Kurosawa N, Owada E, Ito K
Hokkaido Institute of Pharmaceutical Sciences, Japan.
Yakugaku Zasshi. 1993 Oct;113(10):698-704. doi: 10.1248/yakushi1947.113.10_698.
To understand the previous result of higher bioavailability of rectal salbutamol (SB) compared with oral SB, in situ experiments using rabbit duodenal and rectal loop were carried out. After the intravenous (i.v.) and intraportal (i.p.) dosing of SB, fraction of dose which avoids the hepatic first-pass-effect (Fh) was calculated from the areas under the blood concentration-time curve (AUC). The Fh was about 10% and unchanged significantly with increasing i.p. dose (5-20 mg). Intraduodenal (i.d.) or intrarectal (i.r.) dosing of SB was made after the i.v. and i.p. dosing, and the AUC's and the residual amount in the loop were obtained to estimate the parameters. The results of the i.d. and i.r. dosing were as follows; for the extent of bioavailability (EBA), 7.7 +/- 1.5% and 14.5 +/- 2.3%, for the fraction of dose absorbed (fa), 93.9 +/- 3.7% and 33.8 +/- 3.3%, and for the fraction of absorbed SB which avoids first-pass-effects (F), 8.4 +/- 1.9% and 43.0 +/- 6.0% (mean +/- S. E., n = 4). Consequently, SB dosed i.d. was absorbed completely, and received first-pass-metabolism in the mucosa (about 20%) and then in the liver (about 90%), which caused the low bioavailability. While, in i.r. dosing, SB absorption was poor. However, higher bioavailability was obtained owing to about 40% of rectal venous blood flow which bypasses the liver and negligible first-pass-metabolism in the mucosa (about 4%).
为了解直肠给予沙丁胺醇(SB)比口服SB具有更高生物利用度的先前结果,进行了使用兔十二指肠和直肠肠袢的原位实验。静脉注射(i.v.)和门静脉注射(i.p.)SB后,根据血药浓度-时间曲线(AUC)下的面积计算避免肝脏首过效应(Fh)的剂量分数。Fh约为10%,且随着i.p.剂量(5-20mg)增加无显著变化。在静脉注射和门静脉注射后进行十二指肠内(i.d.)或直肠内(i.r.)给予SB,并获得AUC和肠袢中的残留量以估计参数。i.d.和i.r.给药的结果如下:生物利用度程度(EBA)分别为7.7±1.5%和14.5±2.3%,吸收剂量分数(fa)分别为93.9±3.7%和33.8±3.3%,以及避免首过效应的吸收SB分数(F)分别为8.4±1.9%和43.0±6.0%(平均值±标准误,n = 4)。因此,i.d.给予的SB被完全吸收,并在黏膜(约20%)和随后在肝脏(约90%)中经历首过代谢,这导致了低生物利用度。而在i.r.给药中,SB吸收较差。然而,由于约40%的直肠静脉血流绕过肝脏且黏膜中的首过代谢可忽略不计(约4%),获得了更高的生物利用度。