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College of Pharmacy and Nutrition, University of Saskatchewan
A mixture of amino acids inhibits propranolol metabolism in
perfused rat livers. To obtain mechanistic information about the interaction, a related but less tissue-bound drug, metoprolol, was used
to determine Vmax and
KM for parent drug and two metabolites in the
presence and absence of amino acids. Six groups of 4 livers from 24 male Sprague-Dawley rats were perfused in the single-pass mode at 3 ml/min/g liver for 130 min with oxygenated buffer containing 3.74, 4.49, 5.61, 7.48, 18.7, or 44.9 µM metoprolol. From 50 to 90 min, a
balanced amino acid mixture was included in the buffer. Samples of
liver effluent taken every 5 min were analyzed by HPLC for metoprolol
and two metabolites,
-hydroxymetoprolol and
O-demethylmetoprolol. Steady-state concentrations of drug
determined before, during, and after amino acids were used to determine
Vmax and apparent KM
values by nonlinear curve-fitting under each condition. Amino acids
reversibly reduced the Vmax values of
metoprolol and both metabolites by ~50% without significantly
affecting apparent KM values. As a result,
large increases in availability occurred, especially at low metoprolol
inlet concentrations (>90%). Amino acids also increased oxygen
consumption until the effluent buffer was almost depleted. Possible
mechanisms influencing Vmax include direct
inhibition of metabolic enzymes by amino acids or cosubstrate (NADPH or
oxygen) limitation. Amino acid-mediated pericentral oxygen depletion in
the hepatic sinusoids could result in inhibition of drug-metabolizing
enzymes, and is consistent with a reduction of
Vmax and oxygen depletion in the effluent
buffer during amino acid coinfusion. We postulate that one or more of
these mechanisms could contribute to the interaction between food and
high first-pass drugs observed in humans.