Clinical pharmacokinetics of penicillins in the neonate: a review of the literature.

BACKGROUND: Sepsis is common in neonates and a major cause of morbidity and mortality. Sixty percent of preterm neonates receive at least one antibiotic during the first week of life, with penicillins being the most frequently administered antibiotics. The clearance (Cl), serum half-life (t((1/2))) and volume of distribution (Vd) of penicillins are different in the neonate than in the adult. As such, the pharmacokinetics of penicillins need be studied in neonates in order to optimise therapy in this age class with these drugs. OBJECTIVES: The aim of this study was to review the published data on the pharmacokinetics of penicillins in the neonate in order to provide a critical analysis of the literature and, consequently, a useful tool in the hands of the physician. METHODS: The bibliographic search was performed electronically using the PubMed and EMBASE databases as search engines. An initial search was performed with the keywords "pharmacokinetics", "penicillins" and "neonates". Secondly, other searches were performed using the keywords "pharmacokinetics" and "neonates", followed by the name of a single antibiotic. The search included articles up to 2007. RESULTS: There have been few pharmacokinetic studies on the use of penicillins in neonates. The results from those few studies that have been carried out suggest that the Cl is reduced and t((1/2)) prolonged in the neonate as compared with the more mature infant. There is little variation in Vd during the first week of life. In the premature neonate, Cl is reduced compared to the full-term infant. As postnatal age proceeds, the Cl of penicillins increases. CONCLUSIONS: More pharmacokinetic studies are required to provide a sound scientific basis for planning a dosage regimen with penicillins in the neonate.

Placental transfer of antibiotics administered to the mother: a review.

BACKGROUND: The purpose of antibiotic treatment in pregnant women is to treat the mother and/or the fetus since it is known that antibiotics administered to the mother cross the placenta and reach the fetus. A comparison of the drug concentration in maternal and fetal plasma gives an indication of the exposure of the fetus to the maternally administered antibiotics. AIM: The aim of this study was to review the literature pertaining to the placental transfer of antibiotics in man and to classify the antibiotics according to the type of transfer involved. A table has been developed for use by physicians that lists the name of the antibiotic, the drug concentration in the cord and maternal plasma at delivery and the type of transfer involved. METHODS: An initial medline search was performed with the key words "placental transfer of antibiotics" with the limit of "human". A second medline search was performed with the key words "placental transfer of..." followed by the class names of the antibiotic such as penicillins, cephalosporins, aminoglycosides, tetracyclines and macrolides. The bibliographic search on the placental transfer of antibiotics covered the period up to July 2005. RESULTS: 3 types of placental transfers were identified. A few antibiotics cross the placenta rapidly and equilibrate in the maternal and cord plasma; this type of transfer is termed "complete" and include the antibiotics ampicillin, methicillin, cefmenoxime and cefotiam. Antibiotics which show incomplete transfer to the placenta where concentrations are lower in the cord than maternal plasma are said to have "incomplete" transfer and these include azlocillin, dicloxacillin, piperacillin, sulbenicillin, cefoxitin, amikacin, gentamicin, kanamycin, streptomycin, fosfomycin, thiamphenicol, griseofulvin, vancomycin and colistimethate. Ceftizoxime is the only antibiotic so far known whose concentrations are higher in the cord than maternal plasma. This type of transfer is called "exceeding" transfer. CONCLUSION: All examined antibiotics cross the human placenta including those with a molecular weight greater than 1000 kDa such as vancomycin and colistimethate but there are 3 distinct types of placental transfer: complete, incomplete and exceeding and most antibiotics exhibit incomplete transfer.

Clonazepam serum protein binding during development.

