Effect of NMDA antagonists on rapid tolerance to benzodiazepines

We have reexamined the effect of NMDA antagonists [(+)MK-801 and ketamine] on rapid tolerance to chlordiazepoxide. (+)MK-801 and ketamine blocked the development of rapid tolerance to chlordiazepoxide, but this effect was dependent on the dose ratio of the NMDA antagonist to that of the benzodiazepine used to produce rapid tolerance. Furthermore, NMDA antagonists blocked both learned and unlearned tolerance to chlordiazepoxide. It appears that in addition to impairment of memory and learning, NMDA antagonists may also influence some other mechanism involved in the production of drug-tolerance.

Characterization of the Phenomenon of rapid tolerance to ethanol

Motor impairment (tilt-plane) and hypothermia tests were used to further characterize the phenomenon of rapid tolerance to ethanol. Five experiments were carried out to clarify the relationship between rapid and chronic tolerance. The first experiment demonstrated that the extent of tolerance on day 2 produced by the single dose of 4 g/kg alcohol on day 1 was similar to that resulting from two divided doses, administered 2 h apart. In the second experiment, a linear relationship between treatment dose and rapid tolerance development was demonstrated in that higher day 1 treatment doses resulted in greater rapid tolerance development. In the third, a parallel dose-response relationship, similar to that known for chronic tolerance, was observed for rapid tolerance. In the fourth experiment, we compared the development of rapid tolerance under three different conditions: (a) in groups of rats that were not subjected to testing at all (no testing); on day 1, (b) in groups of rats that were not tested on the apparatus but handled at all test times on day 1 (dummy testing); and (c) in groups of rats that were tested at all test times on day 1 (testing or intoxicated group). No testing on day 1 failed to produce rapid tolerance to ethanol whereas testing and dummy testing of animals on day 1 after pretreatment with ethanol-produced rapid tolerance to ethanol on day 2. In the last experiment, immediate posttrial administration of ketamine was found not to block rapid tolerance development. These findings provide additional support for similarities between the mechanisms of rapid and chronic tolerance.

Adenosine mediates metabolic and cardiovascular responses to hypoxia in fetal sheep

1. In seven unanaesthetized fetal sheep (> 80% term), isocapnic hypoxia (arterial partial pressure of O2, Pa,O2, approximately 15 mmHg) was induced for 1 h by lowering maternal inspired PO2. Fetal hypoxia was also produced during intra-arterial administration of the adenosine receptor antagonist 8-(p-sulphophenyl)-theophylline (8-SPT). The fetal 8-SPT infusion was begun just prior to hypoxia and was stopped when fetal Pa,O2 was returned to normal. 2. Hypoxia induced a progressive fetal acidosis, a rise in mean arterial pressure, a transient fall in heart rate and a decrease in breathing movements. 8-SPT significantly reduced the metabolic acidosis and abolished the hypertension and bradycardia without altering hypoxic inhibition of fetal breathing. Administration of the vehicle for 8-SPT during hypoxia did not significantly affect the normal fetal metabolic and cardiovascular responses to acute O2 deprivation. 3. It is concluded that adenosine mediates the fetal bradycardia and hypertension produced by hypoxia, indicating that adenosine modulates fetal autonomic responses to acute oxygen deficiency. Secondly, adenosine contributes to fetal metabolic acidaemia, suggesting that adenosine also modulates fetal glycolytic responses to hypoxia.

D-cycloserine enhances rapid tolerance to ethanol motor incoordination

In a recent study, we showed that D-cycloserine, an agonist at the glycine site of the NMDA receptor, enhances the development of rapid tolerance to ethanol. In the present study, we report that the acquisition of rapid tolerance to the motor incoordination effect of ethanol (tilt-plane test) was increased only when D-cycloserine was injected before, but not after, the intoxicated practice under ethanol. The effect of D-cycloserine on tolerance when this agonist was administered in divided doses before and after test was similar to that obtained when D-cycloserine was injected before test. Higher doses of D-cycloserine did not produce a further enhancement of rapid tolerance. Moreover, when the dose of ethanol on day 1 was large enough to induce rapid tolerance per se, D-cycloserine did not further enhance the tolerance. The enhancement of tolerance by D-cycloserine was antagonized by previous administration of ketamine. The enhancement of ethanol tolerance by D-cycloserine and the antagonism of this effect by ketamine cannot be attributed to changes in pharmacokinetics of ethanol. Taken together, these results confirm the participation of the NMDA receptor system in the development of tolerance to ethanol, and reinforce earlier findings about the involvement of learning in tolerance.

