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At least 19 recordsLinked to original sources

PubMed1991

A case of acetohexamide-induced hypoglycemia: the influence of hypothyroidism on the metabolism of acetohexamide.

Prolonged hypoglycemia induced by acetohexamide (AH) in a patient with noninsulin dependent diabetes mellitus accompanied by primary hypothyroidism was presented. A 74-year-old man who had been treated with AH (500mg, daily) for diabetes mellitus since 1973 was admitted to our hospital in Oct. 1988 because of hypoglycemic coma. On admission, the level of blood glucose was 20mg/dl. Continuous intravenous administration of 10 per cent glucose solution led to improvement in the mental state on the second day. However, the level of blood glucose remained between 30 to 45mg/dl for four days after admission. On the fifth day, a fasting blood glucose level finally reached 75mg/dl. In a thyroid function test, the serum levels of thyroid hormone showed the following decreases: T3 68ng/dl, T4 2.8 micrograms/dl, free T4 0.3ng/dl, while basal TSH levels increased to 50.3 microU/ml. Since anti-thyroid microsomal antibody was positive and thyroid 99mTc-pertechnetate uptake was slightly elevated, the hypothyroidism in this patient was considered to be caused by chronic thyroiditis. Urinalysis was positive for protein. In a renal function test, the blood urea nitrogen was 26.7mg/dl and creatinine 1.7mg/dl, and creatinine clearance decreased to 22ml/min. After thyroid function returned to euthyroid, creatinine clearance improved (41 ml/min). To clarify the relationship between hypothyroidism and the metabolism of AH, the serum levels of AH and its metabolite hydroxyhexamide (HH) following oral administration of AH (500mg) were evaluated before and after thyroxine replacement therapy. The blood glucose level before therapy was lower than that after therapy, and hypoglycemic symptoms were observed early in the second and third morning after AH administration.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetohexamide↗

PubMed1988

Metabolic reduction of acetohexamide in rat kidney: sex difference and effect of streptozotocin-induced diabetes.

The acetohexamide reductase activity in 10000 x g supernatant fluids of kidney homogenates was significantly higher in male than in female rats. Although difference in activity of acetohexamide reductase in the cytosol between the sexes was not observed, the activity in the microsomes was considerably higher in male than in female rats. These findings indicate that the microsomal enzyme plays an important role in the sex difference of acetohexamide reduction by 10000 x g supernatant fluids of kidney homogenates. The sensitivities to inhibitors of microsomal acetohexamide reductase were different from those of cytosolic acetohexamide reductase. Furthermore, streptozotocin-induced diabetes significantly decreased acetohexamide reductase activity only in the kidney microsomes of male rats, resulting in the abolishment of the sex difference of acetohexamide reduction by 10000 x g supernatant fluids of kidney homogenates.

Acetohexamide↗

PubMed1989

In vivo and in vitro binding of (-)-hydroxyhexamide, a major metabolite of acetohexamide, to rabbit serum.

The in vivo and in vitro bindings of (-)-hydroxyhexamide, a major metabolite of acetohexamide, to rabbit serum were examined by using an ultrafiltration method. The in vivo serum protein binding of (-)-hydroxyhexamide was much lower than the in vitro serum protein binding. The in vitro serum protein binding of (-)-hydroxyhexamide was strongly displaced by the addition of acetohexamide. Furthermore, the in vitro serum protein binding of (-)-hydroxyhexamide in the presence of acetohexamide and (-)-hydroxyhexamide at the same concentrations as those found 1.0 h after acetohexamide administration was approximately similar to the in vivo serum protein binding of (-)-hydroxyhexamide. These results lead us to conclude that acetohexamide, the parent drug of (-)-hydroxyhexamide, plays an important role in the in vivo serum protein binding of (-)-hydroxyhexamide.

Acetohexamide↗

PubMed1977

Acetohexamide hypoglycemia: treatment by peritoneal dialysis.

Acetohexamide hypoglycemia in a patient with renal failure has been successfully treated by peritoneal dialysis. Peritoneal dialysis was done in such a patient, and specimens of serum were collected to measure levels of acetohexamide and its main active metabolite, hydroxyhexamide. During dialysis, hypoglycemia was corrected. After 17 1/2 hours of dialysis, serum acetohexamide level was essentially unchanged. Serum hydroxyhexamide level had decreased at a slower rate than the rate of decrease previously measured in a uremic patient not on dialysis. Although peritoneal dialysis may correct the hypoglycemia, the data suggest that acetohexamide and hydroxyhexamide are not dialyzable. Due to these problems this drug should not be used in patients with chronic renal failure. The drug of choice to control hyperglycemia in patients with renal insufficiency is insulin. If for any reason insulin cannot be used, tolbutamide is the oral hypoglycemic agent of choice.

