The antinociceptive effect of Delta9-tetrahydrocannabinol in the arthritic rat

Our study addressed the hypothesis that spinal release of endogenous opioids underlies Delta9-tetrahydrocannabinol (Delta9-THC)-induced antinociception in Freund's adjuvant-induced arthritic and nonarthritic rats. The paw-pressure test was used to assess the antinociceptive effects of Delta9-THC versus those of morphine, and opioid and cannabinoid receptor-selective antagonists were used to characterize the involved receptors. Cerebrospinal fluid was collected after Delta9-THC injection (i.p.) for the measurement of endogenous opioid peptides. Our results indicate that morphine or Delta9-THC is equally potent and efficacious in both nonarthritic and arthritic rats. Delta9-THC-induced antinociception is attenuated by the kappa opioid receptor antagonist, nor-binaltorphimine, in arthritic rats only. Delta9-THC induces increased immunoreactive dynorphin A (idyn A) levels in nonarthritic rats while decreasing idyn A in arthritic rats. We hypothesize that the elevated idyn A level in arthritic rats contributes to hyperalgesia by interaction with N-methyl-D-aspartate receptors, and that Delta9-THC induces antinociception by decreasing idyn A release.     

Synergy between delta9-tetrahydrocannabinol and morphine in the arthritic rat

We have shown in past isobolographic studies that a small amount of Delta(9)-tetrahydrocannabinol (Delta(9)-THC) can enhance morphine antinociception in mice. However, previous studies of the Delta(9)-THC/morphine interaction were performed using normal mice or rats and evaluated acute thermal antinociception. Less is known about cannabinoid and opioid interactions involved in mechanical nociception and in chronic inflammatory pain models, such as Freund's complete adjuvant-induced arthritic model. One fixed-ratio combination was chosen for testing the interaction between Delta(9)-THC and morphine in the Freund's adjuvant-induced arthritic model. This combination represented a 1:1 ratio of the drugs and thus consisted of equieffective doses ranging from 0.1 to 5 mg/kg Delta(9)-THC and from 0.1 to 5 mg/kg morphine. The combination ED(50) value for the fixed ratios (total dose) in relation to the ED(50) value of the drugs alone was determined. The isobolographic analysis indicated a synergistic interaction between Delta(9)-THC and morphine in both the non-arthritic and the arthritic rats. Since Freund's adjuvant-induced alteration in endogenous opioid tone has been previously shown, our data indicate that such changes did not preclude the use of Delta(9)-THC and morphine in combination. As with acute preclinical pain models in which the Delta(9)-THC/morphine combination results in less tolerance development, the implication of the study for chronic pain conditions is discussed.     

Inhibition of naloxone-induced withdrawal in morphine dependent mice by l-trans-Δ9-tetrahydrocannabinol

The effects of various doses of l-trans-Δ⁹-tetrahydrocannabinol (Δ⁹-THC) on naloxone-induced withdrawal were studied in mice rendered dependent on morphine by the pellet implantation procedure. When administered i.p., 30 min prior to naloxone, Δ⁹-THC, inhibited the naloxone-induced withdrawal jumping response. Two other signs of morphine withdrawal (defecation and rearing behavior) were also suppressed by Δ⁹-THC. It is suggested that Δ⁹-THC or some of its derivatives may have potential use in narcotic detoxification.     

Influence of several anesthetic agents on the effects of Δ9-tetrahydrocannabinol on the heart rate and blood pressure of the mongrel dog

Δ⁹-Tetrahydrocannabinol (Δ⁹-THC) 1 mg/kg, i.v. produced a slight but significant reduction in the heart rate of conscious mongrel dogs, and these effects were greatly potentiated by pentobarbital and/or urethane anesthesia. However, significant increase in the heart rate was noted following Δ⁹-THC administration in the dogs anesthetized with a combination of morphine plus chloralose; further, neither morphine nor chloralose alone could reverse the bradycardic effects of Δ⁹-THC. Tachycardia induced by Δ⁹-THC in these dogs could be reversed by bilateral vagotomy or by pretreatment of the animals with methylatropine, or propranolol and/or practolol. The data indicated a complex interaction between Δ⁹-THC and morphine-chloralose combination and the tachycardia induced by Δ⁹-THC under this anesthesia may be due to release of epinephrine by a reflexogenic mechanism involving afferent vagi. Further, while the bradycardic effects of Δ⁹-THC were essentially identical under pentobarbital or urethane anesthesia, the hypotensive effects were similar in urethane or chloralose anesthetized dogs. The study emphasizes that anesthetic interaction should be taken into consideration while investigating mechanisms of actions of pharmacological agents.     

