Auditory impairment in guinea pigs treated with isepamicin.

Groups of adult guinea pigs were treated intramuscularly with isepamicin at doses of 100, 150 and 225 mg/kg/day for 21 days. For comparison, two other groups were administered either saline or amikacin 225 mg/kg/day. Auditory function, as measured by the Preyer pinna reflex and the brain stem evoked response, was impaired in both the isepamicin and amikacin groups treated with 225 mg/kg/day, and to a lesser extent in the group receiving isepamicin 150 mg/kg/day. Morphological evaluation of the organ in Corti, performed either by scanning electron microscopy or by light microscopy, showed the typical pattern of damage associated with the aminoglycosides. The greatest damage was observed at 225 mg/kg/day, with no difference between isepamicin and amikacin. Isepamicin 100 mg/kg/day produced no impairment in auditory function and very little change in the morphology of the organ of Corti.

Simple measurement of isepamicin, a new aminoglycoside antibiotic, in guinea pig and human plasma, using high-performance liquid chromatography with ultraviolet detection.

Isepamicin, the 1-N-(S-alpha-hydroxy-beta-aminopropionyl) derivative of gentamicin B, is a new aminoglycoside antibiotic, which not only has most of the properties of amikacin but also is effective against several amikacin-resistant strains of bacteria. The drug was assayed in guinea-pig and human plasma with a high-performance liquid chromatographic procedure using precolumn derivatization with 1-fluoro-2,4-dinitrobenzene and ultraviolet detection. Linearity was established over the range 0.5-40 micrograms/ml using 50 microliters of plasma. Accuracy has a mean relative error of less than 3% and precision a mean coefficient of variation of 5%. Isepamicin was determined without interference from plasma constituents or other drugs commonly prescribed during aminoglycoside therapy. This procedure correlates well with radioimmunoassay and can be used either in experimental studies or therapeutic monitoring of plasma levels.

Aminoglycoside dosing regimen and pharmacokinetic parameters in the guinea pig.

To complement a study on aminoglycoside dosing regimen and ototoxicity in the guinea pig, we designed an experiment to examine: (1) the effect of dosing regimen on guinea pig pharmacokinetic parameters, and (2) possible differential accumulation after repeated intramuscular administrations of netilmicin and amikacin (150 mg/kg/day) for 7 days by 1 or 3 daily injections. The area under the curve (AUC infinity) and the maximum plasma concentration (Cmax) were dose-dependent. Within each regimen, no significant difference was observed between days 1 and 7. Little or no accumulation was observed after 21 days of treatment. The results show a good dose-dependence of AUC infinity and Cmax and are in accordance with data from human studies. Moreover, the fact that no accumulation occurred in the guinea pig suggests that it is a suitable animal model to evaluate the relation between aminoglycoside ototoxicity and dosing regimen.

Relation of dosing regimen to aminoglycoside ototoxicity: evaluation of auditory damage in the guinea pig.

Groups of guinea pigs were injected intramuscularly for 21 days with netilmicin or amikacin 150 mg/kg/day by one or three daily injections. Amikacin was also tested at 225 mg/kg/day with each dosing regimen. Auditory function was evaluated during the experiment by reflexological and electrophysiological tests. Morphological damage to the inner ear was also evaluated. Netilmicin had no effect on the auditory function nor did it damage the organ of Corti. Conversely, amikacin impaired the auditory function and produced loss of hair cells in a dose-related manner. The effect was equally marked with both dosing regimens of 225 mg/kg/day, whereas a slight decrease of auditory impairment was observed with 150 mg/kg administered once a day. The data suggest that administration of a single daily dose of aminoglycosides does not increase the risk of ototoxicity specifically associated with each compound.

High-performance liquid chromatographic determination of netilmicin in guinea-pig and human serum by fluorodinitrobenzene derivatization with spectrophotometric detection.

A high-performance liquid chromatographic procedure for netilmicin determination in guinea-pig and human serum using pre-column derivatization with 1-fluoro-2,4-dinitrobenzene and UV detection is described. Linearity was established over the range 0.5-40 micrograms/ml using only 50 microliters of serum. Accuracy and precision were good, with a mean coefficient of variation less than 5% and a mean relative error less than 4%. This procedure correlates well with an enzyme multiplied immunoassay technique and has a sensitivity similar to those of published fluorescence derivatization methods.

Comparative actions of four aminoglycoside antibiotics on the vestibular function in guinea-pigs.

