Muitos equinos participantes de provas de corrida, ao exame endoscópico, apresentam evidências de ocorrência de Hemorragia Pulmonar Induzida pelo Exercício (HPIE). A HPIE trata-se de um sangramento de origem pulmonar que ocorre em equinos durante atividade física intensa e pela alta prevalência, muitas vezes associada aos equinos de corrida. Considerando, baseado nos estudos realizados, que o principal mecanismo descrito no desenvolvimento dos quadros de HPIE envolve o aumento da pressão transmural, resultante do aumento da pressão pulmonar causada pelo exercício físico, a furosemida parece ter papel importante na atenuação destes fatores, o que suporta a sua utilização nestes animais. Foram avaliados 21 equinos da raça Puro Sangue Inglês, atletas de distintas modalidades (corrida e polo), com e sem HPIE em dois momentos, antes (T0) e 4 horas após a administração da furosemida (T1) na dose de 0,5 mg/kg. Os animais foram submetidos a exame ecocardiográfico nos dois momentos, e também a colheita de sangue para avaliação hematológica e bioquímica. Ao exame ecocardiográfico foram consideradas as seguintes variáveis: FC, DC, VEj, FEj, VSFVE, VDFVE, FS, SIV, PLVE, DVE em sístole e diástole, AEs, Ao, AE:Ao, TEVE, E-S, e pico de velocidade do fluxo na artéria pulmonar. Para os exames laboratoriais foram consideradas as seguintes variáveis: He, Hb, Ht, VCM, HCM, CHCM, Leu, Neu, Linf, Mon, Plaq, AST, GGT, Alb, Pt, BT e BD. O uso da furosemida exerceu influência sobre os índices ecocardiográficos estudados de animais sem HPIE alterando a velocidade do fluxo da artéria pulmonar e o TEVE. Os demais parâmetros ecocardiográficos estudados bem como os parâmetros hemáticos não apresentaram alteração significativa, exceção feita aos valores de ureia e creatinina que aumentaram em T1, em função da hemoconcentração, sendo significantemente maiores no grupo sem HPIE. / Many racehorses at endoscopic examination after race present evidence of Exercise Induced Pulmonary Hemorrhage (HPIE). HPIE is a bleeding that occurs from pulmonary origin in horses during intense physical activity, often associated, by the high prevalence, to the racehorses, being able to present itself in many other equines, since undergoing intense physical exercise. Considering, based on previous studies, that the main mechanism involved in the development of HPIE involves the increase of the transmural pressure, resulting from the increase of the pulmonary pressure caused by the physical exercise, furosemide seems to play an important role in the attenuation of these factors, which supports their use in these animals. Twenty-one Thoroughbred horses, athletes, with and without HPIE were evaluated at two moments, before (T0) and 4 hours after furosemide administration (T1) at a dose of 0.5 mg / kg. All equines were submitted to echocardiographic examination at both moments, as well as blood sampling for hematological and biochemical evaluation. Echocardiographic examination showed the following variables: FC, DC, VEj, FEj, VSFVE, VDFVE, FS, SIV, PLVE, DVE, AEs, Ao, AE:Ao, TEVE, E-S, and flow in the pulmonary artery. For the laboratory tests, the following variables were considered: He, Hb, Ht, VCM, HCM, CHCM, Leu, Neu, Linf, Mon, Plaq, AST, GGT, Alb, Pt, BT and BD. Furosemide influenced some echocardiographic indexes of non-HPIE animals, altering the velocity of pulmonary artery flow and TEVE. All others echocardiographic and hematological parameters did not present any influence of furosemide administration, although urea and creatinine values have increased in T1 due to the hemoconcentration in non-HPIE group.

A avaliação da estabilidade dos medicamentos e sua correta utilização em diferentes veículos de infusão são fundamentais para garantir a manutenção das características terapêuticas do fármaco e para promover minimização de eventos adversos. Incompatibilidades entre as estruturas dos fármacos, em diferentes veículos de administração, podem gerar possíveis associações antagônicas ou sinérgicas, resultando em alterações das propriedades físico-químicas e, consequentemente, dos efeitos farmacológicos e das respostas clínicas esperadas. A proteína verde fluorescente (GFP) por apresentar propriedades de sensibilidade e especificidade, mostra-se promissora como potencial biossensor da estabilidade de fármacos em soluções parenterais de grande volume (SPGV), por apresentar sensibilidade a alterações das propriedades físico-químicas do meio. GFP é uma proteína compacta, globular e ácida, composta de um monômero de 27kDa, que vem sendo extensivamente utilizada como indicador biológico em processos de esterilização e desinfecção devido a sua estabilidade a altas temperaturas. O surgimento de métodos analíticos modernos e de alta precisão como a espectrofotometria de UV e a cromatografia líquida de alta eficiência (HPLC), alinhados a potencial utilização das proteínas fluorescentes como forma de avaliar as alterações da estabilidade de fármacos nas SPGV, vêm contribuir para a correta e racional utilização dos