting for an overall increase in the minimum inhibitory concentrations (MIC) of many drugs against several groups of bacteria is evaluated.

Anti-Bacterial Agents↗

Anesthesia in the mouse using a combination of ketamine and promazine.

An anesthetic combination of ketamine and promazine was tested in 25 male and 25 female mice of each of two strains. The mean induction time was 5 minutes for the C57BL/6We mouse and 8 minutes for the DBA/2We mouse. No sex differences were observed. The mean duration time was 45 minutes for the C57BL/6We male, 53 minutes for the C57BL/TWe female, 29 minutes for the DBA/2We male, and 35 minutes for the DBA/2We female. The mean recovery time was 39 minutes for the C57BL/6We male, 38 minutes for the C57BL/6We female, 21 minutes for the DBA/2We male, and 24 minutes for the DBA/2We female. The drug combination provided effective anesthesia for these strains of the laboratory mouse for a period of 30--50 minutes after a single intramuscular injection.

Anesthesia↗

The photodynamic effect of chlorpromazine, promazine, and hematoporphyrin on lens protein.

Calf lens protein was irradiated with near ultraviolet (UV) light in the presence of the drugs chlorpromazine, promazine, and hematoporphyrin. It then was analyzed by SDS-polyacrylamide gel electrophoresis and amino acid analysis. Marked increases in protein photopolymerization (other than S-S bond formation) and histidine destruction were noted in the presence of these drugs. In all cases, these effects were reduced in the presence of a singlet oxygen quencher, thus suggesting that these photodynamic effects are due, at least in part, to a Type II mechanism.

Chlorpromazine↗

Anesthesia in the rabbit using a combination of ketamine and promazine.

An anesthetic combination of ketamine and promazine (75mg/kg by ketamine content) was tested in 15 male and 15 female adult New Zealand white rabbits. The mean induction time was 9 minutes for both the male and female. Mean duration for anesthesia was 61 minutes for the male and 49 minutes for the female. The mean recovery time was 22 minutes for the male and 33 minutes for the female. The drug combination provided effective anesthesia for a period of 50--60 minutes after a single intramuscular injection.

Anesthesia↗

[Investigation of the interaction of carbamazepine or promazine with bovine serum albumin, using a new dialysis device (author's transl)].

The construction and operation of a new dialysis device are described. The unbound fraction of a drug in a buffered solution of albumin can be determined after 10-15 minutes. The usefullness of this device was demonstrated by the determination of the unbound fraction of Carbamazepine or Promazine in buffered solutions of bovine serum albumin. The results agreed with those obtained by control methods (equilibrium dialysis and gel filtration). Furthermore, the binding of Carbamazepine to bovine serum albumin was characterised by determining the overall binding constant (K1), the apparent binding constant (k+), the number of binding sites per molecule of albumin (n), the free reaction energy deltaFdegrees, and the unbound fraction of the drug.

Binding Sites↗

Studies on the existence of synergism between different antibiotics and a phenothiazine tranquilizer, promazine, possessing antimicrobial property.

Different antibiotics were tested for their capacity to exhibit synergism when used in combination with promazine (Pr), a tranquilizer endowed with powerful antimicrobial property. For this purpose the minimum inhibitory concentration (MIC) of different antibiotics and Pr was first determined by spot inoculation technique on nutrient agar plates to select the concentrations of the antibiotics and Pr to be used as well as the sensitive strains. It was observed that Pr in combination with tetracycline (Tc) demonstrated a marked enhancement of the inhibitory capacity of each drug, both against the Gram-positive and Gram-negative bacteria, following disc diffusion technique. The in vitro findings were further substantiated with the in vivo effects of Pr along with Tc using Salmonella typhimurium NCTC 74 as the challenge strain in mice. The synergism obtained was further corroborated in terms of the increase in the size of their inhibition zones compared with their unaltered individual zones to determine the level of significance. This result was also confirmed by the checkerboard test using doubling dilutions of both the agents.

Animals↗

Mechanistic insight from a volume profile for electron transfer between promazine and hexaaquairon(III).

The kinetics of the outer-sphere electron-transfer reaction between promazine (dimethyl-(3-phenothiazin-10-yl-propyl)-amine) and hexaaquairon(III) was studied using a high-pressure stopped-flow technique. The effect of pressure (over the range 0.1-130 MPa at 25 degrees C and ionic strength 1.0 M) on the reaction rate in aqueous perchloric acid solution resulted in volumes of activation of -6.2 +/- 0.4 and -12.5 +/- 0.5 cm(3) mol(-)(1) for the forward and reverse processes, respectively. The effect of pressure on the overall equilibrium constant revealed a reaction volume of +5.0 +/- 0.2 cm(3) mol(-)(1). The reported volume profile reveals mechanistic information on the electron-transfer process in terms of volume changes along the reaction coordinate. The volume of activation for the promazine/promazine(+*) self-exchange reaction was calculated on the basis of the Marcus cross relationship.

Journal Article↗