Localized anesthesia of a specific brain region using ultrasound-responsive barbiturate nanodroplets

Background: Targeted neuromodulation is a valuable technique for the study and treatment of the brain. Using focused ultrasound to target the local delivery of anesthetics in the brain offers a safe and reproducible option for suppressing neuronal activity. Objective: To develop a potential new tool for localized neuromodulation through the triggered release of pentobarbital from ultrasound-responsive nanodroplets. Method: The commercial microbubble contrast agent, Definity, was filled with decafluorobutane gas and loaded with a lipophilic anesthetic drug, before being condensed into liquid-filled nanodroplets of 210 ± 80 nm. Focused ultrasound at 0.58 MHz was found to convert nanodroplets into microbubbles, simultaneously releasing the drug and inducing local anesthesia in the motor cortex of rats (n=8). Results: Behavioral analysis indicated a 19.1 ± 13% motor deficit on the contralateral side of treated animals, assessed through the cylinder test and gait analysis, illustrating successful local anesthesia, without compromising the blood-brain barrier. Conclusion: Pentobarbital-loaded decafluorobutane-core Definity-based nanodroplets are a potential agent for ultrasound-triggered and targeted neuromodulation.

Stability of pentobarbital in soil

Intravenous injection of barbiturates, particularly pentobarbital (5-ethyl-5-pentan-2-yl-1,3-diazinane-2,4,5-trione), is a widely used method to euthanize large animals such as horses. However, one concern with this method is the fate of pentobarbital after the disposal of the carcass. As tissues decompose, pentobarbital may leach into the soil and from there migrate to groundwater. A method using methanol extraction, solid phase concentration, and liquid chromatography (LC/MS) has been developed to measure pentobarbital in soils. Recovery of pentobarbital from soil averaged approximately 85% from different soil types including topsoil, potting soil, sand, stall sweepings, and loam. The method was capable of detecting pentobarbital levels of 0.1 ppm. A calibration curve was constructed with a linear range of 1 ppm to 100 ppm. The limit of quantification was 0.5 ppm. The rate of degradation of pentobarbital in sand, topsoil, and potting soil was measured over a 17-week period. At the end of week 17, approximately 17% of the pentobarbital remained in the sand, 19% remained in the topsoil, and 10% remained in the potting soil. While there was a significant decrease in the pentobarbital recovered from the soil, there were still detectable amounts of pentobarbital present in the soil after 17 weeks. To determine the importance of bacterial degradation, the three soil types were autoclaved before addition of pentobarbital. After autoclaving, no degradation of pentobarbital was observed in sand and one topsoil sample, while there was no difference in the degradation of pentobarbital in autoclaved potting soil versus potting soil that had not undergone autoclaving.

Enhancement of Pentobarbital-induced Sleep by the Vaporized Essential Oil of Citrus keraji var. kabuchii and its Characteristic Component, y-Terpinene

Kabuchii (Citrus keraji var. kabuchii hort. ex Tanaka, Rutaceae) is a peculiar Okinawan citrus fruit. Local farmers cultivating various Citrus fruits say that the fragrance of Kabuchii is the most relaxing, but, there are few reports on the biological effects of the essential oil of Kabuchii and its chemical components [1]. In this study, the sedative effects of inhalation of the vaporized Kabuchii essential oil in open field, Rotarod, and pentobarbital sleep tests are compared with diazepam, as a positive control. In the open field test, both Kabuchii essential oil and diazepam decreased the spontaneous motor activity dose-dependently. The reduction in spontaneous motor activity in the 0.3 mg/cage (ca. 0.0278 mg/L) Kabuchii essential oil group was greater than that in the 1 mg/kg diazepam group. In the Rotarod test, Kabuchii did not affect the motor performance, even at the highest dosage tested (3 mg/cage), whereas diazepam decreased it dose- dependently. The effects of the major or characteristic components of Kabuchii, d-limonene, y-terpinene, thymol, and p-cymene, were also evaluated in the- open field and Rotarod tests. y-Terpinene and thymol significantly decreased spontaneous motor activity at a dosage of 0.3 mg/cage, without affecting motor performance. Thus, y-terpinene was estimated to be the main active component. Reduction in spontaneous motor activity by y-terpinene in the open field test was not observed in intranasal zinc sulfate irrigation-induced anosmic mice. In the pentobarbital sleep test, both Kabuchii essential oil and diazepam potentiated pentobarbital-induced loss of the righting reflex (LRR). The LRR duration prolonging effects of both treatments were inhibited by pretreatment with flumazenil, a benzodiazepine receptor antagonist. The LRR latency reducing effect of Kabuchii was not affected by flumazenil, while that of diazepam was suppressed by it. y-Terpinene showed similar potentiating effects on pentobarbital-induced sleep. Thus, vaporized Kabuchii essential oil and its active component, y-terpinene, have sedative effects comparable with diazepam without inducing motor incoordination, which is a well-known side effect of. diazepam.

Interaction between different extracts of Hypericum perforatum L. from Serbia and pentobarbital, diazepam and paracetamol

Herb-drug interactions are an important safety concern and this study was conducted regarding the interaction between the natural top-selling antidepressant remedy Hypericum perforatum (Hypericaceae) and conventional drugs. This study examined the influence of acute pretreatment with different extracts of Hypericum perforatum from Serbia on pentobarbital-induced sleeping time, impairment of motor coordination caused by diazepam and paracetamol pharmacokinetics in mice. Ethanolic extract, aqueous extract, infusion, tablet and capsule of Hypericum perforatum were used in this experiment. The profile of Hypericum perforatum extracts as well as paracetamol plasma concentration was determined using RP-HPLC analysis. By quantitative HPLC analysis of active principles, it has been proven that Hypericum perforatum ethanolic extract has the largest content of naphtodianthrones: hypericin (57.77 µg/mL) and pseudohypericin (155.38 µg/mL). Pretreatment with ethanolic extract of Hypericum perforatum potentiated the hypnotic effect of pentobarbital and impairment of motor coordination caused by diazepam to the greatest extent and also increased paracetamol plasma concentration in comparison to the control group. These results were in correlation with naphtodianthrone concentrations. The obtained results have shown a considerable influence of Hypericum perforatum on pentobarbital and diazepam pharmacodynamics and paracetamol pharmacokinetics.

Similar effects of nifedipine and hydralazine on anaesthesia and hypermotility induced by pentobarbitone in mice

Nifedipine, a dihydropyridine calcium channel blocker, and hydralazine, a non-calcium channel antagonist vasodilatator, enhanced pentobarbitone-induced sleeping time and reversed locomotor hyperactivity induced by a subhypnotic dose of the barbiturate in mice. The similarity of the behavioural effects, exerted by nifedipine and hydralazine, suggest that haemodynamic factors may play an important role in the interaction of calcium channel antagonists with barbiturates.

Identification of the UDP-glucuronosyltransferase responsible for bucolome N-glucuronide formation in rats

Bucolome N-glucuronide (BCP-NG), a major metabolite of bucolome (BCP), is the first unique N-glucuronide of barbituric acid derivatives to be reported. The purpose of the present study was to identify the UGT isoform(s) responsible for BCP-NG formation in rats. A pharmacokinetic study of BCP and the biliary excretion of BCP-NG was carried out in Wistar rats pretreated with phenobarbital (PB) (PB-pretreated rats), and the results were compared with those of Wistar rats not pretreated with PB (untreated rats). BCP N-glucuronidation activities were studied using hepatic microsomes prepared from Wistar rats pretreated with PB (primarily induces UGT1A1, 1A6 and 2B1) or with clofibric acid (CF, primarily induces UGT1A1 and 1A6), and from Gunn rats (deficiency of UGT1A family), and the results were compared with those of untreated rat microsomes.The plasma elimination clearance value of BCP in PB-pretreated rats was approximately 1.4 times greater than that of untreated rats. The cumulative amount (20.4 +/- 5.9 % of dose) of BCP-NG excreted in PB-pretreated rat bile was approximately 1.5-fold higher than that (13.4 +/- 2.5% of dose) in untreated rat bile, and BCP-NG (5.9 +/- 3.0%) and BCP (3.0 +/- 2.6%) excreted in PB-pretreated rat urine were approximately 3.0- and 1.8-fold higher than those in untreated rat urine (BCP-NG: 2.0 +/- 1.4%; BCP: 1.7 +/- 1.3%), respectively.BCP N-glucuronidation activities in PB- and CF-pretreated microsomes were approximately 1.5- and 1.6-fold higher than in untreated microsomes, respectively. BCP N-glucuronidation activity in the microsomes of Gunn rats was markedly reduced by approximately 8.5% in untreated rat microsomes. The results suggest that UGT 1A1 is primarily responsible for BCP N-glucuronide formation in rats.

