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Rousseau-Blass F, Cribb AE, Beaudry F, Pang DS. A Pharmacokinetic-Pharmacodynamic Study of Intravenous Midazolam and Flumazenil in Adult New Zealand White-Californian Rabbits ( Oryctolagus cuniculus). JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE : JAALAS 2021; 60:319-328. [PMID: 33673881 PMCID: PMC8145127 DOI: 10.30802/aalas-jaalas-20-000084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/03/2020] [Accepted: 09/29/2020] [Indexed: 11/05/2022]
Abstract
Flumazenil, a competitive GABAA receptor antagonist, is commonly used in rabbits to shorten sedation or postanesthetic recovery after benzodiazepine administration. However, no combined pharmacokinetic (PK) and pharmacodynamic (PD) data are available to guide its administration in this species. In a prospective, randomized, blinded, crossover study design, the efficacy of IV flumazenil (FLU; 0.05 mg/kg) or saline control (SAL; equal volume) to reverse the loss of righting reflex (LORR) induced by IV midazolam (1.2 mg/kg) was investigated in 15 New Zealand white rabbits (2.73 to 4.65 kg, 1 y old). Rabbits were instrumented with arterial (central auricular artery) and venous (marginal auricular vein) catheters. After baseline blood sampling, IV midazolam was injected (T0). Flumazenil or saline (FLU/SAL) was injected 30 s after LORR. Arterial blood samples were collected at 1 and 3 min after midazolam injection, and at 1, 3, 6, 10, 15, 21, 28, 36, 45 and 60 min after injection with flumazenil. Plasma samples for midazolam, 1-OH-midazolam and flumazenil were analyzed using high performance liquid chromatography-high-resolution mass spectrometry and the time to return of righting reflex (ReRR) was compared between groups (Wilcoxon test). FLU terminal half-life, plasma clearance and volume of distribution were 26.3 min [95%CI: 23.3 to 29.3], 18.74 mL/min/kg [16.47 to 21.00] and 0.63 L/kg [0.55 to 0.71], respectively. ReRR was 25 times faster in rabbits treated with FLU (23 [8 to 44] s) compared with SAL (576 [130 to 1141] s; 95%CI [425 to 914 s]). Return of sedation (lateral recumbency) occurred in both groups (7/13 in FLU; 12/13 in SAL) with return of LORR in a few animals (4/13 in FLU; 7/13 in SAL) at 1540 [858 to 2328] s. In the population and anesthesia protocol studied, flumazenil quickly and reliably reversed sedation induced by midazolam injection. However, the potential return of sedation after flumazenil administration warrants careful monitoring in the recovery period.
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Affiliation(s)
- Frédérik Rousseau-Blass
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada; Groupe de recherche en pharmacologie animale du Québec (GREPAQ), Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | - Alastair E Cribb
- Cummings School of Veterinary Medicine, Tufts University, N Grafton, Massachusetts
| | - Francis Beaudry
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada; Groupe de recherche en pharmacologie animale du Québec (GREPAQ), Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | - Daniel Sj Pang
- Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec, Canada; Groupe de recherche en pharmacologie animale du Québec (GREPAQ), Université de Montréal, Saint-Hyacinthe, Québec, Canada; Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine (UCVM), University of Calgary, Calgary, Alberta, Canada;,
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Bicker J, Alves G, Falcão A, Fortuna A. Timing in drug absorption and disposition: The past, present, and future of chronopharmacokinetics. Br J Pharmacol 2020; 177:2215-2239. [PMID: 32056195 DOI: 10.1111/bph.15017] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 01/05/2020] [Accepted: 01/27/2020] [Indexed: 12/20/2022] Open
Abstract
The importance of drug dosing time in pharmacokinetics, pharmacodynamics, and toxicity is receiving increasing attention from the scientific community. In spite of mounting evidence that circadian oscillations affect drug absorption, distribution, metabolism, and excretion (ADME), there remain many unanswered questions in this field and, occasionally, conflicting experimental results. Such data arise not only from translational difficulties caused by interspecies differences but also from variability in study design and a lack of understanding of how the circadian clock affects physiological factors that strongly influence ADME, namely, the expression and activity of drug transporters. Hence, the main goal of this review is to provide an updated analysis of the role of the circadian rhythm in drug absorption, distribution across blood-tissue barriers, metabolism in hepatic and extra-hepatic tissues, and hepatobiliary and renal excretion. It is expected that the research suggestions proposed here will contribute to a tissue-targeted and time-targeted pharmacotherapy.
