Potentiating actions of tranylcypromine and moclobemide on the sympathomimetic activity of dopamine

Clinical Studies on Drug-Drug Interactions Involving Metabolism and Transport: Methodology, Pitfalls, and Interpretation

Many drug-drug interactions (DDIs) are based on alterations of the plasma concentrations of a victim drug due to another drug causing inhibition and/or induction of the metabolism or transporter-mediated disposition of the victim drug. In the worst case, such interactions cause more than tenfold increases or decreases in victim drug exposure, with potentially life-threatening consequences. There has been tremendous progress in the predictability and modeling of DDIs. Accordingly, the combination of modeling approaches and clinical studies is the current mainstay in evaluation of the pharmacokinetic DDI risks of drugs. In this paper, we focus on the methodology of clinical studies on DDIs involving drug metabolism or transport. We specifically present considerations related to general DDI study designs, recommended enzyme and transporter index substrates and inhibitors, pharmacogenetic perspectives, index drug cocktails, endogenous substrates, limited sampling strategies, physiologically-based pharmacokinetic modeling, complex DDIs, methodological pitfalls, and interpretation of DDI information.

Endogenous prostacyclin increases neuronal nitric oxide release in mesenteric artery from spontaneously hypertensive rats

The aim of this study was to analyse the possible influence of endogenous prostacyclin on neuronal nitric oxide (NO) release induced by electrical field stimulation in mesenteric arteries from spontaneously hypertensive rats (SHR). Preincubation with the prostacyclin synthesis inhibitor tranylcypromine decreased NO release induced by electrical field stimulation, which was reversed by exogenous prostacyclin. Preincubation with tranylcypromine increased basal and electrical field stimulation-induced [3H]noradrenaline release. The nitric oxide synthase inhibitor Nomega-nitro-L-arginine methyl esther (L-NAME) increased the vasoconstrictor response induced by electrical field stimulation. In the presence of tranylcypromine, L-NAME did not modify the vasoconstrictor response induced by electrical field stimulation. In the presence of tranylcypromine and prostacyclin, LNAME increased the vasoconstrictor response to electrical field stimulation. These results indicate that endogenous prostacyclin positively modulates the neuronal NO release induced by electrical field stimulation and that this neuronal NO participates in the regulation of the vasomotor response.