Antipyretic, analgesic and anti-inflammatory effects of delta 9-tetrahydrocannabinol in the rat

The effects on body temperature produced by graded doses of Δ⁹-tetrahydrocannabinol (Δ⁹-THC) and phenylbutazone were compared in both normal and pyretic rats. Dose related hypothermic responses were produced by the oral administration of Δ⁹-THC in normal animals. Moreover, Δ⁹-THC significantly reduced elevated temperatures in yeast-induced pyretic rats to near normal levels at doses which exhibited little hypothermic activity in normal rats. The oral antipyretic potency of Δ⁹-THC was approximately 2 times that of phenylbutazone. The comparative oral antinociceptive activity of Δ⁹-THC and selected narcotic and non-narcotic analgesics was determined by the increase in response latency to pressure applied to normal and yeast-inflamed paws. Δ⁹-THC administered orally was essentially inactive at dose levels below those producing pronounced central nervous system depression. The oral anti-inflammatory efficacy of Δ⁹-THC was compared to phenylbutazone and acetylsalicylic acid. Δ⁹-THC was ineffective in inhibiting carrageenin-induced edema of the rat paw following acute or chronic administration.     

Altered regulation of glutamate release and decreased functional activity and expression of GLT1 and GLAST glutamate transporters in the hippocampus of adolescent rats perinatally exposed to Δ9-THC

The long-term effects of perinatal Δ⁹-tetrahydrocannabinol (Δ⁹-THC) exposure – from gestational day (GD) 15 to postnatal day (PND) 9 – on hippocampal glutamatergic neurotransmission were studied in slices from the 40-day-old offspring of Δ⁹-THC exposed (Δ⁹-THC-rats) and vehicle-exposed (control) dams. Basal and in K+-evoked endogenous hippocampal glutamate outflow were both significantly decreased in Δ⁹-THC-rats. The effect of short Δ⁹-THC exposure (0.1 μM) on K⁺-evoked glutamate release disclosed a loss of the stimulatory effect of Δ⁹-THC on hippocampal glutamate release in Δ⁹-THC-rats, but not in controls. In addition, l-[³H]-glutamate uptake was significantly lower in hippocampal slices from Δ⁹-THC-rats, where a significant decrease in glutamate transporter 1 (GLT1) and glutamate/aspartate transporter (GLAST) protein was also detected. Collectively, these data demonstrate that perinatal exposure to cannabinoids induces long-term impairment in hippocampal glutamatergic neurotransmission that persist into adolescence.     

Pharmacological potency of R- and S-3′-hydroxy-Δ9-tetrahydrocannabinol: additional structural requirement for cannabinoid activity

The pharmacological potency of R- and S-3′-hydroxy-Δ⁹-tetrahydrocannabinol (THC) was compared to that of Δ⁹-THC as well as R/S-3′-OH-Δ⁹-THC. The S-isomer was found to be considerably more potent than the R-isomer in producing hypoactivity in mice, static-ataxia in dogs, and in generalization testing in rats trained to discriminate Δ⁹-THC from vehicle. S-3′-OH-Δ⁹-THC was more active than Δ⁹-THC in these tests which means that Δ⁹-THC may be either activated or inactivated in vivo depending upon which metabolite is formed. The difference in potency of these isomers suggests that the conformation of the side chain is critical for behavioral activity. The R and S isomers were found to be equally active in producing hypothermia in mice which is in contrast to the behavioral effects.     