Epidural pentobarbital delivery can prevent locally induced neocortical seizures in rats: the prospect of transmeningeal pharmacotherapy for intractable focal epilepsy

PURPOSE

To determine whether epidural pentobarbital (PB) delivery can prevent and/or terminate neocortical seizures induced by locally administered acetylcholine (Ach) in freely moving rats.

METHODS

Rats were implanted permanently with an epidural cup placed over the right parietal cortex with intact dura mater. Epidural screw-electrodes, secured to the cup, recorded local neocortical EEG activity. In the seizure-termination study, Ach was delivered into the epidural cup, and after the development of electrographic and behavioral seizures, the Ach solution was replaced with either PB or artificial cerebrospinal fluid (aCSF; control solution). In the seizure-prevention study, the epidural Ach delivery was preceded by a 10-min exposure of the delivery site to PB or aCSF. Raw EEG recordings, EEG power spectra, and behavioral events were analyzed.

RESULTS

Ach-induced EEG seizures associated with convulsions, which were unaffected by epidural aCSF applications, were terminated by epidurally delivered PB within 2-2.5 min. Epidural deliveries of PB before Ach applications completely prevented the development of electrographic and behavioral seizures, whereas similar deliveries of aCSF exerted no influence on the seizure-generating potential of Ach.

CONCLUSIONS

This study showed for the first time that epidural AED delivery can prevent, as well as terminate, locally induced neocortical seizures. The findings support the viability of transmeningeal pharmacotherapy for the treatment of intractable neocortical epilepsy.

Circadian Regulation of Arousal: Role of the Noradrenergic Locus Coeruleus System and Light Exposure

STUDY OBJECTIVES

Noradrenergic locus coeruleus (LC) neurons regulate arousal. Previous studies have shown that noradrenergic LC neurons exhibit a circadian rhythm in impulse activity, which peaks during the active period. This is mediated by an indirect circuit projection from the suprachiasmatic nucleus (SCN) to the LC. Here we sought to evaluate the hypothesis that the LC regulates the circadian properties of the sleep-wake cycle.

DESIGN

Sprague-Dawley rats maintained on a light-dark (LD) schedule or in constant darkness (DD) for 3 to 4 weeks were treated with DSP-4, a neurotoxic agent specific for noradrenergic-LC projections. Vigilance states were analyzed before and 3 weeks after LC lesion. The DSP-4 lesion was verified by immunohistochemistry of noradrenergic fibers in the frontal cortex.

SETTING

University of Pennsylvania.

PATIENTS OR PARTICIPANTS

N/A.

INTERVENTIONS

N/A.

MEASUREMENTS AND RESULTS

DSP-4 decreased the amplitude of the sleep-wake rhythm in LD animals by significantly decreasing wakefulness and increasing sleep during the active period. However, DSP-4 had no effect on the sleep-wake cycle of DD animals. Moreover, DD itself decreased the amplitude of the sleep-wake cycle similar to that of the neurotoxic lesion of the noradrenergic system in LD animals. Analysis of noradrenergic fiber staining in the frontal cortex revealed that this effect was associated with fewer fibers or boutons in nonlesioned DD rats than in nonlesioned LD animals.

CONCLUSIONS

Noradrenergic LC neurons provide a circadian regulation of the sleep-wake cycle, and the maintenance of LC function depends on light exposure. Light deprivation induces a loss of noradrenergic fibers, which in turn decreases the amplitude of the sleep-wake rhythm.

A study of the in vitro interaction between lidocaine and premedications using human liver microsomes*

OBJECTIVE

To investigate potential interactions between lidocaine (lignocaine) metabolism and premedication drugs, i.e. psychotropic and antianxiety agents (diazepam, midazolam), hypnotics (pentobarbital, thiamylal), depolarizing neuromuscular blocking agents (vecuronium, pancuronium and suxamethonium), an antihypertensive agent (clonidine) and an H2-receptor blocking agent (cimetidine) using human liver microsomes in vitro.

METHODS

The interaction effects between lidocaine and premedication were examined using human liver microsomal preparations and monitored for enzyme activity. The lidocaine and its main metabolite (monoethylglycinexylide) were measured by HPLC/UV.

RESULTS

Lidocaine metabolism was non-competitively inhibited by midazolam (Ki = 77.6 microM). Thiamylal was a competitive inhibitor of lidocaine metabolism (Ki = 885 microM). Cimethidine, pancuronium and vecuronium weakly inhibited lidocaine metabolism in a concentration-depend manner over the therapeutic range in human liver microsomes. On the contrary, suxamethonium, pentobarbital and clonidine did not inhibit lidocaine metabolism over the therapeutic range in human liver microsomes.

CONCLUSION

These results show that the interactions between lidocaine and midazolam and thiamylal are of potential toxicological and clinical significance.

Reduced sensitivity to ketamine and pentobarbital in mice lacking the N-methyl-D-aspartate receptor GluRepsilon1 subunit

Ketamine is an IV anesthetic with N-methyl-d-aspartate receptor (NMDAR)-blocking properties. However, it is still unclear whether ketamine's general anesthetic actions are mediated primarily via blockade of NMDAR. Functional NMDARs are composed by the assembly of a GluRzeta1 (NR1) subunit with GluRepsilon (GluRepsilon1-4; NR2A-D) subunits, which confer unique properties on native NMDARs. We hypothesized that animals deficient in GluRepsilon1, an abundant and ubiquitously postnatally expressed NMDAR subunit, might be resistant to the effects of ketamine. Here, we evaluated a righting reflex to determine the general anesthetic/hypnotic potency of ketamine administered intraperitoneally to GluRepsilon1 knockout mice and compared these results with those for wild-type mice. Mutant mice were more resistant to ketamine than control mice. Unexpectedly, mutant mice were also more resistant to pentobarbital, which is thought not to interact with NMDAR at clinically relevant concentrations. Although these data in no way eliminate the possibility of the involvement of the NMDAR GluRepsilon1 subunit in mediation of ketamine anesthesia/hypnosis, they suggest the difficulties with interpretation of altered anesthetic sensitivity in knockout animal models.

Comparison of the Effects of Propofol and Pentobarbital on Left Ventricular Adaptation to an Increased Afterload

The purpose of this study was to compare the hemodynamic effects of pentobarbital and propofol and their effects on cardiovascular adaptation to an abrupt increase in left ventricular afterload. Experiments were performed in 12 open-chest pigs instrumented for measurement of aortic pressure and flow, and left ventricular pressure and volume. In one group (n = 6), anesthesia was obtained with sodium pentobarbital (3 mg x kg(-1) x h(-1)), and, in the second group B (n = 6), with propofol (10 mg x kg(-1) x h(-1)). Both groups received sufentanil (0.5 microg x kg(-1) x h(-1)) and pancuronium bromide (0.1 mg x kg(-1)). Left ventricular function was assessed by the slope of end-systolic pressure-volume relationship and stroke work. After baseline recordings, left ventricular afterload was increased by aortic banding. The cardiovascular adaptations triggered by the aortic banding, such as tachycardia, vasoconstriction, and augmentation of myocardial contractility were prevented with propofol, suggesting interference with the baroreflex. Increase in left ventricular afterload decreased mechanical efficiency, regardless of anesthetic agent. These results showed that pentobarbital at 3 mg x kg(-1) x h(-1) has less deleterious hemodynamic effects than propofol at 10 mg x kg(-1) x h(-1).