Acetohexamide↗

PubMed1991

Postnatal development of acetohexamide reductase activities in microsomes and cytosol of rat liver.

The postnatal development of acetohexamide reductase activities in liver microsomes and cytosol were examined in male rats. The developmental pattern of acetohexamide reductase activity in liver microsomes was distinguished from that in liver cytosol. Furthermore, acetohexamide reductase activity in liver microsomes was effectively suppressed by castration, but the activity in liver cytosol was not affected by castration. These results clearly indicate that enzymes with physiologically different roles can catalyze the metabolic reduction of acetohexamide in rat liver.

Age Factors↗

PubMed1990

Drug-metal interactions: copper(II) complex of the antidiabetic drug acetohexamide and pyridine.

The preparation, spectral properties, and crystal structure of a copper(II) complex of 4-acetyl-N-[(cyclohexylamino)carbonyl]benzenesulfonamide, which is known as acetohexamide, and pyridine are reported. The complex Cu(AH)2(py)2, where AH = acetohexamide and py = pyridine, was prepared and characterized by X-ray and ESR. The complex is monoclinic, space group P2(1)/a, with a = 17.412(6), b = 9.039(2), c = 26.531(10) A, beta = 102.24(2) degrees, and Z = 4. The final refinement used 3892 unique reflections and gave an R value of 0.0646. The copper atom is surrounded by four nitrogen atoms in a square-planar arrangement, two from the acetohexamide ligands (Cu-N = 2.009 A) and two from the pyridine molecules (Cu-N = 2.016 A) in a trans geometry. The ESR data support a similar coordination behavior of the copper (g parallel greater than g perpendicular greater than ge) with the unpaired electron in the dx2-y2 orbital.

Acetohexamide↗

PubMed1989

Influence of streptozocin-induced diabetes on reductive metabolism of acetohexamide in rat liver.

Streptozocin-induced diabetes significantly decreased acetohexamide reductase activity of 10,000 g supernatant of liver homogenates from both male and female rats. However, the decrease in activity from female rats was smaller than that from male rats, thereby eliminating the sex difference in the activity of the 10,000 g supernatant. In male rats, the diabetes markedly decreased acetohexamide reductase activity only in the microsomal fraction of liver homogenate, whereas in female rats, it decreased the activity only in the cytosolic fraction. These results indicate that the mechanism for the decreasing effect of the diabetes on reductive metabolism of acetohexamide in 10,000 g supernatant differs between male and female rats.

Acetohexamide↗

PubMed1989

Stereoselective reduction of acetohexamide in cytosol of rabbit liver.

The stereoselective reduction of acetohexamide, an oral antidiabetic drug, was studied by using the cytosol of rabbit liver. A major metabolite of acetohexamide was isolated in 41.5% yield from the enzyme reaction mixture, and identified as (-)-hydroxyhexamide by techniques including the melting point, thin-layer chromatography, infrared spectrometry and optical rotation. The enantiomeric purity of (-)-hydroxyhexamide was determined on the basis of the proton nuclear magnetic resonance (400 MHz) spectrum of ester (diasteromer) derived by the reaction of (-)-hydroxyhexamide with (R)-(+)-alpha-methoxy-alpha-trifluoromethylphenylacetyl chloride. The (-)-hydroxyhexamide isolated from the enzyme reaction mixture was almost 100% in that enantiomeric form. The metabolic reduction of acetohexamide in the cytosol of rabbit liver appeared to be catalyzed by some enzymes with the same stereoselectivity.

Acetohexamide↗

PubMed1986

Reduction of acetohexamide by rabbit heart cytosol.

The acetohexamide reducing activity of cytosol of rabbit heart was compared with that of rabbit liver or kidney. The heart exhibited an approximately 2-fold higher activity than either the liver or kidney. Both aldehyde and ketone reductases may contribute to the reduction of acetohexamide by cytosol of rabbit heart. It is noteworthy that the heart is an important organ reducing acetohexamide.

Acetohexamide↗

PubMed1989

Further studies on reductive metabolism of acetohexamide in heart.

Species and sex differences of acetohexamide reductase activity were investigated using the cytosolic fraction of heart homogenate. The activity in the rabbit was considerably higher than that in the other species (guinea pig, hamster, rat and mouse). No sex difference of the activity was observed in any of the species tested. Ketone-containing drugs (daunorubicin, befunolol and levobunolol) other than acetohexamide were little reduced in the cytosol of rabbit heart. Some aldehyde reductase inhibitors (phenobarbital, valproate and chlorothiazide) were found to decrease the acetohexamide reductase activity in the cytosol of rabbit heart.

Acetohexamide↗

PubMed1977

Peritoneal dialysis in the treatment of acetohexamide-induced hypoglycemia.