medicamentos no ambiente hospitalar. Diante disso a avaliação da estabilidade do coquetel de fármacos composto por furosemida e aminofilina em solução parenteral de 20% manitol e 0,9% NaCl foi sugerida. Amostras foram preparadas nas seguintes soluções (v/v): 20% manitol ou 0,9% NaCl na seguintes proporções utilizadas frequentemente na prática clínica: (i) 80% solução parenteral adicionada de 16% furosemida e 4% água para injeção (excipiente do fármaco aminofilina), (ii) 80% solução parenteral adicionada de 4% aminofilina e 16% água para injeção + NaOH (excipiente do fármaco furosemida), (iii) 80% solução parenteral, adicionada de 16% furosemida e 4% aminofilina (coquetel). As amostras foram avaliadas em espectrofotômetro imediatamente após o preparo e após um período 20h, em y=228nm e y=275nm para os fármacos furosemida e aminofilina, respectivamente. Para os fármacos individualmente associados às SPGV na faixa de pH 10-11, as concentrações finais obtidas foram correspondente ás inicialmente adicionadas e para o fármaco aminofilina foi estável até o período de 20h. Para avaliar a estabilidade dos fármacos associados à solução de 20% manitol a utilização de HPLC mostrou manutenção da estabilidade dos fármacos durante o período de infusão de até 20h. A proteína GFP adicionada as soluções das amostras na concentração 8?g/mL e determinada em espectrofluorímetro (yex=394nm, yem=509nm), mostrou resultados promissores quanto ao sua potencial utilização como biossensor da estabilidade dos fármacos furosemida e aminofilina nas soluções parenterais, mostrando comportamento de concentração e intensidade de fluorescência característicos e proporcionais a perda da estabilidade das soluções. A utilização de proteínas fluorescentes como potencial biossensor da estabilidade de fármacos em soluções parenterais é importante por fornecer parâmetros que garantam a eficácia dos medicamentos veiculados em soluções parenterais, racionalizando a sua utilização no ambiente hospitalar. / Parenteral solutions (PS) are used as vehicles in drugs administration to the organism. The development of analytical techniques that enables the detection of incompatibilities between drugs and PS is mandatory to guarantee their correct association with minimum adverse events. Incompatibilities of drugs in different infusion vehicles change according to physical-chemical properties of solutions, because of the molecular structure, chemical compounds used for preservation and stability of PS components. This fact can promote antagonic or synergic effects with loss of clinical response. The green fluorescent protein (GFP) is compact, globular, and acidic, with 27KDa and has been used as a biologic indicator of sterilization and disinfection process because it is easily detected using UV light, spectrofluorometry, with high thermal stability. GFP specificity and sensibility to physical-chemical changes in the media favors its use as a biosensor for drugs stability in parenteral solutions. The development of analytical methods such as spectrophotometry and high performance liquid chromatography (HPLC) in association with the fluorescent properties of some proteins enable the detection of potential incompatibilities between drugs and parenteral solutions, promoting a rational utilization of drugs in hospital. The evaluation of a diuretic cocktail with furosemide and aminophylline administrated in parenteral solutions of 20% mannitol and 0.9% NaCl was studied. Samples were prepared either in 20% mannitol or 0.9 % NaCl (PS), as follows: (i) 80% parenteral solution added with 16% furosemide and 4% WFI (solvent for aminophylline), (ii) 80% parenteral solution 4% aminophylline and 16% WFI+NaOH (pH 9-10, solvent for furosemide), (iii) 80% parenteral solution, added with 16% furosemide and 4% aminophylline (cocktail). Samples were diluted and prepared in a pH range of 6.5-7.5 and pH 10-11 for aminophylline and furosemide, individually and associated. The samples were prepared with PS including the excipients used in the drugs formulations. The absorbance was determined immediately after preparation and after 20 hours at 25°C and y= 228 nm, 275 nm, respectively for furosemide and aminophylline. GFP stability was determined in a spectrofluorometer (yex=394nm, yem=509nm) by adding 8 µg/mL of the purified protein in a 3.0mL sample (25°C) and the fluorescence intensity was evaluated after 20 hours. For both drugs in parenteral solutions (pH 10-11) the final concentrations observed were similar to the expected, aminophylline was also stable after 20h. When both drugs were associated in parenteral solutions of 20% mannitol, the use of HPLC showed stability for both drugs in the first 20h. The fluorescence intensity of GFP added to the samples was determined in spectrofluorometer (yex=394nm, yem=509nm), showing that fluorescence intensity was proportional to the drugs stability loss. Therefore, the utilization of fluorescence proteins is important to assure the drugs effectiveness and rational utilization in hospital places.