Transgenic Mice with a Hypomorphic NADPH-Cytochrome P450 Reductase Gene: Effects on Development, Reproduction, and Microsomal Cytochrome P450

A mouse model with a hypomorphic NADPH-cytochrome P450 reductase (Cpr) gene (designated Cpr(low) allele) was generated and characterized in this study. The Cpr gene in these mice was disrupted by the insertion of a neo gene in intron 15, which led to 74 to 95% decreases in CPR expression in all tissues examined, including olfactory mucosa, adrenal gland, brain, testis, ovary, lung, kidney, liver, and heart. In the liver, a pattern of pericentral distribution of CPR protein was preserved in the Cpr(low/low) mice, despite an overall reduction in CPR expression. Genotype distribution in F2 pups indicated limited embryonic lethality associated with the Cpr(low) allele, a finding that confirms the role of CPR-dependent enzymes in development. Adult male homozygotes had decreased body weight and decreased heart, lung, and kidney weights, whereas homozygous Cpr(low) females, which had increased serum testosterone and progesterone and decreased copulatory activities, were infertile. Furthermore, adult Cpr(low/low) mice had decreased plasma cholesterol, and some mice developed mild centrilobular hepatic lipidosis. In addition, despite apparently compensatory increases in total microsomal cytochrome P450 content in the liver and kidney, the decreases in CPR expression were accompanied by reductions in systemic clearance of pentobarbital, as well as in hepatic microsomal metabolism of acetaminophen and testosterone. These phenotypes illustrate the potential impact of a globally decreased CPR activity in human adults, and this novel knock-in mouse model provides a unique opportunity for further explorations of the in vivo roles of CPR and CPR-dependent enzymes.

Rat sex differences in anesthesia

Studies involving substantially lengthy rat surgeries require extended anesthesia periods and often involve use of sodium pentobarbital (PENT). Results of previous experiments from our laboratory and elsewhere suggest that the duration of anesthesia and the need for anesthetic supplementation may differ between male and female rats. In the study reported here, we induced anesthesia in male and female Sprague Dawley rats (n = 10 for each sex), using a three-step procedure: brief induction with 5% isoflurane inhalation, PENT (50 mg/kg of body weight, i.p.), combined with 50 mg of PENT/kg given intragastrically. Adequate anesthesia depth was confirmed by absence of a response to a toe pinch. Plasma PENT concentration was measured at sequential 20-min periods and was found, on average, to be lower (P = 0.03) in male (13.28 +/- 1.13 microg/ml) than in female (20.27 +/- 0.66 microg/ml) rats, and decreased more rapidly (P = 0.003) in male rats. Distribution to a fractionally greater lean body mass and more rapid metabolism in males may account for these differences and explain the need for anesthetic supplementation in male, but not female rats.

Sleep time following anesthesia in mouse lines selected for resistance or susceptibility to fescue toxicosis

In previous work, a mouse line selected for resistance (R) to fescue toxicosis had higher activities of two hepatic Phase II detoxification enzymes than a mouse line selected for fescue toxicosis susceptibility (S). The primary objective of the present study was to determine whether those same lines also differed in hepatic Phase I enzyme activity, estimated from sleep time (ST) following sodium pentobarbital anesthesia. Additional objectives were to determine whether ST differences between lines were modulated by endophyte-infected fescue in the diet (with or without an enzyme inducer) and whether ST of individual mice was correlated with the effect of a toxin-containing diet on the postweaning growth of those mice. In Exp. I, 24 males from each line were randomly assigned to each of five diets: control (commercial rodent food meal); E+ (50% endophyte-infected fescue seed, 50% control); E+P (the E+ diet supplemented with 1,000 ppm phenobarbital); E- (50% endophyte-free fescue seed, 50% control); and E-P (the E- diet supplemented with 1,000 ppm phenobarbital). After 4 wk on these diets, ST was measured on all the mice. A second ST was recorded on each mouse by randomly sampling one-fourth of the population after 1, 2, 3, or 4 wk on a pelleted rodent food diet. Regardless of diet, R mice had shorter first and second ST than S mice (P < 0.01), suggesting higher hepatic Phase I microsomal enzyme activity. Mice on both phenobarbital-supplemented diets had shorter first ST than mice whose diets did not include that microsomal enzyme inducer (P < 0.01). In Exp. II, ST was measured on male and female R and S mice (n = 280) after they had been fed the E- diet for 2 wk, then the E+ diet for 2 wk, and then a pelleted rodent food diet for 2 wk. Growth response to the E+ diet was the percentage of reduction in gain on the E+ diet compared to gain on the E- diet the previous 2 wk. As in Exp. I, S mice slept longer than R mice (P < 0.01). The residual correlation between ST and gain reduction associated with the E+ diet equaled 0.04. Thus, an animal's apparent Phase I enzyme activity did not predict its growth rate depression on the toxin-containing diet. Based on these and previous studies, divergent selection for toxicosis response in mice was successful partially by causing divergence in activities of hepatic Phase I and II detoxification enzymes.

Validation of a modified mirrored chamber sensitive to anxiolytics and anxiogenics in mice

RATIONALE

Anxiety is a common disorder in humans that exists in many forms, and animal models of human anxiety are typically employed for the discovery of anxiolytic drugs with human therapeutic potential.

OBJECTIVES

Ideally, animal models of anxiety are validated for the detection of both anxiogenic and anxiolytic effects, but most animal models can effectively only measure anxiolytic-like effects. As control animals typically spend small amounts of time in the aversive portion of an apparatus, decreases in time spent in this portion are difficult to detect.

METHODS

We have modified an existing test of murine anxiety, the mirrored chamber, and have validated this test using several anxiolytic and anxiogenic drugs. In addition, nine mouse strains were compared on the elevated plus maze and modified mirrored chamber.

RESULTS

Increasing doses of ethanol, diazepam, and pentobarbital produced an anxiolytic-like profile while pentylenetetrazol (PTZ), D-amphetamine, and methyl-6, 7-dimethoxyl-4-ethyl-beta-carboline-3-carboxylate (DMCM) appeared anxiogenic. This modified test also dissociated drug effects on anxiety from those on activity for d-amphetamine and diazepam. The inbred mouse strains tested produced a similar range of scores for time spent on the open arms of the elevated plus maze and voluntary reentry time in the mirrored chamber, with an overall genetic correlation of 0.68.

CONCLUSIONS

Since control animals reliably reentered the more aversive portion of the apparatus for 25% of the total time available, the modified mirrored chamber may be able to detect anxiogenic states produced by various stressors and drug withdrawal. Further, the strain differences detected suggest that the modified mirrored chamber will be a valuable tool in the discovery of the genetic bases of anxiety states and disorders.

Alteration of drug kinetics in rats following exposure to trichloroethylene

The effect of trichloroethylene (TCY) was investigated to determine whether repeated exposure alters the pharmacokinetics of some drugs. Sprague-Dawley rats were given intraperitoneal injections of TCY (5 mmol/kg) in corn oil once daily for 3 days, while the control group received only corn oil. Four hours after the last dose, theophylline, quinidine, or pentobarbital were administered. Blood samples were collected at appropriate intervals for drug analyses. There was a small decrease in plasma clearance of theophylline, with no change in volume of distribution (V(d)) as compared with controls. For quinidine, the elimination half-life was unchanged, and the V(d) was decreased by 40%. The clearance of pentobarbital was decreased by 40% in male rats, but not in the females. Nonetheless, the duration of the sleeping time for both sexes was remarkably prolonged as compared with the control group. There was a decrease in the cytochrome P-450 content only in male rats. In conclusion, exposure to TCY causes changes in some drug kinetics, probably resulting from differential effects on the drug-metabolizing enzymes.

Effects of muscle relaxants on EEG, ABR and EMG in rabbits

The effects of baclofen and pancuronium bromide on evoked electromyogram (EMG), cortical electroencephalogram (EEG) and auditory brainstem responses (ABR) were studied in pentobarbital anesthetized normal rabbits. Evoked EMG was measured in the gastrocnemius muscle by electrical stimulation of the sciatic nerve. Intravenous injection of baclofen decreased EEG and arterial blood pressure and light reflex, however, it had no significant influence on EMG or ABR at doses of 10 and 20 mg/kg/h. Pancuronium bromide immediately inhibited respiration, decreased EEG and EMG, however, it had no significant influence on arterial blood pressure, ABR, or light reflex, at doses of 0.4 and 1.0 mg/kg/h in anesthetized rabbits. ABR waves were observed until just before cardiac arrest with both of the muscle relaxants. It is suggested that ABR are not influenced by central or peripheral muscle relaxants, or by pentobarbital.

Use of intravenous valproate in three pediatric patients with nonconvulsive or convulsive status epilepticus

OBJECTIVE

To report the pharmacokinetics of intravenous valproate (VPA) in children with generalized convulsive status epilepticus (GCSE) or nonconvulsive status epilepticus (NCSE). To provide loading and maintenance dosing for patients with hepatic induction secondary to concurrent anticonvulsants.