Severe hypoglycemia in a 67-year-old black male as a result of the ingestion of acetohexamide is described. Because of both his renal status as well as the severity of the hypoglycemia, the patient received peritoneal dialysis. Sequential specimens of serum, urine and dialysate were collected to measure the levels of acetohexamide and its main active metabolite, hydroxyhexamide. The data indicate that these compounds are not dialyzable. In patients with reduced renal function, peritoneal dialysis may be one way to administer large amounts of glucose with very little administration of fluid in the treatment of acetohexamide-induced hypoglycemia. For those azotemic patients whose hypoglycemia is difficult to manage, intensive dialysis might be a means to correct the abnormality of glucose metabolism imposed by uremia.

Acetohexamide↗

PubMed1977

Inadvertent substitution of acetohexamide for acetozolamide.

In three cases acetohexamide (Dymelor), an oral hypoglycemic agent, was mistakenly given to patients instead of acetazolamide (Diamox), which had been prescribed for their glaucoma. A number of similarities, including the fact that both medications are 250-mg white tablets, with similar generic and brand names which are generically repackaged medications juxtaposed on the pharmacist's shelf, predispose to the inadvertent substitution of one medication for the other. In one instance a systemic hypoglycemic reaction resulting in head trauma and confusion ended in an emegency hospital admission following the substitution of acetohexamide for acetazolamide.

Acetohexamide↗

PubMed1989

An infrared study of tautomerism in acetohexamide polymorphs.

Infrared data determined for known polymorphic forms and some new derivatives of acetohexamide and related compounds support the view that acetohexamide polymorphs exhibit keto-enol tautomerism. They indicate that type A polymorphs exist in the enol form, probably stabilized by intramolecular bonding between an O-H and S = O group to form a six-membered ring. Type B polymorphs exist in the keto form with the urea carbonyl group intermolecularly bonded to a sulphonamide N-H. The new evidence disputes previous interpretations of the data.

Acetohexamide↗

PubMed1987

Sex difference of acetohexamide reduction in rat liver.

The acetohexamide reducing activity in hepatic 10,000 X g supernatant was significantly higher in male than in female rats. Evidence obtained in this study suggests that the microsomal carbonyl reductase may contribute to the sex difference in the reductive metabolism of acetohexamide in rats.

Acetohexamide↗

PubMed1992

Factors affecting acetohexamide reductase activities in microsomes and cytosol from the kidney of male rats: age and castration.

Acetohexamide reductase activity in microsomes from the kidney of male rats increased markedly at puberty to approach the maximum level at 8 weeks of age; it was not detected until 4 weeks of age. Furthermore, castration suppressed effectively the activity in kidney microsomes at 8 weeks of age. These findings clearly indicate that the activity in kidney microsomes can be regulated by androgens. On the other hand, in cytosol from the kidney of male rats, a higher acetohexamide reductase activity was observed at all weeks of age tested. Castration had no significant effect on the activity in kidney cytosol.

Aging↗

PubMed1977

GLC determination of acetohexamide and hydroxyhexamide in biological fluids.

A sensitive and specific GLC assay was developed for acetohexamide and hydroxyhexamide, its major metabolite, in plasma and urine. The assay uses tolbutamide as a mass internal standard. Compounds are extracted from acidified plasma or urine with toluene, converted to methylated derivatives with dimethyl sulfate, and measured by GLC using a flame-ionization detector. With GLC-mass spectrometry, the compounds measured are the N-methylsulfonamides resulting from GLC pyrolysis. Plasma and urine data are presented from a bioavailability study to demonstrate the utility of this method.

Acetohexamide↗

PubMed1989

Reversible cholestatic hepatitis caused by acetohexamide.

We report a case of cholestatic hepatitis accompanied by peripheral and hepatic eosinophilia in a patient taking acetohexamide for a period of 1.5 yr. Jaundice developed acutely and was accompanied by fever. After discontinuation of the drug, there was no evidence of further damage, with prompt normalization of liver enzymes, bilirubin, and eosinophil count.

Acetohexamide↗

PubMed1990

Mechanism of pharmacodynamic and pharmacokinetic interactions between acetohexamide and phenylbutazone in rabbits.

The interaction of acetohexamide (AH) with phenylbutazone (PBZ) was investigated in rabbits. Orally administered PBZ caused a potentiation of hypoglycaemic action after oral administration of AH. This can be explained by the fact that the co-administration of PBZ significantly increased both the serum concentrations of AH and its pharmacologically active metabolite. (-)-hydroxyhexamide [(-)-HH], after AH administration. The co-administration of PBZ decreased the renal clearance (Clr) and non-renal clearance (Clnr) of AH. PBZ inhibited the in vitro reduction of AH to (-)-HH and decreased the accumulation of (-)-HH by the kidney cortical slices. These results indicate that the mechanism of in vivo interaction of AH with PBZ is complicated.

Acetohexamide↗