Pharmacokinetic-pharmacodynamic modeling of stimulatory and sedative effects of alprazolam: timing performance deficits

Alprazolam decreased the reinforcement rate and increased the shorter-response rate of contingency-controlled timing behavior under a differential reinforcement of low-rate schedule (DRL 45-s) in rats. An integrated pharmacokinetic-pharmacodynamic (PK-PD) model was developed to describe and characterize the effects of i.v. and s. c. administration of alprazolam. The onset, peak and disappearance of alprazolam effects were evaluated during a 3-hr session. After s. c. alprazolam administration, two peak increases in shorter-response rate occurred at moderate alprazolam serum levels, first in the ascending and then in the descending limb of the concentration-time profile. We used a stimulation-sedation PD model incorporating two opposing effect-link sigmoidal Emax functions to model the two peaks after s.c. alprazolam administration. The model suggested that alprazolam possesses both stimulatory and sedative effects in a continuous but sequential fashion, which corresponded to low- and high-concentration effects as indicated by the EC50 values of 0.09 and 0.18 microg/ml, respectively. Owing to the rapid onset of i.v. administration, the first peak (a transition phase before the onset of the sedative effect) was absent, with the presence of the second peak again coinciding with the offset of the sedative effect. The reinforcement rate (IC50 = 0.02 microg/ml) characterized by the indirect response model to account for the initial hysteresis is an index for evaluating the deficit in timing performance. Although the effects of alprazolam can be described in behavioral terms, simultaneous PK-PD optimization numerically defines the performance and hypothesizes the coexistence of stimulation and sedation components for alprazolam. The stimulation-sedation model may help in delineating the possible mechanisms for adverse rebound side effects and of tolerance in humans.

Schedule induction conditions not only exaggerate intake but also enhance drug solution choice

In previous research, rats exposed to daily, 3 h sessions of schedule-induced polydipsia (SIP) self-administered high doses of cocaine orally. However, a strong and durable preference for cocaine solution to water requires training in addition to mere oral self-administration exposure. If cocaine is dissolved in a preferred vehicle solution, and the vehicle is subsequently faded to water, then a strong preference for cocaine remains. A similar preference can be instituted for lidocaine solution. Such preferences may develop because the gustatory property of a drug becomes associated with the preferred vehicle and remains to function as a durable conditioned reinforcer after vehicle fading. To determine if drug preference is solely a function of this posited conditioning mechanism, or whether it also depends upon the SIP condition, rats were exposed to daily, 3 h sessions of single-ration feeding, rather than the SIP condition. A preferred vehicle (glucose/saccharin solution) was slowly faded from a 0.19 mg/ml lidocaine solution, which was presented concurrently with a choice for water. Although a preference for lidocaine solution to water could be generated, it occurred for only 5 out of 9 rats, and the preference was relatively unstable. By contrast, in two previous studies using SIP, 26 out of 27 rats maintained a preference for lidocaine solution. Thus, SIP not only exaggerates the amount of drug solution ingested but also contributes to the fixation of the associative drug solution choice.

Establishing preference for oral cocaine without an associative history with a reinforcer

Using schedule-induced polydipsia (SIP), a stable, oral, preference for cocaine solution to water presented concurrently can be established by first presenting cocaine in a preferred vehicle, and subsequently fading the vehicle to water. The present study showed that rats exposed to a history of choosing 0.48 mg/ml cocaine in preference to concentrated lidocaine (2 mg/ml) under SIP conditions subsequently maintained this preference when the lidocaine concentration was progressively decreased to zero (water). Preference for lidocaine was tested by fixing it at 0.38 mg/ml (equimolar with 0.48 mg/ml cocaine) while subsequently increasing cocaine from 0.48 mg/ml to 2.5 mg/ml. Lidocaine preference did not occur, rather, preference for concentrated cocaine persisted. The results suggest that the avoidance of lidocaine solution may force the discrimination of the relation between high oral cocaine intake and its reinforcing effects, thereby instituting a stable preference for cocaine.

