ABSTRACT
A simple and sensitive fluorescence method has been developed for the determination of amiloride (AMI) in pharmaceutical tablet and human serum with a portable, cost-effective, and easy-to-operate fluorescence system. The fluorescence system was assembled with some optical and electronic devices mainly including a 370â¯nm light-emitting-diode (LED) as light source, a fiber spectrometer and a Raspberry Pi computer. With the system, AMI produced a strong fluorescence emission at 413â¯nm, and the emitted intensity can maintain good stability with in a wide pH range from 2 to 8. The proposed method was successfully applied to the determinations of AMI in pharmaceutical tablet and human serum. Their detection limits were 1.67â¯ngâ¯mL-1 and 1.43â¯ngâ¯mL-1 respectively, and the recovery was in the range of 94.06-114.0%. Those obtained results proved that the proposed methods combined with the developed fluorescence system could be employed for the routine analysis of amiloride in pharmaceutical tablet and human serum, especially for the fast analysis of them under field conditions.
Subject(s)
Amiloride/blood , Computers , Fluorescence , Humans , Limit of Detection , Spectrometry, Fluorescence/instrumentation , Spectrometry, Fluorescence/methods , TabletsABSTRACT
Epithelial sodium channels (ENaCs) are strongly expressed in the circumventricular organs (CVOs), and these structures may play an important role in sensing plasma sodium levels. Here, the potent ENaC blocker amiloride was injected intraperitoneally in rats and 2h later, the c-Fos activation pattern in the CVOs was studied. Amiloride elicited dose-related activation in the area postrema (AP) but only ~10% of the rats showed c-Fos activity in the organum vasculosum of the lamina terminalis (OVLT) and subfornical organ (SFO). Tyrosine hydroxylase-immunoreactive (catecholamine) AP neurons were activated, but tryptophan hydroxylase-immunoreactive (serotonin) neurons were unaffected. The AP projects to FoxP2-expressing neurons in the dorsolateral pons which include the pre-locus coeruleus nucleus and external lateral part of the parabrachial nucleus; both cell groups were c-Fos activated following systemic injections of amiloride. In contrast, another AP projection target--the aldosterone-sensitive neurons of the nucleus tractus solitarius which express the enzyme 11-ß-hydroxysteriod dehydrogenase type 2 (HSD2) were not activated. As shown here, plasma concentrations of amiloride used in these experiments were near or below the IC50 level for ENaCs. Amiloride did not induce changes in blood pressure, heart rate, or regional vascular resistance, so sensory feedback from the cardiovascular system was probably not a causal factor for the c-Fos activity seen in the CVOs. In summary, amiloride may have a dual effect on sodium homeostasis causing a loss of sodium via the kidney and inhibiting sodium appetite by activating the central satiety pathway arising from the AP.
Subject(s)
Amiloride/pharmacology , Area Postrema/metabolism , Epithelial Sodium Channel Blockers/pharmacology , Epithelial Sodium Channels/metabolism , Neurons/metabolism , Proto-Oncogene Proteins c-jun/metabolism , Amiloride/blood , Amiloride/cerebrospinal fluid , Animals , Area Postrema/drug effects , Blood Pressure/drug effects , Female , Forkhead Transcription Factors/metabolism , Heart Rate/drug effects , Male , Neurons/drug effects , Parabrachial Nucleus/drug effects , Parabrachial Nucleus/metabolism , Rats , Rats, Sprague-DawleyABSTRACT
A single, simple and selective method for simultaneous estimation of amiloride and hydrochlorothiazide in human plasma was validated using triamterine and hydrochlorothiazide (13)C,d2 as internal standard. The compounds were separated on a reverse-phase column with an isocratic mobile phase consisting of 2 mm ammonium acetate pH 3.0 and acetonitrile (30:70, v/v) and detected by tandem mass spectrometry with positive/negative ion mode. The analytes and internal standards were extracted from plasma using simple solid phase extraction. The ion transitions recorded in multiple reaction monitoring mode were m/z 230.1 â 116.0 for amiloride, m/z 254.1 â 237.1 for internal standard, triamterine in positive mode and m/z 296.1 â 204.9 for hydrochlorothiazide, m/z 299.2 â 205.8 for internal standard, hydrochlorothiazide (13)C,d2 in negative ion mode. Linearity in plasma was observed over the concentration range 0.1-10 ng/mL for amiloride and 5.0-500.0 ng/mL for hydrochlorothiazide. The mean recovery was 41.1 and 81.5% for amiloride and hydrochlorothiazide respectively. The coefficient of variation of the assay was less than 11.2 and 5.2% for amiloride and hydrochlorothiazide, respectively, and the accuracy was 89.0-98.1 and 96.6-102.9% for amiloride and hydrochlorothiazide, respectively. The validated method can be applied to the pharmacokinetic study of amiloride and hydrochlorothiazide.