This study was designed to assess the actions of 4 representative aminoglycoside antibiotics on the vestibular functions in guinea-pigs as evidenced by the measurements of the vestibulo-ocular reflex (VOR) either in the horizontal (HVOR) or in the vertical plane (VVOR). VOR responses were evaluated over a wide range of stimulation frequencies prior to and after 10 and 18 days of a multiple dose regimen with dibekacin (150 mg/kg), gentamicin (100 mg/kg), netilmicin (150 mg/kg), tobramycin (100 mg/kg) or saline. All drugs or saline were given intramuscularly twice a day. The labirinthine function was found to be differently impaired by drug administration. Gentamicin induced severe vestibular impairment, which had early onset. Dibekacin greatly reduced all VOR responses, but changes occurred after a longer period of time. Tobramycin and netilmicin induced slight vestibular impairment only after 18 days of treatment. Tobramycin affected both HVOR and VVOR responses at the high frequencies, while netilmicin impaired only the HVOR. Histological examination of vestibular epithelia was conducted by using the Scanning Electron Microscope (SEM). Gentamicin and dibekacin greatly damaged both the cristae of semicircular canals and utriculi, structures which are involved in the generation of VOR responses. Conversely, tobramycin provoked damages only in the cristae of semicircular canals and netilmicin did not affect the vestibular sensory epithelia. These findings indicate that each aminoglycoside produces characteristic actions on the vestibular function which depend on the damage distribution in the labirinthine structures. Among the aminoglycoside examined, netilmicin appears to possess the lowest potential for producing impairment of the vestibular function.

Vestibulo-ocular reflex (VOR) in guinea pigs. Impairment induced by aminoglycoside antibiotics.

The vestibulo-ocular reflexes (VORs) were studied in guinea pigs receiving daily administration of aminoglycoside antibiotics. The vestibular epithelia were also examined by scanning electron microscope technique (SEM). The treatment with aminoglycosides led to varying degrees of VORs according to (i) the type of aminoglycoside drug; (ii) the duration of the treatment and, (iii) the sensitivity of the various vestibular receptors. Gentamicin caused an earlier and severe reduction of the VOR gain. Dibekacin also caused evident damage, but the onset of its action was delayed. Both drugs affected mainly the vertical responses. Tobramycin and netilmicin altered the VORs slightly. Histological examination revealed damage to the sensory epithelia corresponding to the observed VOR impairments.

Comparative oto-vestibular effects in the pigmented guinea pig after dibekacin and netilmicin treatment.

We treated groups of pigmented guinea pigs with either intramuscular netilmicin or dibekacin at 100 and 150 mg/kg per day for 3 weeks. Saline was used as the control solution. All animals were tested weekly for both vestibular and auditory functions. The vestibular function was evaluated by the duration of post-rotatory nystagmus (PRN) elicited by interrupting the rotation of the animal around the vertical axis; auditory function was evaluated by the threshold response for the Preyer's pinna reflex (PPR). All animals were then sacrificed and either their labyrinths or Corti organs were processed for further investigations using the scanning electron microscope (SEM). The duration of PRN decreased over the treatment period in all of the groups as a result of adaptation. However, 150 mg/kg dibekacin produced a significant decrease of the PRN responses as compared to the control and other groups. This effect also continued during the recovery period. Likewise, the PPR threshold of the animals receiving 150 mg/kg dibekacin showed a significant increase at the end of the treatments and during the recovery period, while the other dibekacin group had no significant auditory impairment. Netilmicin at both doses did not significantly affect responses following either vestibular or auditory stimulations. SEM observations demonstrated that the sensory epithelia of the labyrinths and Corti organs affected by 150 mg/kg dibekacin had great losses of stereocilia, while comparable doses of netilmicin (150 mg/kg) had only very moderate losses of stereocilia in the labyrinths but not in the Corti organs.

Prostaglandins and aminoglycoside nephrotoxicity.

