An experimental evaluation of dependence liability of methaqualone diphenhydramine (combination) and methaqualone in rats.
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The effect of methaqualone on the induction of hepatic enzymes was evaluated in rats and compared with that of phenobarbital by measuring effects on hexobarbital and methaqualone hypnosis, plasma and tissue levels of methaqualone, hepatic aniline hydroxylase and aminopyrine demethylase activity and warfarin-induced hypoprothrombinemia. Maximal reductions in hexobarbital hypnosis occurred 3 days after daily administration of 60 mg of methaqualone per kg per day. At this time, the activities of aniline hydroxylase and aminopyrine demethylase were increased 60 and 139%, respectively, and hepatic microsomal proteins increased 15% above controls in methaqualone-pretreated animals. Methaqualone altered its own metabolism as demonstrated by a 48% reduction in methaqualone hypnosis in pretreated animals. The extent and duration of induction by phenobarbital was considerably greater than methaqualone in all experiments. Methaqualone pretreatment did not affect warfarin-induced hypoprothrombinemia, whereas phenobarbital-pretreated animals showed a 32 to 64% reduction in response to the anticoagulant. These studies indicate that methaqualone is a relatively weak inducer of hepatic drug-metabolizing enzymes and has no effect on the anticoagulant acitivty of warfarin.
To study the mechanism whereby toxic doses of methaqualone cause a bleeding tendency in humans, the effects of methaqualone, diphenhydramine, and the combination of methaqualone plus diphenhydramine on blood platelet function were investigated. Exposure of human platelets in platelet-rich plasma in vitro to final concentrations of methaqualone ranging from 1.1 to 4.5 X 10(-4)) M resulted in nearly complete inhibition of the secondary phase and significant inhibition of the primary phase of adenosine diphosphate (ADP)--induced aggregation. Both the slope and height of collagen-induced aggregation responses were reduced significantly in vitro by the drug. When methaqualone final concentrations of 1.1, 2.3, and 4.5 X 10(-4) M were studied in the presence of diphenhydramine (1.1, 2.3, and 4.5 X 10(-5) M, respectively), the degree of inhibition of ADP-induced aggregation was only slightly greater (not significant) than that observed with methaqualone. The platelets of rabbits injected intravenously with methaqualone, 10 mg/kg, demonstrated a significantly decreased ability to aggregate with ADP and collagen 30 and 60 min after administration of the drug. These results suggest that a drug-induced defect of blood platelet function may play a role in the bleeding associated with methaqualone toxicity.
Concentrations of methaqualone have been measured in the serum of five male human subjects receiving five consecutive evening doses of a combination formulation containing methaqualone (250 mg), carbromal (300 mg) and benactyzine (0.33 mg) in each tablet. After administration of the first dose, mean peak serum concentrations of methaqualone (1.2 mug/ml) occurred at 3 h. After obtaining peak levels, mean concentrations of methaqualone declined rapidly during the next 6 h and thereafter more slowly during the next 18 h. After administration of the last (fifth) dose, mean peak serum concentrations of methaqualone (1.9 mug/ml; 1.5 mug/ml above the predose level) occurred at 2 h. After attaining peak levels, mean concentrations of methaqualone declined rapidly during the next 6 h, and thereafter more slowly, with a half-life of approximately 10 h. Mean concentrations of methaqualone in serum samples 24 h after the second, third, fourth or fifth doses were not significantly different (0.3 mug/ml - 0.6 mug/ml) during this period of dosing. This suggests that significant accumulation of methaqualone in the serum did not occur during a period of five consecutive evening doses of the combination formulation.