Subject(s)
Amiloride/blood , Chromatography, Liquid/methods , Hydrochlorothiazide/blood , Tandem Mass Spectrometry/methods , Humans , Least-Squares Analysis , Limit of Detection , Reproducibility of ResultsABSTRACT
A new method for simultaneous determination of amiloride and hydrochlorothiazide by liquid chromatography/electrospray tandem mass spectrometry (LC/MS/MS) operated in positive and negative ionization switching mode was developed and validated. Protein precipitation with acetonitrile was selected for sample preparation. The analytes were separated on a Phenomenex Curosil-PFP (250x4.6 mm, 5 microm) column by a gradient elution with a mobile phase consisting of 0.15% formic acid solution containing 0.23% ammonium acetate and methanol pumped at a flow rate of 1.0 mL.min(-1). Rizatriptan was used as the internal standard (IS) for quantification. The determination was carried out on a Waters Quattro-micro triple-quadrupole mass spectrometer operated in multiple reaction monitoring (MRM) mode using the following transitions monitored simultaneously: positive m/z 230-->171 for amiloride, m/z 270-->158 for rizatriptan, and negative m/z 296-->205 for hydrochlorothiazide. The lower limits of quantification (LLOQs) were 0.1 and 1.0 ng.mL(-1) for amiloride and hydrochlorothiazide, respectively, which were lower than other published methods by using ultraviolet (UV), fluorimetric or mass spectrometric detection. The intra- and inter-day precision and accuracy were studied at three different concentration levels and were always better than 15% (n=5). This simple and robust LC/MS/MS method was successfully applied to the pharmacokinetic study of compound amiloride and hydrochlorothiazide tablets in healthy male Chinese volunteers.
Subject(s)
Amiloride/blood , Diuretics/blood , Hydrochlorothiazide/blood , Spectrometry, Mass, Electrospray Ionization/methods , Tandem Mass Spectrometry/methods , Administration, Oral , Amiloride/pharmacokinetics , Chromatography, High Pressure Liquid , Diuretics/pharmacokinetics , Drug Therapy, Combination , Humans , Hydrochlorothiazide/pharmacokinetics , Male , Reproducibility of Results , Serotonin Receptor Agonists/blood , Triazoles/blood , Tryptamines/bloodABSTRACT
The cyclic voltammograms of amiloride at the hanging mercury drop electrode showed a single well-defined four-electron irreversible cathodic peak in Britton-Robinson (B-R) buffer of pH 2. At higher pH values (pH > or =3), two irreversible cathodic peaks corresponding to the transfer of four (first peak) and two (second peak) electrons, were obtained The peak potentials were shifted to more negative values on the increase of pH of the medium, implying the involvement of protons in the electrode reaction and that the proton-transfer reaction precedes the proper electrode process. The 4-electron single peak (pH 2) or the first peak (pH > or = 3) may be attributed to the cleavage of the -CH=NH double bond of the N-imidino amide group with the release of NH(3) molecule. While the second peak may be due to the saturation of the C?O double bond of the carboxamide moiety. Based on the interfacial adsorptive character of the drug onto the mercury electrode surface, a simple, sensitive and low cost square-wave adsorptive cathodic stripping (SWAdCS) voltammetric procedure was optimized for analysis of the drug. The optimal operational conditions of the proposed procedure were: accumulation potential E(acc)= -0.7 V, accumulation time t(acc)= 60-65s, scan increment= 10 mV, pulse-amplitude = 50-60 mV, frequency =120 Hz using a B-R buffer of pH 8 as a supporting electrolyte. The linear concentration range was found to be 2 x 10(-9) to 2 x 10(-7) M amiloride with limits of detection (LOD) and quantitation (LOQ) of 1.9 x 10(-10) and 6.3 x 10(-10) M, respectively. The procedure was successfully applied for determination of amiloride in pharmaceutical formulation and spiked in human serum. The LOD and LOQ of amiloride spiked in human serum were 5.7 x 10(-10) and 1.9 x 10(-9) M amiloride, respectively. The procedure did not require sample pretreatment or any time-consuming extraction or evaporation steps, other than deproteinization and then centrifugal separation of protein from serum sample prior to analysis of the drug.