Reduction in ATP-sensitive potassium channel-mediated antinociception in diabetic mice

To test our hypothesis that the abnormally low efficacy of -opioid agonists in diabetic mice may be due to functional changes in ATP-sensitive potassium channels, we evaluated the effects of cromakalim on the tail-flick latencies in diabetic and non-diabetic mice. Anti nociceptive effects of morphine (10 µg, ICV) in diabetic mice were significantly less than that in non-diabetic mice. Morphine-induced antinociception in non-diabetic mice was antagonized by pretreatment with glibenclamide (30 µg, ICV), an ATP-sensitive potassium channel blocker. Cromakalim (0.3 and 1 µg, ICV) produced significant, dose-dependent antinociception in non-diabetic mice, which was significantly reduced by pretreatment with glibenclamide. However, cromakalim did not markedly affect the tail-flick latencies in diabetic mice, even at higher doses (3 µg, ICV). On the other hand, [D-Pen^2,5]enkephaline (DPDPE, 5 µg, ICV), a selective -opioid receptor agonist, produced significant antinociception in both diabetic and non-diabetic mice. Since pretreatment with glibenclamide significantly reduced the antinociceptive effect of DPDPE in non-diabetic mice but not in diabetic mice, -opioid receptor-mediated antinociception in diabetic mice may be independent of potassium channels. These results suggest that dysfunction of ATP-sensitive potassium channels may contribute to the demonstrated poor antinociceptive response of diabetic mice to -opioid agonists.     

Time course of the enhancement and restoration of the analgesic efficacy of codeine and morphine by delta9-tetrahydrocannabinol

Delta9-tetrahydrocannabinol (delta9-THC) synergizes with morphine and codeine by releasing endogenous opioids. These studies determined 1) the duration of enhancement of morphine and codeine by delta9-THC, 2) the effect of (delta9-THC on the time course of fully efficacious doses of the opioids, 3) restoration of efficacy of morphine and codeine by delta9-THC, and 4) duration of restoration. Sub-active combination doses of delta9-THC/morphine or delta9-THC/codeine are equivalent in duration of action and efficacy to high-dose opioids alone. Delta9-THC (20 mg/kg p.o.) significantly restores the antinociceptive effects of both high-dose morphine and codeine (100 and 200 mg/kg p.o., respectively) at later time points at which morphine or codeine was no longer active (360- and 120-min post-administration, respectively). Thus, the cannabinoid/opioid combination might be useful in therapeutics to enhance opioid activity, as well as to restore the efficacy of opioids.     

Exposure to a high-fat diet decreases sensitivity to Δ9-tetrahydrocannabinol-induced motor effects in female rats

Arachidonic acid, a fatty acid component of neuronal cell membranes, forms the backbone of endogenous ligands of the endocannabinoid system. The lipid nature of this system may make it particularly susceptible to changes in fat content of the diet, which may, in turn, affect endocannabinoid tone and subsequent changes in receptor expression or activity. The latter would also be expected to affect responses to exogenous cannabinoids. The purpose of the present study was to determine the effects of a high-fat diet on sensitivity to the pharmacological effects of Δ⁹-tetrahydrocannabinol (Δ⁹-THC). Male and female Long-Evans rats were fed either a diet of standard rodent chow or chow enhanced with corn oil. Subsequently, they were repeatedly assessed for Δ⁹-THC-induced hypomobility, catalepsy and hypothermia. Female rats that received the high-fat diet beginning in adolescence or in adulthood became significantly less sensitive to the effects of Δ⁹-THC on motor behavior, but not its hypothermic effects, with faster development of decreased sensitivity in female rats that began the high-fat diet as adults. In contrast, diet-induced differences either did not occur, or were less pronounced, in male rats of both ages. After acute injection, brain and blood levels of Δ⁹-THC and its two primary metabolites were similar regardless of diet. Combined with the fact that diet differentially affected only some of the measures, these results suggest that pharmacokinetic differences cannot fully account for the effects of the high-fat diet on response to Δ⁹-THC. Further, these results suggest that dietary fat content may represent an important consideration in predicting the effects of marijuana in females.     

精氨酸及精氨酸脱羧酶抗体对痛阈及吗啡镇痛作用的影响(英文)

目的进一步阐明胍丁胺对阿片药理作用的影响。方法采用小鼠醋酸扭体法、小鼠热辐射甩尾法、小鼠热板法评价了精氨酸及精氨酸脱羧酶抗体对痛阈、吗啡镇痛及其耐受作用的影响。结果在小鼠醋酸扭体实验中,脑室注射精氨酸能剂量依赖性地抑制小鼠扭体次数,最大抑制率达84 %。在小鼠热辐射甩尾模型中,精氨酸不影响小鼠的甩尾时间,但能剂量依赖性地增强吗啡的镇痛作用,使吗啡2 .5 mg·kg-1的最大可能镇痛百分率从23 %增加到71 %。此外,在小鼠热辐射甩尾实验中,精氨酸能抑制吗啡100 mg·kg-1所诱导的急性耐受。精氨酸上述作用可被咪唑啉受体拮抗剂咪唑克生(3mg·kg-1,ip)所抑制。在小鼠热辐射甩尾实验和小鼠55℃热板实验中,精氨酸脱羧酶抗体能抑制吗啡镇痛,并能加重吗啡所致的耐受。结论上述结果提示,精氨酸及精氨酸脱羧酶在痛阈、吗啡镇痛及吗啡依赖形成过程中具有重要作用。     