A sensitive, rapid, and specific procedure is described for the mass screening and confirmation of methaqualone (Quaalude) in urine specimens. The method is sensitive to 1.0 microgram/ml levels of total methaqualone excretion products (free methaqualone, free hydroxylated methaqualone metabolites, and conjugated hydroxylated methaqualone metabolites). The raw urine is screened directly by radioimmunoassay, which is reactive to all the methaqualone excretion products. Specimens that are screened positive are confirmed by thin-layer chromatography using a solvent system of ethyl acetate-1,2-dichloroethane-chloroform (75:15:10) which separates methaqualone and its four major metabolites without interference from other drugs or urinary substances. The distinctive spot pattern produced by the methaqualone metabolites makes false positive results nearly impossible.
1. The effects of acute and chronic treatment of methaqualone on ethanol preference, the rate of disappearance of ethanol and on toxicity were studied in mice and rats. 2. Acute treatment with methaqualone showed a dose-dependent suppression in the voluntary intake of ethanol in C57Bl/6J mice in rats. No significant change in ethanol intake was observed during chronic methaqualone treatment and withdrawal. 3. Methaqualone pretreatment significantly (P less than 0.005) delayed the disappearance of ethanol in the blood and brain over a period of 50 and 200 min after a loading dose of 2.0 g/kg, i.p., of ethanol. 4. Methaqualone pretreatment at doses of 140 and 200 mg/kg significantly increased ethanol toxicity by 11% and 28%, respectively. Co-administration of ethanol using 6.0, 7.0 and 8.0 g/kg also reduced the LD50 of methaqualone by 19%, 24% and 40%, respectively. 5. Chronic administration with ethanol decreased the toxicity due to methaqualone. Potentiation of ethanol toxicity by methaqualone may be of clinical importance in view of the narrow range of safety margin of ethanol.
1. Oral administration of therapeutic doses (250 mg) of methaqualone (Melsed) to adult human subjects gives rise to the urinary excretion of methaqualone-N-oxide. This metabolite has been identified by chromatography and mass spectrometry and quantitatively determined by reduction with titanium trichloride to methaqualone which was then determined by g.l.c. 2. The N-oxide accounts for 5-9% of the dose in 24 h. 3. 2-Nitrobenzo-o-toluidide, a possible oxidation product of methaqualone-N-oxide, has not been detected. 4. The urinary excretion of unchanged methaqualone is less than 0-3% of the dose. The ease with which methaqualone-N-oxide is thermally converted to methaqualone casts doubts on the previously published figures for the urinary excretion of methaqualone.
Effects of methaqualone were studied on the key pecking of pigeons maintained under various schedules of food presentation. One group of pigeons responded under a multiple fixed-ratio, fixed-interval schedule. Methaqualone (3.0--10.0 mg/kg) decreased the relatively low rates of responding under the fixed-interval schedule but left unchanged the higher rates under the fixed-ratio schedule. Higher doses of methaqualone decreased responding under both schedules. Another group of pigeons responded under a fixed-interval schedule in which responding was suppressed (punished) by electric shock presented according to a fixed-ratio schedule. Suitable doses of methaqualone increased punished responding. A 2-fold change in shock intensity produced little change in rates and patterns of responding, yet methaqualone produced much greater increases in responding punished by the lower intensity shock. Regardless of whether or not responding was punished, the effects of methaqualone on fixed-interval performance depended on the rate of responding in the absence of drug; low rates of responding in the early periods of the fixed-interval were increased by doses that increased less or decreased the higher response rates in the later periods. These rate-dependent effects of methaqualone were modulated by the shock intensity; the rate-increasing effects obtained at the lower intensity shock were uniformly greater than those obtained at the higher intensity. The behavioral effects of methaqualone were generally qualitatively similar to effects reported for many sedative hypnotics.