Subject(s)
Amiloride/blood , Mercury , Amiloride/analysis , Amiloride/chemistry , Electrochemistry/methods , Electrodes , Humans , Hydrogen-Ion Concentration , Pharmaceutical Preparations/analysis , Pharmaceutical Preparations/blood , Pharmaceutical Preparations/chemistry , TabletsABSTRACT
Plasma aldosterone concentrations and the magnitude of amiloride-sensitive Na(+) transport in the proximal and distal colon of newly caught wild possums, and of possums maintained on either low or high Na(+) diets, were determined to evaluate their role in the regulation of salt content of faeces in common brushtail possums. Wild animals had a plasma aldosterone concentration of 439+/-115 pmol l(-1) and high levels of amiloride-sensitive Na(+) transport in both the proximal and distal colon. Animals maintained on a low Na(+) diet for 14 days excreted very little Na(+) in the urine and had an elevated aldosterone concentration (840+/-246 pmol l(-1)), but levels of amiloride-sensitive Na(+) transport in the proximal and distal colon were similar to those in wild animals. Conversely, while provision of a high Na(+) diet (7 days or 14 days) resulted in increased urinary Na(+) excretion and a fall in aldosterone (approximately 250 pmol l(-1)), there was no reduction in the amount of amiloride-sensitive Na(+) transport in either the proximal or distal colon. These data strongly indicate that aldosterone does not regulate amiloride-sensitive Na(+) transport in the colon of possums and that the colon is not involved in the regulation of salt content of the faeces in this species.
Subject(s)
Aldosterone/physiology , Amiloride/blood , Colon/metabolism , Opossums/metabolism , Sodium/metabolism , Animal Feed , Animals , Animals, Wild/metabolism , Biological Transport/physiology , Colon/physiology , Diet, Sodium-Restricted , Electric Conductivity , Male , Natriuresis , Potassium/urineABSTRACT
The kinetics of amiloride was investigated in plasma, urine, faeces and tissues of rats after oral (10 mg/kg) and i.v. (10 mg/kg bolus and 35 microg/h for 4-days infusion) administration. Initially the experimental data were analyzed by a multiexponential model, then a compartmental model was developed to describe the drug kinetics in plasma, urine, faeces and tissues after the i.v. bolus and the oral administration simultaneously. Aim of the model was also to predict the drug kinetics in plasma and tissues of rats after continuous i.v. infusion. The results of the prediction and the discrepancies between prediction and observed data allowed a deeper insight into the pharmacokinetics of amiloride.
