A oxcarbazepina (OXC) é indicada como terapia adjuvante ou monoterapia no tratamento de crises epilépticas parciais ou crises tônico-clônicas generalizadas em adultos e crianças. A OXC sofre rápida eliminação pré-sistêmica com formação do metabólito ativo 10-hidroxicarbazepina (MHD), o qual possui como enantiômeros o R-(-)- e o S-(+)-MHD. A OXC e o MHD são substratos da glicoproteína-P (P-gp), que pode ser inibida pelo verapamil. O presente estudo avalia a influência do verapamil na farmacocinética e perfusão cerebral da OXC e dos enantiômeros do MHD em voluntários sadios. Os voluntários sadios (n=12) receberam em uma ocasião doses de 300 mg/12h de OXC e em outra ocasião doses de 300 mg/12h de OXC associadas com 80 mg/8h de verapamil. As amostras de sangue foram coletadas no estado de equilíbrio durante 12 horas e a avaliação da perfusão cerebral realizada utilizando a tomografia computadorizada por emissão de fóton único (SPECT) antes do início do tratamento e nos tempos 4, 6 ou 12h após a administração da OXC. As concentrações plasmáticas total e livre da OXC e dos enantiômeros do MHD foram avaliadas por LC-MS/MS. A análise farmacocinética não compartimental foi realizada com o programa WinNonlin e a farmacocinética populacional foi desenvolvida utilizando a modelagem não-linear de efeitos mistos com o programa NONMEM. Os limites de quantificação obtidos foram de 12,5 ng OXC/mL de plasma e 31,25 ng de cada enantiômero MHD/mL de plasma para a análise da concentração total, enquanto foi de 4,0 ng de OXC/mL de plasma e de 20,0 ng de cada enantiômero do MHD/mL de plasma para a determinação da concentração livre. Os coeficientes de variação obtidos nos estudos de precisão e a porcentagem de inexatidão inter e intra-ensaios foram inferiores a 15%, assegurando a reprodutibilidade e repetibilidade dos resultados. A análise farmacocinética não compartimental da OXC em monoterapia resultou nos seguintes parâmetros: concentração plasmática máxima (Cmax) de 1,35 ?g/mL como valor total e 0,32 ?g/mL como concentração livre em 1,0 h, área sob a curva concentração plasmática versus tempo (AUC0-12) de 3,98 ?g.h/mL e meia-vida de eliminação de 2,45 h, volume de distribuição aparente (Vss/F) de 352,17 L e clearance aparente (CLss/F) de 75,58 L/h. A disposição cinética do MHD é enantiosseletiva, com observação de maior proporção para o enantiômero S-(+)-MHD em relação ao R-(-)-MHD (razão AUC0-12 S-(+)/R-(-) de 4,26). A fração livre avaliada no tmax da OXC foi 0,26 para a OXC, 0,42 para o R-(-)-MHD e 0,38 para o S- (+)-MHD, mostrando enantiosseletividade na ligação às proteínas plasmáticas do MHD. O tratamento com o verapamil reduziu o tempo médio de residência (MRT) (4,71 vs 3,83 h) e Cmax como concentração livre (0,32 vs 0,53 ?g/mL) da OXC e aumentou os valores para ambos os enantiômeros do MHD de Cmax como valor total (2,60 vs 3,27 ?g/mL para o R-(-)- e 11,05 vs 11,94 ?g/mL para o S-(+)-MHD), Cmax como concentração livre (3,11 vs 4,14 ?g/mL para o S-(+)-MHD), Cmédia (2,11 vs 2,42 ?g/mL para o R-(-)- e 8,10 vs 9,07 ?g/mL para o S-(+)-MHD) e AUC0-12 (25,36 vs 29,06 ?g.h/mL para o R-(-)- e 97,19 vs 111,37 ?g.h/mL para o S-(+)-MHD). A ii farmacocinética populacional da OXC foi melhor descrita por modelo de dois compartimentos com eliminação de primeira ordem e com um conjunto de três compartimentos de trânsito para descrever o perfil de absorção da OXC. A disposição de ambos os enantiômeros do MHD foi caracterizada por modelo de um compartimento. Os valores de CLss/F estimados na monoterapia foram de 84,9 L/h para a OXC e de 2,0 L/h para ambos enantiômeros do MHD, enquanto os valores de Vss/F foram de 587 L para a OXC, 23,6 L para o R-(-)-MHD e 31,7 L para o S-(+)- MHD. Concluindo, a associação do verapamil aumentou a biodisponibilidade da OXC em 12% (farmacocinética populacional) e aumentou os valores de AUC de ambos os enantiômeros do metabólito MHD (farmacocinética não compartimental), o que está provavelmente relacionado com a inibição da P-gp no trato intestinal. A associação do verapamil aumentou as concentrações cerebrais preditas de ambos os enantiômeros do MHD em maior extensão do que aquelas observadas no plasma. As mudanças no fluxo sanguíneo cerebral (SPECTs realizados 6h após a administração da OXC) associadas à coadministração de verapamil provavelmente foram causadas pelo aumento dos níveis cerebrais de ambos os enantiômeros do MHD. A confirmação dessa observação requer um braço experimental adicional com SPECTs realizados também após a administração do verapamil em monoterapia. / Oxcarbazepine (OXC) is indicated as adjunctive therapy or monotherapy for the treatment of partial or generalized tonic-clonic seizures in adults and children. OXC undergoes rapid pre-systemic reduction with formation of the active metabolite 10- hydroxycarbazepine (MHD), which has the enantiomers R-(-)- and S-(+)-MHD. OXC and MHD are substrates of P-glycoprotein (P-gp), which can be inhibited by verapamil. The present study evaluates the influence of verapamil on the pharmacokinetics and cerebral perfusion of OXC and the MHD enantiomers in healthy volunteers. The healthy volunteers (n=12) received on one occasion doses of 300 mg/12h OXC and on another occasion they received doses of 300 mg/12h OXC associated with 80 mg/8h of verapamil. Blood samples were collected at steady state for 12 hours and the assessment of cerebral perfusion was performed using a single-photon emission computed tomography (SPECT) before the beginning of treatment and at times 4, 6 or 12 hours after OXC administration. The total and free plasma concentrations of OXC and MHD enantiomers were assessed by LC-MS/MS. The non-compartmental pharmacokinetics analysis was performed using the WinNonlin program, and population pharmacokinetics was developed using nonlinear mixed effects modelling with NONMEM.The limits of quantification obtained were 12.5 ng/mL plasma for OXC and 31.25 ng of each MHD enantiomer/mL plasma for total concentration analysis, while it was 4.0 ng OXC/mL plasma and 20.0 ng of each MHD enantiomer/mL plasma for the free concentration determination. The coefficients of variation obtained in studies of accuracy and the percentage of inaccuracy