Excretion of Sulfanilylguanidine in Material Drained from Human Biliary Tract

Abstract

Recently a new sulfonamide drug, sulfanilylguanidine, has been developed and studied by Marshall and various other workers. 1 Although the solubility of this drug is not markedly different from that of various related compounds, it appears to be absorbed rather slowly from the gastro-intestinal tract. Because in recent studies of the excretion of various dyes by the liver it has been found that marked differences in excretion occur which cannot at present be correlated in a satisfactory manner with either solubility or diffusibility of the dyes, 2 it seemed possible that the apparent failure of absorption of sulfanilylguanidine might be really due to a removal of the drug from the blood stream by the liver, and a return of the material to the gastro-intestinal tract in the bile flowing through the biliary ducts. At about the time when a supply of sulfanilylguanidine became available for experimental purposes 2 patients were operated on for lesions of the biliary tract, and T tubes inserted into the ducts to provide post-operative drainage. It was decided to study the excretion of sulfanilylguanidine through the bile ducts of these patients. Two grams of sulfanilylguanidine were therefore given to each, and its concentration in the blood, urine and bile determined. The methods previously described 3 were found to be quantitatively applicable to the study of sulfanilylguanidine and were used in these experiments. The results are given in Table 1. One of the patients showed a moderate, and the other a minimal concentration of the drug in the blood. It is evident that in neither instance was there any evidence that unusually great concentrations of sulfanilylguanidine occurred in the bile. The ratio between the concentrations in blood and bile were essentially similar to those found in the previous study of sulfapyridine. The thesis that the apparent failure of absorption of sulfanilylguanidine resulted in part from a marked reëxcretion of the drug into the intestine therefore proved incorrect.