Uptake, translocation, and metabolization of amitriptyline, lidocaine, orphenadrine, and tramadol by cress and pea.

The uptake, translocation, and metabolization of four widely used drugs, amitriptyline, orphenadrine, lidocaine, and tramadol, were investigated in a laboratory study. Cress (Lepidium sativum L.) and pea (Pisum sativum L.) were employed as model plants. These plants were grown in tap water containing the selected pharmaceuticals at concentrations ranging from 0.010 to 10 mg L-1, whereby the latter concentration was employed for the (tentative) identification of drug-related metabolites formed within the plant. Thereby, mainly phase I metabolites were detected. Time-resolved uptake studies, with sampling after 1, 2, 4, 8, and 16 days, revealed that all four pharmaceuticals were taken up by the roots and further relocated to plant stem and leaves. Also in these studies, the corresponding phase I metabolites could be detected, and their translocation from root to stem (pea only) and finally leaves could be investigated.

[Biophysical parameters of erythrocyte membranes and mechanisms of interaction with non-opioid analgesics under acute pain syndrome].

Methods of fluorescent probing, spectrophotometry and microcalorimetry were applied to investigate the alterations in biophysical parameters of erythrocytes membranes, and specifically microviscosity, surface charge, molecular organization of lipid bilayer and lipid-protein interactions under conditions of acute pain syndrome produced by experimental chemical lesion. The distinctive features of non-opiod analgesics interactions and binding to the erythrocytes membranes of rats subjected to acute nociceptive pain accompanied with oxidative stress development were investigated. The abilities of analgesics under research, and namely paracetamol, aspirin, phenazone, ketorolac, pyrodazole, ketoprofenum, natrium mefenaminate, indometacin, nimesulide to make up physico-chemical complexes with lipoperoxidation modified erythrocytes surface and protein-lipid bilayer showed marked changes. The significance of oxidative damage of biophase under conditions of acute pain syndrome for analgesics effective pharmacodynamics and pharmacokinetics realization is under consideration.

Upregulation of cytochromes P450 2B in rat liver by orphenadrine.

1 The alkylamine drug orphenadrine (ORPH) is an inducer and inhibitor of the microsomal cytochrome P450 (CYP) system in mammals. This study evaluated the selectivity of CYP induction by ORPH in rat liver. 2 Immunoblot analysis indicated that ORPH was a selective inducer of the phenobarbitone (PB)-inducible CYP2B in rat liver. CYP2B protein was increased to approximately 14-fold of levels in untreated rat liver. By comparison PB increased CYP2B expression 40-fold. Corresponding increases in the activity of CYP2B-dependent androstenedione 16beta-hydroxylation were measured in microsomes from ORPH and PB-induced rats. 3 Northern analysis indicated that CYP2B1/2 mRNA was increased in ORPH-induced rat liver. Consistent with this finding, ORPH was found to activate a PB-responsive enhancer module in constitutive androstane receptor (CAR)-transfected Hep G2 cells. 4 Other alkylamines like troleandomycin impair CYP turnover. We tested whether ORPH induction of CYP2B may include a post-translational component. In PB-pretreated animals ORPH administration delayed the loss of CYP2B after PB withdrawal, but no evidence for altered turnover was found. 5 These studies establish ORPH as a selective inducer of CYP2B in rat liver. Induction appears to be mediated pretranslationally by CAR activation of CYP2B gene transcription. Post-translational stabilisation by an ORPH metabolite does not elicit induction. Induction of CYP2B may influence pharmacokinetic interactions involving ORPH.

Metabolite complex formation of orphenadrine with cytochrome P450. Involvement of CYP2C11 and CYP3A isozymes.