Subject(s)
Amiloride/pharmacokinetics , Diuretics/pharmacokinetics , Administration, Oral , Amiloride/blood , Amiloride/urine , Animals , Diuretics/blood , Diuretics/urine , Rats , Rats, Wistar , Tissue DistributionABSTRACT
The study presents an accurate and precise HPLC assay for the determination of furosemide and amiloride in human specimens. Both drugs were extracted from human plasma with ethyl acetate; furosemide was extracted at pH 1 and amiloride at pH 12. While chromatographic separation conditions, i.e., column, mobile phase and flow-rate were the same for both investigated drugs, furosemide was detected using a UV absorbance detector, whereas amiloride, because of its very low therapeutic range, was detected with a spectrofluorimetric detector. The linearity of the furosemide and amiloride assays were confirmed over the range of 30-3000 ng/ml and 0.5-30 ng/ml, respectively. These concentrations correspond well with the therapeutic ranges of both drugs. The extraction recoveries, depending on concentration, exceed 80% for furosemide and 74% for amiloride. The reported methods were applied to pharmacokinetic investigations of the two compounds taken in form of a drug combination.
Subject(s)
Amiloride/blood , Diuretics/blood , Furosemide/blood , Adult , Amiloride/administration & dosage , Amiloride/pharmacokinetics , Chromatography, High Pressure Liquid , Diuretics/administration & dosage , Diuretics/pharmacokinetics , Drug Combinations , Furosemide/administration & dosage , Furosemide/pharmacokinetics , Humans , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
The separation and determination of amiloride, metoprolol, deacetylmetipranolol, labetalol and furosemide in human serum and urine by capillary isotachophoresis were investigated. Amiloride and beta-blockers were separated by cationic isotachophoresis in the electrolyte system sodium morpholinoethanesulfonate buffer (pH 5.5) (cL = 10 mM)-glutamic acid. Furosemide was separated using the anionic electrolyte system histidine hydrochloride buffer (pH 6.2) (cL = 10 mM)-morpholinopropanesulfonic acid. Endogenous and the possible exogenous compounds were almost totally removed from serum and urine by solid-phase extraction using a Separon SGX C18 cartridge. The recovery of compounds varied from 98.2 to 103.2%. The linearity range for the compounds was 50-1000 ng/ml. The relative standard deviations varied from 0.1 to 5.6%. The overall limits of determination ranged from 32 to 46 ng/ml of urine and from 39 to 46 ng/ml of serum, depending of the type of drugs.
Subject(s)
Cardiovascular Agents/blood , Cardiovascular Agents/urine , Electrophoresis, Capillary , Adrenergic beta-Antagonists/blood , Adrenergic beta-Antagonists/urine , Amiloride/blood , Amiloride/urine , Electrophoresis, Capillary/statistics & numerical data , Furosemide/blood , Furosemide/urine , Humans , Hydrogen-Ion Concentration , Labetalol/blood , Labetalol/urine , Metipranolol/analogs & derivatives , Metipranolol/blood , Metipranolol/urine , Metoprolol/blood , Metoprolol/urine , Reproducibility of ResultsABSTRACT
1. The relative potencies of amiloride (5 and 20 mg) and spironolactone (25 and 100 mg) for plasma and erythrocyte electrolytes were investigated in a double-blind, randomised, balanced, crossover study in 12 normal men treated concomitantly with hydrochlorothiazide 100 mg daily for 1 week. 2. Participants satisfied an a priori requirement for a fall in plasma potassium concentration of at least 0.5 mmol l-1 after 7 days of treatment with hydrochlorothiazide alone. 3. After hydrochlorothiazide alone, plasma potassium and sodium concentrations fell (P < 0.001). There were associated reductions in erythrocyte sodium (P < 0.01). Plasma magnesium concentration did not change, although erythrocyte magnesium decreased (P < 0.001). 4. Both amiloride and spironolactone attenuated the thiazide-induced fall in plasma potassium (relative potency, amiloride:spironolactone 10:1, 95% confidence interval 6.3-16.2:1). Amiloride but not spironolactone was associated with a dose-related increase in plasma magnesium; a relative potency estimation was precluded. There was little evidence of influences of amiloride or spironolactone on erythrocyte electrolytes. 5. On a weight basis, amiloride is ten times more potent than spironolactone as a potassium-sparing agent in diuretic-treated subjects but neither agent had major effects on erythrocyte potassium. The drugs may have divergent actions on magnesium handling; hydrochlorothiazide alone had no influence on plasma magnesium.
