Phenytoin was observed to inhibit competitively the sodium dependent high affinity synaptosomal transport of both glutamate (Glu) and gamma-aminobutyric acid (GABA) with Ki values of 66 +/- 10 and 185 +/- 65 microM, respectively. This contrasted with a previous report that the uptakes of Glu and GABA were enhanced by phenytoin. The degree of inhibition is dependent on the concentrations of the competing drug and substrate present. Taking the therapeutic levels of phenytoin and the overall brain Glu and GABA contents, the degrees of inhibition obtainable appear to be negligible. However, as most of the high levels of Glu and GABA in the brain are intracellular, Glu, and GABA concentrations in the microenvironment of the uptake sites may be sufficiently small so that the ability of phenytoin to inhibit Glu and GABA transport may contribute significantly to the anticonvulsant property of this drug.
[3H]Phenytoin binding to rat cortical membrane was significantly enhanced in the presence of diazepam. This binding is saturable, reversible and displacable by unlabelled phenytoin. Analyses of the binding data either by the Scatchard plot or by the displacement curve revealed a high and a low affinity sites with Kd values of 32 +/- 5 nM and 8.5 +/- 1.1 microM, respectively. Similar enhancement of [3H]phenytoin binding was observed when diazepam was replaced by Ro 5-4864 (4'-chlorodiazepam) which is selective for the 'peripheral' type benzodiazepine binding sites. In contrast, neither the 'central' type receptor selective agonist clonazepam nor the antagonist Ro 15-1788 enhanced [3H]phenytoin binding. Therefore, it seems that these phenytoin binding sites in rat cerebral cortex are associated with a benzodiazepine site similar to the 'peripheral' type binding site for its selective affinity for Ro 5-4864. However, judging from the micromolar concentrations required for the enhancement of [3H]phenytoin binding, they appear unlikely to be the same 'peripheral' type binding sites as measured by [3H]Ro 5-4864 binding (Kd approx. 1 nM). The micromolar affinity benzodiazepine recognition sites are a possibility, if they indeed exist.
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