Altered pharmacokinetic-pharmacodynamic relationship of heptabarbital in experimental renal failure in rats

The purpose of this investigation was to determine whether renal dysfunction is associated with an alteration in the concentration-anesthetic effect relationship of heptabarbital (HB). Adult female rats were pretreated with uranyl nitrate (5 mg/kg i.v.) to produce renal dysfunction. Saline-injected rats served as controls. The concentration-effect relationship of HB was determined both at onset of loss of righting reflex (LRR) during an i.v. infusion (0.563 mg/min) and at offset of LRR after administration of a bolus dose (82 and 111 mg/kg in renal failure and controls, respectively, inducing similar durations of effect). In renal failure HB concentrations in serum (total and free) and in brain and cerebrospinal fluid (CSF) both at onset and offset of LRR were reduced significantly. When HB was infused at different rates (0.225, 0.563 and 1.50 mg/min) rats with renal impairment had slightly increasing HB concentrations at onset of LRR with increasing infusion rate, not only in serum and brain but also in CSF. When HB was administered in different bolus doses (71, 77, 80 and 96 mg/kg i.v.) the duration of effect increased linearly with the logarithm of the dose, but HB concentrations in serum (both total and free), brain and CSF at offset of LRR were similar, indicating the absence of (inter)active metabolites. The results indicate that renal dysfunction is associated with an increased sensitivity of the brain to HB, which is unrelated to changes in the disposition of HB.