A correlação in vitro - in vivo (CIVIV) refere-se ao estabelecimento de uma relação racional entre uma propriedade in vitro de uma forma farmacêutica (FF) e uma característica biológica, ou parâmetros derivados destas, produzidas a partir da absorção do fármaco, liberado por uma FF. Para o desenvolvimento de uma CIVIV, são necessárias três ou mais formulações, as quais são avaliadas em relação ao comportamento de dissolução e à biodisponibilidade (BD), e por meio do cálculo de deconvolução, estimam-se as frações absorvidas. A furosemida, fármaco modelo, é um diurético usado no tratamento de hipertensão. Este fármaco é classificado como classe IV do sistema de classificação biofarmacêutico (SCB) (Amidon et al., 1995). O objetivo do presente trabalho foi estabelecer uma CIVIV para formas farmacêuticas (FFs) de liberação modificada contendo complexo de furosemida e hidroxipropil-&#946-ciclodextrina (HP-&#946-CD), a partir de ensaios de dissolução e estudos de BD. O complexo de furosemida e HP-&#946-CD foi obtido por liofilização e caracterizado por análise térmica, solubilidade e permeabilidade. A partir do complexo, foram produzidas cinco formulações de comprimidos de liberação modificada, com diferentes concentrações de hidroxipropilmetilcelulose (HPMC) (10-30%). Estas foram submetidas aos estudos de dissolução com o aparato II. Destas, foram selecionadas três formulações com perfis distintos e submetidas ao estudo com o aparato IV e posteriormente ao estudo de BD. A partir destes resultados foi estabelecida uma CIVIV e esta foi avaliada por meio da validação interna. Foi realizado o estudo in silico de previsão das curvas de decaimento plasmático com emprego dos programas, STELLA® e Simcyp®, a partir dos dados: solubilidade da furosemida; dissolução a partir das formulações e dados farmacocinéticos obtidos a partir da injeção intravenosa do medicamento referência. Quanto à caracterização do complexo, os ensaios termoanalíticos sugerem que a furosemida forme complexo de inclusão com a HP-β-CD pela técnica da liofilização. Observou-se o aumento da solubilidade em relação ao fármaco puro. Entretanto, quanto à permeabilidade, avaliada por meio do PAMPA (permeabilidade em membrana artificial paralela), os resultados foram semelhantes entre o fármaco puro e o complexo. Quanto ao comportamento de dissolução, avaliado com emprego dos aparatos II e IV, observou-se que as formulações apresentaram perfis de dissolução distintos. Os resultados do estudo de BD indicaram que a concentração do HPMC tem impacto relevante na absorção da furosemida. Foram obtidas correlações lineares a partir dos dados de fração absorvida e de dissolução, com coeficiente de determinação de 0,7662 para o aparato II e de 0,96017 para o IV. A validação interna da CIVIV empregando o aparato IV indicou que a correlação foi satisfatória. O estudo in silico de previsão das curvas de decaimento plasmático demonstrou que, nas condições empregadas, o modelo desenvolvido com o STELLA® foi mais preditivo do que o obtido pelo Simcyp®. / The in vitro - in vivo correlation (IVIVC) refers to the establishment of a rational relationship between a in vitro property of a pharmaceutical form (PF) and a biological characteristic or parameters derived from those, produced from the absorption of a drug released from a PF. For the development of an IVIVC, it is necessary three or more formulations, which are evaluated in relation to the dissolution behavior and for bioavailability (BA), calculating by deconvolution, an estimated absorbed fractions. Furosemide, a model drug, is a diuretic used in the treatment of hypertension. This drug is classified as class IV from biopharmaceutical classification system (BCS) (Amidon et al., 1995). The objective of this study was to establish an IVIVC for pharmaceutical forms (PFs) with modified release containing furosemide complexed with hydroxypropyl-β-cyclodextrin (HP-β-CD), from dissolution tests and BA studies. The complex of furosemide and HP-β-CD was obtained by freeze-drying and characterized by thermal analysis, the solubility and the permeability. From the complex were produced five modified release tablet formulations, with different concentrations of hydroxypropylmethylcellulose (HPMC) (10-30%). These formulations were subjected to dissolution studies with the apparatus II. From these, three formulations with distinct profiles were selected and subjected to dissolution study with apparatus IV and subsequently to the BA study. From these results, an IVIVC was established and this was evaluated by internal validation. The in silico study was conducted to predict plasma decay curves with employment programs, STELLA® and Simcyp®, from the following data: furosemide solubility, dissolution from the formulations evaluated and pharmacokinetic data obtained from intravenous drug reference. From characterization of the complex, the thermoanalytical tests suggest that furosemide form inclusion complex with HP-β-CD by freeze-drying technique. It was observed an increased solubility compared to the pure drug. However, permeability results, as assessed by the PAMPA (Parallel artificial membrane permeability), were similar for both furosemide and the complex. As for the dissolution behavior, evaluated with apparatus II and IV, so it was observed that the formulations showed an distintict profile. it was observed that the formulations produced showed different dissolution profiles. The results form BA assays indicated that the HPMC concentration has an important impact on the furosemide absorption. It was obtained a linear correlation from absorption fraction and dissolution data, with the determination coefficient of 0.7662 to apparatus II and 0.96017 from apparatus IV. Internal validation, with the IVIVC obtainted from apparatus IV, indicated that the correlation obtained was satisfactory. The in silico study predicted plasma decay curves, showed that under the conditions used, the model developed with STELLA® was more predictive than the model obtained by Simcyp®.