Clonazepam protein binding was investigated in sera from five different umbilical cords, 45 children (aged 2 mo to 12 yr), and five adults (aged 27 to 40 yr). The unbound fraction (means +/- SE) of clonazepam was 17.3% +/- 0.7% in umbilical cord serum and 13.9% +/- 0.2% in adult serum (P less than 0.01). In children, the unbound fraction of clonazepam reached the adult values during the first year of life. The kinetics of clonazepam serum protein binding were studied in three umbilical cord serum and three adult serum specimens. The number of binding sites (n, reported as moles per gram protein) and the association constant (K, reported as M-1) were estimated from double reciprocal plots of 1/r against 1/D (r is the number of moles bound per gram plasma protein; D is the molar concentration of unbound drug). In umbilical cord sera, the mean values (+/- SE) of n and K were 8.4 +/- 0.6 X 10(-7) mol/gm and 8.3 +/- 0.9 X 10(4) M-1. In adult serum samples the corresponding values were 3.0 +/- 0.8 X 10(-7) mol/gm and 2.7 +/- 0.6 X 10(5) M-1, which indicated lower binding capacity but higher affinity for clonazepam of plasma proteins in adults than in children.

Placental transfer of drugs administered to the mother.

Drugs administered to mothers have the potential to cross the placenta and reach the fetus. Under particular circumstances, the comparison of the drug concentration in the maternal and fetal plasma may give an idea of the exposure of the fetus to the maternally administered drugs. In this review drugs are classified according to their type of transfer across the placenta. Several drugs rapidly cross the placenta and pharmacologically significant concentrations equilibrate in maternal and fetal plasma. Their transfer is termed 'complete'. Other drugs cross the placenta incompletely, and their concentrations are lower in the fetal than in maternal plasma. The majority of drugs fit into 1 of these 2 groups. A limited number of drugs reach greater concentrations in fetal than maternal plasma. It is said that these drugs have an 'exceeding' transfer. The impression prevails that suxamethonium chloride (succinylcholine chloride) and doxorubicin do not cross the placenta. However, a careful analysis of the literature suggests that this impression is wrong and that all drugs cross the placenta, although the extent transfer varies considerably. The following parameters were considered as possible factors determining the extent of placental transfer: (i) the molecular weight of the drug; (ii) the pKa (pH at which the drug is 50% ionised); and (iii) the extent of drug binding to the plasma protein. Drugs with molecular weights greater than 500D have an incomplete transfer across the human placenta. Strongly dissociated acid drug molecules should have an incomplete transfer, but this does not seem to be an absolute rule. For example, ampicillin and methicillin transfer completely and they are strongly dissociated at physiological pH. The extent of drug binding to plasma protein does not influence the type of drug transfer across the human placenta.

Methods of determining plasma and tissue binding of drugs. Pharmacokinetic consequences.

The available techniques for the investigation of drug binding to plasma and tissues protein are reviewed and the advantages and disadvantages of the various techniques stated. A comparison of different plasma protein binding techniques is made which shows that the size of the unbound fraction of drug may be influenced by the method used. Protein binding may be assayed by methods including equilibrium dialysis, ultrafiltration, ultracentrifugation, gel filtration, binding to albumin microspheres and circular dichroism. Tissue binding techniques can involve testing binding to isolated organs, tissue slices, homogenates and isolated subcellular particles. Details of the available methods to compute pharmacokinetic constants are given. Stereoselective binding has been investigated for a limited number of drugs and the difference in the binding of 2 enantiomers is usually modest. The measurement of the binding constants is often required to characterise the drug-protein interaction. Mathematical and graphical methods to compute the pharmacokinetic parameters are discussed. The implications of binding on the volume of distribution and clearance of drugs are examined.

Human liver morphine UDP-glucuronyl transferase enantioselectivity and inhibition by opioid congeners and oxazepam.