Determination of cocaine and its metabolites in serum microsamples by high-performance liquid chromatography and its application to pharmacokinetics in rats

A single-solvent extraction step high-performance liquid chromatographic method is described for quantitating cocaine and its three metabolites in rat serum microsamples (50 microl). The separation used a 2.1-mm I.D. reversed-phase Brownlee C18 column with an isocratic mobile phase consisting of methanol-acetonitrile-25.8 mM sodium acetate buffer, pH 2.2, containing 1.29-10(-4) M tetrabutylammonium phosphate (12.5:10:77.5, v/v/v). The detection limit was 2.5 ng/ml for all the compounds using an ultraviolet detector operated at 235 nm. The method was used to study the pharmacokinetics of cocaine after an intravenous (i.v.) bolus dose (4 mg/kg).

Differential reinforcement of low rate performance, pharmacokinetics and pharmacokinetic-pharmacodynamic modeling: independent interaction of alprazolam and caffeine

To investigate the interaction between alprazolam and caffeine, performance on a differential reinforcement of low-rate behavior schedule and the respective pharmacokinetics (PK) were explored in concurrent studies. Alprazolam PK was not altered by caffeine, but alprazolam retarded caffeine absorption indirectly, as inferred by the lack of i.v. drug administration PK interaction, thereby decreasing serum methylxanthine concentrations. Inasmuch as alprazolam was more potent and short-lived than caffeine in decreasing the reinforcement rate (consonant with their respective t(1/2) values, 0.44 and 3.1 hr), the alprazolam/caffeine potency ratio decreased across the session time, which determined the expression of the combined effects. Thus, the decreased methylxanthine level yielded slightly less disruption in performance for the observed combined effect, compared to the expected calculated effect, only near the end of a session. The interaction was PK linked and mainly not distinguishable from independence as indicated by the Poch dose-response curve method and the integration of PK and pharmacodynamics. The sigmoid maximal effect-link pharmacodynamic model indicated that caffeine did not alter the concentration at half of the maximal effect value of alprazolam and suggested that the interaction is not competitive, but independent. Although the nature of the benzodiazepine-methylxanthine interaction has been controversial in other behavioral studies, as is the role of PK in determining behavior, this and our previous study make it evident that the interaction is independent not only across doses and routes of administration, but also with respect to two indices of differential reinforcement of low rate performance.

Transparent and gauze dressings and their effect on infection rates of central venous catheters: a review of past and current literature

Infection has been identified as a potentially life-threatening complication of central venous catheterization. The type of dressing applied to the catheter site has been suggested to influence the incidence of catheter-related infection. Although numerous research studies were conducted before 1990 and in the past 5 years to compare the effect of gauze and transparent dressing on the infection rate of central venous catheters, results are conflicting. This literature review analyzes some of those efforts.

Tolerance to the anxiolytic effects of the triazolobenzodiazepines triazolam and alprazolam, as measured by the ingestion of a hypertonic sodium chloride solution in rats

Rats were adapted to a water-deprivation regimen that allowed daily 1-hr drinking sessions of a single fluid, either 1.5% NaCl solution or water. Oral, presession, acute doses of triazolam (0.05-1.6 mg/kg) or alprazolam (0.4-6.4 mg/kg) produced dose-related increases in session NaCl solution ingestion. The relative potencies found for these two drugs approximated their relative Ki values reported in the literature. The increased ingestion produced in this and other experiments by anxiolytic agents is presented as an alternative way of evaluating punishment attenuation, and hence anxiolytic activity. Chronic oral dosing (every 2nd day) with triazolam (0.2 mg/kg) or alprazolam (1.2 mg/kg) led, after several weeks, to partial, but surmountable, tolerance to the increased NaCl solution ingestion produced by these drugs, which was confirmed by a rightward shift in the dose-effect relations. During chronic dosing, no corresponding declines in the independently evaluated increases in water intake produced by these drugs occurred. Abrupt drug discontinuation produced a precipitous decrease in NaCl solution intake, with subsequent recovery. For triazolam, the initial discontinuation decrease in intake to below the original base line suggested the possible accrual of a mild physiological dependence under this moderate chronic dose regimen.