Subject(s)
Amiloride/pharmacology , Hydrochlorothiazide/pharmacology , Magnesium/blood , Potassium/blood , Spironolactone/pharmacology , Adult , Aldosterone/blood , Amiloride/adverse effects , Amiloride/blood , Double-Blind Method , Drug Interactions , Erythrocytes/chemistry , Humans , Hydrochlorothiazide/adverse effects , Intracellular Fluid/metabolism , Male , Spironolactone/adverse effects , Spironolactone/bloodABSTRACT
An assay for amiloride was devised for efficient use with the wide variety of analogues available. Amiloride was extracted from 1-ml plasma samples by elution from a C8 preparative column with 6% acetonitrile-45% methanol-5.4% acetic acid, adjusted to pH 4.0 with trimethylamine. Samples were lyophilized, resuspended in 50% methanol, filtered through 0.22-microns Spin-X cartridges, applied to a reversed-phase C18 column, and eluted in a 0-50% acetonitrile gradient in 0.4% acetic acid, pH 4.5 (1.2 ml/min). Detection by ultraviolet absorbance at 360 nm was linear from 1 to 1000 ng. Versatility of the method was demonstrated with the analogues benzamil, 6-hydro-, 6-iodo-, 5-hexamethylene-, and 5-chlorobenzyl-2',4'-dimethylbenzyl-amiloride.
Subject(s)
Amiloride/analogs & derivatives , Amiloride/blood , Chromatography, High Pressure Liquid/methods , Administration, Oral , Amiloride/administration & dosage , Animals , RabbitsABSTRACT
A simple, cheap and specific quantitative method for the determination of the selective Na+/H+ exchange inhibitor, 5-(N,N-hexamethylene)amiloride, in plasma and aqueous solutions has been developed. The method involves extraction with ethyl acetate, thin-layer chromatography and spectrofluorodensitometry. The compound was separated from several unidentified metabolites in plasma. The detection limit was 6 x 10(-7) M. The calculated metabolic extraction by the liver was 29%, and the plasma half-life was 12.8 min. The free, active concentration of 5-(N,N-hexamethylene)amiloride was 19.4% of the total concentration, as determined by equilibrium dialysis.
Subject(s)
Amiloride/analogs & derivatives , Chromatography, Thin Layer/methods , Densitometry/methods , Amiloride/blood , Animals , SwineABSTRACT
In humans and animals, the administration of Li or amiloride results in a defect in urinary acidification. Both agents are thought to cause this by a voltage-dependent mechanism in the distal nephron. This study was designed to determine the effects of chronic Li and amiloride administration on the two main transport enzymes in rat nephron collecting tubule, the Na-K-adenosine triphosphatase (ATPase) and the H(+)-ATPase. We also examined the effects of both agents on these enzymes in vitro. Amiloride administration resulted in a decrease in Na-K-ATPase and H(+)-ATPase activities in cortical collecting tubule and medullary collecting tubule. Therapeutic concentrations of amiloride in vitro inhibited Na-K-ATPase activity, but only in cortical collecting tubule. The effects of Li administration were different; it decreased Na-K-ATPase and H(+)-ATPase in both cortical collecting tubule and medullary collecting tubule. In cortical collecting tubule, the inhibitory effect on H(+)-ATPase activity was seen in vitro at a Li concentration similar to that found in urine. In contrast to the effect of Li on the H(+)-ATPase, in vitro Li stimulated Na-K-ATPase activity. These results suggest that the mechanism of action whereby these two agents result in distal renal tubular acidosis in humans and animals are different. In the collecting tubule, amiloride appears to act solely through a voltage-dependent mechanism by inhibiting cortical collecting tubule Na-K-ATPase. Li, by contrast, appears to have an additional effect in the cortical collecting tubule to inhibit the H(+)-ATPase. The biochemical differences seen with these drugs may explain the more severe acidemia universally found in animals after chronic Li administration.