O presente trabalho teve por objetivo o desenvolvimento e aplicação de diferentes procedimentos para quantificação do fármaco furosemida, explorando suas reações e características físicas. Os métodos apresentados podem ser divididos em estáticos e em fluxo. Dentre os procedimentos estáticos utilizou-se a titrimetria de óxido-redução, a qual explorou as reações de hidrólise e oxidação do fármaco; a determinação espectrofotométrica em batelada, que explorou a reação de complexação com íons Fe3+, e a determinação empregando métodos eletroanalíticos, como voltametria cíclica, de pulso diferencial e de onda quadrada, nos quais o comportamento eletroquímico do analito foi explorado. Todos os procedimentos estáticos serviram de base para o desenvolvimento de procedimentos dinâmicos, em fluxo, visando minimizar a manipulação de padrões e amostras, bem como reduzir o consumo de reagentes e soluções, a geração de resíduos e aumentar a freqüência analítica. Com relação aos procedimentos dinâmicos foram realizados experimentos empregando detectores espectrofotométricos com base em reações de óxido-redução e complexação, fluorimétricos, com base na emissão pelo analito quando excitado e no seu aumento em ambientes micelares, e eletroanalíticos, com base na hidrólise e oxidação do fármaco em meios adequados. Observou-se, como previsto, perda de sensibilidade nos métodos dinâmicos quando comparados aos procedimentos estáticos, porém com aumento na freqüência analítica, redução de custos operacionais, minimização na manipulação das soluções. Os resíduos gerados foram reaproveitados na maioria dos casos. Todos os procedimentos descritos foram aplicados a amostras comerciais e/ou material biológico sintético, com resultados satisfatórios quando comparados estatisticamente aos obtidos para mesma amostra por meio de método de comparação oficial. Ensaios de adição e recuperação demonstraram, também, a aplicabilidade das estratégias apresentadas; não foram observadas interferências dos demais constituintes das formulações farmacêuticas. / The development and application of different procedures for the quantification of the drug furosemide, exploiting its reactions and physical properties are described. The presented methods were based in static and flow injection procedures. Among the static redox procedures titrimetry was applied, which exploited the hydrolysis and oxidation reactions of this drug; batch spectrophotometric determination was carried out applying the complexation between furosemide and ferric ions and, electroanalytical determinations, by cyclic, differential pulse and square wave voltammetry, were developed exploiting the electrochemical behavior of the analyte. All the static procedures were used as base to the development of flow injection methods, aiming to minimize the manipulation of standards and samples, as well as to reduce the reagent and solutions consumes and the waste generation, and to improve the analytical frequency. Based on the flow injection procedures some experiments were developed using spectrophotometric detectors, applying redox and complexation reactions; fluorimetric detectors, based on the fluorescence emission generated by the analyte when excited and exploiting its improvement by micellar media; and electrochemical detectors, based on the hydrolysis and oxidation under suitable conditions. Lost of sensitivity could be observed in the flow injection procedures, on the other hand, improvement on analytical frequency, reduction on operational costs and minimization on solutions handling could also be noted. The waste generated was reused in the majority of the cases. All the procedures described were applied to commercial samples and/or synthetic biological material, with satisfactory results when statistically compared to those obtained by a reference method to the same samples. Recovery tests also demonstrated the applicability of the developed strategies. Interference from the constituents of the pharmaceutical formulations was not observed.

A correlação in vitro - in vivo (CIVIV) refere-se ao estabelecimento de uma relação racional entre uma propriedade in vitro de uma forma farmacêutica (FF) e uma característica biológica, ou parâmetros derivados destas, produzidas a partir da absorção do fármaco, liberado por uma FF. Para o desenvolvimento de uma CIVIV, são necessárias três ou mais formulações, as quais são avaliadas em relação ao comportamento de dissolução e à biodisponibilidade (BD), e por meio do cálculo de deconvolução, estimam-se as frações absorvidas. A furosemida, fármaco modelo, é um diurético usado no tratamento de hipertensão. Este fármaco é classificado como classe IV do sistema de classificação biofarmacêutico (SCB) (Amidon et al., 1995). O objetivo do presente trabalho foi estabelecer uma CIVIV para formas farmacêuticas (FFs) de liberação modificada contendo complexo de furosemida e hidroxipropil-&#946-ciclodextrina (HP-&#946-CD), a partir de ensaios de dissolução e estudos de BD. O complexo de furosemida e HP-&#946-CD foi obtido por liofilização e caracterizado por análise térmica, solubilidade e permeabilidade. A partir do complexo, foram produzidas cinco formulações de comprimidos de liberação modificada, com diferentes concentrações de hidroxipropilmetilcelulose (HPMC) (10-30%). Estas foram submetidas aos estudos de dissolução com o aparato II. Destas, foram selecionadas três formulações com perfis distintos e submetidas ao estudo com o aparato IV e posteriormente ao estudo de BD. A partir destes resultados foi estabelecida uma CIVIV e esta foi avaliada por meio da validação interna. Foi realizado o estudo in silico de previsão das curvas de decaimento plasmático com emprego dos programas, STELLA® e Simcyp®, a partir dos dados: solubilidade da furosemida; dissolução a partir das formulações e dados farmacocinéticos obtidos a partir da injeção