Pharmacokinetics and bioavailability of midazolam after intravenous, subcutaneous, intraperitoneal and oral administration under a chronic food-limited regimen: relating DRL performance to pharmacokinetics

The effects of midazolam on animal behavior often are evaluated under a chronically food-limited regimen, which is used to implement food-reinforced performance, but the corresponding pharmacokinetics are lacking. The present study investigated the pharmacokinetics of midazolam after i.v., s.c., i.p., and p.o. administration in food-limited rates. A two-compartment model best described the concentration-time profiles for the four routes of administration. The rate of midazolam absorption was rapid, and peak concentrations were attained in less than 7 min for the three extravascular routes. The mean volume of distribution of the central compartment and clearance were 0.77 l/kg and 2.03 l/h per keg, respectively. Midazolam elimination half-lives for the four routes of administration ranged from 23.1 to 49.5 min, and metabolites could not be detected. The mean absolute bioavailability was route-dependent: 39.3% (s.c.) 19.2% (i.p.) and 4.6% (p.o.). The markedly low oral bioavailability found in food-limited rats contrasted to the value reported for free-feeding rates (45%). Although the i.p. route yielded the highest maximum concentration on occasion, serum midazolam concentration-time profiles were variable, but did correspond to respective sedative responses. DRL 45-s performance after s.c., i.p., and p.o. administration further supported the advisability of using the s.c. route of administration, as opposed to the i.p. route, for studying midazolam dose-response relations. The bioavailability values assessed from DRL performance also agree with the measured pharmacokinetic values.

Alprazolam, caffeine and their interaction: relating DRL performance to pharmacokinetics

Three-hour sessions of differential reinforcement of low-rate behavior (DRL 45-s) in rats were used to investigate alprazolam, caffeine, and their interactions at the onset, peak and disappearance of serum alprazolam, while caffeine level remained constant. The dose-response curve (DRC) method of Pöch permitted an extensive evaluation of the kind (additivity or independence) of interactions occurring in combined drug effects. The alprazolam and caffeine DRCs were used to derive theoretical additive and independent relations, and the observed combined effects compared to these functions. Behavior-time profiles of the combined effects were similarly compared. Serum alprazolam and caffeine concentrations correlated with their respective behavior-time profiles. No acute tolerance was observed either for the individual drugs or their combinations. Alprazolam was more potent than caffeine in disrupting DRL behavior. Because alprazolam is much shorter-lived (t1/2 = 32 min) than caffeine (t1/2 = 3 h) in rats, potency ratios between alprazolam and caffeine changed across session time (from 123 to 4), which determined the expression of the combined effects. Although the combined effects were not distinguishable in terms of additivity or independence in both the DRCs and in the behavior-time profiles, they showed neither synergism nor antagonism. The pharmacokinetics of alprazolam were not altered by caffeine, but those of caffeine were affected by alprazolam.

Determination of midazolam and its metabolites in serum microsamples by high-performance liquid chromatography and its application to pharmacokinetics in rats

A single-solvent extraction step high-performance liquid chromatographic method is described for quantitating midazolam and its two hydroxy metabolites in rat serum microsamples (50 microliters). The separation used a 2 mm I.D. reversed-phase Symmetry C18 column with an isocratic mobile phase consisting of methanol-acetonitrile-14.9 mM sodium acetate in water at pH 3.0 (10:23:67, v/v). The detection limit was 10 ng/ml for all the compounds using an ultraviolet detector operated at 230 nm. The method was used to study the pharmacokinetics of midazolam after an intravenous bolus dose (0.75 mg/kg).

Conditions sufficient for the production of oral cocaine or lidocaine self-administration in preference to water

Groups of rats were given a chronic history of drinking cocaine solutions of different concentrations in daily, 3-h schedule induced polydipsia sessions. Animals failed to develop a preference for cocaine solution to concurrently presented water. Schedule-induction conditions were maintained, and the animals were divided into separate groups, drinking either cocaine or lidocaine placed in a highly acceptable vehicle (glucose-saccharin solution). Animals preferred their respective drug solutions to concurrently presented water, and these preferences remained stable after the glucose-saccharin vehicle was gradually faded to water, leaving only cocaine or lidocaine, respectively, in the solution. Thus a stable preference for drug solution to water could be instituted in rats for either cocaine or lidocaine solution (putative reinforcing and nonreinforcing agents, respectively) given an appropriate associative history, with high intakes maintained by schedule-induction. Conditions sufficient for the initiation of an oral preference and high intake for a putatively reinforcing drug cannot be assumed to occur owing to the drug's reinforcing property in the absence of demonstrating the ineffectiveness of an appropriate negative control substance.

