Skip to main content
Device Global Header

Subscribe
or Renew

Advanced Search

This article is available to subscribers. Subscribe now. Already have an account? Sign in

Original ArticleFree PreviewArchive

Subarachnoid Distribution of Drugs after Lumbar Injection

List of authors.
  • Richard E. Rieselbach, M.D.†,
  • Giovanni Di Chiro, M.D.‡,
  • Emil J. Freireich, M.D.§,
  • and David P. Rall, M.D., Ph.D.

DIRECT injection of drugs into the subarachnoid space is required for treatment of several diseases involving the leptomeninges. This is necessary because of the virtual exclusion of certain plasma constituents by the bloodcerebrospinal-fluid barrier due to molecular size, protein binding, lipid insolubility or ionization.2 Drugs included in this category are polymyxin B and amphotericin B.3 , 4 The antimetabolites 6-mercaptopurine and methotrexate, used in the therapy of acute leukemia, do not attain significant levels in spinal fluid when administered systemically.2 , 5 Therefore, meningeal leukemia, the diffuse involvement of the meninges by leukemic cells, must often be treated with an intrathecally administered drug such . . .

Funding and Disclosures

* From the Clinical Pharmacology and Experimental Therapeutics Service, Medicine Branch, National Cancer Institute, and the Section on Neuroradiology of the National Institute of Neurological Diseases and Blindness, National Institutes of Health.

An abstract of this work has previously been published.1

∥ Saran wrap — Dow chemical.

** Ansco, Nonscreen.

†† Squibb Pharmaceuticals.

We are indebted to Messrs. James Gaskins, William Matthews and Joseph Morel for technical assistance, Drs. G. Milton Shy, Emil Frei, III, and Jack D. Davidson for helpful suggestions and to Dr. Louis B. Thomas for reviewing the microscopical sections.

Author Affiliations

BETHESDA, MARYLAND

† Present address, Department of Medicine, Washington University, St. Louis, Missouri.

‡ Head, Section on Neuroradiology, National Institute of Neurological Diseases and Blindness.

§ Senior investigator, National Cancer Institute.

¶ Assistant chief, Medicine Branch, National Cancer Institute.

Print Subscriber? Activate your online access.