Hormonal disturbances and effect of pharmaca.

The hormonal milieu of the organism may exert certain influences on the activity and lasting of the effect of some drugs. This was demonstrated in female rats with the example of a steroid hormone (estrone) and a short acting barbiturate derivative (hexobarbital). Estrus produced with estrone is not to be influenced by ovariectomy. Hyperthyrosis lead to the cumulation of estrogens in active form and lengthened their effect. Hypothyrosis accelerated estrogen metabolism inducing a relatively ephemer effect of estrone. Hexobarbital metabolism is faster in ovariectomised rats as well as in thyroidectomised ones than in controls. The catatoxic effect of testosterone is bringing about a short anesthesia. Hyperthyrosis reduced the effect of hexobarbital to one fourth of the control values. A special care is necessary in administering drugs when endocrine disorders are present. Individual dosages of the pharmaca may be taken into consideration to adapt the right dosages to the hormonal disturbances.     

Enantiospecific quantification of hexobarbital and its metabolites in biological fluids by gas chromatography/electron capture negative ion chemical ionization mass spectrometry.

A highly sensitive and specific assay based on gas chromatography/electron capture negative ion chemical ionization mass spectrometry has been developed for the analysis of the enantiomers of hexobarbital and its major metabolites in human urine and plasma. S-(+)-(5-2H3)hexobarbital and R-(-)-(5-2H3)hexobarbital were synthesized for clinical studies along with (+/-)-(1,5-2H6)hexobarbital and the deuterated major metabolites for use as internal and reference standards. Hexobarbital enantiomers and their metabolites were analyzed after pentafluorobenzyl and trimethylsilyl derivatization, following solid-phase extraction from plasma and urine. Intense negative ion spectra were observed for all of the derivatives. The base peak in the spectra corresponded to the M-pentafluorobenzyl anion [M-PFB]- except for 1,5-dimethylbarbituric acid, where M-. was the most abundant ion. The applicability of the method was demonstrated by following the plasma concentration-time profiles and urinary excretion in a male extensive metabolizer of mephenytoin who was given a pseudoracemic oral dose of hexobarbital containing equal 50 mg amounts of S-(+)-2(H0)hexobarbital and R-(-)-(2H3)hexobarbital. Marked stereoselective disposition was observed, with the R-(-)-enantiomer being more efficiently metabolized, primarily by alicyclic oxidation and ring cleavage.     

Expression of a human liver cytochrome P-450 protein with tolbutamide hydroxylase activity in Saccharomyces cerevisiae

The human liver cytochrome P-450 (P-450) proteins responsible for catalyzing the oxidation of mephenytoin, tolbutamide, and hexobarbital are encoded by a multigene family (CYP2C). Although several cDNA clones and proteins related to this "P-450MP" family have been isolated, assignment of specific catalytic activities remains uncertain. Sulfaphenazole was found to inhibit tolbutamide hydroxylation to a greater extent than mephenytoin or hexobarbital hydroxylation. The inhibition by sulfaphenazole was competitive for tolbutamide and hexobarbital hydroxylation but with much different Ki values (5 vs 480 microM, respectively). Inhibition of mephenytoin hydroxylase was not competitive. The results suggest that different P-450 proteins in the P450MP family may be involved in the metabolism of these compounds. A cDNA clone (MP-8) related to the P-450MP family, isolated from a bacteriophage lambda gt11 human liver library, was expressed in Saccharomyces cerevisiae by using the pAAH5 expression vector. Yeast transformed with pAAH5 containing the MP-8 sequence (pAAH5/MP-8) showed a ferrous-CO spectrum typical of the P-450 proteins. Immunoblotting with anti-P450MP revealed that pAAH5/MP-8 microsomes contained a protein with an Mr similar to that of P-450MP-1 (approximately 48,000) that was not present in microsomes from yeast transformed with pAAH5 alone (1.7 X 10(4) molecules of the expressed P-450 per cell). Microsomes from pAAH5/MP-8 contained no detectable mephenytoin 4'-hydroxylase activity but were more active in tolbutamide hydroxylation, on a nanomoles of P-450 basis, than human liver microsomes. The pAAH5/MP-8 microsomes also contained hexobarbital 3'-hydroxylase activity, although the enrichment compared to liver microsomes was not great with respect to the tolbutamide hydroxylase activity.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effects of lipid A content, hydrocortisone and polymyxin B on endotoxin-induced decreases in in vivo drug metabolism

Using hexobarbital sleeping and zoxazolamine paralysis time as indices of in vivo hepatic drug metabolism, the effects of endotoxin on drug action appear to be time- and dose-dependent and the lipid A moiety of endotoxin appears to be responsible for its inhibitory effects. These studies have also demonstrated that polymyxin B can ameliorate the adverse effects of endotoxin on drug metabolism. Since hydrocortisone protects mice from endotoxin lethality, but does not alter the prolongation of hexobarbital sleeping time caused by endotoxin, it is possible to separate the lethal effects of endotoxin from its effects on drug metabolism.     