inter and intra-assay were less than 15%, ensuring the result reproducibility and repeatability. The non-compartmental pharmacokinetic analysis of OXC in monotherapy treatment, resulted in the following parameters: maximum plasma concentration (Cmax) of 1.35 ?g/mL as total concentration and 0.32 mg/mL as free concentration in 1.0 h, area under the plasma concentration vs time curve (AUC0-12) was 3.98 ?g.h/mL, half-life of 2.45 h, apparent volume of distribution (Vss/F) of 352.17 L and the apparent clearance (CLSS/F) of 75.58 L/h. The MHD kinetic disposition is enantioselective, with observation of a greater proportion of the S-(+)-MHD enantiomer compared to R-(-)-MHD (ratio AUC0-12 S-(+)/R-(-) of 4.26). The free fraction measured in the tmax of OXC was 0.26 for OXC, 0.42 for R-(-)-MHD and 0.38 for S-(+)-MHD, showing enantioselectivity in the plasma protein binding of MHD. Verapamil treatment reduced the mean residence time (MRT) (4.71 vs 3.83 h) and Cmax (0.26 vs 0.31 ?g/mL) as free concentration for OXC and increased the both MHD enantiomers values of Cmax (2.60 vs 3.27 ?g/mL for R-(-)- and 11.94 vs 11.05 ?g/mL for S-(+)-MHD) as total concentration, Cmax (3.11 vs 4,14 ?g/mL for S- (+)-MHD) as free concentration, Cavg (2.11 vs 2.42 ?g/mL for R-(-)- and 8.10 vs 9.07 ?g/mL for S-(+)-MHD) and AUC0-12 (25.36 vs 29.06 ?g.h/mL for R-(-)- and 97.19 vs 111.37 ?g.h/mL for S-(+)-MHD). The population pharmacokinetics of oxcarbazepine was best described by a two-compartment model with first-order elimination and a iv set of three transit compartments to describe the absorption profile of the parent compound. The disposition of both MHD enantiomers was characterised by onecompartment model. The CLss/F estimates in monotherapy were 84.9 L/h for OXC and 2.0 L/h for both MHD enantiomers, whereas the values of Vss/F were 587 L for OXC, 23.6 L for R-(-)-MHD and 31.7 L for S-(+)-MHD. In conclusion, verapamil coadministration increased the OXC bioavailability in 12% (population pharmacokinetics) and increased the AUC of both metabolite MHD enantiomers (non-compartmental pharmacokinetics), which is probably related to the inhibition of P-gp in the intestinal tract. Verapamil co-administration increased the predicted brain concentrations of both MHD enantiomers in a greater extent than those observed in plasma. Changes in cerebral blood flow (SPECTs performed 6h after administration of OXC) associated with co-administration of verapamil were probably caused by an increase in brain levels of both MHD enantiomers. Confirmation of this observation requires additional experimental arm with SPECTs also performed after administration of verapamil in monotherapy.

The thesis entitled "Structure and reactivity in bridged polycyclic systems: cis-trans enantiomerism, fulvene cycloadditions and crystallographic studies of bridgehead β-ketoacids " consists of two parts. Part I contains 3 chapters, and deals with cycloaddition reactions of 6-arylfulvenes with maleic anhydride and nitrones (The products in the case of maleic anhydride display cis-trans enantiomerism). Part II contains 2 chapters, and deals with resolution of racemic primary amines, racemic amino acids and the relative decarboxylation propensities of bicyclic β-ketoacids in solid state. Part I Chapter 1: A new case of the uncommon cis-trans enantiomerism is presented in the Diels-Alder cycloadducts (3 & 4) of 6-arylfulvenes (1) with maleic anhydride (2).1 The resolution of the cis-trans enantiomers were accomplished via the formation of diastereomeric imides 6 and 7 with (1S)-(naphth-1-yl)ethylamine (5), and their subsequent hydrolysis and recyclisation (Scheme 1). The enantiomers 3 and 4 were characterized spectrally, polarimetrically (including CD) and by chiral HPLC. The chiral anhydrides were also stereospecifically converted to the corresponding imides by treatment with aq. ammonia in excellent yields. The crystal structure of one of the diastereomeric imides (derived from 6-phenylfulvene) was determined, and based on the known S configuration of the naphthylethylamine moiety, the configurations of the original anhydride adducts could be assigned.2 Scheme 1 Chapter 2: In this chapter tricyclic imides (8a-c) were prepared by Diels-Alder reaction of 6-arylfulvenes (1a-c) and maleic anhydride (2),2 followed by treatment with aq. NH3. The exo isomers were found to exist as conglomerates when the aryl group was p-tolyl or p-anisyl (although not phenyl). Triage of the p-tolyl racemate (Scheme 2), followed by reaction with p-toluenesulphonyl chloride in CH2Cl2/Et3N, led to the crystalline enantiopure N-tosylimides 9 (These were also found to be conglomerates). X-ray diffraction analysis of the N-tosylimides (9) via the anomalous dispersion technique led to the assignment of the absolute configurations (as either E or Z).3, 4 The original p-tolyl imide enantiomers were found to racemise upon UV irradiation in CHCl3. Based on this, a possible second order asymmetric transformation under photochemical conditions was attempted, and indeed led to the isolation of crystalline imide with a small ee (~15%).5 Scheme 2 Chapter 3: This chapter deals with the fulvene-nitrone cycloadditions. The possibility of discovering examples of the rare (6π + 4π) cycloaddition prompted an exploration of the reaction between electron-rich nitrones and pentafulvenes. In previous reports of such cycloadditions, diazomethane or benzonitrile oxide was used as 4π component.6 Building on previous work from this laboratory,7 the reaction between a set of substituted fulvenes and electron rich nitrones were studied. Theoretical calculations indicate that the (6π + 4π) mode would be favored when the fulvene-nitrone cycloaddition is controlled by the LUMO (fulvene) – HOMO (nitrones) interaction.8 Electron withdrawing groups on the fulvene would lower the LUMO and facilitate the above orbital interaction. Therefore the reaction between electron poor fulvenes and nitrones was taken up for further study. In particular, fulvene (10) was reacted with nitrones (11). However, only a (2π + 4π) mode was observed, involving one of the endocyclic double bond of the fulvene, in moderate yields (Scheme 3). Structures of