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Affiliation(s)
- Joana Bicker
- Laboratory of Pharmacology, Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal.,CIBIT/ICNAS-Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal
| | - Gilberto Alves
- CICS-UBI-Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Amílcar Falcão
- Laboratory of Pharmacology, Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal.,CIBIT/ICNAS-Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal
| | - Ana Fortuna
- Laboratory of Pharmacology, Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal.,CIBIT/ICNAS-Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal
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Larouche CB, Johnson R, Beaudry F, Mosley C, Gu Y, Zaman KA, Beaufrère H, Dutton C. Pharmacokinetics of midazolam and its major metabolite 1-hydroxymidazolam in the ball python (Python regius) after intracardiac and intramuscular administrations. J Vet Pharmacol Ther 2019; 42:722-731. [PMID: 31469454 DOI: 10.1111/jvp.12806] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/07/2019] [Accepted: 07/31/2019] [Indexed: 11/28/2022]
Abstract
Midazolam is a benzodiazepine with sedative, muscle relaxant, anxiolytic, and anticonvulsant effects. Twelve ball pythons (Python regius) were used in a parallel study evaluating the pharmacokinetics of 1 mg/kg midazolam following a single intracardiac (IC) or intramuscular (IM) administration. Blood was collected from a central venous catheter placed 7 days prior, or by cardiocentesis, at 15 time points starting just prior to and up to 72 hr after drug administration. Plasma concentrations of midazolam and 1-hydroxymidazolam were determined by the use of high-performance liquid chromatography tandem-mass spectrometry and pharmacokinetic parameters were estimated using noncompartmental analysis. The mean ± SD terminal half-lives of IC and IM midazolam were 12.04 ± 3.25 hr and 16.54 ± 7.10 hr, respectively. The area under the concentration-time curve extrapolated to infinity, clearance, and apparent volume of distribution in steady-state of IC midazolam were 19,112.3 ± 3,095.9 ng*hr/ml, 0.053 ± 0.008 L hr-1 kg-1 , and 0.865 ± 0.289 L/kg, respectively. The bioavailability of IM midazolam was estimated at 89%. Maximum plasma concentrations following an IM administration were reached 2.33 ± 0.98 hr and 24.00 ± 14.12 hr postinjection for midazolam and 1-hydroxymidazolam, respectively, and 22.33 ± 20.26 hr postinjection for 1-hydroxymidazolam following IC administration.
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Affiliation(s)
- Cédric B Larouche
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.,Toronto Zoo, Toronto, Ontario, Canada
| | - Ron Johnson
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Francis Beaudry
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Département de Biomédecine Vétérinaire, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | - Craig Mosley
- VCA Canada, 404 Veterinary Emergency and Referral Hospital, Newmarket, Ontario, Canada
| | - Yu Gu
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Kristopher Afshaun Zaman
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Hugues Beaufrère
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
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Simon BT, Scallan EM, O O, Ebner LS, Cerullo MN, Follette C, Cox SK, Doherty TJ, Lizarraga I. Pharmacokinetics and pharmacodynamics of midazolam following intravenous and intramuscular administration to sheep. Am J Vet Res 2017; 78:539-549. [DOI: 10.2460/ajvr.78.5.539] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Zhuang X, Wang X, Wang J, Li J, Zheng A, Lu C, Zhang Z. Comparative pharmacokinetics and bioavailability of intranasal and rectal midazolam formulations relative to buccal administration in rabbits. RSC Adv 2015. [DOI: 10.1039/c5ra10549h] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The rectal and intranasal formulations under current development demonstrated comparative potential for administering midazolam in treating seizures in a medical emergency service.
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Affiliation(s)
- XiaoMei Zhuang
- State Key Laboratory of Toxicology and Medical Countermeasures
- Beijing 100850
- China
- Beijing Institute of Pharmacology and Toxicology
- Beijing 100850
| | - XiaoYing Wang
- State Key Laboratory of Toxicology and Medical Countermeasures
- Beijing 100850
- China
- Beijing Institute of Pharmacology and Toxicology
- Beijing 100850
| | - Juan Wang
- State Key Laboratory of Toxicology and Medical Countermeasures
- Beijing 100850
- China
- Beijing Institute of Pharmacology and Toxicology
- Beijing 100850
| | - JingLai Li
- State Key Laboratory of Toxicology and Medical Countermeasures
- Beijing 100850
- China
- Beijing Institute of Pharmacology and Toxicology
- Beijing 100850
| | - AiPing Zheng
- State Key Laboratory of Toxicology and Medical Countermeasures
- Beijing 100850
- China
- Beijing Institute of Pharmacology and Toxicology
- Beijing 100850
| | - Chuang Lu
- Millennium Pharmaceuticals
- Takeda
- Cambridge
- USA
| | - ZhenQing Zhang
- State Key Laboratory of Toxicology and Medical Countermeasures
- Beijing 100850
- China
- Beijing Institute of Pharmacology and Toxicology
- Beijing 100850
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