Preparation,morphology and drug metabolism of isolated hepatocyte and liver organ cultures from the human fetus

Isolated hepatocytes of human fetuses (week 9–20 of gestation) were prepared by digestion of liver slices with Dispase l and repeated centrifugations. These cells metabolized drugs by first order kinetics for at least 4 h and retained their drug metabolizing enzyme activities for more than 24 h. Using cultures of human fetal liver slices (week 5–20 of gestation) first order kinetics of drug metabolism could be measured for up to 3 days. These findings correlate well with concomitant morphological studies. Electron microscopy revealed that the liver cells of human fetuses (week 9–20 of gestation) contained numerous cavities of the rough endoplasmic reticulum (ER) and only single membranes of the smooth ER. The isolated liver cells maintained their morphological integrity for up to 24 h in culture. Sections derived from liver slices cultured for up to 3 days did not show any significant morphological alterations, except for some swellings of mitochondria, vacuolisations and fat inclusions that occurred in the sinus endothelia and blood cells. A gradual disintegration began on day 4, and after 7 days intact cells could no longer be demonstrated. The metabolism of the benzodiazepine drugs prazepam, diazepam and medazepam as well as diphenylhydantoin, hexobarbital and halothane were measured in these systems. Both the isolated hepatocyte and liver organ cultures should be useful to study whether a relationship exists between the emryotoxicity of certain drugs and their metabolism in the human fetus.     

Pharmacokinetics of Hexobarbital,Sulphadimidine and Chloramphenicol in Neonatal and Young Pigs

Half-life and apparent specific volume of distribution of hexobarbital, sulphadimidine and chloramphenicol were investigated in newborn, 1, 3, 5 and 8 weeks old pigs. Hexobarbital sleeping time and plasma concentration of hexobarbital at recovery were measured in the same age groups. The half-life of hexobarbital and chloramphenicol was long in newborn pigs but decreased fast during the first week after birth. From 1 to 8 weeks after birth the decrease was less pronounced. The half-life of sulphadimidine increased during the first 3 weeks of life, but in 1 and 3 weeks old pigs the amount of N4-acetylated sulphadimidine in plasma at 200 min. after the injection was higher than in the newborn pigs. The apparent specific volume of distribution of hexobarbital, sulphadimidine and chloramphenicol was changed in different ways from birth to 8 weeks of age. The hexobarbital sleeping time was very long in the newborn pigs and decreased until 3 weeks of age. The concentration of hexobarbital in plasma at recovery was unchanged from birth to 8 weeks of age. The concentration of chloramphenicol metabolites in plasma 100 min. after the injection increased very fast during the 8 weeks of observation. The concentration of N4-acetylated sulphadimidine in plasma at 200 min. after the injection increased from birth to 1 week of age, then it decreased. The data are stressing that the neonatal pig is a convenient model for pharmacokinetic testing of drugs used as pharmacotherapeutics in neonatal life.     

Binding of anticonvulsant drugs to cytochrome P-450: correlation with evidence of induction of hepatic microsomal enzymes.

Mephenytoin, diphenylhydantoin, pheneturide, and phenobarbital produced a concentration-dependent inhibition in the binding of hexobarbital to cytochrome P-450 at the type 1 site, while sulthiame slightly potentiated, and ethosuximide did not affect the binding characteristic of hexobarbital. Diphenylhydantoin, phenobarbital, and pheneturide have previously been shown to enhance the urinary excretion of D-glucaric acid (DGA), while sulthiame inhibited the potentiation of DGA excretion caused by these drugs, and ethosuximide produced no change. The results suggest a close relationship between the ability of these drugs to induce hepatic microsomal drug-metabolizing enzyme systems (as indicated by enhancement of DGA excretion) and binding behaviour at the type 1 site.     