Dose-dependent surmountability of locomotor activity in caffeine tolerance

For two chronic intraperitoneal caffeine dose regimens (10 and 80 mg/kg per day), tolerance developed rapidly (2-3 days) to the stimulatory effects of caffeine on locomotor activity. However, surmountability of the tolerant activity rate levels by caffeine administration was dose dependent: Activity rate was restored fully by acute caffeine administration for the 10 mg/kg per day series, but not for the 80 mg/kg per day series. The extent of tolerance was also dose-dependent: Tolerance was incomplete for the low-dose daily caffeine series but complete for the high-dose series. Upon discontinuation of daily caffeine dosing, activity rate decreased to the original baseline levels for both chronic series. Caffeine tolerance and the quantification of its surmountability may be explained by the pharmacokinetics of caffeine and the upregulation of adenosine receptors.

Oral and IP caffeine pharmacokinetics under a chronic food-limitation condition

For food-limited rats, serum caffeine was proportional to IP caffeine doses (10-40 mg/kg) for Cmax and area under the curve [AUC(0-24 h)], whereas the three dimethylxanthine (DMX) metabolites of caffeine were disproportional over the dose range. Steady-state concentrations of caffeine and the three metabolites were evident at the 11th day of chronic, daily caffeine IP 20 mg/kg doses. Both caffeine and the three metabolites were dose proportional for Cmax and AUC(0-24 h) by schedule-induced oral caffeine self-administration within the dose range taken (9-38 mg/kg). These results contrast with the nonlinear kinetics of caffeine reported for rats under ad lib conditions. Elimination rate constants (Kel) remained the same for the two routes, but apparent volume of distribution (AVd) and clearance (Cl) were different. The order of the Kel values was caffeine > paraxanthine > theophylline > theobromine. The effects of linear vs. nonlinear caffeine pharmacokinetics may have distinct implications for the resulting pharmacodynamics.

Stimulus control of addictive behavior: persistence in the presence and absence of a drug

Rats were exposed daily to a food schedule-induced polydipsia condition, in which water and 0.16 mg/ml cocaine solution were available concurrently, with the cocaine solution indicated by a discriminative stimulus (SD) light. The cocaine solution was preferred, and the preference was maintained when the SD was gradually eliminated by fading its intensity. For a second group, if cocaine concentration was the stimulus gradually eliminated, preference for the resulting solution (water) indicated by the SD was stably maintained. For two additional groups, if either the light SD or the cocaine stimulus was removed abruptly rather than gradually, few animals retained preferences. These studies reveal the importance of establishing strong stimulus control for the initiation and persistence of drug abuse behavior.

Tolerance to oral and IP caffeine: locomotor activity and pharmacokinetics

Locomotor activity increase was a bitonic function of acute caffeine IP doses (2.5-40 mg/kg) in rats. When the schedule-induced polydipsic, orally self-administered dose of caffeine was increased over blocks of daily 3 h sessions from 9.3 to 36.5 mg/kg, postsession activity increased monotonically as a function of dose. The rate of tolerance development to the increase in locomotor activity produced by caffeine depended on the route of administration. Tolerance onset occurred on the fourth day of chronic IP doses, but remained incomplete after 21 doses. With the highest dose level of oral caffeine self-administration, tolerance developed on day 13, but remained incomplete even after 17 doses. Acute tolerance occurred for each of the IP doses, whereas a linear relation between locomotor activity and serum caffeine concentration was obtained after oral self-administration. There were two- to threefold higher locomotor activity AUCs(4 h) with oral caffeine at three dose levels compared to the activity AUCs(4 h) for IP doses.

Acute and chronic nicotine effects on multiple-schedule behavior: oral and SC routes

For rats responding on a 3 h FI 4 min FR 20 schedule of food reinforcement, presession SC nicotine doses (0.1-0.8 mg/kg) produced depression in all responding followed by stimulation of FI responding that was dependent upon both time and dose. With daily presession 0.8 mg/kg SC nicotine injections for 9 days, no tolerance to the depressive or stimulatory effects of nicotine occurred. When nicotine solutions were orally self-administered by presession exposure to 3 h of schedule-induced polydipsia, the subsequent FR responding was unaffected, but the degree of FI response stimulation and its duration occurred in a dose-related fashion (1.18-4.10 mg/kg). Prolonged daily sessions of oral nicotine self-administration provide a technique for investigating the effects of chronic exposure to nicotine. The postingestive effects of nicotine reveal stimulatory effects that last for at least 3 h.