No evidence for a protracted change in endogenous opioid activity following chronic opiate treatment in mice: parallel recovery of cross tolerance to stress and morphine antinociception

The involvement of central endogenous opioids in swim-induced antinociception in mice is well documented. The response is attenuated by central or systemic naloxone, displays two-way cross tolerance with morphine and is correlated with apparent occupation of central opiate receptors by endogenous ligands. Swim-induced antinociception was utilised as an in vivo model of endogenous opioid function to investigate a possible protracted functional change in endogenous opioid release or inactivation following chronic opiate treatment. Antinociceptive responses (tailflick latency) to morphine (4.4 mg/kg, SC) and swimming were determined at various times following chronic methadone (24 days treatment, 102 mg/kg day in drinking water for the last 20 days) and chronic morphine (1 g/kg sustained release) treatment. In both experiments, parallel recovery from cross tolerance was observed for morphine-and swim-induced antinociception. These results were consistent with the view that no protracted functional change in the release or inactivation of endogenous opioids had occurred following chronic opiate treatment.     

The role of nitric oxide in diabetes-induced changes of morphine tolerance in rats

Several neuroendocrine complications including diabetes change the morphine antinociception and the development of tolerance to the drug. Morphine antinociception was reduced significantly in morphine tolerant diabetic rats compared to the non-diabetic animals. The exact mechanism of this effect is not known. This study was performed to determine the role of nitric oxide (NO) on morphine tolerance in diabetic state. Nociceptive responses in alloxan-induced diabetic morphine tolerated rats were measured by the hot-plate test. The urinary nitric oxide level was measured spectrophotometrically with Griess reagent. For the conversion of nitrate to nitrite, vanadium chloride was used. The results showed that experimental diabetes increased morphine analgesia. Conversely, degree of tolerance to morphine was diminished in diabetic state. The urinary nitrite content in diabetic morphine tolerated rats was higher than non-diabetic groups. L-arginine significantly increased the NO production in diabetic morphine tolerated animals, whereas aminoguanidine decreased it. Appropriately, L-arginine increased the latency time of reaction to noxious stimuli in diabetic compared to non-diabetic rats. L-arginine-treated animals also showed more tolerance to morphine analgesia. As expected, aminoguanidine deducted the level of morphine tolerance in diabetic animals. It is suggested that NO has a modulatory role in the effects of diabetes on morphine analgesia and tolerance.     

The effect of Δ-tetrahydrocannabinol on the uptake and release of C-dopamine from crude striatal synaptosomal preparations

Δ⁹-Tetrahydrocannabinol (Δ⁹-THC) and a water soluble ester derivative (compound I) caused a concentration-related decrease in the uptake of ¹⁴C-dopamine into crude synaptosomal preparations derived from mouse striata. Both were less potent than amphetamine in this preparation. In the presence of 10^?7m amphetamine the IC₅₀ of Δ⁹-THC was unaffected. The IC₅₀ is the concentration of drug in the medium which will inhibit the uptake of ¹⁴C-dopamine into the synaptosomes by 50%. However in the presence of 3.0 × 10^?6m Δ⁹-THC, the dose response curve to amphetamine was shifted to the right and the IC₅₀ of amphetamine was increased. Δ⁹-Tetrahydrocannabinol and compound I increased the release of ¹⁴C-dopamine from preparations pre-incubated with ¹⁴C-dopamine. The effect was small but significant. The effects of amphetamine and Δ⁹THC combined were additive on this system. The mode of action of Δ⁹-THC with regard to the dopaminergic system of the striatum is discussed.     

