The pharmacokinetics of mezlocillin were examined in rats following bolus intravenous doses of 20 or 200 mg/kg. Mezlocillin exhibited bi-or triexponential disposition profiles, and the area under the concentrationtime curve increased nonproportionally with dose similar to reported findings in humans. Apparent total, renal, and nonrenal clearances and the volume of distribution at steady-state all decreased by 45 to 50% with the higher dose, and the elimination half-life was longer (8 2 versus 15 3 min). Mezlociliin exhibits low saturable binding in rat serum, ranging from 20 to 40% bound. Pharmacokinetic parameters based on free drug demonstrated dose-dependent characteristics similar to those with total drug. Use of the volume of distribution from the low dose allowed calculation of the true mean residence time. The linear relationship between dose and mean residence time from free concentrations yielded pooled Michaelis-Menten parameters. These were used as initial estimates in the simultaneous nonlinear fitting of the low-and high-dose mean free concentrations to a three-compartment model with sequential distribution and Michaelis-Menten elimination to describe the nonlinearity of mezlocillin disposition further.The pharmacokinetics of mezlocillin are dose dependent in healthy volunteers (1) and in subjects with renal dysfunction (12). This phenomenon has generally been attributed to decreased total, renal, and nonrenal clearances with larger doses (1, 12). Concentration-dependent plasma protein binding and smaller central and total volumes of distribution have also been reported with larger doses of mezlocillin (1,12,17).A significant portion of the nonrenal clearance of mezlocillin has been attributed to biliary excretion of unchanged drug (2, 6, 7). Both renal and nonrenal clearances are decreased when the drug is coadministered with probenecid, suggesting that dual active secretion processes exist (19). Saturation of biliary as well as renal excretion mechanisms may occur with mezlocillin (1, 6, 12). However, one study indicated that these excretion pathways were not saturable and that another process may account for mezlocillin nonlinearity (7).This study evaluates the mechanism(s) responsible for the nonlinear disposition of mezlocillin by examining the protein binding and renal and nonrenal excretion in rats following two dose levels of mezlocillin. The utility of moment analysis for providing initial estimates for nonlinear curve fitting is also examined.
MATERIALS AND METHODSStudy design. A cannula was implanted into the jugular veins of eight male Sprague-Dawley rats (350 to 500 g) under light ether anesthesia, and the rats were then placed in a restraining cage. Normal saline was infused at 1 ml/h to keep the cannula patent. Rats were dosed 1 h after waking with 20 or 200 mg of mezlocillin sodium (Miles Pharmaceuticals) per kg. Four rats were used for each group. Blood samples (0.3 ml) were drawn serially at appropriate times (as illustrated in Fig. 2 and 4), and the serum was separated and frozen ...