CASE SUMMARY

Two patients (10 y, 34 mo) with GCSE refractory to benzodiazepines, phenobarbital, phenytoin, and pentobarbital received intravenous VPA. Apparent volume of distribution (Vd) following a 20 mg/kg loading dose was 0.29 L/kg. Maintenance infusions of 4-6 mg/kg/h produced steady-state total concentrations of 66 mg/L and 92.4 mg/L (unbound concentration 44.6 mg/L). Clearance ranged from 63-66 mL/h/kg. An eight-year-old with NCSE received intravenous VPA (13.4 mg/kg load followed by 9 mg/kg every 8 h). Total and unbound steady-state VPA concentrations were 32.9 mg/L and 21.2 mg/L, respectively. Elimination half-life was eight hours.

DISCUSSION

We constructed a pharmacokinetic simulation using VPA parameters from children receiving mono- or polyanticonvulsants. Our Vd and elimination half-life rates were comparable with published pediatric values. Patients on hepatic inducers had clearance rates 2.5 times those of children receiving oral anticonvulsant polytherapy. Unbound fractions (48.3% and 66%) were significantly higher than normal.

CONCLUSIONS

A 20 mg/kg loading dose should produce a concentration after the bolus dose of approximately 75 mg/L. Initial infusion should consider hepatic induction (noninduced = 1 mg/kg/h, polyanticonvulsant therapy = 2 mg/kg/h, and high-dose pentobarbital = 4 mg/kg/h). Adjustments should be based on response and serum concentrations.

Pharmacokinetic alterations after severe head injury. Clinical relevance

Pharmacological therapy, present and future, will undoubtedly continue to play a large role within the overall management of patients with severe head injury. Nevertheless, limited clinical data are available to evaluate the effect of severe head injury on pharmacokinetics. The disruption of the blood-brain barrier secondary to trauma and/or subsequent hyperosmolar therapy can be expected to result in higher than expected brain drug concentrations. Aggressive dietary protein supplementation may result in increased oxidative drug metabolism. These effects may counterbalance inhibitory influences on drug metabolism secondary to cytokine release during the acute phase response. Alterations in protein binding can also be anticipated with the hypoalbuminaemia and increases in alpha 1-acid glycoprotein typically observed in these patients. Based on studies in other patient populations, moderate hypothermia, a treatment strategy in patients with head injury, can decrease drug metabolism. The pharmacokinetics of the following drugs in patients with severe head injury have been studied: phenytoin, pentobarbital (pentobarbitone), thiopental (thiopentone), tirilazad, and the agents used as marker substrates, antipyrine, lorazepam and indocynanine green (ICG). Several studies have documented increase in metabolism over time with phenytoin, pentobarbital, thiopental, antipyrine and lorazepam. Increases in tirilazad clearance were also observed but attributed to concurrent phenytoin therapy. No changes in the pharmacokinetics of ICG were apparent following head injury. With the frequent use of potent inhibitors of drug metabolism (e.g., cimetidine, ciprofloxacin) the potential for drug interaction is high in patients with severe head injury. Additional pharmacokinetic investigations are recommended to optimise pharmacological outcomes in patients with severe head injury.

Lack of tolerance to the anxiolytic effect of diazepam and pentobarbital following chronic administration in perinatally undernourished rats

Adult female rats, undernourished at perinatal age, were evaluated for anxiolytic action in the plus-maze test after acute and chronic administration of diazepam (DZP) and pentobarbital (PTB). Deprived (D) rats chronically treated with vehicle showed an increased anxiety as compared with control (C) animals. A single intraperitoneal (i.p.) administration of DZP (1 mg/kg) or PTB (7.5 mg/kg) produced similar anticonflict effect in both C and D rats. Tolerance to the anxiolytic effect of DZP and PBT developed in C rats after a 15-day administration schedule, whereas no tolerance was observed in D animals. Drug disposition was not altered after chronic treatment either in C or in D rats. Gamma-aminobutyric acid (GABA)-mediated chloride uptake in microsacs of cerebral cortex of naive D rats was decreased as compared with naive C rats. After chronic DZP administration (1 mg/kg/day i.p. for 15 days), GABA-mediated 36Cl- influx in brain cortex microsacs of C rats did not change; however, GABA efficacy was increased in microsacs of D animals. In addition, chronic DZP treatment induced GABA-benzodiazepine uncoupling in brain cortex of C rats, but not in D animals, as assessed by chloride uptake in microsacs. Chronic PTB treatment (7.5 or 30 mg/kg/day i.p. for 15 days) did not modify GABA stimulation or GABA-PTB interaction in cortical microsacs of C or D rats.

Changes in brain barbiturate concentration in brain-dead rabbits

Pentobarbital concentration was evaluated in the brain tissues of brain-dead rabbits. Pentobarbital was infused into the vein of Japanese white male rabbits at 60 mg/kg/h until an isoelectric EEG of the cortex was reached. Brain death was induced by inflation of a balloon catheter placed in the subdural space. The diagnosis of brain death was confirmed by a flat line ABR wave. A significant increase in heart rate, intracranial pressure, and mean arterial pressure, was observed following brain death induction. These parameters returned to below basal values within 60 mm. Immediately after, and at 6 h and 24 h after brain death, each group of rabbits was sacrificed by phenobarbital overdose, and brains were then removed for determination of pentobarbital concentration in the brain tissue. Blood pentobarbital disappeared about 18 h after brain death was induced. Although the brain pentobarbital concentration slightly decreased over time, a high concentration of pentobarbital remained in the brain 24 h after brain death was induced.

Is arachis oil a solvent only, or does it also have an effect on the central nervous system?

Peanut (Archis hypogaea L.) seed, an important oil crop (arachis oil) throughout the world, is grown in large quantities in Africa, India and China. The oil is used in many edible products, including shortenings, margarines and mayonnaise, as a cooking and frying oil and as a salad oil. Arachis oil contains fatty acids and antioxidants. It has been shown to be unexpectedly atherogenic in the diets of experimental animals (Chow 1992).

Mechanisms of barbiturate inhibition of acetylcholine receptor channels

We used patch clamp techniques to study the inhibitory effects of pentobarbital and barbital on nicotinic acetylcholine receptor channels from BC3H-1 cells. Single channel recording from outside-out patches reveals that both drugs cause acetylcholine-activated channel events to occur in bursts. The mean duration of gaps within bursts in 2 ms for 0.1 mM pentobarbital and 0.05 ms for 1 mM barbital. In addition, 1 mM barbital reduces the apparent single channel current by 15%. Both barbiturates decrease the duration of openings within a burst but have only a small effect on the burst duration. Macroscopic currents were activated by rapid perfusion of 300 microM acetylcholine to outside-out patches. The concentration dependence of peak current inhibition was fit with a Hill function; for pentobarbital, Ki = 32 microM, n = 1.09; for barbital, Ki = 1900 microM, n = 1.24. Inhibition is voltage independent. The kinetics of inhibition by pentobarbital are at least 30 times faster than inhibition by barbital (3 ms vs. < 0.1 ms at the Ki). Pentobarbital binds > or = 10-fold more tightly to open channels than to closed channels; we could not determine whether the binding of barbital is state dependent. Experiments performed with both barbiturates reveal that they do not compete for a single binding site on the acetylcholine receptor channel protein, but the binding of one barbiturate destabilizes the binding of the other. These results support a kinetic model in which barbiturates bind to both open and closed states of the AChR and block the flow of ions through the channel. An additional, lower-affinity binding site for pentobarbital may explain the effects seen at > 100 microM pentobarbital.

Pharmacokinetics of thiopental and pentobarbital enantiomers after intravenous administration of racemic thiopental

We studied the pharmacokinetics of thiopental enantiomers in 14 healthy patients aged 37-73 yr receiving racemic thiopental by intravenous (IV) bolus or IV infusion. Plasma concentration of each enantiomer was measured by chiral high-performance liquid chromatography. After IV bolus, the total plasma clearance (CL) (295 +/- 132 mL/min) and volume of distribution at steady state (Vss) (139 +/- 38.5 L) of R-thiopental were significantly greater than those of S-thiopental (230 +/- 104 mL/min and 114 +/- 47.5 L, respectively). The plasma unbound fraction (fu) was determined by ultrafiltration of plasma from six healthy volunteers. The fu of R-thiopental (12.4% +/- 0.6%) was significantly greater than that of S-thiopental (10.0% +/- 1.0%). When the CL and Vss of the two enantiomers were corrected for the difference in mean fu, there were no significant differences between enantiomers for these variables. As the 20%-30% difference between the enantiomers in total CL and total Vss could be accounted for by stereoselectivity in fu, these differences are not likely to be clinically significant. During 105-180 min IV infusion of racemic thiopental to the other patients, there was no difference between enantiomers in mean plasma concentrations of total or unbound thiopental or total pentobarbital, a major metabolite of thiopental (P > 0.05). Therefore, it is appropriate to relate pharmacodynamic effects to racemic plasma concentrations of thiopental during IV infusion of racemic thiopental.

