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Dopaminergic neuronal responses to a non-amphetamine CNS stimulant.

The present study compares the effects of d-amphetamine (d-AMP) and the potent non-amphetamine CNS stimulant, amfonelic acid (AFA), on the firing rate of single midbrain dopaminergic (DA) neurons and on neostriatal DA metabolism (dihydroxyphenylacetic acid--DOPAC). The results indicate that AFA, like d-AMP, reduces the firing rate of DA neurons, although unlike d-AMP, AFA does not cause a decrease in neostriatal DOPAC content and, in fact, enhances that produced by haloperidol (HALO). The AFA-induced decrease in firing rate, like d-AMP, is reversed by the DA receptor blocker HALO, but again unlike d-AMP, the decrease in firing rate is not prevented by catecholamine synthesis inhibition with alpha-methyl-para-tyrosine. Thus, both amphetamine and amfonelic acid have identical electrophysiological effects on DA neurons but act by different mechanisms.

3,4-Dihydroxyphenylacetic Acid↗

Dopamine and sexual behavior in the male rat: a reevaluation.

In castrated male rats treated with a low dose of testosterone propionate (0.40 mg/kg per week), the dopamine agonists amphetamine and amfonelic acid reduced mount latency without affecting other aspects of sexual behavior. Apomorphine, in doses between 0.05 and 0.15 mg/kg, and 1-DOPA 5-45 mg/kg + carbidopa 50 mg/kg, lacked effect on sexual behavior. Both amphetamine and amfonelic acid increased locomotor activity in a dose-dependent manner. Apomorphine, in the lowest dose, produced a reduction whereas the higher doses of this drug as well as all doses of 1-DOPA lacked effect on this behavior. In castrated animals implanted with a testosterone-filled Silastic capsule, showing a level of sexual activity indistinguishable from that of intact animals, amphetamine and amfonelic acid did not affect sexual behavior. The dopamine receptor antagonists haloperidol and cis(Z)-flupentixol reduced sexual behavior, whereas pimozide was without effect in the dose range used. The doses of haloperidol and flupentixol that were required to reduce sexual activity were such that they also affected motor execution measured in a treadmill test. It is suggested that increased dopaminergic neurotransmission may stimulate sexual behavior in an indirect way, augmenting behavioral arousal. The inhibitory effects of dopamine antagonists could be explained either by a reduced arousal level or by motor deficiencies.

Amphetamines↗

A rat model of distractibility: effects of drugs modifying dopaminergic, noradrenergic and GABAergic neurotransmission.

A procedure for analyzing effects of drugs on distractibility is proposed. Rats are trained to traverse a straight runway with a sucrose solution as reinforcement. Once the response has been acquired, an additional runway ending in an empty box is connected. The time spent investigating this additional runway is the measure of distractibility. Amphetamine, 1 mg/kg i.p., increased distractibility. In rats that were never reinforced, amphetamine at a dose of 1 mg/kg reduced the time spent in the additional runway. This shows that the effects of amphetamine in the reinforced animals cannot be interpreted as enhanced exploration. Furthermore, the benzodiazepines diazepam (2 and 4 mg/kg, i.p.) and chlordiazepoxide (2.5, 5 and 10 mg/kg, i.p.), known to enhance exploration of novel environments, did not affect the time spent in the additional runway in sucrose-reinforced animals. It was concluded that the procedure indeed is a model of distractibility. The dopamine antagonist cis(Z)-flupenthixol, at a dose of 0.25 mg/kg, i.p., blocked the effects of amphetamine, 1 mg/kg. Flupenthixol itself, in doses of 0.25 and 0.5 mg/kg, did not affect the time spent in the additional runway. This suggests that enhanced dopaminergic activity indeed is responsible for the effects. This proposal is further supported by experiments showing that the noradrenaline precursor dihydroxyphenylserine (10 mg/kg + carbidopa, 50 mg/kg, both i.p.) and the noradrenergic neurotoxin DSP4 (50 mg/kg, i.p.) had no effect on distractibility. Moreover, amfonelic acid, a dopamine releaser with slight or no effect on noradrenergic neurotransmission, had effects very similar to those of amphetamine when given in doses of 0.25 and 0.5 mg/kg, i.p. A lower dose, 0.125 mg/ kg, was ineffective. Taken together, these data suggest that enhanced dopaminergic neurotransmission increases distractibility in the rat. However, both amphetamine and amfonelic acid may stimulate serotonin release. Until serotonergic drugs have been tested, a contribution of this transmitter cannot be ruled out. The distraction procedure may constitute an animal model of some kinds of disordered information processing.