1. Morphine uridine diphosphate glucuronyl transferase (UDP-GT) was studied in human liver microsomes. The (-)- and (+)-morphine enantiomers were used as substrates and inhibitors, such as oxazepam and various opioid congeners were employed to characterize the different glucuronidation pathways. The kinetics of the oxazepam inhibition were studied in the rat liver. 2. The overall glucuronidation of (+)-morphine was higher than that of (-)-morphine. The morphine congeners tested, potently inhibited the formation of (-)-morphine-3-glucuronide ((-)-M3G), except for normorphine and codeine. The formation of (+)-morphine-6-glucuronide [+)-M6G) was potently inhibited by only dextromethorphan and (+)-naloxone. All drugs except normorphine inhibited the formation of (+)-M3G by 18-50%. 3. The metabolism of (-)-morphine to (-)-M3G was more sensitive to oxazepam inhibition than the formation of (+)-M3G from (+)-morphine in the rat liver. 4. The glucuronidation of natural morphine is subject to in vitro interaction with oxazepam and several opiate drugs. Our study supports the theory of more than one type of UDP-GT being involved in morphine glucuronidation.

Human fetal liver cultures: basal activities and inducibility of epoxide hydrolases and aryl hydrocarbon hydroxylase.

The environmental influence of various drugs on the epoxide hydrolase with styrene oxide (EHSO) or benzo(a)pyrene-4,5-oxide (EHBPox) as substrate and the aryl hydrocarbon hydroxylase (AHH) activity was studied in monolayer cultures of human fetal hepatocytes (HFH) obtained at legal abortions. Hepatocytes were isolated by trypsin treatment of liver fragments and primary HFH cultures were maintained in Eagle's minimum essential medium supplemented with 15% newborn calf serum. The HFH were plated on culture dishes and allowed to 'settle' for one day before adding various drugs (in 1 microliter dimethylsulfoxide/ml) or solvent only and assay 1-2 days later. The basal AHH activity [assayed with 3H-benzo(a)pyrene as substrate] varied between 2 and 8.4 pmoles/min/mg protein and the basal EHSO activity was 0.3-4.9 nmoles/min/mg protein (n = 6) after one or two days' culture. The corresponding activity of EHBPox was 0.23-1.48 nmoles/min/mg protein (n = 5). Exposure of cultures to 2 mM phenobarbital (Pb), 2.5-25.0 microM benzanthracene (BA), 0.1 mM trans-stilbene oxide (TSO), or 5 microM beta-naphtoflavone (beta NF) resulted in a 1.2-3.7-fold induction of EHSO. Induction of EHBPox was also observed with Pb, beta NF, BA and TSO as inducers. Pb gave a dose-dependent induction of both EH at 0.1, 1.0 and 2.0 mM. Our results demonstrate that EH and AHH activities in HFH cultures are inducible by classical in vivo inducers. Although difficult to prove, it is plausible that such induction takes place also in intrauterine life.

Regional distribution of diazepam and its metabolites in the brain of cat after chronic treatment.

Repeated administration of diazepam leads to remarkable accumulation of N-desmethyldiazepam in white matter structures and in subcortical areas such as thalamus, hypothalamus, and hypophysis. Diazepam and the hydroxylated metabolites were present in lesser amounts. The distribution pattern of diazepam and N-desmethyldiazepam offers a rationale for its efficacy in inhibiting seizures spreading and for the lack of effect on primary foci discharges.

Binding of imipramine to platelet membranes is reduced in panic attacks.

The binding of imipramine (IMI) to platelet membranes was investigated in 13 patients suffering from panic attacks (PA), in 5 patients affected by schizophrenic disorder (S), and in 11 healthy volunteers (V). From 6 volunteers, from 5 patients with panic attacks, and from all the schizophrenic patients, blood samples were collected in the spring, whereas from the others the samples were collected in the autumn. IMI binding was studied according to a protocol provided by the WHO. Binding parameters, the maximum binding capacity (Bmax), and the dissociation constant (Kd) were measured after construction of the Scatchard plot. The differences between V and PA and between V and S were tested by analysis of variance followed by a t-test. Overall and intragroup relationships between Bmax or Kd and diagnosis and season were assessed by a 2-way analysis of variance (ANOVA). Bmax (mean +/- SD) was 947 +/- 269 (V), 742 +/- 160 (PA), and 712 +/- 254 (S) fmol/mg protein. V was different from PA (P less than 0.04) and from S (P less than 0.01). Kd (mean +/- SD) was 1.41 +/- 0.6 (V), 1.15 +/- 0.6 (PA), and 0.79 +/- 0.20 (S) nM. V was different from S only (P less than 0.01). Our results show that panic attacks and schizophrenia decrease the binding capacity of IMI in platelets. In addition, we found a significant difference between patients and controls only for the samples taken in the spring. No statistically significant difference was detectable between the 2 groups in the autumn samples.(ABSTRACT TRUNCATED AT 250 WORDS)

Interindividual variability of the human hepatic sulphotransferases.