Changes in mixed-function oxidase system in the perfused liver of the cold-acclimated rat

Changes in the hepatic cytochrome P-450-dependent drug-metabolizing system were studied in perfused livers obtained from cold-acclimated male Wistar rats after 30 days of cold exposure (4C) when using hexobarbital as a substrate. In fasted animals the cold-acclimated rats showed higher levels of hexobarbital metabolic rates compared to control rats, but there was no significant difference in fed animals. The maximum rates of hexobarbital metabolism produced by xylitol perfusion were also significantly higher in the perfused liver of cold-acclimated rats. It was concluded that the function of the cytochrome P-450 system for hexobarbital in cold-acclimated rats changed due to both an increase in the activity of the cytochrome P-450 system and to changes in regulation of the cytochrome P-450 system by the supply of reducing equivalents.     

Effect of psychotropic drugs on somatosensory evoked cortical potentials]

The effects of some typical clinically tested psychotropic drugs were studied in acute experiments on awake rats. Potentials in somatosensory cortex were evoked by peripheral stimulation. Haloperidol, diazepam, medazepam, desipramin and a new substance, the MPP-sulton, caused significant modification in latency and amplitude of some components of the potentials. Between the effects of psychotropic drugs exist differences which, in turn, were clearly distinguishable from the modification of these evoked responses by unspecific narcotic effects of hexobarbital.     

Nonsubstrate induction of a soluble bacterial cytochrome P-450 monooxygenase by phenobarbital and its analogs

A soluble, cytochrome P-450-dependent fatty acid hydroxylase--epoxidase complex from Bacillus megaterium ATCC 14581 can be induced more than 100-fold by the addition of phenobarbital or one of its analogs (hexobarbital) to the growth medium. These barbiturate inducers are apparently not substrates for the enzyme nor do they activate the monooxygenase in the cell-free system. The induction efficiency of both phenobarbital and hexobarbital can be significantly increased with respect to monooxygenase activity by autoclaving the inducer in the growth medium rather than by adding it to the medium after autoclaving. Turnover numbers of about 3 000 nmoles of substrate oxygenated per min per nmole of P-450 were obtained in crude cell-free preparations obtained from maximally induced cultures. Our data indicate that products formed by heating phenobarbital or hexobarbital in the growth medium are significantly better inducers of monooxygenase activity than are the unaltered drugs.     

The effects of cyclic 3'5' adenosine monophosphate on the acute tolerance induced by ethanol in male rats.

The effect of cyclic 3′5′ adenosine monophosphate (cAMP) on the acute tolerance induced by ethanol was studied in male rats. The acute tolerance was measured with a hexobarbital anesthesia method, where the dose of hexobarbital needed to obtain a burst suppression of 1 second or more in EEG is determined. Ethanol 2.0 g/kg was given ip 0.25 or 3 h prior to the threshold determination. cAMP 10 mg/kg or saline was given iv 6 h prior to the threshold determination.After saline pre-treatment less hexobarbital was needed 0.25 h after ethanol administration compared to 3 h after ethanol administration, although the blood levels were similar. An acute tolerance had developed. Pre-treatment with cAMP had no effect on the dose of hexobarbital needed without ethanol nor on the dose needed 3.0 h after ethanol administration. 0.25 h after ethanol more hexobarbital was needed in the animals pre-treated with cAMP compared with the corresponding saline treated animals. The dose of hexobarbital was as large as the one needed 3.0 h after ethanol. Thus cAMP seems to facilitate the induction of acute tolerance to ethanol while the hexobarbital threshold as such is uninfluenced.     

Enhancement of hexobarbital-induced sleep by lysine and its metabolites

Lysine has been shown to be metabolized in the rat brain to pipecolic acid which is a precursor of piperidine. Lysine and its proposed metabolites in this pathway were studied for the first time for their effect on the sleeping time induced by hexobarbital in the rat. Only $\text{L}$-lysine and $\text{D}$-lysine were found to prolong sleeping time significantly without toxic effect. A 3-day pretreatment with $\text{L}$-lysine produced an even more profound sleep prolongation. In most cases sleep enhancement was accompanied by a significant shortening of the time of sleep onset. Quantification of brain hexobarbital levels in the control and treated rats indicates that prolongation of sleeping time was not produced by inhibition of hexobarbital metabolism. The sleep prolonging effect of lysine, therefore, may be a direct action of lysine, or the metabolite(s) derived $\text{in}$$\text{vivo}$ from lysine, on the central nervous system.     

Liver extract effect on liver microsomal system and on an experimental model of intoxication]

A lyophilized liver extract (FLR) lengthens hexobarbital action in control rats ; it decreases slightly the induction of hepatic microsomal enzymes and normalizes diphenylhydantoin protection against electroshock seizure in phenobarbital-treated animals ; in the event of a CC14 intoxication, this extract reestablishes values close to normal for mebubarbital metabolism in mice and for BSP clearance in rats. FLR could act in regularizing drug metabolism.     