Influence of nitric oxide synthase inhibition on the development of rapid tolerance to ethanol

We recently reported that the nitric oxide (NO) synthase inhibitor L-nitroarginine (L-NA) blocks the development of rapid tolerance to the motor incoordinating effect of ethanol in the tilt-plane test. To clarify the mechanism of L-NA blockade of tolerance, four additional experiments were carried out using the same test. The first demonstrated that L-NA prevented the development of rapid tolerance to ethanol when injected prior to ethanol either on both Days 1 and 2 or only on Day 1. In the second experiment, tolerance was blocked only when L-NA was injected before but not after behavioral testing on Day 1. In the third, L-NA blocked the enhancement of rapid tolerance to ethanol induced by D-cycloserine (CS), an agonist at the N-methyl-D-aspartate (NMDA) receptor. In the last experiment, L-NA pretreatment did not influence blood ethanol disappearance curves on Day 1, or ethanol concentrations in brain, tail blood or decapitated trunk blood on Day 2. These data argue against state-dependent learning as the basis of the L-NA effect, and confirm and extent our previous observation that NO plays a role in the development of rapid tolerance to ethanol.

Effect of NMDA antagonists on rapid and chronic tolerance to ethanol: importance of intoxicated practice

Recent studies from our laboratory have shown that NMDA antagonists ((+)MK-801 and ketamine) inhibit the development of both rapid and chronic tolerance to the motor-impairing (moving belt test) and hypothermic effects of ethanol. The present experiments were designed to determine a) the generality of this inhibition, by using a different test of motor function, the tilt-plane test, and b) the possible importance of the experimental paradigm (i.e., with and without intoxicated practice), for the effect of the NMDA antagonist on ethanol tolerance. Daily administration of ethanol 3.3 g/kg for 5 days produced the same degree of tolerance on this test, whether it was given as a single dose of 3.3 g/kg before the daily training session or as divided doses of 2.3 g/kg before and 1 g/kg immediately after the session. The inhibitory effect of a single dose of (+)MK-801 (0.25 mg/kg IP) on rapid tolerance did not last longer than 1 day. Therefore, daily administration of the NMDA antagonists was necessary to block development of chronic tolerance. Daily injection of (+)MK-801 (0.25 mg/kg IP) failed to block chronic tolerance, but inclusion of a second dose of (+)MK-801 daily, and progressive increase of this second dose during the chronic treatment period did block chronic tolerance. Unlike (+)MK-801, ketamine does not have motor-impairing effects of its own, and does not potentiate those of ethanol; it was, therefore, used in the remaining experiments. Groups of rats received ethanol (3.3 g/kg) or saline, either before a daily practice session on the tilt-plane or after it.(ABSTRACT TRUNCATED AT 250 WORDS)

Interaction between N-methyl-D-aspartate (NMDA) and serotonin (5-HT) on ethanol tolerance

Earlier work from this laboratory had shown that 5-HT is involved in the development of tolerance to ethanol, and that enhancement of 5-HT levels by L-tryptophan accelerated tolerance development. To explore the possibility that NMDA receptors are involved in the 5-HT effect on tolerance, we examined the effect of a noncompetitive N-methyl-D-aspartate (NMDA) antagonist [(+)MK-801] on the ability of L-tryptophan to enhance tolerance to the effect of ethanol on tilt-plane test performance by the rat. L-Tryptophan treatment resulted in the development of rapid tolerance to a dose of ethanol that failed to produce such tolerance by itself. However, prior administration of (+)MK-801 blocked the L-tryptophan effect on rapid tolerance development, in a dose-dependent manner. These results suggest that NMDA receptors are involved in the 5-HT enhancement of ethanol tolerance.