intravenosa do medicamento referência. Quanto à caracterização do complexo, os ensaios termoanalíticos sugerem que a furosemida forme complexo de inclusão com a HP-β-CD pela técnica da liofilização. Observou-se o aumento da solubilidade em relação ao fármaco puro. Entretanto, quanto à permeabilidade, avaliada por meio do PAMPA (permeabilidade em membrana artificial paralela), os resultados foram semelhantes entre o fármaco puro e o complexo. Quanto ao comportamento de dissolução, avaliado com emprego dos aparatos II e IV, observou-se que as formulações apresentaram perfis de dissolução distintos. Os resultados do estudo de BD indicaram que a concentração do HPMC tem impacto relevante na absorção da furosemida. Foram obtidas correlações lineares a partir dos dados de fração absorvida e de dissolução, com coeficiente de determinação de 0,7662 para o aparato II e de 0,96017 para o IV. A validação interna da CIVIV empregando o aparato IV indicou que a correlação foi satisfatória. O estudo in silico de previsão das curvas de decaimento plasmático demonstrou que, nas condições empregadas, o modelo desenvolvido com o STELLA® foi mais preditivo do que o obtido pelo Simcyp®. / The in vitro - in vivo correlation (IVIVC) refers to the establishment of a rational relationship between a in vitro property of a pharmaceutical form (PF) and a biological characteristic or parameters derived from those, produced from the absorption of a drug released from a PF. For the development of an IVIVC, it is necessary three or more formulations, which are evaluated in relation to the dissolution behavior and for bioavailability (BA), calculating by deconvolution, an estimated absorbed fractions. Furosemide, a model drug, is a diuretic used in the treatment of hypertension. This drug is classified as class IV from biopharmaceutical classification system (BCS) (Amidon et al., 1995). The objective of this study was to establish an IVIVC for pharmaceutical forms (PFs) with modified release containing furosemide complexed with hydroxypropyl-β-cyclodextrin (HP-β-CD), from dissolution tests and BA studies. The complex of furosemide and HP-β-CD was obtained by freeze-drying and characterized by thermal analysis, the solubility and the permeability. From the complex were produced five modified release tablet formulations, with different concentrations of hydroxypropylmethylcellulose (HPMC) (10-30%). These formulations were subjected to dissolution studies with the apparatus II. From these, three formulations with distinct profiles were selected and subjected to dissolution study with apparatus IV and subsequently to the BA study. From these results, an IVIVC was established and this was evaluated by internal validation. The in silico study was conducted to predict plasma decay curves with employment programs, STELLA® and Simcyp®, from the following data: furosemide solubility, dissolution from the formulations evaluated and pharmacokinetic data obtained from intravenous drug reference. From characterization of the complex, the thermoanalytical tests suggest that furosemide form inclusion complex with HP-β-CD by freeze-drying technique. It was observed an increased solubility compared to the pure drug. However, permeability results, as assessed by the PAMPA (Parallel artificial membrane permeability), were similar for both furosemide and the complex. As for the dissolution behavior, evaluated with apparatus II and IV, so it was observed that the formulations showed an distintict profile. it was observed that the formulations produced showed different dissolution profiles. The results form BA assays indicated that the HPMC concentration has an important impact on the furosemide absorption. It was obtained a linear correlation from absorption fraction and dissolution data, with the determination coefficient of 0.7662 to apparatus II and 0.96017 from apparatus IV. Internal validation, with the IVIVC obtainted from apparatus IV, indicated that the correlation obtained was satisfactory. The in silico study predicted plasma decay curves, showed that under the conditions used, the model developed with STELLA® was more predictive than the model obtained by Simcyp®.

To see if aggressive diuresis in first twenty four hours is associated with a comparable number of total days in the hospital as compared to non-aggressive diuresis. In this retrospective cohort study, we compared the length of hospital stay of consecutive patients admitted in one year based on their diuresis during the first twenty-four hours of hospitalization: aggressive diuresis (group 1) i.e. > 2400mL versus non-aggressive diuresis (group 2) i.e. ≤ 2400mL urine output. Patients were excluded if in cardiogenic shock, had creatinine level above 3 mg/dL on admission, or on dialysis. A total of 194 patients were enrolled (29 in group 1 and 165 in group 2 respectively). The Kaplan-Meier estimate of the median cumulative proportion of patients still hospitalized for the group 1 was 4 days and in group 2 was 5 days (log-rank test; P=0.67). In univariate analysis, Cox PH regression showed unadjusted hazard rate of discharge from hospital was slightly higher in group 1 than group 2 but was statistically non-significant (HR=1.08; P=0.70). In multivariate Cox model analysis, creatinine at the time of admission when greater than 1.6mg/dL (P=0.75), LVEF (P= 0.14), total twenty-four hours dose of intravenous Furosemide given (P=0.98) and interaction between Furosemide dose and Creatinine level (P=0.79) were not significant predictor of hospital discharge. Adjusted hazard rate for discharge from hospital was 12% higher in group 1 than group 2 but still statistically non-significant (HR=1.12; P=0.60). Since the length of hospital stay is similar between two groups, we suggest the goal of diuresis to be less than 2400mL in first twenty-four hours to prevent excessive dehydration.