Metabolism of diphenyloxazole (PPO) by mouse liver microsomes.

2, 5-Diphenyloxazole (PPO) is an inducer and inhibitor of aryl hydrocarbon hydroxylase. We report that PPO is itself metabolized to an alkali-extractable metabolite with intense fluorescence. The fluorescence spectra of excitation and emission indicate peaks at 345 nm and 510 nm, respectively. The reaction is linear with respect to time and enzyme concentration. NADPH is required for activity and the reaction is inhibited by carbon monoxide and 7, 8-benzoflavone but not by SKF-525A or hexobarbital. The intensity of fluorescence produced is similar to that of benzo (a) pyrene. PPO may be a useful model compound in studies of drug metabolism by the mixed function oxidase.     

Gradients of O2 concentration in hepatocytes.

1. Cytochrome P/450-dependent mixed function oxidations of hexobarbital, phenyramidol, and alprenolol in intact hepatocytes were examined at different steady state oxygen concentrations. Apparent Kmo2 values were determined to be 6.4 +/- 1.7, 3.6 +/- 0.6, and 9.8 +/- 1.2 micronM, respectively. 2. Apparent Kmo2 values for metabolism of hexobarbital and alprenolol by liver microsomes were 4.3 +/- 0.4 and 8.7 +/- 0.7 micronM, similar to the corresponding values for whole cells. Therefore, no detectable gradient of O2 concentration exists between extracellular space and endoplasmic reticulum of hepatocytes at these oxygen concentrations. 3. Steady state concentrations of ATP, ADP, AMP, lactate, and pyruvate at different steady state oxygen concentrations were used as indicators of mitochondrial oxygen dependence in intact hepatocytes. Half-maximal changes occurred at [O2] = 12.6 micronM for cytoplasmic [NAD+]/[NADH] (estimated from [lactate]/[pyruvate]), at 7.0 micronM for [ATP]/[ADP], and at 2.8 micronM for adenylate energy charge. The apparent cellular respiratory Kmo2 was 1.90 +/- 0.18 micronM. 4. Comparison of values for oxygen dependence of mitochondrial functions in isolated hepatocytes with published values for isolated mitochondria suggests that a substantial intracellular oxygen gradient exists between the outer cellular membrane and the mitochondrial inner membrane at po2 values below the critical O2 tensions.     

Spectral studies on drug-cytochrome P-450 interaction in isolated rat liver cells

Various drugs including hexobarbital, lidocaine and nortriptyline were added to suspensions of liver cells isolated from untreated and phenobarbital-treated male rats. Upon drug addition, there was a fast binding to cytochrome P-450, as revealed by the appearance of a rapidly growing type I spectral change in the difference spectrum. When this had reached optimal magnitude, an absorption peak at 437 nm could often be seen to appear and quickly disappear, followed by yet another increase in absorption at about 446 nm; the latter and the type I spectral change then rapidly disappeared. These spectral changes were most pronounced with liver cells from phenobarbital-treated rats which contained markedly increased levels of cytochrome P-450. Also the rate of hexobarbital binding to cytochrome P-450 seemed to be increased after phenobarbital pretreatment. Finally, evidence was obtained that the major part of cytochrome P-450 in the isolated liver cells is present in an oxidized, non-substrate-bound form.     

Defining the in Vivo Role for cytochrome b5 in cytochrome P450 function through the conditional hepatic deletion of microsomal cytochrome b5

In vitro, cytochrome b5 modulates the rate of cytochrome P450-dependent mono-oxygenation reactions. However, the role of this enzyme in determining drug pharmacokinetics in vivo and the consequential effects on drug absorption distribution, metabolism, excretion, and toxicity are unclear. In order to resolve this issue, we have carried out the conditional deletion of microsomal cytochrome b5 in the liver to create the hepatic microsomal cytochrome b5 null mouse. These mice develop and breed normally and have no overt phenotype. In vitro studies using a range of substrates for different P450 enzymes showed that in hepatic microsomal cytochrome b5 null NADH-mediated metabolism was essentially abolished for most substrates, and the NADPH-dependent metabolism of many substrates was reduced by 50-90%. This reduction in metabolism was also reflected in the in vivo elimination profiles of several drugs, including midazolam, metoprolol, and tolbutamide. In the case of chlorzoxazone, elimination was essentially unchanged. For some drugs, the pharmacokinetics were also markedly altered; for example, when administered orally, the maximum plasma concentration for midazolam was increased by 2.5-fold, and the clearance decreased by 3.6-fold in hepatic microsomal cytochrome b5 null mice. These data indicate that microsomal cytochrome b5 can play a major role in the in vivo metabolism of certain drugs and chemicals but in a P450- and substrate-dependent manner.     