Effect of D-cycloserine on rapid tolerance to ethanol

We recently reported that the noncompetitive NMDA antagonists, (+)MK-801 and ketamine, block the development of rapid tolerance to ethanol. In the present article, we show that D-cycloserine (CS), an agonist at the glycine site of the NMDA receptor that enhances learning and memory, also enhances the development of rapid tolerance to ethanol. Rats were pretreated on day 1 with saline or CS, followed 30 min later by ethanol (2.3 g/kg, IP) or saline. At the end of motor impairment testing on the tilt-plane apparatus, a second injection of CS (3 mg/kg, IP, each time) or saline was given, followed 30 min later by ethanol or saline. Ethanol pretreatment alone (at this dose) did not result in rapid tolerance to ethanol on day 2. However, the group pretreated with CS and ethanol on day 1 showed significant tolerance on day 2 compared to other groups. Pretreatment with CS on day 1 did not affect the motor impairment response to the first exposure to ethanol whether this was on day 1 or day 2. In another experiment, administration of (+)MK-801 (0.25 mg/kg, IP) prior to CS abolished the rapid tolerance enhancement by CS. These findings are further evidence that the NMDA system, which requires activation by the glycine receptor, plays a major role in the development of at least some forms of ethanol tolerance.

Inhibition of nitric oxide synthesis impairs rapid tolerance to ethanol

To examine whether nitric oxide was involved in the development of rapid tolerance to the motor-incoordinating effects of ethanol (tilt-plane test), three experiments were undertaken in a rapid tolerance paradigm in rats. The first experiment tested the effect of the nitric oxide synthase inhibitor, L-nitro-arginine, on the acquisition of ethanol tolerance. The second compared the effects of L-nitro-arginine with those of its inactive isomer, D-nitro-arginine. The third examined whether overload with the substrate L-arginine would prevent the action of L-nitro-arginine on rapid tolerance. The results demonstrated that L-nitro-arginine prevented the development of rapid tolerance, while D-nitro-arginine was ineffective. An excess of the substrate L-arginine reversed the inhibitory action of L-nitro-arginine on tolerance development. These data suggest that nitric oxide may play a role in the development of tolerance to ethanol. The role of nitric oxide in ethanol tolerance may be similar to its role in memory and learning, involving facilitation of transmission in certain NMDA synapses.

Ketamine retards chronic but not acute tolerance to ethanol

Motor impairment (tilt-plane test) was used to investigate whether the noncompetitive N-methyl-D-aspartate (NMDA) antagonist ketamine prevents the development of chronic and acute tolerance to ethanol. Rats were treated with ethanol or saline in the presence and absence of ketamine (separate groups) for 10 days and tested for ethanol tolerance in the absence of ketamine on the fifth and tenth days. In other studies, the effect of ketamine on acute tolerance to ethanol was examined. Rats that received ethanol daily without ketamine showed significant tolerance to ethanol on days 5 and 10, but those receiving ethanol plus ketamine daily showed significantly less tolerance to ethanol. Thus, ketamine interfered with the development of chronic tolerance just as it had been found previously to prevent rapid tolerance. In contrast, ketamine failed to block acute tolerance to ethanol. These results would suggest that the phenomena of acute tolerance and chronic tolerance have differences not previously reported.

Effect of (+)MK-801 and ketamine on rapid tolerance to ethanol

The motor impairment (tilt-plane test) responses to ethanol were significantly reduced on days 2, 3, 4, or 5 in rats receiving ethanol (2.3 and 1.7 g/kg) 24 and 22 h earlier, compared to the control group pretreated with saline. Administration of (+)MK-801, prior to behavioral testing with ethanol on day 1, inhibited the development of tolerance on all these days. Tolerance and the inhibitory effect of (+)MK-801 could no longer be seen if the second injection of ethanol was given on day 7, 8 or 11. Administration of (+)MK-801 on day 1 but after behavioral testing with ethanol did not block the development of rapid tolerance to ethanol on day 2. Administration of another commonly employed NMDA antagonist, i.e., ketamine, prior to ethanol on day 1, also blocked the development of rapid tolerance to ethanol. The findings suggest that NMDA antagonists block rapid tolerance by preventing some adaptation that occurs during intoxicated practice.