The role of prostaglandins in the development of aminoglycoside-induced acute renal failure was studied in CD-COBS rats (200 to 250 g). The animals were treated with gentamicin (80 mg/kg), acetylsalicylic acid (ASA, 100 or 200 mg/kg), or both drugs or saline for 5 or 10 days. Renal function was studied measuring creatinine clearance, blood urea nitrogen (BUN), and serum electrolytes, urine osmolality, and maximal urinary concentrating capacity after water deprivation and vasopressin administration. Gentamicin toxicity on the proximal tubule was evaluated by measuring urinary excretion of the lysosomal enzyme N-acetylglucosaminidase (NAG). Renal prostaglandin (PG) production was evaluated measuring the concentration of PGE2, PGD2, PGF2 alpha, 6-keto-PGF1 alpha, and thromboxane B2 (TXB2) in whole renal homogenate after a 15-min incubation at 37 degrees C using gas chromatography-mass spectrometry. Gentamicin alone reduced the glomerular filtration rate (GFR) 20 to 30% after 5 and 10 days of treatment. Combination with ASA potentiated the toxic effect of the aminoglycoside after 10 but not after 5 days of treatment. Similarly, gentamicin reduced the urinary concentrating capacity and addition of ASA worsened the effects. Gentamicin markedly increased NAG excretion but this effect was reduced by ASA, probably as a result of lysosomal stabilization. ASA alone inhibited the production of prostaglandins in renal tissue by 70 to 90% after single or multiple doses. The animals treated with gentamicin alone presented a significant, specific increase in PGE2 production after 10 days of treatment but this increase did not occur when the two compounds were given together. Since PGE2 has a vasodilatory effect in the kidney these results suggest that it may play a specific role in maintaining normal renal blood flow and GFR during the development of aminoglycoside nephrotoxicity. The inhibition of prostaglandin production by nonsteroid anti-inflammatory drugs prevents this compensatory mechanism and worsens the renal damage.

A beta-carboline antagonizes benzodiazepine actions but does not precipitate the abstinence syndrome in cats.

The beta-carbolines, which are potent ligands for benzodiazepine receptors, antagonize the pharmacological actions of benzodiazepines. In the cat, the stable beta-carboline derivative methylamide-beta-carboline-3-carboxylate, FG 7142, and the specific benzodiazepine antagonist Ro 15-1788 reversed behavioral and electroencephalographic (EEG) changes produced by a single dose of diazepam. Surprisingly, the beta-carboline did not elicit signs of withdrawal when given after 22 days of a daily dose regimen of diazepam, while Ro 15-1788 precipitated an acute abstinence syndrome largely characterized by tremors, increased muscle tone, back arching, myoclonic jerks and pupil dilatation. Unlike Ro 15-1788, the beta-carboline produced effects of its own such as behavioral states of arousal and fearfulness. These findings indicate that the beta-carboline functionally interacts with benzodiazepine receptors in a manner unlike that seen with typical agonists and antagonists.

Effects of the R, R-isomer of labetalol, SCH 19927, in isolated tissues and in spontaneously hypertensive rats during a repeated treatment.

The alpha 1- and beta 1-adrenoceptor blocking activity of the R, R-isomer of labetalol, SCH 19927, was assessed in isolated tissues and compared with that of labetalol. The antihypertensive actions of both compounds were then evaluated during a 10-day dose regimen in spontaneously hypertensive rats (SHR). SCH 19927 produced a competitive alpha 1- and beta 1-blockade in vitro as indicated by the parallel shift to the right of the dose-response curves for norepinephrine and isoprenaline, respectively. SCH 19927 was found 4 times more potent as beta 1-blocker and 6.5 times less potent as alpha 1-blocker than labetalol. In conscious SHR, both SCH 19927 and labetalol produced long-lasting antihypertensive effects during the 10-day period of repeated administration with 10 mg/kg p.o. No tolerance to the antihypertensive activity occurred during the treatment. These findings suggest that SCH 19927 is more potent as a beta-blocker than as an alpha-blocker in isolated tissues and produces an effective antihypertensive activity during a repeated dose regimen.

Pharmacological studies with quazepam, a new benzodiazepine hypnotic.

7-Chloro-1-(2,2,2-trifluoroethyl)-5-(o-fluorophenyl)-1, 3-dihydro-2H-1,4-benzodiazepine-2-thione (Sch 16134, quazepam) demonstrated high safety and effective hypnotic properties. Toxicity of quazepam in mice was extremely low at the largest doses administered of 5000 mg/kg p.o. and 1370 mg/kg i.p. as compared to LD50 values for flurazepam of 756 (635-889) mg/kg p.o. and 254 (234-280) mg/kg i.p. In cats, quazepam did not produce overt toxicity even at the highest dose administered, 1000 mg/kg p.o., whereas death occurred after the administration of flurazepam at a median dose of 250 mg/kg p.o. In addition, flurazepam produced central excitation and convulsions. Quazepam did not affect hemodynamic parameters in conscious dogs and anesthetized cats. Autonomic functions were virtually unaffected by the drug in anesthetized cats. In interaction studies in mice, quazepam did not interact with cimetidine while it potentiated the sedative activity of alpha-methyldopa, ethanol and propranolol. The CNS depressant properties of quazepam were further investigated by studying its effects on spontaneous motor activity in mice and EEG pattern in immobilized cats. In mice, quazepam reduced locomotor activity at doses which did not impair motor coordination thus differing from flurazepam which did. In the EEG study, quazepam produced a slow wave EEG pattern comparable to that of physiological sleep, while flurazepam induced a similar EEG activity which alternated with a fast frequency pattern of moderate amplitude. Quazepam also showed potent anticonvulsant activity. These results suggest that quazepam is likely to be a safe and effective sleep-promoting agent.