Subject(s)
Amiloride/pharmacology , Kidney Tubules, Collecting/drug effects , Lithium/pharmacology , Amiloride/blood , Animals , Injections, Intraperitoneal , Kidney Tubules, Collecting/enzymology , Lithium/blood , Male , Proton-Translocating ATPases/metabolism , Rats , Rats, Inbred Strains , Sodium-Potassium-Exchanging ATPase/metabolismABSTRACT
A high-performance liquid chromatographic method using fluorescence detection for the simultaneous determination of furosemide and amiloride is described. The chromatographic system is based on reversed-phase ion-pair chromatography with sodium dodecylsulphate as ion-pairing agent. The same counter-ion is used for the ion-pair liquid-liquid extraction to ethyl acetate. The minimum detectable concentration amounts to 0.3 ng of furosemide and 0.03 ng of amiloride per ml of plasma. The applicability of the method is demonstrated by the analysis of plasma samples taken from volunteers receiving both drugs.
Subject(s)
Amiloride/blood , Chromatography, High Pressure Liquid/methods , Fluorescence , Furosemide/blood , Administration, Oral , Amiloride/administration & dosage , Furosemide/administration & dosage , HumansABSTRACT
A sensitive and simplified high-performance liquid chromatographic procedure has been developed for quantification of amiloride in rabbit plasma, as well as human plasma and urine. Following protein precipitation with perchloric acid, the supernatant was directly injected into a C18 Nucleosil column. The mobile phase consisted of methanol-water (45:55) containing 0.1 M perchloric acid, and the compound was quantitated using a fluorescence detector at excitation and emission wavelengths of 286 and 418 nm, respectively. The average recovery was 97.6%. The calibration curve was linear over the range 2.0-20.0 ng/ml. The limit of detection was 0.5 ng/ml.
Subject(s)
Amiloride/blood , Amiloride/urine , Administration, Oral , Amiloride/pharmacokinetics , Animals , Biological Availability , Chromatography, High Pressure Liquid , Humans , Indicators and Reagents , Injections, Intravenous , Rabbits , Spectrometry, FluorescenceABSTRACT
We have previously shown that amiloride suppresses the induction of sustained ventricular tachycardia both in dogs late following myocardial infarction and in patients. In those studies the only electrophysiologic correlate of amiloride's antiarrhythmic activity observed was prolongation of ventricular effective refractory period at the zone bordering the infarct. The purpose of this study was to assess the pharmacologic effects of amiloride associated with antiarrhythmic efficacy. However, amiloride has multiple pharmacologic effects, including inhibition of the slow inward calcium current (ICa), inhibition of the sodium-calcium and sodium-hydronium ion exchangers, acidification of intracellular pH resulting in partial inhibition of the inwardly rectifying potassium current (IK1), and increase in serum potassium and magnesium. The approach used in this study was to use selective pharmacologic probes to produce the known components of amiloride's pharmacologic effects. The selective agents consisted of verapamil (partial blockade of ICa), 3',4'-dichlorobenzamil (partial inhibition of the Na-Ca exchanger), 5-(N-ethyl-N-isopropyl) amiloride (partial inhibition of the Na-H exchanger), the combination of these congeners, KCl infusions to increase serum potassium, MgSO4 infusions to increase serum magnesium, the combination of KCl and MgSO4 infusions, barium (partial block of IK1), ryanodine (partial blockade of sarcoplasmic reticulum calcium release), and placebo. In this study only barium produced antiarrhythmic and electrophysiologic effects similar to those of amiloride. However, amiloride prolongs border zone refractoriness selectively, whereas barium prolongs refractoriness diffusely throughout the myocardium. Blockade of ICa by verapamil, increases in serum magnesium and potassium alone or in combination, and partial blockade of sarcoplasmic reticulum by ryanodine were not antiarrhythmic in this model. Monotherapies that produced partial blockade of the Na-Ca and Na-H exchangers separately did not produce antiarrhythmic activity. However, the combination of these amiloride congeners reproduced the antiarrhythmic activity of amiloride but did not prolong border zone refractoriness. From these studies we conclude that the antiarrhythmic activity of amiloride relates to (a) selective blockade of IK1 in the border zone and/or (b) combined inhibition of sodium-calcium and sodium-hydronium ion exchangers.