Chronic ?-tetrahydrocannabinol during adolescence increases sensitivity to subsequent cannabinoid effects in delayed nonmatch-to-position in rats

Early-onset marijuana use has been associated with short- and long-term deficits in cognitive processing. In human users, self-selection bias prevents determination of the extent to which these effects result only from drug use. This study examined the long-term effects of Δ⁹-tetrahydrocannabinol (Δ⁹-THC), the major psychoactive constituent of marijuana, in a delayed nonmatch-to-position task (DNMP). Male Long-Evans rats were injected daily with 10 mg/kg Δ⁹-THC during or after adolescence [postnatal days (PN) 21-50 or PN50-79, respectively] or with vehicle. On PN91, training in DNMP was initiated. Successful acquisition and pharmacological challenge began on approximately PN300. Decreases in accuracy were observed at lower doses of Δ⁹-THC in Δ⁹-THC-treated rats (versus vehicle-treated rats). Administration of chronic Δ⁹-THC at a younger age tended to enhance this effect. While anandamide did not decrease accuracy in any group, rats treated with Δ⁹-THC during adolescence initiated fewer trials at the 30 mg/kg dose of anandamide than did rats in the other two groups. To the extent tested, these differences were pharmacologically selective for cannabinoids, as scopolamine (positive control) decreased accuracy at the same dose in all groups and amphetamine (negative control) did not affect accuracy in any of the groups at doses that did not impair overall responding. These results suggest that repeated administration of a modest dose of Δ⁹-THC during adolescence (PN21-50) or shortly thereafter (PN50-79) produces a long-term increase in latent sensitivity to cannabinoid-induced impairment of performance in a complex operant task.     

THE EFFECT OF δ9-TETRAHYDROCANNABINOL (δ9-THC) ON THE TURNOVER RATE OF BRAIN SEROTONIN OF THE RAT

1. One isotopic and three non-isotopic methods were used to determine the effect of an acute intravenous dose of Δ⁹-tetrahydrocannabinol (Δ⁹-THC, 2 mg/kg) on the rat brain turnover rate of serotonin. 2. In control animals the turnover rate of serotonin was about 2 nmol/g per h. This rate was not altered by Δ⁹-THC when it was calculated from the rise of 5-hydroxyindoleacetic acid following probenecid or from the rise of serotonin following pargyline. 3. Δ⁹-THC did not alter the serotonin turnover rate when it was calculated from the conversion of ³H-tryptophan to ³H-serotonin. 4. The serotonin turnover rate was significantly increased by Δ⁹-THC when the rate was calculated from the decline of 5-hydroxyindoleacetic acid following pargyline. 5. These results suggest that Δ⁹-THC does not alter the turnover of rat brain serotonin. The previously reported Δ⁹-THC-induced changes in body temperature and increased brain levels of 5-hydroxyindoleacetic acid may be mediated by some other mechanism such as interference by Δ⁹-THC of the vesicular binding of serotonin.     

GABAergic mediation in the inhibition of hippocampal acetylcholine turnover rate elicited by delta 9-tetrahydrocannabinol.

Both intravenous Δ⁹-tetrahydrocannabinol (Δ⁹-THC) and intraseptal muscimol reduce the turnover rate of acetylcholine (TR_ACh) in the hippocampus by 50 and 58%, respectively, without affecting the hippocampal content of ACh. The ACh content and the TR_ACh, in other areas of rat brain examined are unchanged. Bicuculline fails to alter the hippocampal TR_ACh when administered intraseptally but prevents the decreased hippocampal TR_ACh induced by Δ⁹-THC or muscimol. The effect is specific to the septal-hippocampal cholinergic pathway since lesioning the fimbria (2 hr) abolishes the effect. Moreover, neither naltrexone nor destruction of septal dopaminergic nerve terminals with 6-hydroxy-dopamine injected into area A₁₀ prevents the decreased TR_ACh after Δ⁹-THC. This suggests that neither endophinergic nor dopaminergic neurons are involved in the reduction of the TR_ACh in the hippocampas following administration of Δ⁹-THC or muscimol. When the metabolism of γ-aminobutyric acid (TR_GABA) is measured, Δ⁹-THC produces a 2-fold increase in the TR_GABA which is specific for the septum. These results suggest that Δ⁹-THC inhibits TR_ACh in the cholinergic septal-hippocampal pathway by increasing the release of GABA from septal GABAergic interneurons.     