these adducts were assigned based on NMR and X-ray crystal structure determination. The failure to observe the (6π + 4π) mode (14) is intriguing, and it is not clear whether this is due to electronic or steric reason. Scheme 3 Part II Chapter 1 describes the resolution of racemic primary amines and racemic amino acids (16) via the formation of diastereomeric imides. For this purpose D-camphoric anhydride (15) was chosen as the chiral auxiliary for the following reasons: it is of low-molecular weight with a rigid backbone, and is also easily prepared and purified.9 Primary amine (16) was treated with D-camphoric anhydride (15) in presence of CHCl3/DCC to form the corresponding diastereomeric imides 17 and 18. (In the case of amino acids, the corresponding methyl esters were treated with D-camphoric anhydride (15) in presence of triethylamine in chloroform). The resulting diastereomeric imides 17 and 18 were separated by silica gel column chromatography (Scheme 4), and hydrolyzed to the chiral amines (or amino acids). (The by-produced camphoric acid could be reconverted to D-camphoric anhydride (15). Scheme 4 Chapter 2: The relative ease with which β-ketoacids tend to lose CO2 is intriguing and has been the focus of numerous mechanistic studies.10-12 It is generally believed that the decarboxylation of β-ketoacids occurs via a six-centered hydrogen bonded transition state (19), which leads to the formation of the enol tautomer (20) of the final ketone product (Scheme 5). Scheme 5 Scheme 6 The initial formation of the enol is apparently supported by the high thermal stability of bicyclic β-ketoacids, in which the carboxylic acid functionality is at bridgehead. In these the formation of the enol would be disfavored by Bredt’s rule, which forbids the formation of a double bond at the bridgehead (particularly in the smaller bicyclic compounds). Also, it may be expected that these trends would be manifested in the ground state. This is because there would be a stereoelectronic requirement for the decarboxylation reaction, by which the bond to the carboxylic group would need to be parallel to the C=O π bond of the keto group. Therefore, it was of interest to study the crystal structures of suitable β-ketoacids in the hope of evidencing the above structural trends (Structure for the analogs 21-23 have been reported previously (Scheme 6)).13-15 In fact, the approach pioneered by Dunitz was of particular interest in this regard. 16 In this approach crystal structures of a series of analogs were studied; these analogs possess varying degrees of strain that could be considered as leading to the transition state of a certain reaction. The bond length and related data are then employed to ‘map’ the reaction dynamics. Compound Bond* lengths (Å) Increase in the bond length compared to ketopinic acid (%) Decarboxylation temp.17 * fine bond at the bridgehead to the COOH group. In the case of the decarboxylation of β-ketoacids, a correlation between the lengthening of the bond to the COOH group and the ease of decarboxylation was sought. Therefore the set of analogs 24-26 were prepared (Scheme 6) and their crystal structures determined by X-ray diffraction (at 100K). In the case of 26, an increase of 2.47% relative to 21 in the Cα-COOH bond length was observed. However, no evidence for an intramolecular O=C-O-H…O=C H-bonding, was observed in the crystal structures of 24-26. Instead, the COOH moieties were seen to participate in intermolecular O-H…O hydrogen bonding via the well known carboxylic acid dimer motif. The β-ketoacids were also converted into their corresponding S-benzylisothiouronium salts (Scheme 6), to study the effect of destroying the COOH dimer motif. The salts 27 and 28 could be obtained in a form suitable for single crystal X-ray diffraction. The crystal structures revealed an increase in the Cα-COO- bond length to an extent of 1.97% in case of 28 relative to 27. Also, there is an increase in the relevant bond length of ~0.8% on going from 24 (m.p. 145 °C) to 26 (m.p. 132 °C). Note also that these compounds melts with decompositions. Therefore, it appears that the ease of decarboxylation of these analogs is reflected in the relative lengthening of the bond to the COOH group. Thus, this study represents an application of the Dunitz crystallographic approach to reaction dynamics,16 to the case of the decarboxylation of β-ketoacids.(For structural formula pl see the pdf file)

Different multiple-injection methodologies and the partial filling technique (PFT) have been utilized for separation of pharmaceuticals by capillary elec-trophoresis. In multiple-injection capillary zone electrophoresis (MICZE), the samples and all standards, used for construction of the calibration curve, are analyzed within a single run. Four different modes of MICZE have been described by means of equations, which were experimentally verified. The developed equations facilitate the transfer from conventional single-injection CZE to one or more of these MICZE-modes, depending on the selectivity between the analyte and the injection marker. The applicability of two of these modes was then demonstrated by quantification of buserelin and salbutamol, re-spectively in commercially available pharmaceutical products. The content of buserelin in an injection solution was determined to 0.94 mg/ml, which only deviated slightly from the declared concentration (1 mg/ml). An alter-native mode of MICZE, offering a higher number of sequential sample injec-tions, was then utilized for single-run determination of salbutamol in 15 tab-lets, with a labelled content of 8 mg. The average content of the tablets was determined to 7.8 mg, with an intra-tablet variation of 3 % or less. Moreover, UV- and mass-spectrometric detection of enantiomeric amines, resolved by non-aqueous capillary electrophoresis (NACE), was demon-strated. Separation of enantiomeric amines was achieved using the chiral selector (-)-2,3:4,6-di-O-isopropylidene-2-keto-L-gulonic acid, (-)-DIKGA. Introduction of the non-volatile (-)-DIKGA into the mass-spectrometer was avoided by using the PFT, where the capillary is only partially filled with electrolyte containing the chiral selector.