Effects of physostigmine on benzodiazepine toxicity.

The interactions between physostigmine and chlordiazepoxide, diazepam, flurazepam were experimentally evaluated in rats and mice by the following test: loss of righting reflex (LRR), acute toxicity, cardiovascular toxicity and EEG pattern. Physostigmine did not modify the duration of LRR produced by chlordiazepoxide. Conversely, the recovery after diazepam was significantly longer. The LD50 of diazepam and chlordiazepoxide were not modified by physostigmine administration, but that of flurazepam was significantly decreased. Heart rate and blood pressure did not change significantly with physostigmine pre-treatment. However, the total lethal dose was lowered for chlordiazepoxide and flurazepam. Only the reversal by physostigmine of the EEG pattern due to benzodiazepines, offers experimental support to the claimed usefulness of physostigmine in benzodiazepine intoxication in humans. Furthermore, the potentiation of flurazepam toxicity must be taken into account in the debate concerning the clinical advantages of physostigmine.

Histological evaluation of ototoxic reaction due to some aminoglycoside antibiotics.

Twenty-one days s.c. treatment with netilmicin, gentamicin, sisomicin, and kanamicin at different doses were performed in albino guinea pigs of both sexes. Block surface preparation of Corti's organ was carried out and missing OHCs and IHCs counted in selected areas of each turn. The animals treated with gentamicin and sisomicin showed a dose-depending missing of hair cells, preferably relative to the outer ones and quantitatively the same for both the antibiotics. Furthermore, a characteristic distribution of the damage progressively increasing from the apex to the basal turn of the cochlea was detected. Kanamicin at 267 and 400 mg/kg gave the complete destruction of OHCs and IHCs along the whole cochlea while at 178 mg/kg did not show any significant damage in comparison to the control group. Finally, netilmicin neither damaged Corti's organ nor statistically determined missing OHCs and IHCs at all the doses used. These histological results and the previous electrophysiological and reflexological observations obtained in the guinea pig show a higher safety of netilmicin in comparison to the other aminoglycosides used for the problem relative to ototoxicity.

Reproductive and teratological studies with a new aminoglycoside: netilmicin (Sch 20569).

Reproductive and teratological studies were undertaken with netilmicin (Sch 20569), a new semisynthetic aminolgycoside antibiotic structurally related to sisomicin. The administration of 32 and 80 mg/kg/day, by the intramuscular route, in the rat prior to and during pregnancy and lactation did not affect the fertility of animals, the resorptions rate and the vitality of the litters until the second generation. Also in the rabbit, the dose of 32 mg/kg/day by intramuscular route during pregnancy did not cause any embryotoxic effect. No gross malformations were observed in both species. The minor skeletal malformation, described as "wavy ribs", was observed at a significant level only in the rat foetuses generated by dams treated with a dose as high as 80 mg/kg/day by the intramuscular route.

Auditory function in guinea pigs treated with netilmicin and other aminoglycoside antibiotics.

The following aminoglycoside antibiotics netilmicin, sisomicin, gentamicin, and kanamycin were submitted to a comparative study of their ototoxicity using both reflexological (Preyer's pinnareflex) and electrophysiological (near and far field) methods. The daily s.c. administration of sisomicin, gentamicin, and kanamycin for 21 days provoked a dose-related impairment of the cochlear function, detected with all the employed techniques. On the other hand, a very low ototoxic effect of netilmicin was demonstrated with electrophysiological but not with the reflexological evaluation. The reliability of the methods used in these experiments is also compared.

Comparison of neuromuscular effects and acute toxicity of some aminoglycoside antibiotics.

The correlation between acute toxicity and the effects occurring at neuromuscular junction level of some aminoglycoside antibiotics was investigated. Netilmicin (Sch 20569), sisomicin, gentamicin and kanamycin were administered i.v. in the rat and the following effects were studied: neuromuscular blocking activity (sciatic-gastrocnemius preparation), and acute toxicity evaluation. Neuromuscular blocking effects were found to be well correlated to acute toxicity data for all test-antibiotics. Comparison of results gave a sequence of relative potency which was as follows: netilmicin = sisomicin greater than gentamicin greater than kanamycin. Our findings confirmed that both respiratory failure, reporter as a side effect of the clinical use of aminoglycosides, and experimental toxicity follow the neuromuscular block.