The variability among subjects of the hepatic activities of O-sulphotransferase towards dopamine, p-nitrophenol, testosterone and ethinyloestradiol and of N-sulphotransferase with 1,2,3,4-tetrahydroisoquinoline (TIQ) as substrate is described. The rates of testosterone and TIQ sulphation were higher in men than women whereas those of ethinyloestradiol, dopamine and p-nitrophenol were similar in both sexes. The sulphotransferase activities towards p-nitrophenol and dopamine were positively skewed whereas those towards ethinyloestradiol approached normality. The coefficients of variations for the sulphotransferase activities ranged between 34% and 62% indicating a considerable variability among subjects. The rates of dopamine-, TIQ- and p-nitrophenol-sulphation were measured in the mucosa of the human intestine, and the duodenum/liver ratios were 10, 0.9 and 0.1, respectively. Thus the contribution of the intestine in the sulphation of xenobiotics is substrate dependent.

Chloroform bioactivation by microsomes from colonic and ileal mucosa of rat and man.

The cytochrome P-450 system present in colonic and small-intestinal mucosal microsomes from control and beta-naphthoflavone pretreated rats is not able to catalyze the biotransformation of chloroform either oxidatively or reductively. Anoxic incubations of 14CHCl3 with mucosal microsomes obtained from human colon and ileum biopsies resulted in significant levels of covalent binding to lipids but not to protein; no covalent binding was measured after room-air-equilibrated incubations. The bioactivation of CHCl3 by human colonic mucosal microsomes can therefore occur in conditions which may be representative of the physiologically low oxygenation of the outer layers of this tissue. These results support the possibility of an association between colonic cancer and exposure to CHCl3, claimed in some epidemiological studies, but not evident from studies of laboratory animals.

Inhibition of human liver and duodenum sulfotransferases by drugs and dietary chemicals: a review of the literature.

Sulfotransferase catalyzes the transfer of sulfate, donated by 3'-phosphoadenosine-5'-phosphosulfate, to an acceptor substrate that may be a hydroxy group or an amine group. Man is exposed daily to drugs and dietary chemicals that can inhibit sulfotransferase activity. The aim of this study was to review the literature concerning the inhibition of sulfotransferases by drugs and dietary chemicals in the human liver and duodenum. The IC50 value of mefenamic acid for human liver phenol sulfotransferase (SULT 1A1) was 0.02 microM and for human liver catechol sulfotransferase (SULT1A3) 76 microM with a SULT 1A3/SULT1A1 ratio for the IC50 of 3,800. Mefenamic acid is therefore a potent and selective inhibitor of human liver SULT1A1. The IC50 values of mefenamic acid for the sulfation rates of (-)-salbutamol and (-)-apomorphine were 4 orders of magnitude greater in the human duodenum than in the liver. Salicylic acid inhibited the sulfation of (-)-apomorphine in human liver with an IC50 of 54 gM but did not inhibit the sulfation of (-)-apomorphine in human duodenum. Quercetin, a flavonoid present in edible fruit, vegetable and wine, was a potent inhibitor of human liver SULT1A1 and estrogen sulfotransferase (EST) activities and the sulfation of resveratrol. Quercetin inhibited the sulfation of dopamine, (-)-salbutamol, minoxidil and paracetamol and the IC50 values were 1 - 2 orders of magnitude greater in human duodenum than in the liver. In conclusion, mefenamic acid, salicylic acid and quercetin inhibit SULT1A1 whereas SULT1A3 is relatively resistant to the inhibition by these compounds. Under particular circumstances, human duodenum sulfotransferase is more resistant than liver sulfotransferase to the inhibition by mefenamic acid, salicylic acid and quercetin.