Linalool is a monoterpene can be biosynthesized by some plants in the racemic form, ( })-linalool, or in the form of enantiomers, (+)-linalool or (-)-linalool. The evaluation the activity of pure isomers has become important in the discovery of new drugs with improved therapeutic potential and a lower rate of adverse effects. So, the objective of the present study was to evaluate the vasorelaxant action induced by the enantiomers, (+) and (-)-linalool in rat superior mesenteric artery, besides seeks to elucidate the mechanisms of action involved in this effect. For both, male Wistar rats (200 . 300 g) were euthanized by exsanguination under anesthesia and superior mesenteric artery was removed. Rings were obtained (1-2 mm) this artery, and were mounted in organ baths containing 10 mL of Tyrode fs solution at 37 C and gassed with carbogen. For isometric tension recordings, each ring was suspended by cotton thread fixed in a force transducer connected to an acquisition system. In rings with functional endothelium pre-contracted with 10 ÊL of phenylephrine, both enantiomers were able to induce significant concentration-dependent vasorelaxation. Such as the effect presented by the (-)-linalool (Emax = 75 } 3%, n = 6) were higher than those for the (+)-linalool (Emax = 41 } 3%, n = 4), sought to evaluate the mechanism of action involved in their action vasorelaxant. In rings without functional endothelium, the vasorelaxation induced by (-)-linalool was significantly attenuated compared to the condition where the rings with functional endothelium were pre-contracted with phenylephrine (Emax = 55 } 1.5%, n = 5). Similar results were obtained after incubation with 10-8 M of atropine, an antagonist of muscarinic receptors (Emax = 50 } 5 %; n = 5); or with 10-4 M of L-NAME, an inhibitor of NO synthesis (Emax = 57 } 5 %; n = 6); or with 30 ÊM of hydroxocobalamin, a NO scavenger (Emax = 45 } 5 %; n = 6). In rings without functional endothelium incubated with 1 mM TEA, a blocker of non-selective K+ channels, the vasorelaxation induced by (-)-linalool had not changed significantly (Emax = 70 } 4 %; n = 4). However, in endothelium-denuded rings pre-contracted with KCl 80 mM, the oil-induced relaxation was significantly higher than that obtained without functional endothelium in rings pre-contracted with phenylephrine (Emax = 92 } 2 %; n = 5). In addition, isolated concentrations of (-)-linalool significantly reduced the contractions induced by CaCl2 (10-6 . 10-2 M) or by Na3VO4 (10-5 . 3 x 10-2 M), a non-selective inhibitor of protein tyrosine phosphatases. These results suggest that the effects induced by linalool occur mainly by the action of one of its isomers, the (-)-linalool. This isomer produces an effect vasorelaxant in rat superior mesenteric artery which is in part, dependent on the endothelium which is given by the activation of muscarinic receptors and the NO release. Furthermore, the endothelium-independent vasorelaxation is due to inhibition of calcium channel voltage-sensitive and involves the sensitization of the contractile machinery in vascular smooth muscle. / Linalol e um monoterpeno que pode ser biossintetizado por algumas plantas na forma racemica, ( })-linalol, ou na forma de enantiomeros, (+)-linalol ou (-)-linalol. A avaliacao da atividade dos isomeros puros tem tornado-se importante para a descoberta de novas drogas com melhor potencial terapeutico e menor indice de efeitos colaterais. Assim, o objetivo do presente estudo foi avaliar a acao vasorelaxante induzida pelos enantiomeros, (+) e (-)-linalol em arteria mesenterica superior de rato, alem de buscar elucidar os mecanismos envolvidos neste efeito. Para tanto, ratos Wistar machos (200 . 300 g) foram sacrificados por dessangramento sob anestesia e a arteria mesenterica superior foi removida. Desta arteria foram obtidos aneis (1-2 mm) que foram mantidos em cubas para orgao isolado contendo 10 mL de solucao nutritiva de Tyrode a 37 oC e gaseificada com carbogenio. Para o registro das contracoes isometricas, cada anel foi suspenso por linha de algodao fixada a um transdutor de forca conectado a um sistema de aquisicao de dados. Em aneis com endotelio funcional pre-contraidos com 10 ÊM fenilefrina, ambos enantiomeros foram capazes de induzir vasorelaxamento significativo dependente da concentracao. Como o efeito apresentado pelo (-)-linalol (Emax = 75 } 3 %; n = 6) foi maior que aquele apresentado pelo (+)-linalol (Emax = 41 } 3 %; n = 4), buscou-se avaliar o mecanismo de acao envolvido em sua acao vasorelaxante. Em aneis sem endotelio funcional, o vasorelaxamento induzido pelo (-)-linalol foi significativamente atenuado em relacao a condicao onde os aneis com endotelio funcional foram pre-contraidos com fenilefrina (Emax = 55 } 1,5 %; n = 5). Resultados semelhantes foram obtidos apos incubacao com 10-8 M de atropina, um antagonista de receptores muscarinicos (Emax = 50 } 5 %; n = 5); ou 10-4 M de L-NAME, um inibidor da sintese de NO (Emax = 57 } 5 %; n = 6); ou 30 ÊM de hidroxocobalamina, um sequestrador de NO (Emax = 45 } 5 %; n = 6). Em aneis sem endotelio funcional pre-incubados com 1 mM de TEA, um bloqueador nao seletivo de canais para K+, o vasorelaxamento induzido pelo (-)-linalol nao foi alterado significativamente (Emax = 70 } 4 %; n = 4). Porem, em aneis sem endotelio funcional pre-contraidos com KCl 80 mM, o vasorelaxamento induzido pelo oleo foi significativamente maior que aquele obtido em aneis sem endotelio funcional pre-contraidos com fenilefrina (Emax = 92 } 2 %; n = 5). Alem disso, concentracoes isoladas de (-)-linalol foram capazes de antagonizar contracoes induzidas por CaCl2 (10-6 . 10-2 M) e Na3VO4 (10-5 . 3 x 10-2 M), um inibidor nao-seletivo de proteinas tirosina-fosfatases. Estes resultados sugerem que os efeitos induzidos pelo linalol ocorrem, principalmente, pela acao de um de seus isomeros, o (-)-linalol. Este isomero produz um efeito vasorelaxante em arteria mesenterica superior de rato que e em parte, dependente do endotelio, o qual se da pela ativacao de receptores muscarinicos e pela liberacao de NO. Alem disso, o vasorelaxamento independente do endotelio e decorrente da inibicao dos canais para calcio sensiveis a voltagem e envolve a sensibilizacao da maquinaria contratil na musculatura lisa vascular.