Expression and inhibition of cytochrome P450 (CYP) isozymes capable of forming an orphenadrine metabolite complex were studied in microsomes of untreated and inducer-treated male and female rats. High levels of complex-forming isozymes were found in microsomes of untreated male as compared to female rats. Treatment of male rats with several P450 inducers did not considerably increase the extent of in vitro complex formation. In female rats, however, phenobarbital or dexamethasone treatments led to pronounced induction. The isozyme specificity of complex formation was investigated by several approaches including: 1. inhibition by orphenadrine of isozyme-specific P450 activities, such as hydroxylation of testosterone, O-dealkylation of pentoxy-and ethoxyresorufin and complex formation with triacetyloleandomycin (TAO), 2. inhibition of orphenadrine complex formation by metyrapone, TAO, and cimetidine, and 3. correlation of complex levels with immunochemically, enzymatically, or spectroscopically determined amounts of P450 isozymes. Our data suggest that CYP2C11, a CYP3A isozyme and an unidentified P450 species are involved in complex formation with orphenadrine, but exclude the involvement of CYP1A1/2 and CYP2B1/2. The capability of CYP2C11 to form a metabolite complex with orphenadrine is strongly suggested for the following reasons: 1. Efficient inhibition of testosterone 2 alpha- and 16 alpha-hydroxylation by complex formation with orphenadrine in microsomes of untreated male rats, 2. high expression of orphenadrine-complexing isozymes in untreated male compared to female rats, 3. specific inhibition of in vitro complex formation by cimetidine, 4. suppression of complex-forming isozymes by 3-methylcholanthrene and beta-naphthoflavone, and 5. concomitant induction of complex-forming isozymes, immunodetectable CYP2C11, and testosterone 2 alpha-hydroxylase by stanozolol. That at least one, but not all, CYP3A isozymes is involved in complex formation is concluded from inhibition experiments with TAO that show that orphenadrine complexation can be significantly inhibited in microsomes of dexamethasone-treated, but not in microsomes of untreated rats. Furthermore, complex formation with TAO is not inhibited by orphenadrine in microsomes of phenobarbital (PB)-treated rats. In PB-treated female rats, a further unidentified complex-forming isozyme can be detected that is not inhibited by complex formation with TAO.

Orphenadrine is an uncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist: binding and patch clamp studies.

Orphenadrine has been used as an antiparkinsonian, antispastic and analgesic drug for many years. Here we show that orphenadrine inhibits [3H]MK-801 binding to the phencyclidine (PCP) binding site of the N-methyl-D-aspartate (NMDA)-receptor in homogenates of postmortem human frontal cortex with a Ki-value of 6.0 +/- 0.7 microM. The NMDA receptor antagonistic effects of orphenadrine were assessed using concentration- and patch-clamp techniques on cultured superior colliculus neurones. Orphenadrine blocked open NMDA receptor channels with fast kinetics and in a strongly voltage-dependent manner. The IC50-value against steady state currents at -70 mV was 16.2 +/- 1.6 microM (n = 6). Orphenadrine exhibited relatively fast, concentration-dependent open channel blocking kinetics (Kon 0.013 +/- 0.002 10(6) M-1S-1) whereas the offset rate was concentration-independent (Koff 0.230 +/- 0.004 S-1). Calculation of the ratio Koff/Kon revealed an apparent Kd-value of 17.2 microM which is nearly identical to the IC50 calculated at equilibrium.

Modulation of antagonist binding to histamine H1-receptors by sodium ions and by 2-amino-2-hydroxymethyl-propan-1,3-diol HCl.

1. NaCl (100 mM) reduced the potency of (+)-N-methyl-4-methyldiphenhydramine ((+)-QMDP) as an inhibitor of the binding of [3H]-mepyramine to histamine H1-receptors on guinea-pig cerebellar membranes to a greater extent than that of mepyramine, consistent with the greater inhibitory effect of Na+ on the binding of [3H]-QMDP than on the binding of [3H]-mepyramine. 2. The concentration of 2-amino-2-hydroxymethyl-propan-1,3-diol HCl (Tris, HCl) buffer, pH 7.5, present had little effect on the temelastine-insensitive binding of [3H]-mepyramine, but caused a concentration-dependent inhibition of the binding of [3H]-mepyramine sensitive to 1 microM temelastine (H1-receptor binding), with an approximate IC50 of 75 mM, assuming that complete inhibition would have been achieved. 3. Inhibition of [3H]-mepyramine binding by Na+ was more marked in 10 mM than in 50 mM Tris HCl and was not evident in 200 mM Tris HCl. 4. The Kd for the temelastine-sensitive binding of [3H]-mepyramine measured in 10 mM Tris HCl, 0.24 +/- 0.01 nM, was increased by 2.2 +/- 0.2 fold by 100 mM NaCl, without any significant change in the maximum binding (Bmax). The Bmax for [3H]-mepyramine was similarly unchanged in 50 mM Tris HCl, but the Kd was increased 2.5 +/- 0.2 fold. 5. The Kd for the temelastine-sensitive binding of [3H]-mepyramine was also increased in 50 mM,compared with 10 mM, N-[2-hydroxyethyl]piperazine-N'-[2-ethanesulphonic acid] KOH (HEPES.KOH)buffer (Kd 0.25 +/- 0.02 nm in 10 mM HEPES), but the evidence for an interaction between HEPES and Na+ was less clear.6. The effect of 100 mM NaCl on the inhibition of [3H]-mepyramine binding in 10 mM Tris HCl was examined for a range of antagonists. The decrease in potency caused by Na+ was greatest for triprolidine, (+)-chlorpheniramine and benzilylcholine (9.6-10.3 fold increase in K1 values) but the binding of mepyramine and promethazine was much less affected (1.8 and 1.9 fold increase in Kd respectively). The Kd for temelastine was not significantly changed. In contrast to the general decrease in antagonist affinity in the presence of Na+, the for MDL 16,455A (4-[1-hydroxy-4-[4-(hydroxydiphenylmethyl)-1-piperidinyl]butyl]-alpha,alpha-dimethylbenzene acetic acid) was increased, but only by 1.5 fold.7. It is concluded that Na+ can act as an allosteric effector of the binding of antagonists at the histamine HI-receptor. Tris HCl also appears to have an allosteric action at the H1-receptor.

