Dexamethasone hepatic induction in rats subsequently treated with high dose buprenorphine does not lead to respiratory depression

Toxicol Appl Pharmacol. 2006 Dec 15;217(3):352-62. doi: 10.1016/j.taap.2006.09.011. Epub 2006 Sep 30.

Abstract

In humans, asphyxic deaths and severe poisonings have been attributed to high-dosage buprenorphine, a maintenance therapy for heroin addiction. However, in rats, intravenous buprenorphine at doses up to 90 mg kg(-1) was not associated with significant effects on arterial blood gases. In contrast, norbuprenorphine, the buprenorphine major cytochrome P450 (CYP) 3A-derived metabolite, is a potent respiratory depressant. Thus, our aim was to study the consequences of CYP3A induction on buprenorphine-associated effects on resting ventilation in rats. We investigated the effects on ventilation of 30 mg kg(-1) buprenorphine alone or following cytochrome P450 (CYP) 3A induction with dexamethasone, using whole body plethysmography (N=24) and arterial blood gases (N=12). Randomized animals in 4 groups received sequential intraperitoneal dosing with: (dexamethasone [days 1-3]+buprenorphine [day 4]), (dexamethasone solvent [days 1-3]+buprenorphine [day 4]), (dexamethasone [days 1-3]+buprenorphine solvent [day 4]), or (dexamethasone solvent [days 1-3]+buprenorphine solvent [day 4]). Buprenorphine alone caused a significant rapid and sustained increase in the inspiratory time (P<0.001), without significant effects on the respiratory frequency, the tidal volume, the minute volume, or arterial blood gases. In dexamethasone-pretreated rats, there was no significant alteration in the respiratory parameters, despite CYP3A induction and significant increase of the ratio of plasma norbuprenorphine-to-buprenorphine concentrations. In conclusion, dexamethasone did not modify the effects of 30 mg kg(-1) buprenorphine on rat ventilation. Our results suggest a limited role of drug-mediated CYP3A induction in the occurrence of buprenorphine-attributed respiratory depression in addicts.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Buprenorphine / analogs & derivatives
  • Buprenorphine / blood
  • Buprenorphine / pharmacokinetics
  • Buprenorphine / toxicity*
  • Cytochrome P-450 CYP3A / biosynthesis
  • Dexamethasone / pharmacology*
  • Enzyme Induction
  • Glucocorticoids / pharmacology*
  • Injections, Intraperitoneal
  • Liver / drug effects*
  • Liver / enzymology
  • Male
  • Narcotics / pharmacokinetics
  • Narcotics / toxicity*
  • Pulmonary Ventilation / drug effects
  • Pulmonary Ventilation / physiology
  • Rats
  • Rats, Sprague-Dawley
  • Respiratory Function Tests
  • Respiratory Insufficiency / chemically induced
  • Respiratory Insufficiency / physiopathology
  • Respiratory Insufficiency / prevention & control*

Substances

  • Glucocorticoids
  • Narcotics
  • Buprenorphine
  • norbuprenorphine
  • Dexamethasone
  • Cytochrome P-450 CYP3A