Pharmacokinetics of acetaminophen in the human neonate: formation of acetaminophen glucuronide and sulfate in relation to plasma bilirubin concentration and D-glucaric acid excretion.

The purpose of this study was to determine if certain physiologic parameters (plasma bilirubin concentration and urinary excretion rate of D-glucaric acid) can be used to predict a newborn infant's ability to eliminate a phenolic drug, and particularly to predict the ability to conjugate that drug with glucuronic acid. Tweleve healthy 2- to 3-day-old full-term infants with plasma bilirubin concentrations of 1.0 to 11.6 mg/100 ml and D-glucaric acid excretion rates of 0.131 to 0.345 mg/kg/day received a single oral dose of acetaminophen, 12 mg/kg. Urine was collected serially for 48 hours and analyzed for acetaminophen, acetaminophen glucuronide, acetaminophen sulfate, and D-glucaric acid. The biologic half-life of acetaminophen was 3.5 plus or minus 0.85 hours (average plus or minus SD) as compared to average values of 1.9 to 2.2 hours observed in five reported studies on a total of 39 adults. The rate constant for acetaminophen glucuronide formation in neonates was considerably smaller, on the average, than in adults but the average rate constant for acetaminophen sulfate formation was somewhat larger than in adults. There is not statistically significant colucaric acid excretion. The results of this study suggest that the limited ability of neonates to conjugate phenolic drugs with glucuronic acid is compensated to a degree by a well-developed capability for sulfate conjugation.

[Effect of human serum albumin on transport of drugs through human erythrocyte membranes].

The binding properties to human serum albumin (HSA) and the transport of drugs through human erythrocyte membranes were examined with benzoic acid or its twenty-five derivatives (o-, m-, or p-hydroxybenzoic acid, o-, m-, or p-aminobenzoic acid, o-, m-, or p-nitrobenzoic acid, o-, m-, or p-toluic acid, o-, m-, or p-fluorobenzoic acid, o-, m-, or p-chlorobenzoic acid, o-, m-, or p-bromobenzoic acid, aspirin, salicyluric acid, alpha-resorcylic acid and gamma-resorcylic acid) and with glycosides (arbutin, salicin, glycyrrhizin and four p-nitrophenylglycosides) or their aglycons (hydroquinone, saligenin, glycyrretinic acid and p-nitrophenol). The drugs having hydroxyl group and amino group to o-site and those having nitro group, methyl group and halogen group to m- or p-site showed higher affinity with HSA and the plasma hindered the permeability of these drugs. The glycosides bind to each site (1, 2, and 3) of HSA more weakly than do their aglycons and they were difficult for plasma to hinder membrane permeation. The binding constants of each drug to HSA (Kb-site 1, Kb-site 2, Kb-site 3 and Kb-total) and the inhibition ratio (IR) related to the partition coefficient (P): Kb-site 1 (M-1) = 2.1479 x 10(3).square root of P - 5.2824.P + 2.0985 x 10(3) (R = 0.9371), Kb-site 2 (M-1) = 4.3741 x 10(3).square root of P - 15.2068.P + 6.5660 x 10(3) (R = 0.6788), Kb-site 3 (M-1) = 2.2176 x 10(4).log P + 1.2022 x 10(4) (R = 0.5227), Kb-total (M-1) = 1.0214 x 10(4).square root of P - 33.3721.P + 1.6919 x 10(4) (R = 0.7413), IR (%) = 19.885.log P + 17.916 (R = 0.8605). IR obtained from predictive equations (IR = 17.837.log P - 13.286. log Kb-site 1 + 0.175.square root of Kb-site 2 + 0.074.square root of K b-site 3 + 37.355, R = 0.9642, F = 71.4937***, ***; p < 0.001) by multiple regression analysis was compatible with experimental IR.

Modeling of controlled release of aspirin derivatives from human erythrocytes.

The transport of aspirin (ASP) and its derivatives (m- or p-acetoxybenzoic acid (m- or p-AcOHBA), o-propionyloxybenzoic acid (PrOHBA), o-butyryloxybenzoic acid (BuOHBA), o-acetoxyhippuric acid (AcOHPA), and o-acetoxy-N-benzoyl-beta-alanine (AcONBA)) through human erythrocyte membrane was investigated. ASP derivatives were transported into the erythrocytes where they were hydrolyzed and then released, although the derivatives varied in the rate of transport. In different binding positions, the hydrolyzed derivatives were released rapidly in the order of p- > m- > o-AcOHBA (ASP). The rates of derivatives were accelerated by lengthening of the side chain of the acetoxyl group (BuOHBA > PrOHBA > ASP). The rate of release of o-, m- or p-AcOHBA, BuOHBA and PrOHBA was related to hydrolysis rate in erythrocytes but not to partition coefficient (log P). In different amino acids in a carboxyl group of ASP, the release of AcONBA was slower and about 2 h was required to attain equilibrium. The release of AcOHPA was also slower and increased gradually during an incubation of 3 h. The rate of release of AcOHPA and AcONBA was not related to hydrolysis rate in the erythrocytes. The rates were equivalent values with the predicted values calculated by log P of tested drugs. It was suggested from these results that ASP derivatives were able to control the release from human erythrocytes.