Inhibition by cations of antagonist binding to histamine H1-receptors.

The binding of the quaternary radioligand [3H] QMDP to the histamine H1-receptor was inhibited by a series of mono- and di-valent cations. The order of potency was Hg2+ greater than Cd2+ greater than Zn2+ greater than Ni2+ greater than Co2+ greater than Mn2+ greater than Ca2+ greater than Mg2+ greater than Li+ = Na+ greater than K+ greater than Cs+. The binding of [3H] mepyramine, a tertiary amine, was inhibited by the divalent cations to a similar extent as the binding of [3H] QMDP. Li+ also had a similar potency against the two ligands, but Na+ was a much more potent inhibitor of the binding of [3H] QMDP than that of [3H] mepyramine.

Evidence for complexation of P-450 IIC6 by an orphenadrine metabolite.

Removal of the orphenadrine metabolite from its complex with rat liver P-450 IIB1 is associated with a discrepancy in the reactivation of IIB1 activity. Two possible explanations are that either (1) NADPH-P-450-reductase is inaccessible to the restored IIB1, or (2) complexation of other P-450s may occur. Exogenous P-450 reductase increased all pathways of steroid hydroxylation (1.9 to 3.6-fold) but did not enhance reactivation of IIB1-dependent steroid 16 beta-hydroxylation. Instead, P-450 IIC6-dependent progesterone 21-hydroxylase activity was increased after dissociation to 122% of control. IIC6 activity was also inhibited in vitro in microsomes from phenobarbital-induced rats (ki = 151 microM). Thus, orphenadrine appears to complex P-450 IIC6 as well as IIB1 in rat liver.

Pharmacokinetics of diphenhydramine and a demethylated metabolite following intravenous and oral administration.

Ten healthy volunteers received a single 50-mg dose of diphenhydramine (DP) hydrochloride intravenously and orally on two separate occasions. Kinetics of DP and a major demethylated metabolite (DMDP) were determined from multiple plasma samples drawn during a 24- to 48-hour period after dosage. Modification of a gas chromatographic (GC) technique allowed simultaneous quantitation of DP and DMDP. Mean kinetic variables for DP after intravenous (IV) dosage were: volume of distribution, 4.5 L/kg; elimination half-life, 8.4 hours; clearance, 6.2 mL/min/kg. After oral DP administration, a peak plasma level of 66 ng/mL was reached 2.3 hours after dosage. Systemic availability was 72%, nearly identical to the predicted estimate (71%) based on clearance of IV DP relative to hepatic blood flow. Appearance of the metabolite, DMDP, mirrored disappearance of DP; the area under the plasma concentration-time curve (AUC) for DMDP was highly correlated (r = .79, P less than .05) with a clearance of IV DP. However, metabolite AUC was significantly higher after oral as opposed to IV DP (218 vs 145 hr-ng/mL, P less than .05). Because DP and DMDP elute nearly identically on standard GC systems, methodologic modifications are needed to resolve them. Coelution of the two compounds could bias kinetic data based on plasma concentration presumed to be specific for intact DP.

Combination therapy with haloperidol and orphenadrine in schizophrenia. A clinical and pharmacokinetic study.

The use of anti-cholinergic drugs for counteracting neuroleptic induced extrapyramidal side-effects (EPS) is controversial. A possible increase in anticholinergic symptoms and a pharmacokinetic interaction are reported in literature. In order to determine these points, 22 schizophrenic patients were studied. Haloperidol (HL) was administered for 3 weeks and Orphenadrine (ORD) only in the second week of treatment. ORD reduced significantly EPS and its withdrawal led to a marked deterioration of EPS and psychopathological picture. There was an increase in HL plasma levels after starting ORD, and ORD plasma levels were positively related to EPS amelioration. Finally, prolactin seemed to be higher in those patients with EPS, particularly after ORD withdrawal.

Relationship between molecular structure and cytochrome P450-metabolic intermediate complex formation, studied with orphenadrine analogues.