There are mainly two manufacturing processes used in the pharmaceutical industry, namely direct compression and granulation of which granulation can be subdivided into wet granulation and dry granulation. Wet granulation is a process still widely used in the pharmaceutical industry and provides better control of drug content uniformity and compactibility at low drug concentrations. Lactose monohydrate and microcrystalline cellulose (MCC) were used as fillers in this study. Both these fillers possess unacceptable powder flow properties and the use of wet granulation may improve this property. One of the advantages of lactose monohydrate over MCC is that it is partially water soluble. A fractional factorial design was used in this study. Twelve tablet formulations were formulated containing different combinations of active ingredients (furosemide or pyridoxine hydrochloride), fillers (lactose monohydrate or MCC) and a binder (Kollidon® VA64) in three different concentrations (0.75, 1.5 or 3.0% w/w). The binder was used to produce granules by means of wet granulation, using ethanol as granulating fluid. The granules were dried in an oven and screened through different sized sieves to produce the final granulated powder formulations ready for tableting. A disintegrant (Ac-di-sol®) and lubricant (magnesium stearate) were incorporated into the granulated powder formulations extra-granular (0.5% w/w) and were kept as a constant in this study throughout all the formulations. A Turbula® mixer was used to mix the granulated powder formulations for a constant 5 minutes. During the first phase of the study, tablets were compressed using 2 compression settings (22 and 24). These compression settings were used to determine what effect different external pressures would have on the different tablet properties. Tablet weight for all the formulations was kept constant at 250 mg, although the volume of the matrix differed for each tablet formulation. The physical properties of the tablets were evaluated with regard to weight variation, mechanical strength (crushing strength and friability) and disintegration. Tablet formulation 12 yielded unsatisfactory tablets, due to poor powder flow into the die. Tablet formulations that contained the highest binder concentration (3.0% w/w) and were compressed at the highest compression setting (24) (formulations 4 and 9), exhibited the highest mechanical strength. The disintegration results revealed that the tablet formulations containing MCC as filler disintegrated faster compared to those containing lactose monohydrate. The increase in binder concentration caused an increase in mechanical strength, possibly decreasing tablet porosity, therefore prolonging disintegration time due to impeded water penetration into the tablet matrix. During the final phase of the study, dissolution studies were conducted on the different tablet formulations in 0.1 M HCl for 120 minutes. In terms of dissolution results, the initial dissolution rate (DRi) and extent of dissolution (AUC) were compared. It was found that the tablet formulations containing pyridoxine hydrochloride as active pharmaceutical ingredient (API) exhibited faster drug dissolution (higher DRi and AUC-values) compared to those tablet formulations containing furosemide. The faster dissolution exhibited by the pyridoxine hydro- chloride containing formulations can possibly be attributed to the fact that pyridoxine hydrochloride is good water soluble whereas furosemide is practically insoluble in water. The effect of the filler depended on the aqueous solubility of the filler and the concentration of the binder (Kollidon VA64) employed. An increase in binder concentration led to a decrease in the initial rate of dissolution as well as the extent of drug dissolution. In the case of the pyridoxine hydrochloride containing formulations, formulation 9 exhibited the slowest DRi and lowest extent of drug dissolution (1.40 ± 0.03 µg.cm-3.min-1 and 2396.52 ± 26.43 µg.cm-3.min respectively). In the case of the furosemide containing formulations, formulation 4 exhibited the slowest DRi and lowest extent of drug dissolution (0.22 ± 0.07 µg.cm-3.min-1 and 1018.62 ± 59.74 µg.cm-3 min respectively). In both cases, the formulations contained Kollidon VA64 in a concentration of 3% w/w and were compressed at compression setting 24. The disintegration process of tablets goes hand in hand with the dissolution process and results have shown that by establishing rapid contact between drug particles and the surrounding medium proves to be a necessity for rapid drug dissolution. Disintegration does not assure drug dissolution, but when prolonged, slower dissolution rates can be obtained, implying a slow rate and low extent of drug dissolution. The disintegrant in this study was incorporated extra-granular ensuring rapid tablet disintegration. However, due to binder concentration of 3% w/w, granule disintegration was probably negatively affected resulting in a lower drug surface area exposed to the surrounding dissolution medium, leading to a slower initial rate and extent of drug dissolution. From the results obtained during this study it was evident that formulation variables such as the type of filler, the concentration of the binder and compression setting employed during tablet manufacturing can have a ronounced effect on the pharmaceutical availability of the active ingredient. However, the extent of the effect was dependent on the aqueous solubility of the active ingredient. / Thesis (MSc (Pharmaceutics))--North-West University, Potchefstroom Campus, 2013.

