The metabolism and excretion of enzyme-inducing doses of phenobarbital by rats with bile fistulas.

The metabolism of enzyme-inducing doses of 14C-phenobarbital injected i. p. into bile duct-cannulated rats has been studied using improved chromatographic separation and quantification techniques. In animals with bile fistulas most of the 14C-phenobarbital was excreted in bile as p-hydroxyphenobarbital conjugated with glucuronic acid. In urine the main substance found was phenobarbital, with significant amounts of p-hydroxyphenobarbital and varying amounts of its glucuronide conjugate. Animals without bile fistulas excreted 80% dose of phenobarbital in the urine; metabolites were free phenobarbital, p-hydroxyphenobarbital and conjugated material. Approx 90% of the conjugated material was the glucuronide. Only free phenobarbital and p-hydroxyphenobarbital were found in the faeces. Animals drinking plain water excreted 50-65% dose of phenobarbital (80 mg/kg) in bile and the remainder mainly in the urine, whereas superhydrated animals (drinking 5% glucose and 0.9% NaCl) excreted 90% of the dose as free phenobarbital in the urine. Phenobarbital is the only labelled material detectable in hepatic tissue and portal, vena caval or aortic blood, which indicates that phenobarbital is the enzyme-inducing substance and that liver and kidney rapidly eliminate all metabolites. Metabolism of phenobarbital in vivo is a complex process involving interaction of hepatic and intestinal metabolism, partial readsorption from the intestinal tract and renal elimination.

Comparison of the induction course, biophysical chemical interactions and photochemical action spectra of phenobarbital and 3-methylcholanthrene induce hepatic microsomal P-450.

A comparison has been made of the physical and chemical properties of hepatic microsomal P-450 and associated enzyme systems from rats treated with phenobarbital or with 3-methylcholanthrene and other polycyclic aryl hydrocarbons. The results of these studies, though preliminary in nature, indicate clearly that the aryl-induced mixed-function oxidase systems differ significantly from the PB-induced ones in time course of induction, spectral properties, hyroxylase and demethylase activities, CO-inhibition of these reactions and light-reversal of the inhibition. The results support and extend the findings of other investigators regarding the differential biophysical and biochemical properties of aryl-induced systems and provide an experimental design for studying these properties in greater depth at the maximum of aryl induction.

Postoperative oral and intravenous nutrition.

Oral and intravenous high calorie-amino acid nutritional therapy postoperatively resulted in significant weight gain, improved colonic wound healing and maintenance of normal intravascular albumin levels. Provision of caloric needs without amino acids minimized weight loss postoperatively. However, infusion of hypertonic dextrose solutions resulted in severe generalized hepatic fatty infiltration and marked hypoalbuminemia. Protein and calorie deprivation by administration of 5% dextrose and water resulted in the greatest postoperative weight loss, reduced intravascular albumin levels and decreased colonic anastomotic strength. Comparison of oral and intravenous diet administration demonstrated that hypertonic dextrose infusion was markedly deleterious to hepatic morphology and serum protein metabolism in normal rats. Further clinical investigation appears indicated in previously well-nourished patients undergoing extensive surgery who will not be able to ingest adequate nutrients in the postoperative period.