Determination of alprazolam and its major metabolites in serum microsamples by high-performance liquid chromatography and its application to pharmacokinetics in rats

A high-performance liquid chromatographic method using a single-solvent extraction step is described for quantitating alprazolam and its metabolites in rat serum microsamples (50 microliters). The separation used a 2-mm I.D. reversed-phase Ultrasphere C18 column with a mobile phase of methanol-acetonitrile-sodium acetate buffer. By decreasing the methanol content in the mobile phase, triazolam and its metabolites can be extracted and separated using the same method. The detection limit was 5 ng/ml for all the compounds using an ultraviolet detector at 230 nm. The method showed the effect of aging on alprazolam pharmacokinetics following 0.8 mg/kg intravenous bolus alprazolam administration.

Determination of cocaethylene, cocaine and their metabolites in rat serum microsamples by high-performance liquid chromatography, and its application to pharmacokinetic studies in rodents

A single-solvent extraction step high-performance liquid chromatographic method is described for quantitating cocaethylene in rat serum microsamples (50 microliters), a substance formed in vivo when cocaine and ethanol are present concurrently. The separation used a 2 mm I.D. reversed-phase Nova-Pak C18 column with a mobile phase of acetonitrile-phosphate buffer containing an ion-pairing reagent. With an ultraviolet detector operated at 230 nm, a linear response was observed from 0.05 to 2.0 micrograms/ml with a detection limit of 5 ng/ml for cocaethylene, cocaine and norcocaine. The method showed a longer half-life for cocaethylene than for cocaine in rat.

Oral cocaine self-administration: relation of locomotor activity to pharmacokinetics

Rats were exposed to daily schedule-induced polydipsia sessions in which solutions of cocaine HCl were available. Both cocaine solution concentration (0.08-0.32 mg/ml) and session duration (0.25-3 h) were varied to determine their effects on locomotor activity rate. Additional animals were used to determine the effect of session length on serum cocaine and metabolite levels when drinking 0.32 mg/ml cocaine solution. Changes in locomotor activity rate were related to serum cocaine concentration by a linear concentration-effect model. By estimation from the linear model, the serum cocaine concentration threshold for increasing locomotor activity was about 0.01 microgram/ml. Under these schedule-induction conditions, there was no evidence for the development of acute tolerance to the locomotor-stimulating activity of cocaine.

Orally self-administered cocaine: reinforcing efficacy by the place preference method

In three separate place preference conditioning (PPC) experiments, groups of rats were exposed to different modes of receiving cocaine: IP cocaine doses (7.5 mg/kg), PO cocaine self-administered bolus doses (15 mg/kg), and 1-h schedule-induced cocaine-solution drinking sessions (19.1 mg/kg). Oral cocaine self-administration of PO bolus and schedule induction took place in situations that preceded transfer into an apparatus for PPC sessions. Thus, the reinforcing efficacies of the pharmacological consequences of both oral cocaine self-administration methods were evaluated by a procedure separate from the self-administration behavior itself. The IP cocaine dose imposition and the two oral cocaine self-administration arrangements all resulted in dose-exposure conditions sufficient for the production of PPC. The serum and brain cocaine pharmacokinetics sufficient for the production of reinforcing efficacy were measured and related to previous data.

Sustained synergism by chronic caffeine of the motor control deficit produced by midazolam

To evaluate the effects of chronic caffeine on the impairment of discriminative fine motor control produced by midazolam, rats were trained to hold a force transducer steady to deliver food pellets. Chronic, daily doses of midazolam (3 mg/kg SC) led to a stable level of motor impairment. Chronic caffeine (20 mg/kg IP) alone usually produced a more moderate deficit or, for one animal, no deficit. Combined, chronic administration of these doses yielded a sustained synergism in motor performance impairment, which contrasted with the antagonism usually found between the benzodiazepines and methylxanthines when performance is evaluated by psychomotor tests not requiring fine motor control. The observed synergism was not explicable in terms of measured disposition of the drugs. The synergistic production of fine motor dyskinesia by the concurrent administration of caffeine and midazolam may be relevant to the triggering of anxiety attacks by caffeine observed in panic disorder patients.