There are mainly two manufacturing processes used in the pharmaceutical industry, namely direct compression and granulation of which granulation can be subdivided into wet granulation and dry granulation. Wet granulation is a process still widely used in the pharmaceutical industry and provides better control of drug content uniformity and compactibility at low drug concentrations. Lactose monohydrate and microcrystalline cellulose (MCC) were used as fillers in this study. Both these fillers possess unacceptable powder flow properties and the use of wet granulation may improve this property. One of the advantages of lactose monohydrate over MCC is that it is partially water soluble. A fractional factorial design was used in this study. Twelve tablet formulations were formulated containing different combinations of active ingredients (furosemide or pyridoxine hydrochloride), fillers (lactose monohydrate or MCC) and a binder (Kollidon® VA64) in three different concentrations (0.75, 1.5 or 3.0% w/w). The binder was used to produce granules by means of wet granulation, using ethanol as granulating fluid. The granules were dried in an oven and screened through different sized sieves to produce the final granulated powder formulations ready for tableting. A disintegrant (Ac-di-sol®) and lubricant (magnesium stearate) were incorporated into the granulated powder formulations extra-granular (0.5% w/w) and were kept as a constant in this study throughout all the formulations. A Turbula® mixer was used to mix the granulated powder formulations for a constant 5 minutes. During the first phase of the study, tablets were compressed using 2 compression settings (22 and 24). These compression settings were used to determine what effect different external pressures would have on the different tablet properties. Tablet weight for all the formulations was kept constant at 250 mg, although the volume of the matrix differed for each tablet formulation. The physical properties of the tablets were evaluated with regard to weight variation, mechanical strength (crushing strength and friability) and disintegration. Tablet formulation 12 yielded unsatisfactory tablets, due to poor powder flow into the die. Tablet formulations that contained the highest binder concentration (3.0% w/w) and were compressed at the highest compression setting (24) (formulations 4 and 9), exhibited the highest mechanical strength. The disintegration results revealed that the tablet formulations containing MCC as filler disintegrated faster compared to those containing lactose monohydrate. The increase in binder concentration caused an increase in mechanical strength, possibly decreasing tablet porosity, therefore prolonging disintegration time due to impeded water penetration into the tablet matrix. During the final phase of the study, dissolution studies were conducted on the different tablet formulations in 0.1 M HCl for 120 minutes. In terms of dissolution results, the initial dissolution rate (DRi) and extent of dissolution (AUC) were compared. It was found that the tablet formulations containing pyridoxine hydrochloride as active pharmaceutical ingredient (API) exhibited faster drug dissolution (higher DRi and AUC-values) compared to those tablet formulations containing furosemide. The faster dissolution exhibited by the pyridoxine hydro- chloride containing formulations can possibly be attributed to the fact that pyridoxine hydrochloride is good water soluble whereas furosemide is practically insoluble in water. The effect of the filler depended on the aqueous solubility of the filler and the concentration of the binder (Kollidon VA64) employed. An increase in binder concentration led to a decrease in the initial rate of dissolution as well as the extent of drug dissolution. In the case of the pyridoxine hydrochloride containing formulations, formulation 9 exhibited the slowest DRi and lowest extent of drug dissolution (1.40 ± 0.03 µg.cm-3.min-1 and 2396.52 ± 26.43 µg.cm-3.min respectively). In the case of the furosemide containing formulations, formulation 4 exhibited the slowest DRi and lowest extent of drug dissolution (0.22 ± 0.07 µg.cm-3.min-1 and 1018.62 ± 59.74 µg.cm-3 min respectively). In both cases, the formulations contained Kollidon VA64 in a concentration of 3% w/w and were compressed at compression setting 24. The disintegration process of tablets goes hand in hand with the dissolution process and results have shown that by establishing rapid contact between drug particles and the surrounding medium proves to be a necessity for rapid drug dissolution. Disintegration does not assure drug dissolution, but when prolonged, slower dissolution rates can be obtained, implying a slow rate and low extent of drug dissolution. The disintegrant in this study was incorporated extra-granular ensuring rapid tablet disintegration. However, due to binder concentration of 3% w/w, granule disintegration was probably negatively affected resulting in a lower drug surface area exposed to the surrounding dissolution medium, leading to a slower initial rate and extent of drug dissolution. From the results obtained during this study it was evident that formulation variables such as the type of filler, the concentration of the binder and compression setting employed during tablet manufacturing can have a ronounced effect on the pharmaceutical availability of the active ingredient. However, the extent of the effect was dependent on the aqueous solubility of the active ingredient. / Thesis (MSc (Pharmaceutics))--North-West University, Potchefstroom Campus, 2013.

Muitos equinos participantes de provas de corrida, ao exame endoscópico, apresentam evidências de ocorrência de Hemorragia Pulmonar Induzida pelo Exercício (HPIE). A HPIE trata-se de um sangramento de origem pulmonar que ocorre em equinos durante atividade física intensa e pela alta prevalência, muitas vezes associada aos equinos de corrida. Considerando, baseado nos estudos realizados, que o principal mecanismo descrito no desenvolvimento dos quadros de HPIE envolve o aumento da pressão transmural, resultante do aumento da pressão pulmonar causada pelo exercício físico, a furosemida parece ter papel importante na atenuação destes fatores, o que suporta a sua utilização nestes animais. Foram avaliados 21 equinos da raça Puro Sangue Inglês, atletas de distintas modalidades (corrida e polo), com e sem HPIE em dois momentos, antes (T0) e 4 horas após a administração da furosemida (T1) na dose de 0,5 mg/kg. Os animais foram submetidos a exame ecocardiográfico nos dois momentos, e também a colheita de sangue para