Aldehyde-Lyases↗

A microbiological evaluation of apalcillin.

The in vitro activity of apalcillin was tested against 350 clinical isolates of Escherichia coli, Enterobacter, Klebsiella, Proteus, Pseudomonas aeruginosa and Streptococcus faecalis. Using a minimal inhibitory concentration of 16 mg/l as the breakpoint, only 19.7% of the strains were resistant to apalcillin. A regression analysis demonstrated that it is possible to test bacteria for sensitivity with a 20 micrograms apalcillin disc. The results on Mueller-Hinton agar are very similar to those on Iso-Sensitest medium. Like other ureido penicillins, apalcillin is sensitive to most beta-lactamases; it is effective against ampicillin-resistant strains since it penetrates the outer membrane of gram-negative bacteria well and is highly effective against target proteins. Strains producing high amounts of beta-lactamases do become resistant to apalcillin.

Ampicillin↗

In vitro activity of the newer quinolones compared with the classic ones and tobramycin.

The halogenated substitution of quinolone derivatives has given rise to a new group of substances called newer quinolones, which possess extraordinary antibacterial activity in vitro. The aim of our study was to compare the effect of the newer quinolones ciprofloxacin (CIP), norfloxacin (NOR) and enoxacin (ENO) with that of the classical ones nalidixic acid (NA), oxolinic acid (OX) and pipemidic acid (PIP) and with a widely-used aminoglycoside tobramycin (TBR). This was tested on 2,263 strains from clinical isolations. Evaluating the effect of the least active substances as a unit, we generally found the MIC90s to be of the following order: (Formula: see text). The remaining groups among the antibiotics studied are ordered identically, the most potent being the newer quinolones in the following order: CIP is at least four times superior to NOR, which in turn is at least twice as effective as ENO for gram-positive organisms, but only 1.2 times for gram-negative bacilli.

Anti-Bacterial Agents↗

In vitro susceptibility of aerobic gram-negative blood culture isolates to oxolinic acid, norfloxacin, ciprofloxacin, enoxacin, pefloxacin, ofloxacin and oxo-enoxacin.

100 gram-negative strains isolated from blood cultures were selected for the evaluation of the in vitro activity of oxolinic acid, norfloxacin, ciprofloxacin, enoxacin, pefloxacin, ofloxacin and oxo-enoxacin. Ciprofloxacin showed the highest intrinsic activity. Oxo-enoxacin, the major metabolite of enoxacin, was 10-15-fold less active than enoxacin. Against Enterobacteriaceae and Vibrionaceae, all fluorinated quinolones except norfloxacin were equally effective, while against non-fermenters, ciprofloxacin and ofloxacin demonstrated greater activity than the others. Resistance to oxolinic acid had a detrimental effect on susceptibility to the new fluorinated quinolones.

Anti-Bacterial Agents↗

The comparative activity of pefloxacin, enoxacin, ciprofloxacin and 13 other antimicrobial agents against enteropathogenic microorganisms.

In this study, we compared the activity of pefloxacin, enoxacin and ciprofloxacin against 269 enteropathogenic strains (Campylobacter jejuni, enteropathogenic Escherichia coli, Salmonella typhi, Shigella spp., Vibrio cholerae and Yersinia enterocolitica) with that of rosoxacin, flumequin, nifuroxazide, erythromycin, chloramphenicol, ampicillin, cefotaxime, tetracycline, amikacin, netilmicin, sulfamethoxazole, trimethoprim and co-trimoxazole. Pefloxacin, enoxacin and ciprofloxacin were always among the most active compounds. Furthermore, resistant strains or strains with elevated MIC values were not found. The MIC90 value for these three compounds was less than or equal to 0.25 mg/l, except for C. jejuni where it was 0.3 mg/l and 1.4 mg/l for pefloxacin and enoxacin, respectively.