Synergism by caffeine and by cocaine of the motor control deficit produced by midazolam

To evaluate the effects of caffeine and cocaine on the impairment of discriminative motor control produced by midazolam, rats were trained to hold a force transducer operated with a paw so that it remained between upper and lower limits of a force band for a continuous 1.5-s period to deliver each food pellet. Acute doses of 3 mg/kg midazolam SC impaired motor performance. Except for one animal, caffeine (10-40 mg/kg IP) had little or no effect on performance, while cocaine (3.75-22.5 mg/kg IP) produced dose-related impairment. When each dose of caffeine was combined with 3 mg/kg midazolam, a marked synergism in motor performance impairment occurred. Cocaine plus midazolam produced mainly an additive synergism. The conspicuous synergistic action of caffeine on the motor control deficit produced by midazolam contrasts with the typical antagonism found between the benzodiazepines and methylxanthines when performance is evaluated by psychomotor tests not requiring fine motor control.

Midazolam withdrawal and discriminative motor control: effects of FG 7142 and Ro 15-1788

Rats chronically drank either water or midazolam solution (0.1 mg/ml) in daily, 3-h schedule-induced polydipsia sessions and were evaluated in daily motor control sessions after polydipsia when midazolam metabolite levels had fallen to zero (withdrawal). Under midazolam polydipsia, animals orally self-administered between 21 and 38 mg/kg daily. The effect of acute drug administration [midazolam (0.75-3 mg/kg, SC), FG 7142 (1-8 mg/kg, IP), Ro 15-1788 (10-20 mg/kg, IP)] on motor control performance was similar after either chronic water or midazolam polydipsia. Thus chronic, oral midazolam self-administration did not lead to tolerance to the motor impairment produced by SC midazolam, nor did the daily discontinuation lead to impaired motor performance, nor had these performances, which occurred after daily elevated midazolam metabolite levels had reached zero (withdrawal), become sensitized to the effects of either the benzodiazepine inverse agonist FG 7142 or the agonist Ro 15-1788.

Behavioral tolerance to flurazepam

Rats were trained to earn 180 food pellets in daily, fixed-interval 1-min sessions. When performance had stabilized, a Before group was given a weekly 16 mg/kg flurazepam injection IP for 3 weeks immediately before the sessions, while an After group received their weekly injections immediately after the sessions. Then, the After group received 3 such weekly injections before the sessions. Behavioral tolerance developed by the 2nd flurazepam injection for the Before group, but for the After group, the 3 postsession flurazepam injections resulted in subsequent tolerance to presession flurazepam injection for session lever presses, but not for the time taken to earn 180 pellets. Dispositional tolerance to the serum elimination rate of flurazepam did not develop over the course of 3 injections. Behavioral suppression still evident in the initial portion of sessions with the 2nd and 3rd presession injection coincided with the duration of rising and high levels of serum flurazepam.

Chronic oral cocaine self-administration: pharmacokinetics and effects on spontaneous and discriminative motor functions

Rats receiving repeated doses of oral cocaine (15 mg/kg) showed replicable increases in large-movement and small-movement activity rates, but sensitization to the repeated doses did not develop. With a schedule-induction procedure, as the daily, 3-hr, oral dose of self-administered cocaine increased, marked dose-related increases occurred in both large-movement locomotor activity rate and the time for which these elevations were sustained during the following daily 2-hr activity session. Sensitization developed. At the highest levels of self-administered oral cocaine (about 80 mg/kg), post-administration serum cocaine levels remained undiminished for the activity-session period, as did the large-movement activities of most animals, indicating no development of acute tolerance. Rats receiving repeated doses of oral cocaine (15 mg/kg) showed discriminative motor control deficits as well as increases in work rate. These changes were dose-related in animals self-administering oral cocaine under the schedule-induction procedure. Upon withdrawal of cocaine from the schedule-induction animals, motor behavior returned to precocaine base-line performance for most animals. The behavior of the animal with the largest cocaine intake did not return. After a schedule-induced oral cocaine intake session, the tail-tip and trunk serum measures for cocaine and its metabolites were approximately equivalent, while brain cocaine and norcocaine levels remained markedly elevated over serum values.