Induction and maintenance of anesthesia in dogs by intravenous administration of methohexital

OBJECTIVE

To devise and test an i.v. methohexital infusion regimen for induction and maintenance of surgical anesthesia in dogs from which they would rapidly recover.

DESIGN

Dose-response and plasma concentration-effect study.

ANIMALS

11 clinically normal dogs.

PROCEDURE

Bolus methohexital pharmacokinetic variables were determined in ketamine- and pentobarbital-anesthetized dogs. Plasma methohexital concentrations required to inhibit purposeful movement in response to painful stimuli were determined during a stepped methohexital infusion in the same dogs on a second occasion. These pharmacokinetic/pharmacodynamic data were next used to design a bolus and two-stage infusion regimen that would result in stable plasma methohexital concentrations with prolonged infusion. This regimen was tested in a second group of dogs.

RESULTS

Mean steady-state volume of distribution of methohexital in the anesthetized dogs was 1.50 L/kg of body weight and mean elimination clearance was 10.2 ml/kg/min. Mean plasma concentrations required to prevent movement response to a noxious stimulus and at which the dogs could be extubated were 11.8 and 6.9 micrograms/ml, respectively. After a 6-hour infusion, recovery of airway reflexes sufficient to allow extubation required 67 minutes.

CONCLUSIONS

An easily implemented i.v. methohexital infusion regimen for induction and maintenance anesthesia in dogs was developed. During a 6-hour infusion, hemodynamic variables did not change. Use of this regimen resulted in anesthesia of sufficient depth to prevent withdrawal in response to noxious stimuli and in reliable and acceptable emergence times for use in canine survival studies in a cost-effective manner.

Influence of antemortem medication on the determination of brain death

Post-mortem concentration of pentobarbital in the blood and brain of two deceased neurosurgical patients was determined by gas chromatography/mass spectrometry. Patients treated with barbiturate for elevated intracranial pressure after head injury may incur brain death. In the present two cases of brain death a large amount of barbiturate remained in the brain, even when the blood concentration was not detectable, possibly because the blood flow was stagnant in the brain. It is suggested that a patient under barbiturate coma should be given serious consideration as to the determination of brain death, even if barbiturate is negative in the blood.

High-performance liquid chromatographic determination of thiopentone enantiomers in sheep plasma

An HPLC method was developed to determine the plasma concentrations of R(+)- and S(-)-thiopentone for pharmacokinetic studies in sheep. The method required separation of the thiopentone enantiomers from the corresponding pentobarbitone enantiomers which are usually present as metabolites of thiopentone. Phenylbutazone was used as an internal standard. After acidification, the plasma sample were extracted with a mixture of ether and hexane (2:8). The solvent was evaporated to dryness and the residues were reconstituted with sodium hydroxide solution (pH 10). The samples were chromatographed on a 100 mm x 4 mm I.D. Chiral AGP-CSP column. The mobile phase was 4.5% 2-propanol in 0.1 M phosphate buffer (pH 6.2) with a flow-rate of 0.9 ml/min. This gave k' values of 1.92, 2.92, 5.71, 9.30 and 11.98 for R(+)-pentobarbitone, S(-)-pentobarbitone, R(+)-thiopentone, S(-)-thiopentone, and phenylbutazone, respectively. At detection wavelength of 287 nm, the limit of quantitation was 5 ng/ml for R(+)-thiopentone and 6 ng/ml for S(-)-thiopentone. The inter-day coefficients of variation at concentrations of 0.02, 0.1 and 8 micrograms/ml were, respectively, 4.8, 4.4 and 3.5% for R(+)-thiopentone and, respectively, 5.0, 4.3 and 3.9% for S(-)-thiopentone (n = 6 each enantiomer). At the same concentrations, the intra-day coefficients of variation from six sets of replicates (measured over six days) were, respectively, 8.0, 8.0 and 8.8% for R(+)-thiopentone and 8.8, 7.4 and 9.6% for S(-)-thiopentone. Linearity over the standard range, 0.01-40 micrograms/ml, was shown by correlation coefficients > 0.998. This method has proven suitable for pharmacokinetic studies of thiopentone enantiomers after administration of rac-thiopentone in human plasma also and would be suitable for pharmacokinetic studies of the pentobarbitone enantiomers.

Effects of aflatoxin B1 on the sensitivity of the rat central nervous system to pentobarbital-Na racemate

The immobility time of pentobarbital was prolonged in male rats treated with aflatoxin B1 (AFB1), 2 mg/kg, with maximum on the 3rd day after treatment. It cannot be fully explained by the pharmacokinetic mechanisms. In parallel ED50 of pentobarbital was decreased both in males and females. In males the lethal dose of pentobarbital was decreased by about 30%. The pentobarbital concentration in the brain was increased during the immobility time and at awakening after the ip administration of 40 mg/kg of the drug on the 3rd day after AFB1 treatment with doses of 1 mg/kg and 2 mg/kg po in males and females, respectively. The plasma concentration of pentobarbital was significantly increased in treated males only. The content of unchanged pentobarbital in urine within 24 h after its administration was not high (about 1% in males, 2% in females) and in the AFB1 treated animals it virtually did not change. The elevation of the brain level of barbiturate at the time of awakening in AFB1 treated animals may point to a decreased sensitivity to pentobarbital.

Pharmacokinetic and pharmacodynamic studies of centrally acting drugs in rat: effect of pentobarbital and chlorpromazine on electroencephalogram in rat

Electroencephalogram (EEG) alterations in rat after the i.v. administration of pentobarbital (PTB) and chlorpromazine (CPZ) were measured by power spectral analysis. The time courses of PTB concentrations in plasma, cerebrospinal fluid (CSF) and brain were determined after the i.v. administration of PTB (20, 40 mg/kg) by GC-MS. The PTB concentrations in plasma, CSF and brain could be described by a biexponential equation, a CSF model and a blood flow limited model, respectively. The relationship between the alteration of EEG and the PTB concentrations in the CSF or brain or the effect compartment were analyzed using the sigmoid Emax model. The alteration of EEG after PTB administration could be described by the PTB concentration in these compartments using the sigmoid Emax model. These results indicated that the site of action for the alteration of EEG after PTB administration is in instantaneous equilibrium with the CSF, the brain and the effect compartment. Thus, alterations in EEG after PTB administration can be predicted by monitoring the total PTB concentration in plasma. The alteration of EEG after i.v. administration of CPZ (4 mg/kg) showed a two-phase variation. Although the relationship between the alteration of EEG and the CPZ concentrations in CSF or the striatum or the effect compartment (total and free drug) were analyzed using the linear model, the Emax model or the sigmoid Emax model, the two-phase alteration of EEG after CPZ administration could not be described by any of these models. These results indicated that the pharmacokinetic and pharmacodynamic modeling of CPZ during the alteration of EEG may be complicated due to several pharmacokinetic and pharmacodynamic factors, such as an alteration of the free fraction of CPZ in the striatum, the formation of active metabolites, and two different intrinsic effects of CPZ on the EEG (one in an increase and the other in a decrease of the brain's electrical activity.

Identification of the diastereomers of pentobarbital N-glucosides excreted in human urine

A study was undertaken to determine if humans excreted pentobarbital N-glucosides as urinary metabolites following oral administration of pentobarbital. (1'RS,5RS)-1-(beta-D-Glucopyranosyl)pentobarbital ((1'RS,5RS)-PTBG) was isolated from the urine of one subject. The two diastereomers, (1'RS,5R)-PTBG and (1'RS,5S)-PTBG were separated and found to be identical to synthetic standards when compared using HPLC retention times coupled with UV (with and without post-column ionization) and mass spectrometry (HPLC/MS). A HPLC method was developed for detecting and quantifying (1'RS,5R)-PTBG, (1'RS,5S)-PTBG and pentobarbital in urine. Following a single oral dose of sodium pentobarbital to male subjects (n = 6), 1.6-6.2% of the pentobarbital dose was excreted as (1'RS,5S)-PTBG over 60 hours. (1'RS,5R)-PTBG was also detected in one subject and accounted for 0.3% of the pentobarbital dose. Using a modified HPLC system, the four pentobarbital N-glucosides were resolved and analysis of a partially purified pentobarbital N-glucoside extract from one subject indicated that only (1'R,5R)-PTBG and (1'S,5S)-PTBG could be detected as urinary excretion products. These results indicate that the side chain chirality of pentobarbital may influence the observed enantioselectivity for the formation and/or urinary excretion of the pentobarbital N-glucosides.