Animals↗

Chemotherapeutic effects of ofloxacin (HOE 280) and other quinolone-carboxylic derivates in the treatment of experimental lung infections due to Klebsiella pneumoniae DT-S in mice.

The chemotherapeutic activity of ofloxacin (HOE 280), a new pyridone-carboxylic acid derivative, was compared with that of other drugs in the same group, including norfloxacin, ciprofloxacin, enoxacin and in some cases pipemidic acid and nalidixic acid. The test model used was experimental pneumonia caused by Klebsiella pneumoniae DT-S in mice. In the treatment of pneumonic mice, ofloxacin was 4 to 18 times more effective than norfloxacin and enoxacin and in most cases slightly more effective than ciprofloxacin. Pipemidic acid and nalidixic acid showed only low activity or proved to be inactive. In studies on the bactericidal activity of the compounds in vivo, ofloxacin produced a more pronounced effect than ciprofloxacin. With norfloxacin and enoxacin, a bactericidal effect in the infected tissue of the animals was only observed during the first hours after treatment.

Animals↗

[New oral quinolone compounds in chronic bronchitis].

Clinical, microbiological and pharmacokinetic results are presented from studies in 186 patients treated with the new quinolone antimicrobial agents enoxacin, pefloxacin, ciprofloxacin or ofloxacin. Almost all had been admitted to hospital for acute purulent exacerbations of chronic bronchitis, associated mainly with Haemophilus influenzae, Streptococcus pneumoniae, Branhamella catarrhalis or Pseudomonas aeruginosa. The H. influenzae and B. catarrhalis strains were generally very sensitive to the quinolones and sputum concentrations of 1.3 to 4.5 mg/l exceeded the MICs (geometric mean values 0.07 to 0.44 mg/l) by a factor of more than 10. In contrast, P. aeruginosa was slightly less sensitive (geometric mean MICs 0.4 to 4.4 mg/l) and S. pneumoniae much less so (with geometric mean MICs between 0.84 and 6.7 mg/l) and a number of treatment failures were noted with these organisms. Various unwanted drug effects (mostly upper gastro-intestinal) were seen, particularly with enoxacin. The best clinical results were observed with ofloxacin, even with once daily dosage, but the results with the other quinolones could only be described as moderate.

Administration, Oral↗

A review on the impact of 4-quinolones on the normal oropharyngeal and intestinal human microflora.

During the last few years the impact of the newer 4-quinolones, ciprofloxacin, enoxacin, norfloxacin, ofloxacin and pefloxacin, on the human microflora has been studied by several investigators. This review article summarizes the published data concerning these studies. The results show that the oropharyngeal flora is affected only slightly or not at all by the 4-quinolones. All the newer 4-quinolones have a similar effect on the normal intestinal flora. The gram-negative aerobic flora is strongly suppressed during administration of 4-quinolones, while the gram-positive flora is only slightly affected. The anaerobic microflora is hardly affected at all. The emergence of resistant bacterial strains is uncommon, although one study shows increased MIC-values for anaerobes during ciprofloxacin administration. Replacement by yeasts or other inherently resistant microorganisms does not often seem to be a problem. High concentrations of the 4-quinolones are reached in faeces, values between 100-2,200 mg/kg being reported. Since the 4-quinolones do not cause marked ecological disturbances in the intestinal microflora, they may be suitable for selective decontamination in immunocompromised patients, for prophylaxis of urinary tract infections and for treatment of bacterial intestinal infections.

Ciprofloxacin↗

In vitro activity, pharmacokinetics, clinical safety and therapeutic efficacy of enoxacin in the treatment of patients with complicated urinary tract infections.