O carvedilol é um fármaco utilizado na terapêutica da hipertensão e da insuficiência cardíaca congestiva. É disponível para uso clínico como racemato e seus enantiômeros apresentam atividade semelhante sobre os receptores 1-adrenérgicos, sendo que o enantiômero S-(-) é mais ativo como antagonista dos receptores adrenérgicos. O presente estudo visa investigar a influência do Diabetes mellitus (DM) tipo 2 e da insuficiência renal crônica (IRC) em pacientes em diálise peritoneal ambulatorial contínua (DPAC) na farmacocinética enantiosseletiva e na farmacodinâmica do carvedilol em pacientes hipertensos. Os pacientes hipertensos investigados divididos nos grupos controle (n=8), DM tipo 2 (n=8) e IRC em DPAC (n=6) receberam dose única p.o. de 25 mg de carvedilol racêmico. Os enantiômeros do carvedilol e metabólitos 4-hidroxifenil e O-desmetilcarvedilol foram analisados no sistema LC-MS/MS empregando coluna quiral e fase móvel constituída por mistura de metanol: ácido acético: dietilamina. O método foi linear no intervalo de concentrações de 0,1-100 ng de cada enantiômero do carvedilol/mL de líquido de diálise, 0,2-200 ng de cada enantiômero do carvedilol/mL de plasma, 2,5-2500 ng de cada enantiômero do carvedilol, 4-hidroxifenil e O-desmetilcarvedilol/mL de urina. Os parâmetros farmacocinéticos foram calculados empregando o programa WinNonlin. O teste de Wilcoxon foi usado para avaliar as razões enantioméricas dentro dos grupos e o teste de Mann-Whitney foi utilizado para avaliar as diferença dos parâmetros farmacocinéticos entre os grupos. Na investigação do fenótipo oxidativo tipo metoprolol todos os pacientes incluídos no estudo foram fenotipados como metabolizadores extensivos. Os pacientes investigados com DM tipo 2 comparados com o grupo controle não apresentaram alterações na farmacocinética e farmacodinâmica (PK-PD) do carvedilol. Os pacientes com IRC em DPAC apresentaram valores de clearance (CL/F) dos enantiômeros R-(+) - e S-(-)-carvedilol de 25,17 e 27,89 L/h, respectivamente, sendo significativamente inferiores aos obtidos para os pacientes do grupo controle (76,76 e 142,0 L/h). As razões de AUCR/S foram de 2,27 para os pacientes do grupo controle e de 0,97 para os pacientes com IRC em DPAC. Os pacientes com IRC em DPAC não mostraram enantiosseletividade na farmacocinética do carvedilol em razão do acúmulo plasmático preferencial do enantiômero com atividade -bloqueadora S-(-)-carvedilol. / Carvedilol is used for the treatment of hypertension and congestive heart failure. The drug is available for clinical use as the racemate and its enantiomers exert similar activity on 1-adrenergic receptors, whereas the S-(-) enantiomer is more active as a -adrenergic receptor antagonist. The aim of the present study was to investigate the influence of type 2 Diabetes mellitus (DM) and chronic renal failure (CRF) on patients receiving continuous ambulatory peritoneal dialysis (CAPD) on the enantioselective pharmacokinetics and pharmacodynamics of carvedilol in hypertensive patients. The hypertensive patients were divided into a control (n=8), type 2 DM (n=8) and CRF on CAPD (n=6) group and received a single oral dose of 25 mg racemic carvedilol. The enantiomers of carvedilol and of the metabolites 4-hydroxyphenyl and O-desmethylcarvedilol were analyzed by LC-MS/MS using a chiral column and a mobile phase consisting of a mixture of methanol:acetic acid-diethylamine. The method was linear within the following concentration ranges: 0.1-100 ng of each carvedilol enantiomer/mL dialysis fluid, 0.2-200 ng of each carvedilol enantiomer/mL plasma, and 2.5-2500 ng of each enantiomer of carvedilol, 4-hydroxyphenyl carvedilol and O-desmethyl carvedilol/mL urine. The pharmacokinetic parameters were calculated using the WinNonlin program. Enantiomer ratios within groups were evaluated by the Wilcoxon test and the Mann-Whitney test was used to determine differences in the pharmacokinetic parameters between groups. Determination of the metoprolol type oxidation phenotype showed that all patients included in the study were extensive metabolizers. Patients with type 2 DM presented no changes in the pharmacokinetics or pharmacodynamics of carvedilol when compared to the control group. Clearance (CL/F) of the R-(+)- and S-(-)-carvedilol enantiomers was significantly lower in patients with CRF on CAPD (25.17 and 27.89 L/h, respectively) compared to the control group (76.76 and 142.0 L/h). The AUCR/S ratios were 2.27 for control patients and 0.97 for patients with CRF on CAPD. Patients with CRF on CAPD showed no enantioselectivity in the pharmacokinetics of carvedilol due to the preferential plasma accumulation of the enantiomer with -blocker activity, S-(-)-carvedilol.