Hepatoprotective effects of artemisia scoparia against carbon tetrachloride: an environmental contaminant

The hepatoprotective activity of crude extract of artemisia scoparia (aerial parts) was investigated against experimentally produced hepatic damage using carbon tetrachloride (CCl4) as a model hepatotoxin. CCl4 at the dose of 1.5 ml/kg, produced liver damage in rats as manifested by the rise in serum levels of AST and ALT to 395 +/- 110 and 258 +/- 61 IU/l (mean +/- SEM; n = 10) respectively, compared to control values of 106 +/- 15 and 26 +/- 04. Pretreatment of rats with plant extract (150 mg/kg) significantly lowered (P < 0.01), the respective serum GOT and GPT levels to 93 +/- 05 and 27 +/- 03 IU/l, indicating hepatoprotective action. Pentobarbital sodium (75 mg/kg)-induced sleeping time in mice was found to be 140.8 +/- 1.5 min (n = 10) which was similar (P > 0.05) to that obtained in the group of animals pretreated with the plant extract (139.9 +/- 1.8 min). CCl4 treatment extended the pentobarbital sleeping time to 212.2 +/- 19.1 min and pretreatment of animals with plant extract reversed the CCl4-induced prolongation in pentobarbital sleeping time to 143.9 +/- 5.5 min (P < 0.001) which further confirms the protective action of the plant extract against CCl4-induced liver damage. These data indicate that the plant artemisia scoparia is hepatoprotective and validate the folkloric use of this plant in liver damage.

Effect of pentobarbital and gaseous anesthetics on rats selectively bred for ethanol sensitivity

Rats have been genetically selected to have a differential hypnotic response to an acute injection of ethanol. These high alcohol sensitive (HAS) and low alcohol sensitive (LAS) rats were used to investigate commonalities of the mechanism of action of several gaseous anesthetics, pentobarbital and ethanol. Similar studies have been carried out extensively with mouse lines also differentially sensitive to ethanol (short- and long-sleep mice). Like the mice, the rats are also differentially sensitive to the two gaseous anesthetics, enflurane and isoflurane. However, in contrast to results with these mice, we find that the HAS and LAS rats are differentially sensitive to halothane and pentobarbital in the same direction as their sensitivity to ethanol. In other studies, the rats also have been found to be differentially sensitive to phenobarbital as are SS and LS mice. These results show that, by the use of these anesthetics in combination with selectively bred rodent lines, many new opportunities for dissecting the molecular mechanisms of anesthetic agents present themselves.

[The prolongation effect on the duration of pentobarbital anesthesia by submaxillariectomy in male rats]

The present study was performed to investigate the effects of submaxillariectomy (Subx) on the anesthetic effect (sleeping time) of pentobarbital, the concentration-time profile of plasma pentobarbital and the hepatic drug metabolizing enzyme systems in male rats of the Donryu strain. Subx was performed when the rats were 60 days old. Subx prolonged the duration of pentobarbital (30 mg/kg, i.p.) anesthesia at 10, 23 and 43 days after the operation, respectively. At 43 days after Subx, the plasma pentobarbital concentration was higher in the Subx group until 30 min after the administration. There was no significant difference in the hepatic microsomal cytochrome P-450 content between the Subx and control groups. Cytochrome b5 content, aminopyrine N-demethylase and aniline hydroxylase activities were increased significantly in the Subx group. The activity of heme oxygenase, the rate limiting enzyme in the heme catabolic pathway, tended to increase in the Subx group. Furthermore, the activity of delta-aminolevulinic acid synthetase, the rate limiting enzyme in the heme synthetic pathway, was significantly decreased to 51 percent of the control group by Subx. These results may suggest that the prolongation of the duration of pentobarbital anesthesia is caused by Subx due to the change in the pharmacokinetics of pentobarbital, especially the inhibitory effects of the hepatic pentobarbital metabolizing enzyme system.

Region-specific changes of GABAA receptors by tolerance to and dependence upon pentobarbital

An experimental model for inducing tolerance to and dependence upon pentobarbital was characterized. Rats were infused with pentobarbital, 300 micrograms/10 microliter per h i.c.v. for 6 or 7 days, through pre-implanted cannulas by osmotic minipumps. Measurement of brain and serum levels showed that pentobarbital remained mainly inside of the brain. Measurements of sleeping time and susceptibility to convulsant-induced seizures indicated a substantial degree of tolerance and dependence (24 h after termination of infusion). Results of GABAA receptor binding assays showed marked regional variations. While [35S]t-butylbicyclophosphorothionate (TBPS) binding sites were increased in frontal cortices and striata of pentobarbital-dependent animals, KD was increased in striata of tolerant animals. Dependence upon pentobarbital was correlated with increased [3H]flunitrazepam binding sites in all three regions examined. Both high and low affinity [3H]muscimol binding sites were increased in dependent animals, but low affinity sites were decreased in frontal cortices of tolerant animals. KDs of [3H]muscimol high affinity sites were increased in cerebellum after animals developed dependence upon pentobarbital. KDs of [3H]muscimol low affinity sites were decreased in striata of pentobarbital tolerant animals. These findings further support the hypothesis that GABAA receptors in discrete areas of the brain have different subunit compositions and are regulated differentially by pharmacological modulators.

Effects of social isolation on pentobarbital activity in mice: relationship to racemate levels and enantiomer levels in brain

The effects of social isolation on hypnotic actions induced by pentobarbital (PB) were investigated pharmacokinetically in isolated and aggregated mice and rats. Animals were administered i.p. 50 mg/kg of sodium (+-)-PB, S(-)-PB or R(+)-PB. Experiments in mice indicated that the duration of sleep induced by sodium (+-)-PB was reduced in the isolated mice, while the onset of sleep or the (+-)-PB brain levels at the time of awakening did not differ significantly between isolated and aggregated mice. These results suggest that changes in pharmacokinetics of PB may underlie the difference in duration of sleep between isolated and aggregated mice. In additional experiments in mice, brain concentrations of (+-)-PB, S(-)-PB or R(+)-PB were determined at predetermined intervals after injection. These experiments demonstrated that the brain concentrations of (+-)-PB, as well as those of S(-)-PB, at each predetermined timepoint in mice sacrificed before awakening were significantly lower in the isolated mice. The brain R(+)-PB levels in the isolated mice were also significantly lower as compared with those in the aggregated mice at each timepoint after injection. Experiments in rats indicated that urinary 3'-hydroxypentobarbital (major metabolite) concentrations were higher in the isolated rats at 0 to 6 hr after injection, suggesting an increased rate of hepatic drug metabolism in the isolated rats. Take together, these findings suggest that an increased rate of metabolism of PB, especially that of the S(-)-enantiomer which is responsible for hypnotic action, in isolated rodents may be involved in the shorter duration of sleep time induced by sodium (+-)-PB.

Rate of increase of plasma drug level influences subjective response in humans

This study addressed the commonly held, but seldom tested, notion that faster rates of increase of drug effects are associated with more positive subjective effects. Sodium pentobarbital was administered to normal healthy volunteers in either a single oral dose or in a series of divided, cumulating doses, and subjective responses were monitored. Twelve subjects participated in three weekly sessions, during which they received capsules containing placebo, 150 mg pentobarbital in a single dose (SIN) or 180 mg pentobarbital administered in six divided doses (DIV) of 30 mg every 30 min. Doses of pentobarbital in the SIN and DIV were selected to produce similar peak plasma levels. Blood samples were obtained at regular intervals for plasma drug level determinations, and throughout the session subjects completed self-report mood questionnaires (e.g., Profile of Mood States, visual analog ratings of drug liking and drug "high") and psychomotor performance tests (e.g., Digit Symbol Substitution Test). As expected, the SIN and DIV conditions yielded similar peak levels of pentobarbital, but the peak was attained more rapidly in the SIN condition. Despite the similarity in peak plasma levels, subjects reached greater peaks in ratings of "high" and wanted more of the drug when they were in the SIN condition. On an end-of-session liking questionnaire they also reported significantly greater liking of the drug in the SIN condition. On other measures of drug effects (e.g., sedation and psychomotor impairment) no significant differences were observed between the conditions. Thus, the rate of increase of the drug's effects specifically influenced subjects' ratings on subjective measures (e.g., "high" and liking) that may be associated with risk for abuse.(ABSTRACT TRUNCATED AT 250 WORDS)