Minimal inhibitory concentrations (MIC) of enoxacin, nalidixic acid, pipemidic acid, norfloxacin, ciprofloxacin, ofloxacin and pefloxacin against isolates from 400 urological in-patients with complicated urinary tract infections (UTI) were determined by means of an agar dilution technique (10(4) cfu, multipointer). 28 patients (21 male, seven female) aged 36 to 84 years with complicated UTI due to sensitive bacteria were treated orally with 200 mg enoxacin b.i.d. for six to 14 days. Plasma and urine samples were collected from 19 patients, at intervals prior to and following a 400 mg dose of enoxacin, and enoxacin concentrations were determined by a high pressure liquid chromatography (HPLC) method. The MICs of enoxacin against all but one of the gram-negative isolates cultured from 265 urological patients were between 0.03 and 4 mg/l. The MICs against 134 gram-positive isolates were between 0.25 and 16 mg/l except for two strains of streptococci. At a concentration of 4 mg/l (8 mg/l), 90.3% (98%) of the total spectrum of isolates were inhibited by enoxacin. Of the quinolones tested, ciprofloxacin appeared to be the most active compound in vitro and cinoxacin the least active antimicrobial agent. The in vivo activity of enoxacin was comparable to that of norfloxacin, ofloxacin and pefloxacin. Oral administration of 400 mg of enoxacin to elderly patients resulted in peak serum concentrations between 0.7 and 6.3 mg/l (mean 3.6 mg/l) attained between 1.0 and 6.0 h following drug ingestion. The mean urinary recovery of parent drug within 24 h was 31.2% of the administered dose. 25 of 28 patients treated orally with enoxacin could be followed-up for five to 14 days after the end of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[In vitro activity of new quinolones against nonfermenters and references to sensitivity tests].

Studies of cross resistance between norfloxacin, ofloxacin, enoxacin and ciprofloxacin using 599 strains of non-fermentative gram-negative rods (297 Pseudomonas spp. and 302 Acinetobacter spp.) resulted in nearly identical minimal inhibitory concentrations of norfloxacin and enoxacin Comparing MIC values, in most ofloxacin was one to four dilution steps superior to enoxacin, and ciprofloxacin was one to four dilution steps superior to ofloxacin. There was not much difference in MICs when species were studied in more detail. In some instances susceptibility testing with more than one new quinolone may be necessary, and evaluation criteria are given.

Acinetobacter↗

The comparative pharmacokinetics and tissue penetration of four quinolones including intravenously administered enoxacin.

The pharmacokinetics and tissue penetration of four quinolones were studied. The compounds were norfloxacin (400 mg p.o.), enoxacin (600 mg p.o. and 400 mg i.v.), ciprofloxacin (100 mg i.v. and 500 mg p.o.) and ofloxacin (600 mg p.o.) given to healthy volunteers. Of the oral agents studied ofloxacin and ciprofloxacin were the most rapidly absorbed (Tmax 1.2 h) and enoxacin the least (Tmax 1.9 h). The serum levels attained were highest in the case of ofloxacin (after allowing for the higher dose administered). The serum half-lives were norfloxacin 3.75 h, ciprofloxacin 3.9 h (p.o.), 4.0 h (i.v.), ofloxacin 7.0 h and enoxacin 6.2 h (p.o.) and 5.1 h (i.v.). All agents penetrated the blister fluid readily. The 24 h urine recovery (as measured by a microbiological assay) was 62% for enoxacin (p.o.), 46.4% following i.v. enoxacin (plus 11.6% oxo-enoxacin, measured by HPLC) 27% for norfloxacin, 30.6% for oral ciprofloxacin, 75.7% for i.v. ciprofloxacin and 73% for ofloxacin.

Adult↗

In vitro activity, pharmacokinetics, clinical safety and therapeutic efficacy of enoxacin in the treatment of patients with complicated urinary tract infections.