Promotion of rectal absorption of sodium ampicillin by disodium glycyrrhetinic acid 3 beta-O-monohemiphthalate in rats.

The promotional effect on rectal absorption of sodium ampicillin (ABPC) by the glycyrrhetinic acid derivative disodium glycyrrhetinic acid 3 beta-O-monohemiphthalate (GA MHPh) was studied in rats and compared with those of sodium caprate (CAP) and sodium glycocholate (GLY). Duration of the promotive effect of GA MHPh was also studied. Rectal absorption of ABPC was significantly enhanced by addition of GA MHPh at an optimum concentration of about 1.5%. The plasma maximum concentration of ABPC was 78.71 micrograms/ml 10 min after its rectal administration at 100 mg/kg with 1.5% GA MHPh. The bioavailability of ABPC with and without 1.5% GA MHPh was 82.12% and 3.92%, respectively. Thus, absorption of ABPC in the presence of 1.5% GA MHPh was about 21 times that of ABPC alone. GA MHPh was more effective as an absorption promoter than either CAP or GLY. Its promoting action on the mucosal membrane was apparent immediately, reached a maximum at 5 min and remained for at least 20 min after rectal administration of the solution. It is therefore suggested that GA MHPh is a very useful promoter absorption of the hydrophilic drug ABPC when administered rectally.

Utility of a rectal suppository containing the antiepileptic drug zonisamide.

A suppository of zonisamide (ZNS) was investigated from the viewpoint of pharmaceutical evaluation, pharmacokinetics and pharmacological effect. Two types of ZNS suppositories were prepared. One used Witepsol (H-15:S-55 = 3:1) as a lipophilic base and the other polyethylene glycol (PEG, 4000:1500 = 4:1) as a hydrophilic base. The in vitro release rate of ZNS from the PEG suppository was significantly rapid compared with that of ZNS from Witepsol. Male Wistar rats were administered ZNS (20 mg/kg) using an intravenous, oral or rectal (PEG or Witepsol) route. The absorption of ZNS from the PEG suppository was more rapid than that of ZNS from the Witepsol suppository or from the oral preparation. The peak plasma concentration (Cmax) after a rectal administration of ZNS with Witepsol or PEG suppository was significantly higher than that after the oral administration of ZNS. However, the bioavailability of the three preparations was approximately 100%. Male ICR mice were administered ZNS (80 mg/kg) using the oral or rectal (PEG or Witepsol) route. A positive correlation was observed between the electroshock seizure (ES) threshold and ZNS concentration in plasma or brain. Further, there was no significant difference in the ES threshold or the ZNS concentration in plasma or brain among the three preparations. These results indicate that a ZNS suppository is a very useful preparation from the viewpoint of both pharmacokinetics and pharmacological action.

Characteristic biotransformation of aminopyrine in rat when administered with barbital.

After the administration of aminopyrine with or without barbital to rats, aminopyrine and its main metabolites were detected in plasma and the brain by means of gas chromatography-mass spectrometry. It was clarified that a marked increase of 4-monomethylaminoantipyrine was observed in the case of coadministration of aminopyrine and barbital, while the plasma level of aminopyrine decreased significantly compared with single administration.

Change in erythrocyte shape induced by cyclosporine administration.

In order to estimate the effect of the long term administration of cyclosporine (CsA) on the shape change of erythrocytes, erythrocyte shapes which are observed with a scanning electron microscope were classified according to the nomenclature of Bessis for stomatocyte-echinocyte shape transformation. As a result of observing the erythrocyte shape of fifty-six patients with kidney transplantation treated with CsA, the morphological index of the erythrocytes of patients significantly increased to 0.0835+/-0.0085*** in comparison with 0.0004+/-0.0051 of those from healthy volunteers (control) (***: p<0.001, ANOVA). Such transformations had no relation to the subjects' sex or age. On the other hand, the erythrocytes of patients administered more than 100 ng/ml of CsA and posttransplanted within less than two years were transformed by CsA from the state of discocyte to echinocyte. In rats, the morphological index of erythrocytes of rats treated with 3 mg/kg/d or 5 mg/kg/d of CsA significantly increased in comparison with rats treated with saline (control). Furthermore, the erythrocytes of two patients were observed in terms of shape before the treatment with CsA. In both patients, the echinocyte type of erythrocyte increased by treatment with CsA. In vitro, the morphological index of the erythrocytes incubated with plasma containing CsA significantly increased, to 0.459+/-0.066*** in comparison with 0.064+/-0.029 of the control. It is suggested from these results that CsA treatment induces the echinocyte type of erythrocyte.