Tolerance to ethanol and cross-tolerance to pentobarbital and barbital in four rat strains

Chronic ethanol treatment by gastric intubation conferred tolerance to ethanol-induced motor impairment and hypnosis in four different rat strains: Fischer 344, Long-Evans, Sprague-Dawley, and Wistar. Cross-tolerance to barbital was also observed in all strains after chronic treatment with ethanol. However, chronic ethanol treatment failed to produce cross-tolerance to pentobarbital-induced motor impairment and hypnosis in any of the four strains. The demonstration of cross-tolerance to barbital and the lack of it to pentobarbital after chronic ethanol treatment confirms and extends recent observations on the specificity of the site and/or mechanism of action of sedative-hypnotic drugs that differ in lipid solubility.

The treatment of multiple intracranial tuberculous abscesses: a case report

A Chinese female aged 2 years 8 months with tuberculous meningitis developed hydrocephalus requiring insertion of a ventriculoperitoneal shunt. After adequate anti-tuberculosis chemotherapy for 14 weeks, multiple intracranial tuberculous abscesses developed. The lesions increased in size and number accompanied by clinical deterioration. Repeated drainage operations were performed in view of the increased intracranial pressure. The child made a remarkable recovery after an initial stormy course.

Initial sensitivity, acute tolerance and alcohol consumption in Fischer 344 and Long Evans rats

In separate groups of Fischer 344 and Long Evans rats, initial sensitivity and acute tolerance to ethanol were determined in a jumping test. Sensitivity measurements in each strain were carried out in separate subgroups at ethanol doses of 1.5, 2.0, and 2.5 g/kg IP. Similarly, acute tolerance was measured in different subgroups of each strain using the method of two successive doses of ethanol (2 + 0.4 g/kg; 2 + 0.7 g/kg and 2 + 1.0 g/kg, respectively). After completion of sensitivity and acute tolerance measurement, acute tolerance was then tested in all rats. Based on their acute tolerance values, they were divided into three groups: high, medium, and low. Two weeks after the last acute tolerance test, six rats from each group (i.e., the six highest and six lowest from the high and low acute tolerance groups, respectively, and six from the mid-range of the medium tolerance group) were tested for voluntary ethanol drinking in the limited access model. Long Evans rats had lower initial CNS sensitivity to ethanol-induced impairment of jumping performance than Fischer 344 rats. Long Evans rats also drank significantly more alcohol than the Fischer 344 but there was no significant difference in acute tolerance development between these two strains. Moreover, within each strain the rats differing in acute tolerance development (i.e., high, medium, and low) showed no difference in alcohol consumption. These results suggest that acute tolerance development is not the main determinant of differences in ethanol drinking.

Factors involved in the differential response to ethanol, barbital and pentobarbital in rats selectively bred for ethanol sensitivity

Two lines of rats, 'least affected' (LA) and 'most affected' (MA), had been selectively bred for their differential sensitivity to ethanol. Both males and females of the LA strain were observed to be less sensitive than their MA counterparts to the acute hypnotic and motor-impairing effects of ethanol. However, a lower ethanol metabolic rate of the MA males suggests that both CNS and metabolic factors contribute to their enhanced sensitivity to ethanol. By contrast, no differences were observed between the LA and MA males with respect to the hypnotic and subhypnotic effects of pentobarbital or to the clearance of this drug. MA females were more sensitive only to the hypnotic effects of pentobarbital, probably because of a smaller apparent volume of distribution. No strain difference was observed in the hypnotic effect or clearance of barbital. These observations suggest that, in spite of a differential sensitivity to ethanol, the LA and MA lines do not differ in their response to the barbiturates tested.