avaliação hematológica e bioquímica. Ao exame ecocardiográfico foram consideradas as seguintes variáveis: FC, DC, VEj, FEj, VSFVE, VDFVE, FS, SIV, PLVE, DVE em sístole e diástole, AEs, Ao, AE:Ao, TEVE, E-S, e pico de velocidade do fluxo na artéria pulmonar. Para os exames laboratoriais foram consideradas as seguintes variáveis: He, Hb, Ht, VCM, HCM, CHCM, Leu, Neu, Linf, Mon, Plaq, AST, GGT, Alb, Pt, BT e BD. O uso da furosemida exerceu influência sobre os índices ecocardiográficos estudados de animais sem HPIE alterando a velocidade do fluxo da artéria pulmonar e o TEVE. Os demais parâmetros ecocardiográficos estudados bem como os parâmetros hemáticos não apresentaram alteração significativa, exceção feita aos valores de ureia e creatinina que aumentaram em T1, em função da hemoconcentração, sendo significantemente maiores no grupo sem HPIE. / Many racehorses at endoscopic examination after race present evidence of Exercise Induced Pulmonary Hemorrhage (HPIE). HPIE is a bleeding that occurs from pulmonary origin in horses during intense physical activity, often associated, by the high prevalence, to the racehorses, being able to present itself in many other equines, since undergoing intense physical exercise. Considering, based on previous studies, that the main mechanism involved in the development of HPIE involves the increase of the transmural pressure, resulting from the increase of the pulmonary pressure caused by the physical exercise, furosemide seems to play an important role in the attenuation of these factors, which supports their use in these animals. Twenty-one Thoroughbred horses, athletes, with and without HPIE were evaluated at two moments, before (T0) and 4 hours after furosemide administration (T1) at a dose of 0.5 mg / kg. All equines were submitted to echocardiographic examination at both moments, as well as blood sampling for hematological and biochemical evaluation. Echocardiographic examination showed the following variables: FC, DC, VEj, FEj, VSFVE, VDFVE, FS, SIV, PLVE, DVE, AEs, Ao, AE:Ao, TEVE, E-S, and flow in the pulmonary artery. For the laboratory tests, the following variables were considered: He, Hb, Ht, VCM, HCM, CHCM, Leu, Neu, Linf, Mon, Plaq, AST, GGT, Alb, Pt, BT and BD. Furosemide influenced some echocardiographic indexes of non-HPIE animals, altering the velocity of pulmonary artery flow and TEVE. All others echocardiographic and hematological parameters did not present any influence of furosemide administration, although urea and creatinine values have increased in T1 due to the hemoconcentration in non-HPIE group.

O presente trabalho teve por objetivo o desenvolvimento e aplicação de diferentes procedimentos para quantificação do fármaco furosemida, explorando suas reações e características físicas. Os métodos apresentados podem ser divididos em estáticos e em fluxo. Dentre os procedimentos estáticos utilizou-se a titrimetria de óxido-redução, a qual explorou as reações de hidrólise e oxidação do fármaco; a determinação espectrofotométrica em batelada, que explorou a reação de complexação com íons Fe3+, e a determinação empregando métodos eletroanalíticos, como voltametria cíclica, de pulso diferencial e de onda quadrada, nos quais o comportamento eletroquímico do analito foi explorado. Todos os procedimentos estáticos serviram de base para o desenvolvimento de procedimentos dinâmicos, em fluxo, visando minimizar a manipulação de padrões e amostras, bem como reduzir o consumo de reagentes e soluções, a geração de resíduos e aumentar a freqüência analítica. Com relação aos procedimentos dinâmicos foram realizados experimentos empregando detectores espectrofotométricos com base em reações de óxido-redução e complexação, fluorimétricos, com base na emissão pelo analito quando excitado e no seu aumento em ambientes micelares, e eletroanalíticos, com base na hidrólise e oxidação do fármaco em meios adequados. Observou-se, como previsto, perda de sensibilidade nos métodos dinâmicos quando comparados aos procedimentos estáticos, porém com aumento na freqüência analítica, redução de custos operacionais, minimização na manipulação das soluções. Os resíduos gerados foram reaproveitados na maioria dos casos. Todos os procedimentos descritos foram aplicados a amostras comerciais e/ou material biológico sintético, com resultados satisfatórios quando comparados estatisticamente aos obtidos para mesma amostra por meio de método de comparação oficial. Ensaios de adição e recuperação demonstraram, também, a aplicabilidade das estratégias apresentadas; não foram observadas interferências dos demais constituintes das formulações farmacêuticas. / The development and application of different procedures for the quantification of the drug furosemide, exploiting its reactions and physical properties are described. The presented methods were based in static and flow injection procedures. Among the static redox procedures titrimetry was applied, which exploited the hydrolysis and oxidation reactions of this drug; batch spectrophotometric determination was carried out applying the complexation between furosemide and ferric ions and, electroanalytical determinations, by cyclic, differential pulse and square wave voltammetry, were developed exploiting the electrochemical behavior of the analyte. All the static procedures were used as base to the development of flow injection methods, aiming to minimize the manipulation of standards and samples, as well as to reduce the reagent and solutions consumes and the waste generation, and to improve the analytical frequency. Based on the flow injection procedures some experiments were developed using spectrophotometric detectors, applying redox and complexation reactions; fluorimetric detectors, based on the fluorescence emission generated by the analyte when excited and exploiting its improvement by micellar media; and electrochemical detectors, based on the hydrolysis and oxidation under suitable conditions. Lost of sensitivity could be observed in the flow injection procedures, on the other hand, improvement on analytical frequency, reduction on operational costs and minimization on solutions handling could also be noted. The waste generated was reused in the majority of the cases. All the procedures described were applied to commercial samples and/or synthetic biological material, with satisfactory results when statistically compared to those obtained by a reference method to the same samples. Recovery tests also demonstrated the applicability of the developed strategies. Interference from the constituents of the pharmaceutical formulations was not observed.