Twelve healthy subjects received three single oral doses (250 mg) of methaqualone alone or in combination with diphenhydramine (25 mg). Blood samples were collected for a 48-hr period after each dose and analyzed for methaqualone and its major metabolite, 2-methyl-3-(2'-hydroxymethylphenyl)-4(3H)-quinazolinone. Peak blood concentrations ranging from 1.0 to 2.7 micrograms/ml occurred approximately 1-2 hr after the oral dose. The area under the blood level-time curve, peak plasma level, and elimination half-life for methaqualone were not significantly different (three-way ANOVA, p greater than 0.05) when methaqualone was administered alone, in combination with a diphenhydramine elixir or as a commercial product (capsule) containing both methaqualone and diphenhydramine. Statistically significant intersubject differences in the area under the curve were eliminated if the area was corrected for subject differences in elimination. Blood levels of the metabolite reached an average peak of 314 ng/ml (+/- 107) between 4 and 8 hr after the dose and remained elevated for the 48-hr sampling period. The areas under the blood level time curve of the metabolite were not significantly different for the three treatments. Diphenhydramine administered at the dosage level used in therapeutic combination products did not alter the blood levels of methaqualone or its metabolite. In addition, no significant differences in methaqualone availability from the two commercial formulations tested could be detected.
Methaqualone produces a dose- and time-dependent increase in plasma corticosterone concentration in mice. Acute studies showed that this effect is largely independent of methaqualone-induced hypothermia but can be blocked by pretreatment with dexamethasone, thus demonstrating that the adrenal cortex is not being directly stimulated. It is not clear whether the pituitary-adrenal activation is primarily caused by methaqualone itself or by a hepatic metabolite(s) since pretreatment with SKF 525-A failed either to potentiate or block the effect. Studies employing chronic methaqualone administration provided evidence for a rapid development of tolerance to the pituitary-adrenal effect of the drug. Dose- and time-response studies demonstrated a parallel between plasma concentrations of methaqualone and the stimulation of pituitary-adrenal activity. Furthermore, drug concentrations 1 h following methaqualone administration were diminished in chronically pretreated animals was compared to those previously untreated, suggesting that an altered metabolism of methaqualone may be responsible for the development of tolerance.
Three task variables, stimulus quality, memory set size and response type, were used in a Sternberg binary classification task to define stimulus encoding, short-term memory scanning, and response selection stages within a serial stage reaction process. Mean reaction times, and the slopes and intercepts of the function relating reaction time to memory set size, were used to test the hypothesis that performance deficits seen at two doses of methaqualone (2.9 mg/kg and 5.9 mg/kg), in the range formerly in common clinical use, were specific to the stimulus encoding stage of the reaction process. Mean reaction times were increased significantly by the methaqualone at both doses, but the effects of the two doses did not differ from one another. The intercept of reaction time as a function of set size showed significant main effects of methaqualone, stimulus quality, and response type, and a significant hyper-additive interaction of methaqualone with stimulus quality. At 2.9 mg/kg, the intercept was increased by methaqualone but only with degraded stimuli. At 5.9 mg/kg, the intercept was increased by methaqualone for both high and low quality stimuli. These results suggested a dose-dependent selective effect of methaqualone on the stimulus encoding stage of the reaction process.
We investigated the characteristics of physical dependence on methaqualone. Rats were made physically dependent on methaqualone by the use of the drug-admixed food (DAF) method for 33 days. Pentobarbital, barbital, ethanol and diazepam were cross-administered against methaqualone to evaluate the degree of suppression of methaqualone withdrawal signs as an index for the cross-physical dependence liability of these drugs to methaqualone. To evaluate the cross-physical dependence liability, we used AUC of body weight loss and withdrawal scores between the first cross-administration (9 hr after the withdrawal) and 27 hr after the withdrawal. AUC of weight loss was significantly suppressed by the four test drugs as compared to each control. Withdrawal scores were also significantly inhibited by the cross-administration of barbital, ethanol and diazepam. Considering that the rats given barbital or ethanol fell asleep after the cross-administration, diazepam seems to cause the strongest suppression of methaqualone withdrawal signs among the four test drugs. Thus, physical dependence on methaqualone may be similar by nature to that on benzodiazepines rather than barbiturates and alcohol.