A mefloquina (MQ), fármaco utilizado na profilaxia e tratamento da malária ocasionada por Plasmodium falciparum resistente à cloroquina, é comercializada na forma racêmica. Apresenta disposição cinética estereosseletiva e ação farmacológica diferencial entre os enantiômeros. A maioria dos métodos analíticos desenvolvidos para análise do fármaco em plasma utiliza como técnicas de preparação das amostras, a extração líquido-líquido ou a extração em fase sólida. Por outro lado, a microextração em fase líquida (LPME), técnica recentemente desenvolvida, pode oferecer resultados bastante satisfatórios para amostras complexas, como fluidos biológicos. Portanto, o presente trabalho teve por finalidade o desenvolvimento e validação de um método analítico empregando a cromatografia líquida de alta eficiência com fases estacionárias quirais juntamente com a LPME para a análise enantiosseletiva da MQ em plasma. Empregando-se a coluna Chiralpak AD com fase móvel constituída por hexano/etanol/DEA (97:3:0,05, v/v/v), obteve-se a separação dos enantiômeros da MQ, com tempos de retenção reduzidos e resolução apropriada. Utilizando-se uma membrana capilar de polipropileno, juntamente com éter diexílico (fase orgânica) e ácido perclórico 10 mmol L-1 (fase aceptora) como componentes do sistema de três fases, obteve-se excelente isolamento dos interferentes endógenos aliado a um enriquecimento satisfatório dos analitos, sendo então possível a validação do método desenvolvido. A metodologia otimizada apresentou linearidade satisfatória no intervalo de 50 ? 1500 ng mL-1 com coeficientes de determinação > 0,998 para ambos enantiômeros. Os valores de recuperação absoluta de (-)-(SR)-MQ e (+)-(RS)-MQ foram 33,2% e 35,0%, respectivamente. Precisão e exatidão, avaliadas por estudos intra-ensaio e interensaio, foram < 15% para ambos enantiômeros. Além disso, não foram observadas racemização ou degradação do fármaco durante a preparação das amostras e análise cromatográfica. Posteriormente, o método desenvolvido e validado foi aplicado em um estudo-piloto de disposição cinética em ratos. Verificou-se que a disposição cinética da MQ em ratos foi estereosseletiva, já que maiores concentrações de (+)-(RS)-MQ foram obtidas em todos os tempos de análise avaliados. / Mefloquine (MQ), a drug used for prophylaxis and treatment of malaria caused by chloroquine-resistant strains of Plasmodium falciparum, is commercialized as a racemic mixture. MQ enantiomers demonstrate differential stereoselective dispositions and pharmacodynamic actions. The majority of methods developed for the determination of mefloquine in plasma includes liquid-liquid or solid-phase extraction as sample preparation. On the other hand, liquid-phase microextraction (LPME), a recently developed technique, may offer satisfactory results for complex matrices, such as biological fluids. Therefore, the aim of this work was to develop and validate an analytical method using chiral high-performance liquid chromatography combined with LPME for the enantioselective analysis of MQ in plasma. Employing a Chiralpak AD column with hexane/ethanol/DEA (97:3:0.05, v/v/v) as mobile phase, separation of MQ enantiomers was achieved with short retention times and appropriate resolution. Using a polypropylene-based capillary membrane together with di-n-hexyl ether (organic phase) and 10 mmol L-1 perchloric acid (acceptor phase) as components of a three-phase system, an excelent clean-up of endogenous interferents, allied with a satisfactory enrichment of analytes, was obtained, which allowed method validation. The optimized methodology exhibited good linearity over a 50 - 1500 ng mL-1 range with correlation coefficients of > 0.998 for both enantiomers. The mean recoveries of (-)-(SR)-MQ and (+)-(RS)-MQ were 33.2 and 35.0%, respectively. Precision and accuracy, demonstrated by within-day and between-day assays, were lower than 15% for both enantiomers. Furthermore, no racemization or degradation were seen during sample preparation and chromatographic analysis. Finally, the developed and validated method was applied to a pilot pharmacokinetic assay in rats. An enantiosselective kinetic disposition of MQ enantiomers was observed in rat plasma, as concentrations of (+)-(RS)-MQ were greater than its antipode at all measured times.

A oxcarbazepina (OXC) é indicada como terapia adjuvante ou monoterapia no tratamento de crises epilépticas parciais ou crises tônico-clônicas generalizadas em adultos e crianças. A OXC sofre rápida eliminação pré-sistêmica com formação do metabólito ativo 10-hidroxicarbazepina (MHD), o qual possui como enantiômeros o R-(-)- e o S-(+)-MHD. A OXC e o MHD são substratos da glicoproteína-P (P-gp), que pode ser inibida pelo verapamil. O presente estudo avalia a influência do verapamil na farmacocinética e perfusão cerebral da OXC e dos enantiômeros do MHD em voluntários sadios. Os voluntários sadios (n=12) receberam em uma ocasião doses de 300 mg/12h de OXC e em outra ocasião doses de 300 mg/12h de OXC associadas com 80 mg/8h de verapamil. As amostras de sangue foram coletadas no estado de equilíbrio durante 12 horas e a avaliação da perfusão cerebral realizada utilizando a tomografia computadorizada por emissão de fóton único (SPECT) antes do início do tratamento e nos tempos 4, 6 ou 12h após a administração da OXC. As concentrações plasmáticas total e livre da OXC e dos enantiômeros do MHD foram avaliadas por LC-MS/MS. A análise farmacocinética não compartimental foi realizada com o programa WinNonlin e a farmacocinética populacional foi desenvolvida utilizando a modelagem não-linear de efeitos mistos com o programa NONMEM. Os limites de quantificação obtidos foram de 12,5 ng OXC/mL de plasma e 31,25 ng de cada enantiômero MHD/mL de plasma para a análise da concentração total, enquanto foi de 4,0 ng de OXC/mL de plasma e de 20,0 ng de cada enantiômero do MHD/mL de plasma para a determinação da concentração livre. Os coeficientes de variação obtidos nos estudos de precisão e a porcentagem de inexatidão inter e intra-ensaios foram inferiores a 15%, assegurando a reprodutibilidade e repetibilidade dos resultados. A análise farmacocinética não compartimental da OXC em monoterapia resultou nos seguintes parâmetros: concentração plasmática máxima (Cmax) de 1,35 ?g/mL como valor total e 0,32 ?g/mL como concentração livre em 1,0 h, área sob a curva concentração plasmática versus tempo (AUC0-12) de 3,98 ?g.h/mL e meia-vida de eliminação de 2,45 h, volume de distribuição aparente (Vss/F) de 352,17 L e clearance aparente (CLss/F) de 75,58 L/h. A disposição cinética