Subject(s)
Amiloride/pharmacology , Anti-Arrhythmia Agents , Amiloride/analogs & derivatives , Amiloride/blood , Animals , Anti-Arrhythmia Agents/pharmacology , Barium/pharmacology , Dogs , Dose-Response Relationship, Drug , Drug Interactions , Electrophysiology , Magnesium/blood , Magnesium/pharmacology , Potassium/blood , Potassium/pharmacology , Ryanodine/pharmacology , Tachycardia/drug therapy , Ventricular Function/drug effects , Verapamil/pharmacologyABSTRACT
The disposition profile of amiloride, a potassium sparing agent, was studied in rats by using an HPLC method coupled to spectrofluorometric detection. Amiloride was administered orally and intravenously at the dose of 10 mg/Kg. The most relevant pharmacokinetic parameters are described for both administration routes.
Subject(s)
Amiloride/pharmacokinetics , Administration, Oral , Amiloride/administration & dosage , Amiloride/blood , Animals , Chromatography, High Pressure Liquid , Injections, Intravenous , Male , Rats , Rats, Inbred StrainsABSTRACT
The histamine H2 antagonist cimetidine has been shown to reduce the renal tubular secretion of other organic cations through competition for the specific transport system with organic cations in the renal proximal tubule. The potential interaction between cimetidine and the potassium-sparing diuretic amiloride was investigated in humans and in the isolated perfused rat kidney. A chronic dosing study was conducted in eight healthy subjects who received, in random order, amiloride (5 mg daily), cimetidine (400 mg twice daily), both drugs together, and a control phase in which no drug was present. Cimetidine reduced the renal clearance of amiloride by a mean of 17%, from 358 +/- 134 to 299 +/- 118 ml/min (p less than 0.05), and the urinary excretion of amiloride from 65 +/- 11 to 53 +/- 13% of the dose (p less than 0.05). Amiloride reduced the excretion of cimetidine from 43 +/- 7 to 32 +/- 9% of the dose (p less than 0.05) and the area under the plasma concentration-time curve for cimetidine by a mean of 14% (p less than 0.05) but had no effect on the renal clearance of cimetidine. In the perfused rat kidney, cimetidine reduced the amiloride unbound renal clearance to glomerular filtration rate ratio from 5-7:1 to 1-2:1 (p less than 0.05). These studies demonstrate that cimetidine inhibits the renal tubular secretion of amiloride in humans and in rats to a similar extent. In addition, in humans the gastrointestinal absorption of both amiloride and cimetidine appear to be reduced by each other, by an as yet unknown mechanism.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Amiloride/metabolism , Cimetidine/pharmacology , Kidney Tubules/metabolism , Adult , Amiloride/blood , Amiloride/urine , Animals , Chromatography, High Pressure Liquid , Cimetidine/blood , Cimetidine/urine , Drug Therapy, Combination , Electrolytes/urine , Female , Humans , Male , Models, Biological , Rats , Time FactorsABSTRACT
Recent studies indicate that gallbladder absorption increases during the early stages of experimentally-induced cholesterol gallstone formation. The purpose of the present study was to ascertain whether pharmacologic inhibition of gallbladder ion transport and absorption reduces the incidence of experimentally-induced cholesterol gallstones. Prairie dogs were fed either a control chow or a 1.2% cholesterol-enriched chow for 15 days. One group of cholesterol-fed animals received saline via an orogastric tube; another group received amiloride, a drug known to inhibit in vitro ion transport in the prairie dog gallbladder. The incidence of gallstones in cholesterol-fed animals was reduced from 83% to 13% (p less than 0.025) when the animals were treated with amiloride; this occurred despite a cholesterol-saturation index comparable to that observed in gallstone animals. Additionally, although biliary calcium decreased in the gallbladder, hepatic bile did not in the amiloride-treated animals. These data provide further evidence that altered gallbladder absorption and increased biliary calcium are important factors in the pathogenesis of cholesterol gallstones.