Methylation of quercetin and fisetin, flavonoids widely distributed in edible vegetables, fruits and wine, by human liver.

The aim of this investigation was to study the methylation of quercetin and fisetin, 2 chemically related flavonoids, in human liver and to this purpose, an assay was set-up to measure the rates of quercetin and fisetin methylation in human liver. The methylation rates (pmol/min/mg) of quercetin and fisetin were measured in 10 liver samples and the mean +/- SD and the median were 170+/-30 and 177 (quercetin) and 183+/-15 and 178 (fisetin). The rates of quercetin and fisetin methylation were not different (p = 0.283). The fold of variation among samples was 2 (quercetin) and 1.3 (fisetin). Methyltransferase towards quercetin and fisetin followed Michaelis-Menten kinetics, and the Km values were 2.6+/-0.3 (quercetin) and 8.6+/-0.7 microM (fisetin, p = 0.009) and the Vmax values were 187+/-20 (quercetin) and 276+/-33 pmol/min/mg (fisetin, p = 0.009). Two, 4 and 8 microl of red Chianti wine added to the incubation mixture reduced the rate of quercetin methylation to 75+/-4%, 65+/-9% and 59+/-9%, respectively, and that of fisetin methylation to 62+/-3%, 51+/-3% and 44+/-4%, respectively. In conclusion, quercetin and fisetin are methylated in human liver and their rates of methylation have a limited variation among subjects.

Quercetin inhibits the sulfation of r(-)-apomorphine in human brain.

The first aim of this investigation was to study the sulfation of R(-)-apomorphine in human brain. The second aim was to investigate the inhibition of R(-)-apomorphine sulfation by quercetin in human brain. R(-)-apomorphine is hereafter referred to as apomorphine. Apomorphine sulfation was measured in 5 brain specimens; 3 derived from the frontal cortex and 2 derived from the temporal cortex. The rate of apomorphine sulfation was 5.6 +/- 4.3 pmol/min/mg. The activities of SULT1A1 and SULT1A3, which were also measured in these samples, were 11 +/- 9.1 and 2.6 +/- 1.7 pmol/min/mg, respectively. The rate of apomorphine sulfation correlated with the activity of SULT1A1 (r = 0.989; p = 0.002) and SULT1A3 (r = 0.973; p = 0.005). Apomorphine sulfotransferase followed Michaelis-Menten kinetics, the Km (mean +/- SD) and Vmax values (mean +/- SD) of which, measured in 5 brain samples, were 32 +/- 7.3 microM and 8.9 +/- 7.9 pmol/min/mg, respectively. Quercetin was a potent inhibitor of apomorphine sulfation with an IC50 value, measured in 5 brain samples, of 16 +/- 2.3 nM. The inhibition mechanism of quercetin using apomorphine sulfation in 5 brain samples was mixed, non-competitive with a Ki and Kies (mean +/- SD) of 16 +/- 4.1 and 87 +/- 37 nM, respectively (p = 0.008). The intrinsic clearance value of apomorphine (mean +/- SD) was 247 +/- 170 ml/min/mg(-1) and was decreased to 100 +/- 85 ml/min/mg(-1) (p < 0.01) in the presence of 25 nM quercetin. In conclusion, apomorphine is sulfated in human brain. Sulfation might reduce the level of apomorphine in human brain and be a factor limiting the effect of this drug. Quercetin is a potent inhibitor of apomorphine sulfation and may inhibit the sulfation of apomorphine in human brain in vivo.

Zidovudine glucuronidation in human liver: interindividual variability.

