Shimadzu K, Nishi S, Kariya N, Yamamoto I, Asada A
Department of Anesthesiology and Intensive Care Medicine, Osaka City University Medical School, Japan.
Life Sci. 1998;62(26):2399-405. doi: 10.1016/s0024-3205(98)00222-7.
We hypothesized that changes in the pharmacokinetics of lidocaine might reveal changes in portal circulation induced by catecholamines. Isolated perfused rat liver (IPRL) was selected as an experimental model, since experimental conditions in this model could be regulated. The liver was perfused with a recirculating system at a constant flow rate of 20 ml/min. Two milligrams of lidocaine was administered along with one of three drugs, dopamine, norepinephrine or adenosine triphosphate. The fractional transfer rate constants, k21 and k12, from medium to liver and liver to medium, respectively, and ke, the elimination rate constant, were calculated using a two-compartment model with the SAAM II program. Curves of decay of lidocaine from the recirculating medium consisted of a fast and a slow component. Norepinephrine and high-dose dopamine significantly increased k12, while low-dose dopamine significantly increased k21 and ke compared with control values. Thus, norepinephrine and high-dose dopamine increased lidocaine transfer rate from liver to medium, while low-dose dopamine increased the transfer rate from medium to liver and the rate of elimination from liver. These findings suggest that norepinephrine and high-dose dopamine inhibit hepatic drug uptake and that low-dose dopamine improves uptake in IPRL.
我们推测利多卡因药代动力学的变化可能揭示儿茶酚胺引起的门静脉循环变化。由于该模型的实验条件可以调节,因此选择离体灌注大鼠肝脏(IPRL)作为实验模型。肝脏通过循环系统以20 ml/min的恒定流速进行灌注。将2毫克利多卡因与三种药物之一(多巴胺、去甲肾上腺素或三磷酸腺苷)一起给药。使用带有SAAM II程序的二室模型计算分别从中等介质到肝脏以及从肝脏到中等介质的分数转移速率常数k21和k12,以及消除速率常数ke。利多卡因从循环介质中的衰减曲线由一个快速成分和一个缓慢成分组成。与对照值相比,去甲肾上腺素和高剂量多巴胺显著增加k12,而低剂量多巴胺显著增加k21和ke。因此,去甲肾上腺素和高剂量多巴胺增加了利多卡因从肝脏到中等介质的转移速率,而低剂量多巴胺增加了从中等介质到肝脏的转移速率以及从肝脏的消除速率。这些发现表明,去甲肾上腺素和高剂量多巴胺抑制肝脏药物摄取,而低剂量多巴胺改善IPRL中的摄取。