THE METABOLISM OF THE VOLATILE AMINES. IV. THE ROLE OF DRUGS IN THE PATHOGENESIS OF HEPATIC ENCEPHALOPATHY.
The effects of certain drugs on metabolism of ammonia by the liver and kidneys in dogs were investigated by a technique in which both hepatic inflow and outflow bloods could be repeatedly sampled in unanesthetized healthy animals. Specific representatives of the classes of the drugs studied included thiopental (barbiturates), morphine (opiates and analgesics), promazine (tranquillizers), and chlorothiazide (oral diuretics).The three drugs commonly used as sedatives were all found to impair the ability of the liver to metabolize ammonia. The diuretic, by contrast, increased the amount of ammonia put into the systemic system by the kidneys. Ethanol appeared to have little or no direct effect on ammonia metabolism.The possibility exists that the occurrence of acute hepatic encephalopathy in patients with severe liver disease may be avoided in many cases if these drugs are administered with proper care. Results also indicated that current concepts of the pharmacological action of sedatives, opiates and tranquillizers may require revision.
D000588:Amines; D000641:Ammonia; D000818:Animals; D001774:Blood Chemical Analysis; D001927:Brain Diseases; D002740:Chlorothiazide; D004232:Diuretics; D004285:Dogs; D000431:Ethanol; D006501:Hepatic Encephalopathy; D007668:Kidney; D008099:Liver; D008107:Liver Diseases; D008660:Metabolism; D009020:Morphine; D009461:Neurologic Manifestations; D011395:Promazine; D013874:Thiopental; D014116:Toxicology
D000588:Amines; D004232:Diuretics; D000431:Ethanol; D000641:Ammonia; D009020:Morphine; D002740:Chlorothiazide; D013874:Thiopental; D011395:Promazine
ALCOHOL, ETHYL; AMMONIA; BLOOD CHEMICAL ANALYSIS; BRAIN DISEASES; CHLOROTHIAZIDE; DOGS; KIDNEY; LIVER; LIVER DISEASES; METABOLISM; MORPHINE; NEUROLOGIC MANIFESTATIONS; PROMAZINE; THIOPENTAL; TOXICOLOGIC REPORT