Zidovudine 3'-azido-3'-deoxythymidine is the drug chosen for the treatment of patients suffering from AIDS; zidovudine being a potent inhibitor of HIV replication. The drug is extensively metabolized by conjugation with glucuronic acid into an inactive compound, and 30-40% of the dose is eliminated presystemically. We studied the variability and characterized the frequency distribution of the activity of zidovudine glucuronosyl transferase in 93 specimens of human liver. A rapid and reproducible radiometric assay for the glucuronidation of 14C-zidovudine is reported. The method is based on the extraction of the unreacted zidovudine into organic solvents and the radioactivity of the unextractable zidovudine glucuronide was measured in the aqueous phase residue. The rate of zidovudine glucuronidation was neither sex- nor age-dependent, ranged over 1 order of magnitude, and was positively skewed. The possibility that endogenous bilirubin should interact with glucuronidation of zidovudine was explored and the endogenous concentration of bilirubin was measured in the microsomal preparations of 59 liver samples. The final concentration of bilirubin in the assay mixture for zidovudine glucuronidation ranged between 2.2 and 13.2 microM and did not interact with the rate of zidovudine glucuronidation. The kinetics of glucuronosyl transferase towards zidovudine was studied in 20 livers, Michaelis-Menten kinetics were observed and the K(m) estimate ranged over 2-fold with an average of 2.89 mM. These in vitro results are consistent with the view that the rate of glucuronidation varies over 1 order of magnitude in the human liver and its distribution is positively skewed. This variability may modulate the patient's exposition to zidovudine and thereby the efficacy of therapy.

Phenotype-genotype relationships of SULT1A1 in human liver and variations in the IC50 of the SULT1A1 inhibitor quercetin.

Human sulfotransferases catalyze sulfate conjugation and 2 polymorphic genes, SULT1A1 and SULT1A2 in this family of transferases have been identified, encoding for 2 isoenzymes with very similar properties and substrate specificities. In order to test the hypothesis that variability in sulfation is due to genetic polymorphism in SULT1A1, the sulfation rate of 4-nitrophenol, a diagnostic substrate, was measured in 50 human liver samples and the genotype at the SULT1A1 locus was analyzed. The rate of 4-nitrophenol sulfation varied from 473 - 1,405 pmol/min/mg between the 5th and 95th percentiles, with a median and a mean +/- SD of 757 and 807 +/- 292 pmol/min/mg, respectively. The activities detected among the SULT1A1*2/*2 homozygotes (5 cases) were significantly lower than those of the other 2 genotypes, SULTA1*11/*1 and SULT1A1*1/*2 (5 and 40 cases, respectively), whereas there was no significant difference found between the SULT1A1*1/*1 and SULT1A1*1/*2 genotypes. To evaluate the possible influence of SULT1A2 polymorphism, genotype assays were also performed for this locus. No SULT1A2*2/*2 carrier, 26 SULT1A2*1/*1 and 24 SULT1A2*1/*2 were detected in the population sample under study. However, no correlation between the rate of 4-nitrophenol sulfation and the SULT1A2 genotype was detected. These results confirm that the variation in the rate of 4-nitrophenol sulfation in human liver is mainly due to SULT1A. Since SULT1A1*1/*2 polymorphism accounts for no more than 10% of the phenotypic variation seen in this cohort, other factors must also contribute to the variability in the rate of 4-nitrophenol sulfation in human liver. However, on the basis of the data obtained, variations in age, gender and liver function as possible causative factors can be excluded. The IC50 of quercetin, a potent inhibitor of 4-nitrophenol sulfation, was measured in the liver samples and ranged from 4.6 to 17.3 nM between the 5th and 95th percentiles. The median and the mean +/- SD were 7.7 nM and 8.3 +/- 2.5 nM, respectively. There was a weak but significant correlation between the IC50 value and age of the liver donors (r = 0.283, p = 0.046). The observed variation did not correlate with the genotypes at the SULT1A1 and SULT1A2 loci.

Glutathione conjugation with 1-chloro-2,4-dinitrobenzene (CDNB): interindividual variability in human liver, lung, kidney and intestine.

