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Mol Pharmacol. 1993 Jul;44(1):129-41.
Interaction of tricyclic drug analogs with synaptic plasma membranes: structure-mechanism relationships in inhibition of neuronal Na+/K(+)-ATPase activity.

Carfagna MA, Muhoberac BB.

Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis.

Perturbations of rat brain synaptic plasma membrane (SPM) bilayer structure and Na+/K(+)-ATPase activity were correlated for drugs that are structurally related and exhibit similar toxicological side effects but belong to different pharmacological classes. Na+/K(+)-ATPase IC50 values decrease linearly with increasing octanol/water partition coefficients (log-log plot) for a series of dimethylethylamine-containing drugs (i.e., chlorpromazine, amitriptyline, imipramine, doxepin, and diphenhydramine), emphasizing hydrophobicity in inhibition. However, nortriptyline and desipramine are 1.2 log units less hydrophobic than their N-methylated parent drugs but more potent inhibitors. To investigate this, bilayer surface structure was examined by the binding of the fluorophore 1-anilinonaphthalene-8-sulfonic acid (ANS) to SPMs. The dissociation constant and wavelength maximum of ANS are invariant with drug binding; however, the limiting fluorescence intensity of ANS (F infinity) is increased. Such data indicate that these cationic drugs bind to the membrane surface, increasing the number but not the polarity of ANS binding sites by cancelling charge at anionic phospholipid groups. More importantly, there is a close linear correlation between the concentrations of drugs necessary to increase F infinity by 40% and the IC50 values, with full compensation for the N-demethylated drugs. This correlation implies that drug-induced increases in SPM-bound ANS fluorescence are a better predictor of Na+/K(+)-ATPase inhibition than are octanol/water partition coefficients and that electrostatic interactions are also involved in inhibition. Furthermore, it points toward similar mechanisms of biomembrane surface interaction governing both inhibition and fluorescence change that are common to these drugs. K(+)-dependent p-nitrophenylphosphatase activity is inhibited with the same potency as Na+/K(+)-ATPase activity, indicating that inhibition may involve drug interaction near the K+ binding sites. Furthermore, chlorpromazine, diphenhydramine, and dimethylaminopropyl chloride alter K(+)-activation of K(+)-dependent p-nitrophenylphosphatase, progressing from noncompetitive through mixed to competitive inhibition as their hydrophobicity changes, and these mechanisms are consistent with steric hindrance of K+ binding. In contrast to the ANS data, decreases in 1,6-diphenyl-1,3,5-hexatriene fluorescence anisotropy induced by these drugs do not correlate with Na+/K(+)-ATPase inhibition, and drug N-demethylation enhances inhibition without altering anisotropy; both findings indicate that Na+/K(+)-ATPase activity is not predominantly influenced by changes in bulk fluidity. Taken together, these data suggest that electrostatic interactions at the biomembrane surface between the protonated amino group of the drug and anionic groups on the enzyme and/or phospholipids near the K+binding sites are crucial to inhibition and that drug hydrophobicity modulated the number and orientation of these interactions.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8393517&dopt=Abstract




Eur J Drug Metab Pharmacokinet. 1992 Apr-Jun;17(2):115-20.
In vitro forecasting of drugs that may interfere with codeine bioactivation.

Dayer P, Desmeules J, Striberni R.

Division of Clinical Pharmacology, University Hospital, Geneva, Switzerland.

The O-demethylation of codeine (methylmorphine) into morphine is mediated by the polymorphic cytochrome P450 DB1 (P450 IID6). By means of in vitro screening in human liver microsomes we have studied the effect on codeine bioactivation of several drugs used as analgesics or as adjuvants for pain control. In microsomes from an extensive metabolizer subject, paracetamol (acetaminophen) and NSAIDs (acetylsalicylic acid, diclofenac, indomethacin, piroxicam, and pirprofen), benzodiazepines (chlordiazepoxide, clonazepam, diazepam, flunitrazepam, and midazolam), and anticonvulsants (carbamazepine and phenytoin) did not alter the reaction. There was marked inhibition of in vitro morphine production by neuroleptics (chlorpromazine, haloperidol, levomepromazine, and thioridazine), metoclopramide, and tricyclic antidepressants (amitriptyline, clomipramine, desipramine, imipramine, and nortriptyline). Enzyme kinetics showed competitive inhibition by neuroleptics (chlorpromazine Ki = 0.5 microM) and antidepressants (clomipramine Ki = 6.8 microM), which are substrates of the polymorphic monooxygenase. Due to the low affinity of codeine for P450 DB1 (Km = 100-200 microM), its bioactivation in extensive metabolizers, and thus its analgesic efficacy, is liable to vary greatly when it is combined with any drug that has a high affinity for the polymorphic isozyme.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1425809&dopt=Abstract




J Affect Disord. 1985 Nov;9(3):223-9.
Plasma tyrosine/neutral amino acid ratio correlated with clinical response to nortriptyline in endogenously depressed patients.

Moller SE, Odum K, Kirk L, Bjerre M, Fog-Moller F, Knudsen A.

Ratios in plasma of tryptophan (Trp) and tyrosine (Tyr) to other large neutral amino acids were determined in 26 endogenous depressives before and after treatment with nortriptyline in doses adequate to achieve a steady-state serum level between 70 and 130 ng/ml, i.e., within the recommended therapeutic range. Pretreatment plasma Trp ratio and Tyr ratio were normal and did not change significantly during treatment. The plasma Trp and Tyr concentrations and the plasma Trp ratio showed no significant association with the therapeutic response. However, the pretreatment plasma Tyr ratio correlated significantly and directly with the final Hamilton rating score, and inversely with the per cent reduction of Hamilton rating score. Moreover, depressives with plasma Tyr ratio below the normal mean showed significantly greater clinical improvement than patients with higher plasma Tyr ratio with comparable serum nortriptyline levels. Evidence has been presented that biochemical variables in depressed patients are important determinants of clinical improvement following pharmacotherapeutic treatment. Moreover, the results suggest that the plasma Tyr ratio may be a guideline for antidepressant response to nortriptyline.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2934455&dopt=Abstract













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