Complexation of ferrous cytochrome P450 by metabolic intermediates formed during NADPH-catalyzed metabolism of compounds structurally related to orphenadrine was studied. This so-called metabolic intermediate complexation was determined in rat liver microsomes, obtained from phenobarbital-pretreated rats, at 455 nm using 33 microM of the orphenadrine derivatives. Using secondary amine derivatives with various N-alkyl substituents, a parabolic relationship between the logarithm of percentage of cytochrome P450 complexation and hydrophobic fragmental constant was observed. The derivative with a bulky tertiary butyl group, however, was devoid of metabolic intermediate-complexing activity. This indicates that steric factors besides lipid solubility may govern the complexing activity; also substitution at the phenyl group affects metabolic intermediate complex formation.

Product inhibition in orphenadrine metabolism as a result of a stable cytochrome P-450-metabolic intermediate complex formed during the disposition of mono-N-desmethylorphenadrine (tofenacine) in the rat.

Product inhibition is thought to be involved in unexpected accumulation of orphenadrine, which occurs during chronic medication with this anti-Parkinson drug in man. In previous studies (Biochem. Pharmacol. 31, 2745-2753 (1982) we established the formation of reactive metabolic intermediates (MI) during metabolism of orphenadrine and its mono-N-demethylated metabolite tofenacine, which may block cytochrome P-450 (MI-complex). In this study we investigated the role of MI-complexation in product inhibition. Three different assays were used to establish the amount of cytochrome P-450 involved in MI-complexation, which was induced by tofenacine (30 mg/kg i.p.) in phenobarbital pretreated rats. If liver microsomes were prepared 3 hours after tofenacine injection, both spectral titration of oxidized cytochrome P-450, determination of loss of metyrapone binding sites at reduced cytochrome P-450 as well as ferricyanide oxidation of the MI-complex revealed 8-13% complexation of cytochrome P-450. Our data also suggest that MI-complexation is generated on phenobarbital induced cytochrome P-450 species. Phenobarbital induction was also shown to activate orphenadrine metabolism in vitro. Moreover, with a newly developed capillary GLC method, using nitrogen detection, we showed inhibition of orphenadrine- and tofenacine metabolism in vitro, by MI-complexation. This study therefore showed that MI-complexation may produce product inhibition.

Salicylic acid plasma levels following multiple doses of Norgesic Forte and aspirin.

Plasma salicyclic acid levels from the recommended multiple dose regimen of Norgesic Forte (orphenadrine citrate, aspirin, and caffeine) were compared to those from an equivalent multiple dose regimen of aspirin alone in 24 volunteers. The drugs were administered double-blind so that side effects could also be compared. No statistically significant differences were found between Norgesic Forte and aspirin in peak or trough levels, time to peak level, area under the curve, or mean steady-state level of salicylic acid. Mean steady-state levels averaged 154 +/- 46 (+/- SD) and 152 +/- 49 micrograms/ml on days 5 and 10 following Norgesic Forte versus 161 +/- 49 and 154 +/- 47 micrograms/ml following aspirin. Thus, the aspirin in Norgesic Forte provides an anti-inflammatory amount of salicylic acid equivalent to that of plain aspirin. There was no evidence that the combination of orphenadrine citrate, caffeine, and aspirin in Norgesic Forte caused increased or unusual side effects compared with aspirin alone.

Distribution of [14C]-tofenacine in rat brain after intravenous, intraperitoneal and multiple oral dosage.

The distribution of radioactivity in the rat brain at 5 min after 10 mg/kg of 14C-labelled N-methyl-2[(o-methyl-a-phenylbenzyl)oxy]ethylamine, [14C]-tofenacine-hydrochloride, the active constituent of Elamol¿ and Tofacine¿, i.v. showed a heterogeneous pattern correlating well with what is known about perfusion and capillarization of brain areas. With the passage of time total brain radioactivity decreased rapidly and radioactivity was redistributed. Both processes occurred simultaneously so that a nearly homogeneous pattern was found at 1 h after i.v. administration. The outer layers of the hippocampus were then the only brain areas with a higher concentration of radioactivity. On i.p. administration of 25 mg/kg of [14C]-tofenacine-hydrochloride maximum brain radioactivity was observed at 30 min, the distribution pattern resembling that seen at 5 min after i.v. dosage. Its further time course corresponded to that of the i.v. series. On multiple oral administration of [14C]-tofenacine-hydrochloride (4 doses of 25 mg/kg at 3-h intervals), maximal radioactivity in the rat brain was observed at 120 min after the last dose. Again the distribution was heterogeneous. Areas of high and low radioactivity were very similar to those seen in the i.v. series at the first intervals, although the contrasts were less pronounced. An exception was the hippocampus where the distribution of radioactivity, -- with high levels in the outer layers as the principal feature -- was similar to that at the last intervals after i.v. administration. A model comprising a central compartment and two brain compartments, representing areas of high and low perfusion, respectively, allows a quantitative explanation of the phenomena observed.