PHARMACOLOGY AND TOXICITY OF INTRA-CAROTID ADRIAMYCIN ADMINISTRATION FOLLOWING OSMOTIC BLOOD-BRAIN-BARRIER MODIFICATION

  • 1 January 1981
    • journal article
    • research article
    • Vol. 41  (11) , 4466-4470
Abstract
The effect of reversible blood-brain barrier modification on the delivery of [the antineoplastic drug] adriamycin to the brain was studied in a rodent and canine model. Pharmacokinetic and physiological studies were done in these animals after a wide range of doses of adriamycin (0.1-1.0 mg/kg) were administered into the carotid artery following osmotic barrier modification with mannitol. In the absence of barrier modification, no immunoreactive adriamycin was detected in the cerebrum; following barrier modification, up to 4.5 .mu.g of drug and/or metabolites per g of brain were found. Optimum tissue levels of adriamycin and metabolites were achieved following barrier modification when the drug was administered by bolus or slow continuous (15-min) infusion. Immunoreactive drug was identified in brain for up to 6 h after administration. Significant functional neurotoxicity occurred at all dose levels, even at 0.1 mg/kg, a level at which adriamycin concentration in the brain was below the level of detectability. Neuropathological examination revealed the presence of necrosis and hemorrhagic infarcts. Thus, these pharmacological and toxicity studies suggest that adriamycin (or its metabolites) may produce significant clinical neurotoxicity when even small amounts penetrate the blood-brain barrier.