do MHD é enantiosseletiva, com observação de maior proporção para o enantiômero S-(+)-MHD em relação ao R-(-)-MHD (razão AUC0-12 S-(+)/R-(-) de 4,26). A fração livre avaliada no tmax da OXC foi 0,26 para a OXC, 0,42 para o R-(-)-MHD e 0,38 para o S- (+)-MHD, mostrando enantiosseletividade na ligação às proteínas plasmáticas do MHD. O tratamento com o verapamil reduziu o tempo médio de residência (MRT) (4,71 vs 3,83 h) e Cmax como concentração livre (0,32 vs 0,53 ?g/mL) da OXC e aumentou os valores para ambos os enantiômeros do MHD de Cmax como valor total (2,60 vs 3,27 ?g/mL para o R-(-)- e 11,05 vs 11,94 ?g/mL para o S-(+)-MHD), Cmax como concentração livre (3,11 vs 4,14 ?g/mL para o S-(+)-MHD), Cmédia (2,11 vs 2,42 ?g/mL para o R-(-)- e 8,10 vs 9,07 ?g/mL para o S-(+)-MHD) e AUC0-12 (25,36 vs 29,06 ?g.h/mL para o R-(-)- e 97,19 vs 111,37 ?g.h/mL para o S-(+)-MHD). A ii farmacocinética populacional da OXC foi melhor descrita por modelo de dois compartimentos com eliminação de primeira ordem e com um conjunto de três compartimentos de trânsito para descrever o perfil de absorção da OXC. A disposição de ambos os enantiômeros do MHD foi caracterizada por modelo de um compartimento. Os valores de CLss/F estimados na monoterapia foram de 84,9 L/h para a OXC e de 2,0 L/h para ambos enantiômeros do MHD, enquanto os valores de Vss/F foram de 587 L para a OXC, 23,6 L para o R-(-)-MHD e 31,7 L para o S-(+)- MHD. Concluindo, a associação do verapamil aumentou a biodisponibilidade da OXC em 12% (farmacocinética populacional) e aumentou os valores de AUC de ambos os enantiômeros do metabólito MHD (farmacocinética não compartimental), o que está provavelmente relacionado com a inibição da P-gp no trato intestinal. A associação do verapamil aumentou as concentrações cerebrais preditas de ambos os enantiômeros do MHD em maior extensão do que aquelas observadas no plasma. As mudanças no fluxo sanguíneo cerebral (SPECTs realizados 6h após a administração da OXC) associadas à coadministração de verapamil provavelmente foram causadas pelo aumento dos níveis cerebrais de ambos os enantiômeros do MHD. A confirmação dessa observação requer um braço experimental adicional com SPECTs realizados também após a administração do verapamil em monoterapia. / Oxcarbazepine (OXC) is indicated as adjunctive therapy or monotherapy for the treatment of partial or generalized tonic-clonic seizures in adults and children. OXC undergoes rapid pre-systemic reduction with formation of the active metabolite 10- hydroxycarbazepine (MHD), which has the enantiomers R-(-)- and S-(+)-MHD. OXC and MHD are substrates of P-glycoprotein (P-gp), which can be inhibited by verapamil. The present study evaluates the influence of verapamil on the pharmacokinetics and cerebral perfusion of OXC and the MHD enantiomers in healthy volunteers. The healthy volunteers (n=12) received on one occasion doses of 300 mg/12h OXC and on another occasion they received doses of 300 mg/12h OXC associated with 80 mg/8h of verapamil. Blood samples were collected at steady state for 12 hours and the assessment of cerebral perfusion was performed using a single-photon emission computed tomography (SPECT) before the beginning of treatment and at times 4, 6 or 12 hours after OXC administration. The total and free plasma concentrations of OXC and MHD enantiomers were assessed by LC-MS/MS. The non-compartmental pharmacokinetics analysis was performed using the WinNonlin program, and population pharmacokinetics was developed using nonlinear mixed effects modelling with NONMEM.The limits of quantification obtained were 12.5 ng/mL plasma for OXC and 31.25 ng of each MHD enantiomer/mL plasma for total concentration analysis, while it was 4.0 ng OXC/mL plasma and 20.0 ng of each MHD enantiomer/mL plasma for the free concentration determination. The coefficients of variation obtained in studies of accuracy and the percentage of inaccuracy inter and intra-assay were less than 15%, ensuring the result reproducibility and repeatability. The non-compartmental pharmacokinetic analysis of OXC in monotherapy treatment, resulted in the following parameters: maximum plasma concentration (Cmax) of 1.35 ?g/mL as total concentration and 0.32 mg/mL as free concentration in 1.0 h, area under the plasma concentration vs time curve (AUC0-12) was 3.98 ?g.h/mL, half-life of 2.45 h, apparent volume of distribution (Vss/F) of 352.17 L and the apparent clearance (CLSS/F) of 75.58 L/h. The MHD kinetic disposition is enantioselective, with observation of a greater proportion of the S-(+)-MHD enantiomer compared to R-(-)-MHD (ratio AUC0-12 S-(+)/R-(-) of 4.26). The free fraction measured in the tmax of OXC was 0.26 for OXC, 0.42 for R-(-)-MHD and 0.38 for S-(+)-MHD, showing enantioselectivity in the plasma protein binding of MHD. Verapamil treatment reduced the mean residence time (MRT) (4.71 vs 3.83 h) and Cmax (0.26 vs 0.31 ?g/mL) as free concentration for OXC and increased the both MHD enantiomers values of Cmax (2.60 vs 3.27 ?g/mL for R-(-)- and 11.94 vs 11.05 ?g/mL for S-(+)-MHD) as total concentration, Cmax (3.11 vs 4,14 ?g/mL for S- (+)-MHD) as free concentration, Cavg (2.11 vs 2.42 ?g/mL for R-(-)- and 8.10 vs 9.07 ?g/mL for S-(+)-MHD) and AUC0-12 (25.36 vs 29.06 ?g.h/mL for R-(-)- and 97.19 vs 111.37 ?g.h/mL for S-(+)-MHD). The population pharmacokinetics of oxcarbazepine was best described by a two-compartment model with first-order elimination and a iv set of three transit compartments to describe the absorption profile of the parent compound. The disposition of both MHD enantiomers was characterised by onecompartment model. The CLss/F estimates in monotherapy were 84.9 L/h for OXC and 2.0 L/h for both MHD enantiomers, whereas the values of Vss/F were 587 L for OXC, 23.6 L for R-(-)-MHD and 31.7 L for S-(+)-MHD. In conclusion, verapamil coadministration increased the OXC bioavailability in 12% (population pharmacokinetics) and increased the AUC of both metabolite MHD enantiomers (non-compartmental pharmacokinetics), which is probably related to the inhibition of P-gp in the intestinal tract. Verapamil co-administration increased the predicted brain concentrations of both MHD enantiomers in a greater extent than those observed in plasma. Changes in cerebral blood flow (SPECTs performed 6h after administration of OXC) associated with co-administration of verapamil were probably caused by an increase in brain levels of both MHD enantiomers. Confirmation of this observation requires additional experimental arm with SPECTs also performed after administration of verapamil in monotherapy.