Serotoninergic involvement in ethanol-induced alterations of thermoregulation in long-sleep and short-sleep mice

The effect of ethanol and pentobarbital on in vivo tryptophan hydroxylase activity and its relationship to drug-induced alterations of thermoregulation was examined in long-sleep (LS) and short-sleep (SS) mice. Serotonin function was measured in both the presence and absence of ethanol or pentobarbital in six discrete brain regions. Differences in basal levels of serotonin, 5-hydroxyindole acetic acid or in vivo tryptophan hydroxylase (TpH) activity were found only in the hypothalamus and dorsal raphe nuclei (SS slightly higher). Ethanol (4.2 g/kg i.p) caused significant reductions in in vivo TpH activity in the dorsal and pontine-medullary raphe nuclei and hypothalamus (putative thermoregulatory areas) in both LS (50-60% decrease) and SS (15-30% decrease) mice, but it had no effect on TpH activity in the striatum, cortex or hippocampus. The greater degree of ethanol-induced reduction in TpH activity in LS mice was associated with a greater degree of hypothermia (LS, 4.2 degrees C vs SS, 2.0 degrees C). Pentobarbital had equivalent effects in LS and SS mice on TpH activity in central nervous system thermoregulatory areas (decreases of 40-60%) and on body temperature (decreases of 6.8-7.5 degrees C). When the mice were given ethanol at an elevated environmental temperature (34 degrees C) the hypothermia was almost abolished completely, but depressant effects on TpH activity remained, suggesting that ethanol-induced decreases in TpH activity were direct effects and not secondary to hypothermia. Alterations in ethanol or pentobarbital elimination did not appear to account for the observed differences.(ABSTRACT TRUNCATED AT 250 WORDS)

The influence of cryogenic brain injury on the pharmacodynamics of pentobarbital. Evidence for a serotonergic mechanism

To study of the influence of brain injury on the pharmacodynamics of pentobarbital, the authors examined the effect of a focal cortical freezing lesion in rats on the brain concentration of pentobarbital associated with lack of response to tail clamp. The freezing lesion was made with a probe (-50 degrees C) applied through a craniotomy to the intact dura over the left parietal cortex. Three days after injury the rats were anesthetized with a continuous intravenous infusion of pentobarbital until they first did not respond to tail clamp stimulation. The brains were then removed for determination of pentobarbital by high-performance liquid chromatography. The brain pentobarbital concentration required to prevent response to tail clamp (EC50) was reduced from 209 +/- 39 nmol/g (mean +/- standard deviation) in rats without brain injury to 149 +/- 28 nmol/g in the injured animals (P = 0.005). The cortical serotonin (5-HT) concentration was increased from 1904 +/- 358 pmol/g in uninjured rats to 2513 +/- 598 pmol/g (P less than 0.01) in injured animals ipsilateral to the lesion. Pretreatment of the rats with p-chlorophenylalanine (PCPA, 200 mg/kg by intraperitoneal injection) to inhibit 5-HT synthesis abolished both the increase in 5-HT concentration associated with the injury (left cortex, 708 +/- 389 pmol/g; right cortex, 911 +/- 979 pmol/g) and the effect of the lesion on EC50 (uninjured, EC50 = 186 +/- 24 nmol/g; injured, EC50 = 179 +/- 47 nmol/g). Prevention of the decrease in EC50 by inhibition of 5-HT synthesis provides support for a functional role for 5-HT in the influence of cold injury on the pharmacodynamics of pentobarbital.

Stress in mice increases intrinsic pentobarbitone sensitivity by a predominantly pharmacodynamic mechanism

1. Mice were swum for 3 min at room temperature. 2. After this stress 'sleeping time' in response to pentobarbitone was increased by over 70%. 3. Loss of 'righting reflex' occurred in these stressed animals at brain concentrations of pentobarbitone which were 40% lower than those needed for 'sleep' in the unstressed mice, indicating a true increase in sensitivity to the drug. 'Waking' (the return of the righting reflex) occurred at identical levels in both groups. 4. Kinetic analysis showed that the rates of absorption, elimination and transfer between plasma and brain were slower in the swum than in the unswum mice, probably because of the reduced body temperatures produced by the swimming.

The effect of aluminium chloride upon the transition of drugs through the blood-brain barrier into the central nervous system

In order to determine the effect of Al3+ upon the transition of drugs through the blood-brain barrier into the central nervous system we examined its effect upon a drug that dissociates as a cation (quinidine) and drugs that dissociate as anions (acetylsalicylic acid and pentobarbital). The entry and exit of quinidine into and out of the brain in mice pre-treated with AlCl3 was inhibited. Al3+ did not compete with acetylsalicylic acid for the penetration through the blood-brain barrier but did slow down its elimination from the brain. Brain kinetics of the examined drugs showed good correlation with their central pharmacodynamic effects.

Pharmacokinetics of ampicillin and pentobarbital in the course of subclinical fascioliasis in sheep

Pharmacokinetics of two common veterinary drugs, ampicillin and pentobarbital, were determined in sheep before and four, eight, 12, 17 and 21 weeks after infestation of animals by an oral administration of 150 metacercariae of Fasciola hepatica. The parasite infestation was ascertained by clinical observation of the animals. The pharmacokinetics of ampicillin were not significantly affected by the liver parasitism but the disposition of pentobarbital changed. A significant increase in elimination half-life (around 180 per cent), volume of distribution (130 per cent) and mean residence time (154 to 170 per cent) was observed in sheep infected by the parasite for four to 12 weeks. In these animals, duration of narcosis caused by pentobarbital was prolonged 1.8-fold. The results suggested that both reduced elimination of pentobarbital and impaired distribution of the drug would be responsible for the prolonged duration of narcosis in infected animals.

Management of elevated intracranial pressure

The pathophysiology, clinical manifestations, monitoring techniques, and management of elevated intracranial pressure (ICP) are reviewed. The use of barbiturate coma to treat ICP is discussed in detail. Elevated ICP can be associated with severe head injuries and diseases of the central nervous system such as brain tumors and stroke. Symptoms of elevated ICP may be difficult to distinguish from symptoms of other disease states. ICP monitoring techniques such as the intraventricular catheter and the Camino fiber optic system are useful for determination of ICP elevations before any changes in vital signs or neurological status occur. Conventional treatment and control of ICP elevations includes general and physiologic management (cerebrospinal fluid removal, fluid restriction, controlled hyperventilation, sedation, and elevating the patient's head) and pharmacologic management. Osmotic diuretics, (e.g., urea, mannitol, glycerol) and loop diuretics (e.g., furosemide, ethacrynic acid) are first-line pharmacologic agents used to lower elevated ICP. Corticosteroids may be beneficial in some patients. Patients with elevated ICP refractory to conventional treatment may benefit from therapy with high-dose barbiturates. Pentobarbital has been used in the majority of the clinical studies. Pentobarbital serum concentrations should be determined every 24-48 hours when a patient is in a barbiturate coma because pentobarbital clearance increases with continued high-dose therapy. The treatment of elevated ICP requires aggressive therapy and intensive monitoring. In patients whose ICP is refractory to conventional therapies alone, survival rates have been improved by combining high-dose barbiturates with conventional therapies.

Post-mortem drug redistribution--a toxicological nightmare

Detailed human case data is presented to illustrate the dramatic extent of the phenomenon of post-mortem drug redistribution. The data suggests that there is a post-mortem diffusion of drugs along a concentration gradient, from sites of high concentration in solid organs, into the blood with resultant artefactual elevation of drug levels in blood. Highest drug levels were found in central vessels such as pulmonary artery and vein, and lowest levels were found in peripheral vessels such as subclavian and femoral veins. In individual cases, in multiple blood samples obtained from ligated vessels, concentrations of doxepin and desmethyldoxepin ranged from 3.6 to 12.5 mg/l and 1.2 to 7.5 mg/l, respectively; amobartital, secobarbital and pentobarbital from 4.3 to 25.8 mg/l, 3.9 to 25.3 mg/l and 5.1 to 31.5 mg/l respectively; clomipramine and desmethylclomipramine from 4.0 to 21.5 mg/l and 1.7 to 8.1 mg/l, respectively and flurazepam 0.15 to 0.99 mg/l; imipramine and desipramine from 4.1 to 18.1 mg/l and 1.0 to 3.6 mg/l, respectively. We conclude that this poorly studied phenomenon creates major difficulties in interpretation and undermines the reference value of data bases where the site of origin of post-mortem blood samples is unknown.