Detection of free radicals as a consequence of rat intestinal cellular drug metabolism

Because the intestine is the first pass organ for orally administered drugs and because some of these drugs are known to undergo oxidative metabolism leading to the formation of free radicals, we investigated the potential for this to occur in cell suspensions of rat enterocytes. As part of our study, the effect of intracellularly produced superoxide on cellular metabolism was investigated. The drugs chosen were the quinone, menadione and the aromatic nitro-containing compound, nitrazepam. On incubation of both drugs with isolated enterocytes and the spin trap, 5,5-dimethyl-1-pyrroline N-oxide (DMPO), rapid appearance of an electron paramagnetic resonance (EPR) spectrum was recorded which was characteristic of hydroxyl radicals being spin trapped by DMPO giving 2,2-dimethyl-5-hydroxy-1-pyrrolidenyloxyl (DMPO-OH). Experiments were conducted which determined that the EPR spectrum of DMPO-OH resulted from the initial spin trapping of superoxide by DMPO to yield the corresponding nitroxide, 2,2-dimethyl-5-hydroxyl-1-pyrrolidenyloxyl (DMPO-OOH). Bioreduction of DMPO-OOH by glutathione peroxidase led to the rapid formation of DMPO-OH. We believe this enzymic pathway accounted for the EPR spectrum noted in incubations with either drug in the presence of the spin trap, DMPO. The incubation of enterocytes with both drugs did not mediate release of 51Cr nor lactate dehydrogenase. However, production of 14CO2 from [14C]glucose was severely inhibited (4-5-fold) in the presence of both drugs, while the incorporation of [14C]leucine into trichloroacetic acid precipitable protein was antagonized by menadione only. We conclude that superoxide can be demonstrated to arise as the result of enterocyte metabolism of menadione or nitrazepam. The consequence of oxidative metabolism of these drugs results in cellular dysfunction.     

The NADPH-dependent cytochrome P-450 reduction in liver microsomes of rats of different ages with and without phenobarbital pretreatment.

The activity of NADPH-cytochrome P-450 reductase in liver microsomes of 10- to 60-day-old rats was determined. Neither the half life time of cytochrome P-450 reduction nor the absolute amount of cytochrome P-450 reduced per time unit depend on age. Phenobarbital pretreatment enhances the reduction rate in all age groups. The addition of hexobarbital or ethylmorphine to microsomal suspension accelerates the reduction of cytochrome P-450 in some age groups only. Age differences corresponding to developmental changes in drug-metabolizing activities are not detectable. The NADPH-cytochrome P-450 reductase seems to be not responsible for the age dependence of drug metabolism.     

Stoichiometric cooperation of NADPH and hexobarbital in hepatic microsomes during the catalysis of hydrogen peroxide formation

The interaction of NADPH and hexobarbital during catalysis of microsomal mixed function oxidase-dependent hydrogen peroxide formation has been investigated in hepatic microsomes from phenobarbital-treated rabbits. The application of Job's method (25) of continuous variation revealed optimal conditions for the rate and extent of hydrogen peroxide formation when hexobarbital and NADPH were in equimolar amounts. The formation of a complex of 1 mol NADPH with cytochrome c-reductase and 1 mol hexobarbital with cytochrome P-450 seems to be responsible for limitation of hydrogen peroxide formation. Rate and extent of hydrogen peroxide formation are directly proportional to the amount of hexobarbital and NADPH present and are governed by the mass action equation in a manner similar to that reported for interaction of purified enzymes (G. T. Miwa, S. B. West, M. T. Huang, and A. H. Lu, 1979,J. Biol. Chem.254, 5695–5700). Depending on either the NADPH concentration maintained by a generating system or the hexobarbital concentration, the extent of hydrogen peroxide formation could be shown to be a function of either compound alone, as long as the other one is in excess. The question whether the formation of hydrogen peroxide depends on the availability of two independent one-electron transfer reactions forming O₂^? or of one simultaneous two-electron transfer forming O₂^2? might thus become rather a matter of association of substrate and cosubstrate to a catalytically active complex in which the substrate augments the availability of reducing equivalents.