Contribution of the metabolite 7-hydroxy-Δ1-tetrahydrocannabinol towards the pharmacological activity of Δ1tetrahydrocannabinol in mice

Tritium-labelled 7-hydroxy-Δ¹-tetrahydrocannabinol (³H-7-hydroxy-Δ¹-THC, specific activity 571 Ci/mmole) was prepared from ³H-Δ¹-THC by oxidation with a rat liver microsome preparation. Brain levels of 7-hydroxy-Δ¹-THC and Δ¹-THC in mice were measured 20 min after intravenous injection of either Δ¹-THC (2.0, 1.0 and 0.5 mg/kg) or 7-hydroxy-Δ¹-THC (1.0, 0.5 and 0.25 mg/kg) and correlated with the inhibition of spontaneous motor activity. A theoretical dose-response relationship for Δ¹-THC in the absence of the metabolite was derived on the assumption of additivity of the behavioural effects due to Δ¹THC and 7-hydroxy-Δ¹-THC present together in the mouse brain. The theoretical dose-response line for Δ¹THC and that obtained experimentally for 7-hydroxy-Δ¹-THC were parallel; on the basis of brain concentrations, 7-hydroxy-Δ¹-THC was found to be more potent than Δ¹-THC in producing behavioural changes and the calculated equipotent molar ratio was 7.1. The ratio of the concentrations of Δ¹THC and 7-hydroxy-Δ¹-THC in the mouse brain 20 min after intravenous injection of Δ¹-THC was 5.3 and the contribution of the metabolite to the overall behavioural effect was calculated as 55–63 per cent. Although metabolites of 7-hydroxyΔ¹-THC accounted for only about 10 per cent of the radioactivity present in the mouse brain 20 min after intravenous injection of ³H-7-hydroxy-Δ¹-THC, about 50 per cent of the radioactivity in the blood was present as a chromatographically more mobile material which has not yet been identified.     

THE EFFECTS OF ADRENALECTOMY ON THE CARDIOVASCULAR RESPONSES TO A'-TETRAHYDROCANNABINOL IN RATS

1. In urethane anaesthetized sham-operated rats, intravenous administration of Δ¹-THC (1 mg/kg) caused an immediate and prolonged fall in blood pressure, with a concomitant reduction in pulse rate. 2. In rats which had been adrenalectomized 24 h previously, Δ¹-THC (1 mg/kg, i.v.) also caused a depressor response, but it was significantly shorter in duration than that observed in sham-operated animals. The durations of the cardiac slowing effect were similar in both groups of rats. 3. Hydrocortisone pretreatment (25 μg/kg> i-v), given 45 min before Δ¹-THC, restored the duration of the depressor response to Δ¹-THC in adrenalectomized rats, but it did not have any effect on the bradycardia induced by Δ-THC. 4. Hydrocortisone did not produce any significant effect on the hypotensive action of Δ¹-THC in sham-operated rats, but the cardiac slowing effect was markedly potentiated. 5. These results suggest a lack of correlation between the hypotensive and cardiac slowing actions of the drug and that a certein level of adrenal steroids is necessary for the maintenance of the depressor response to Δ¹-THC.     

Cannabidiol and delta 9-tetrahydrocannabinol metabolism. In vitro comparison of mouse and rat liver crude microsome preparations.

The in vitro biotransformations of cannabidiol (CBD) and Δ⁹-tetrahydrocannabinol (Δ-THC) by hepatic microsomal preparations from mouse and rat were compared and it was found that both cannabinoids are metabolized approximately two to three times faster by a mouse preparation than by a similar preparation from the rat. In both species, however, CBD was metabolized more slowly than Δ⁹-THC. The metabolite patterns resulting from the biotransformations of radioactive CBD and Δ⁹-THC were examined by thin-layer chromatography and were found to be qualitatively identical in both the mouse and rat. In contrast, studies of the rate of cannabinoid metabolism in the presence of excess substrate revealed that CBD metabolism was only linear for about 10 min, whereas Δ⁹-THC metabolism was linear for about 60 min. This difference was noted in both species. The evidence suggests that CBD metabolism is inhibited by its own metabolites. Furthermore, the results of other experiments indicate that CBD metabolites can also inhibit Δ⁹-THC and aminopyrine metabolism. The established ability of CBD to inhibit hepatic microsomal drug metabolism in vivo may also be the consequence of the formation of inhibitory metabolites.