Dose-related and other effects of maternal cimetidine pretreatment during lactation on drug metabolism in mouse dams and pups

The effects of maternal cimetidine pretreatment at different dose levels during lactation, on drug metabolism, were investigated in mouse dams and recently weaned pups. Aminopyrine N-demethylase, aniline hydroxylase and pentobarbitone metabolism were inhibited in both dams and pups in a dose-dependent manner (15, 25 and 50 mg/kg/day, i.p.). Pretreatment at a dose level of 50 mg/kg/day resulted in comparable levels of inhibition of drug metabolism in dams and female pups while male pups were less affected. Of the three indices studied, aniline hydroxylase was the least influenced by cimetidine pretreatment. Thus, the effects of maternal cimetidine pretreatment on drug metabolism in the nursing pair varied with the dose, sex and substrate. The possible implications of these results for man are discussed.

N,N'-diallylpentobarbital (DAPB) metabolites and their effects on pentobarbital-induced sleep and hepatic drug-metabolizing enzymes

1. The biological half-life (t 1/2) of N,N'-diallylpentobarbital (DAPB) in brain after i.p. injection to mouse was 96 min (first phase) and 11 h (second phase). The t 1/2 values in plasma were 102 min and 9.4 h, respectively, after i.p. injection. After intracerebroventricular (i.c.v.) administration, the t 1/2 values in brain and plasma were 18 and 120 min, and 42 and 177 min, respectively. 2. Following i.p. administration of 2-14C-DAPB (80 mg/kg), 58% of the 14C was excreted in the urine in 72 h. Several urinary metabolites were identified by g.l.c.-mass spectrometry, DAPB was metabolized by three major pathways, i.e., omega-1 hydroxylation, epoxide-diol pathway and N-deallylation. 3. The effects of DAPB and its metabolites on pentobarbital (PB)-induced sleep were examined after i.p., i.v. and i.c.v. administration. Metabolite 1 [M-1; (omega-1)-hydroxy-DAPB], an active metabolite, exhibited the most potent prolonging effect. 4. M-1 and other metabolites, as well as unchanged DAPB, showed significant inhibitory effects on mouse hepatic drug-metabolizing enzymes.

Influence of nutritional status on the pharmacokinetics and pharmacodynamics of pentobarbital

The influence of dietary protein deficiency on the pharmacokinetics and pharmacodynamics of pentobarbital was investigated in male Sprague-Dawley rats fed for 4 weeks on a 23% (control) or 5% (low) protein diet ad libitum. Following a single iv dose of 40 mg/kg sodium pentobarbital, the average mean residence time (MRT) was prolonged by 144% (2.3 +/- 0.2 to 5.6 +/- 1.5 hr, mean +/- SD) in the protein-deficient rats, whereas the mean total body clearance (CL) per kilogram of body weight decreased from 0.56 +/- 0.09 to 0.22 +/- 0.06 liter/hr/kg. As a result, the terminal disposition rate constant was decreased by approximately 60% (0.398 +/- 0.037 to 0.178 +/- 0.050 hr-1 when compared to rats on a normal protein diet. No significant differences were found in the two groups of rats with respect to the apparent steady state volume of distribution (Vss). In order to investigate the effect of nutritional status on the concentration-pharmacologic activity relationship, pentobarbital was infused iv at a constant rate of 0.55 mg/min until the animals lost their righting reflex (16 +/- 3 min and 8 +/- 1 min in control and protein-deficient animals, respectively). The total dose and concentration of pentobarbital in plasma were not significantly different between the two groups of animals. However, the concentrations of pentobarbital in plasma water (unbound) and brain were appreciably higher in the rats on a low protein diet. Thus, a diet low in protein appears to be associated with a decreased sensitivity of the central nervous system to the depressant effect of pentobarbital.

Sensitivity to ethanol hypnosis and modulation of chloride channels does not cosegregate with pentobarbital sensitivity in HS mice

Several findings suggest that barbiturates and alcohol produce their sedative effects through a common neural and possibly a common genetic mechanism. We tested this hypothesis by examining the correlation between ethanol and pentobarbital sedative effects in individual animals from a genetically heterogeneous population. The duration of pentobarbital-induced hypnosis (sleep-time) was unrelated to the sleep-time produced by ethanol in heterogeneous stock (HS) mice. Therefore, the present study also examined the effect of ethanol, pentobarbital, and flunitrazepam on muscimol-stimulated chloride flux into brain membranes prepared from HS mice selected for differences in pentobarbital- and ethanol-induced sleep-time. Brain membranes from mice selected for differences in ethanol sleep-time were differentially responsive to ethanol- and flunitrazepam-, but not to pentobarbital-induced augmentation of muscimol-stimulated chloride flux. No differences in augmentation of chloride flux by ethanol, pentobarbital, or flunitrazepam were found in membranes prepared from mice differentially sensitive to pentobarbital hypnosis. The ability of muscimol to stimulate chloride uptake was not related to ethanol or pentobarbital sensitivity. These findings suggest that sensitivity to ethanol is not likely to be genetically linked to pentobarbital sensitivity.

Pulmonary densities during anaesthesia. An experimental study on lung morphology and gas exchange

The nature of dense areas in dependent lung regions regularly seen in anaesthetized humans was examined in a sheep model. During anaesthesia with muscle paralysis and mechanical ventilation dense areas in dependent lung regions could be seen by means of computerized tomography (CT). They had the same location and the same attenuation as in anaesthetized humans. Gas exchange impairment tended to increase in proportion to the size of the dense area on the CT scan. Microscopy showed that the densities in the sheep were atelectatic lung regions, with no or little interstitial oedema and only minor vascular congestion. The atelectatic lung tissue was sharply demarcated and the lung tissue in the immediate vicinity was well aerated, or even hyperinflated. Gravimetry showed the same amount of extravascular fluid and blood per unit lung weight in the atelectatic lung and in the aerated lung region. It is concluded that the densities appearing in dependent lung regions during anaesthesia are caused by atelectasis.

Oral absorption of sodium pentobarbital and effects on gastrointestinal function

An anaesthetic dose (40 mg/kg) of sodium pentobarbital (SP) was administered intragastrically to adult, fasted male rats at total dosing volumes of 1, 2, or 3 ml. Area under the plasma concentration-time curve did not differ for the various dosing volumes. During the initial (rapid) phase of gastric emptying all solutions containing drug appeared to empty at a faster rate than distilled water (2 ml). However, solutions containing drug emptied much more slowly than water during the terminal (slow) phase of gastric emptying. Drug solutions moved along the small intestine at approximately the same rate as distilled water. SP significantly lowered rectal temperature and slowed the propagation velocity of the migrating myoelectric complex (MMC) recorded from four serosal electrodes chronically implanted along the proximal small intestine. In addition, the drug significantly decreased the rate of MMC recurrence, extended the duration of MMC phases, and decreased slow wave frequency at all sites monitored. The results suggest that: 1) the relative oral bioavailability of sodium pentobarbital is not influenced by dosing volume within the range tested, 2) the various dosing volumes of SP tested moved through the gastrointestinal tract at an equal rate, and 3) orally administered SP significantly decreases the propagation velocity and periodicity of the MMC in the small intestine.

The contribution of environmental cues to cross-tolerance between ethanol and pentobarbital

The contribution of Pavlovian conditioning of environmental cues has been studied in relation to tolerance to ethanol-induced hypothermia and cross-tolerance to pentobarbital. Two groups of 12 male Sprague-Dawley rats were exposed every other day to a distinctive set of environmental cues paired with an IP injection of either ethanol 2.5 g/kg or an equivalent volume of isotonic saline. On alternating non-drug days, both groups received saline in the animal room. When they were tested for tolerance to the hypothermic effect of ethanol 2.5 g/kg and cross-tolerance to pentobarbital 25 mg/kg in each environment, tolerance and cross-tolerance in the ethanol-treated group were significantly more pronounced in the ethanol-paired environment than in the saline-paired environment. This indicates the importance of a conditional factor in tolerance and cross-tolerance in this paradigm. Determination of blood levels of ethanol and pentobarbital at various times after injection indicated that conditioned tolerance and cross-tolerance can be explained in part by dispositional factors.