The rate of glutathione conjugation with 1-chloro-2,4-dinitrobenzene (CDNB) was measured in specimens of human liver (n = 93), sigmoid colon (n = 56), renal cortex (n = 67) and lung (n = 68). In the liver there was a weak but significant (r = - 0.247 p = 0.017) negative correlation between the activity of glutathione transferase and the liver donor's age. Such a correlation was not found in the renal cortex, lung and colon. In the renal cortex and in lung the rate of glutathione conjugation with CDNB was a little but significantly (p < 0.05) higher in women than men, whereas no sex-dependent difference was observed in the liver and colon. The distribution of glutathione transferase activity was polymorphic in the mucosa of colon and renal cortex of men but not in that of women. Smoking seems not to affect the glutathione conjugation rate with CDNB in lung. The activity of glutathione transferase was 2-, 6-, and 7-fold greater in liver than in the renal cortex, lung and colon, respectively. There was a large interindividual variability of the hepatic glutathione transferase activity, and because this variability, 15% of the population studied catalyzed the glutathione conjugation with CDNB at a rate similar to those of the renal cortex and duodenum. The subjects with low expression of the hepatic glutathione transferase should be more exposed to the effects of toxic and carcinogenic compounds.

Effect of denervation on cyclic amp regulating enzymes in the rat gastrocnemius muscle.

The activities of cyclic AMP regulatory enzymes (adenylate cyclase and phosphodiesterase) were studied in rat gastrocnemius muscle after denervation. Basal adenylate cyclase activity in whole homogenate increased progressively from the 3rd day reaching values more than 7-fold those of the controls 30 days after denervation. No significant differences between the contralateral and denervated muscle were detected as regards adenylate cyclase activation by catecholamines or NaF. Carbamylcholine was with effect. Cyclic AMP phosphodiesterase activity increased significantly at 3 days after denervation as was still significantly elevated at 60 days.

Pharmacokinetics of pinazepam in healthy volunteers.

The kinetics of pinazepam were studied in six healthy male volunteers aged between 26 and 31 years. The drug was administered in a single oral dose (10 mg). The concentrations of the parent compound and metabolites were measured in the plasma and urine by gas-chromatographic analysis. Plasma levels of pinazepam were fitted to a two-compartment open model with first order absorption rate using a three-exponential equation. Absorption rate constant and peak plasma levels of pinazepam were 1.36 +/- 0.15 h-1 and 36.8 +/- 5.1 ng/ml respectively. Plasma decay of the drug consisted of an initial rapid elimination phase (alpha = 0.46 +/- 0.06 h-1) followed by a slow one (beta = 0.046 +/- 0.004 h-1). N-desmethyldiazepam was the only metabolite detected in the plasma. Its plasma concentrations were higher than those of the parent compound shortly after administration. Urine was collected for 72 h after dosing. Those specimens contained unconjugate pinazepam and N-desmethyldiazepam and glucuronated oxazepam and 3-OH-pinazepam. Only 0.016% of the pinazepam administered was recovered as unchanged compound in the urine.

Imipramine receptors in human platelets: effect of age.

Imipramine receptors were studied in platelets from six healthy young subjects (age between 24 and 38 years), five newborns, and six healthy elderly persons (age between 70 and 81 years). Binding parameters, the maximum binding capacity (Bmax) and the apparent dissociation constant (Kd), were determined by Scatchard's analysis. Level of differences between young subjects and the other groups was determined by Student's t-test. Bmax (mean +/- SD) was 1162 +/- 138 (young persons), 564 +/- 65 (newborn), and 508 +/- 98 (elderly persons) fmol/mg protein. The figure for the young was different from that of the newborn (p less than 0.001) and the elderly (p less than 0.01). Kd (means +/- SD) was 1.78 +/- .69 (young persons), 0.68 +/- 0.13 (newborn), and 0.80 +/- 0.27 nM in the elderly. Kd in the volunteers was different from that in the newborn or the elderly subjects (p less than 0.01). Imipramine receptors in platelets appear to be influenced by development and aging.