Minimal inhibitory concentrations (MIC) of enoxacin, nalidixic acid, pipemidic acid, norfloxacin, ciprofloxacin, ofloxacin and pefloxacin against isolates from 400 urological in-patients with complicated urinary tract infections (UTI) were determined by means of an agar dilution technique (10(4) cfu, multipointer). 28 patients (21 male, seven female) aged 36 to 84 years with complicated UTI due to sensitive bacteria were treated orally with 200 mg enoxacin b.i.d. for six to 14 days. Plasma and urine samples were collected from 19 patients, at intervals prior to and following a 400 mg dose of enoxacin, and enoxacin concentrations were determined by a high pressure liquid chromatography (HPLC) method. The MICs of enoxacin against all but one of the gram-negative isolates cultured from 265 urological patients were between 0.03 and 4 mg/l. The MICs against 134 gram-positive isolates were between 0.25 and 16 mg/l except two strains of streptococci. At a concentration of 4 mg/l (8 mg/l), 90.3% (98%) of the total spectrum of isolates were inhibited by enoxacin. Of the quinolones tested, ciprofloxacin appeared to be the most active compound in vitro and cinoxacin the least active antimicrobial agent. The in vitro activity of enoxacin was comparable to that of norfloxacin, ofloxacin and pefloxacin. Oral administration of 400 mg enoxacin to elderly patients resulted in peak serum concentrations between 0.7 and 6.3 mg/l (mean 3.6 mg/l) attained between 1.0 and 6.0 h following drug ingestion. The mean urinary recovery of parent drug within 24 h was 31.2% of the administered dose. 25 of 28 patients treated orally with enoxacin could be followed-up for five to 14 days after the end of treatment. Enoxacin therapy in these patients resulted in 18 cures, one failure and six relapses (same species). The drug was well tolerated and there was no evidence of renal, hepatic or haematological toxicity. Enoxacin appears to be well suited for the treatment of complicated UTI.

Administration, Oral↗

[Comparative studies of enoxacin and amoxicillin for acute uncomplicated cystitis in women].

120 women suffering from acute uncomplicated bacterial cystitis were treated in an open randomized study either with 1 X 400 mg enoxacin or 1 X 3 g amoxicillin per os. Analysis of midstream urine and bacteriological urine cultures were examined before, two and seven days as well as six weeks after therapy. Treatment with enoxacin resulted in 97.5% (second day), respectively 92.5% (seventh day) bacteriologically sterile urine cultures, whereas the rate of sterile urines following amoxicillin reached only 72.5% (second day), and 65% (seventh day), respectively. Side effects (gastrointestinal, allergic, cardiovascular) were noted in one case in the enoxacin group and in ten cases in the amoxicillin group. The highly active antibiotic derivatives of the 4-quinolone-group (e.g. enoxacin) administered as a single dose achieve high cure rates in carefully selected female patients with acute uncomplicated bacterial cystitis.

Acute Disease↗

Clinical and pharmacokinetic studies on enoxacin in ear, nose and throat infections.

The efficacy and tolerance of enoxacin were tested in 65 patients treated for ear, nose and throat infections with doses of 400 or 600 mg b.i.d. The overall clinical efficacy of enoxacin was excellent in 32, good in 17, fair in six, and poor in five out of 60 evaluable patients. Three female patients complained of stomach pressure and one man of slight nausea, two of allergic skin reactions and one of arthromyalgia. The pharmacokinetic studies showed high enoxacin concentrations in the secretions, pus, and tissues studied, especially in those of the middle ear and the sinuses.

Adult↗

Efficacy of enoxacin in the treatment of bacterial infections of the skin with regards to photosensitization.

Thirty-four patients suffering from various skin infections caused by gram-positive and gram-negative pathogens were treated with enoxacin (400 to 800 mg/day) for 8 to 14 days. A marked abatement of clinical symptoms, accompanied by eradication of the causative pathogens was observed in all 34 patients. Enoxacin was well tolerated. The minimal erythema dose of UVA light was reduced by a mean of 45% in three of the twenty patients receiving the 800 mg daily dosage of enoxacin. No positive reactions could be provoked in a subsequently applied photopatch test, allergic reactions were not observed. These mild reactions seen in a small percentage of patients appear to indicate further specific tests to determine a possible photosensitization effect of enoxacin.

Adult↗