(EN) Cellulose tris-(3,5-dimethylphenylcarbamate) chiral stationary phase was used for separation of selected 24 analytes. Enantioseparations were realized using two systems, high performance liquid chromatography and supercritical fluid chromatography. Effect of mobile phase composition was studied. Five different aditives (isopropylamine, diethylamine, triethylamine, trifluoroacetic acid, isopropylamine combined with trifluoroacetic acid) and their influence on enantioseparation were tested. Influence of two different modifiers (methanol, propan-2-ol) combined with all aditives was also tested in supercritical fluid chromatography system. The aim of this work was to find optimized composition of mobile phase which was suitable for separation of the analytes studied and to compare separation potential among all mobile phases and also between used separations systems. The supercritical fluid chromatography was shown to yield better results, i.e. better resolution in shorter analysis time. However examples of analytes better resolved under optimized conditions in high performance liquid chromatography system have also been found. Keywords (EN) Chirality, enantiomers, enantioselective separation, chiral stationary phase, high performance liquid chromatography, supercritical fluid chromatography.

O carvedilol é um anti-hipertensivo disponível na clínica como mistura racêmica, sendo o (S)-(-)-carvedilol um bloqueador ? e ?1-adrenérgico e o (R)-(+)-carvedilol apenas ?1-adrenérgico. O carvedilol é metabolizado principalmente por glicuronidação e pelo CYP2D6 a hidroxifenilcarvedilol e pelo CYP2C9 a Odesmetilcarvedilol. O presente estudo avalia a disposição cinética e o metabolismo dos enantiômeros do carvedilol, hidroxifenilcarvedilol e O-desmetilcarvedilol em voluntários sadios não comedicados (n=13) ou comedicados com dose única oral de glibenclamida (5 mg) e metformina (500 mg) (n=13) e em pacientes portadores de diabetes mellitus tipo 2 (com bom controle glicêmico e em tratamento com glibenclamida 5 mg/8h e metformina 500 mg/8h; n=14), fenotipados como metabolizadores rápidos (n=26) ou lentos (n=1). Os voluntários e pacientes receberam dose única oral de 25 mg de carvedilol racêmico e amostras seriadas de sangue foram coletadas até 24h após a administração. A frequência cardíaca foi avaliada na situação de exercício isométrico com o handgrip durante 2 min a 30% da contratilidade voluntária máxima e durante o repouso. Os enantiômeros do carvedilol e metabólitos foram analisados em plasma por LC-MS/MS empregando coluna Chirobiotic® V. O método foi linear no intervalo de 0,05 a 100; 0,05 a 10 e 0,02 a 10 ng/mL para os enantiômeros do carvedilol, hidroxifenilcarvedilol e O-desmetilcarvedilol, os desvios do estudo de precisão e exatidão foram inferiores a 15% e não foi observado efeito matriz. A farmacocinética avaliada por modelo não compartimental mostra acúmulo plasmático dos enantiômeros (R)-(+)-carvedilol, (R)-(+)-O-desmetilcarvedilol e (R)-(+)- hidroxifenilcarvedilol. A disposição cinética e o metabolismo dos enantiômeros do carvedilol não diferem entre os grupos de voluntários não comedicados e comedicados com dose única oral de glibenclamida e metformina. No entanto, os valores de AUC de ambos os enantiômeros do metabólito O-desmetilcarvedilol [(R)- (+): 6,92 vs 10,40 vs 11,91 ng.h/mL e (S)-(-): 2,36 vs 4,26 vs 3,98 ng/h/mL] são menores no grupo de pacientes portadores de diabetes mellitus tipo 2 quando comparados ao grupo de voluntários sadios não comedicados ou comedicados. Em compensação, os valores de AUC de ambos os enantiômeros do metabólito hidroxifenilcarvedilol [(R)-(+): 13,89 vs 6,60 vs 4,88 ng.h/mL e (S)-(-): 7,21 vs 1,50 vs 1,45 ng/h/mL] são maiores no grupo de pacientes portadores de diabetes mellitus tipo 2. Os parâmetros farmacocinéticos de um paciente metabolizador lento do CYP2D6, portador de diabetes mellitus tipo 2 e em tratamento com glibenclamida e metformina, permite inferir redução na formação de ambos os enantiômeros do metabólito hidroxifenilcarvedilol compensada pelo aumento na formação de ambos os enantiômeros do metabólito O-desmetilcarvedilol. Logo, a disposição cinética de ambos os enantiômeros do carvedilol sob a forma inalterada não difere entre metabolizadores rápidos e lentos do CYP2D6. O modelo não linear de efeitos mistos para a análise da disposição cinética e metabolismo populacional dos enantiômeros do carvedilol foi desenvolvido no NONMEM v.7.2 é preciso e possui capacidade preditiva adequada avaliada por métodos visuais do ajuste do modelo aos dados e ii bootstrap. Os valores de biodisponibilidade estimados pelo modelo para os enantiômeros (S)-(-) e (R)-(+)-carvedilol, respectivamente 16,43 e 25,4%, não diferem entre voluntários sadios e pacientes portadores de diabetes mellitus tipo 2 em tratamento com glibenclamida e metformina. Os valores de clearance pelo CYP2D6 estimados para o (S)-(-)-carvedilol foram de 1,65 vs 7,28 L/h, respectivamente, para os voluntários sadios e para os pacientes diabéticos, enquanto os estimados para o enantiômero (R)-(+)-carvedilol foram de 2,69 vs 13,7 L/h. Em relação ao clearance pelo CYP2C9, os valores estimados para o (S)-(-)-carvedilol foram de 16,2 vs 7,71 L/h, respectivamente, para os voluntários sadios e para os pacientes diabéticos, enquanto os estimados para o enantiômero (R)-(+)-carvedilol foram de 25,6 vs 10,5 L/h. Os valores de clearance por outras vias metabólicas são maiores para o (S)-(-)- carvedilol do que para o (R)-(+)-carvedilol (28,2 vs 4,86 L/h) e não diferem entre voluntários sadios e pacientes. Os valores de clearance total de ambos os enantiômeros do carvedilol não diferem entre os voluntários sadios e os pacientes portadores de diabetes mellitus tipo 2 [(S)-(-): 46,05 vs 43,19 L/h e (R)-(+): 33,15 vs 29,06 L/h], considerando que os menores clearances do CYP2C9 são compensados por maiores clearances do CYP2D6. A variação da frequência cardíaca induzida pelo exercício isométrico com o handgrip após a administração de dose única oral de 25 mg de carvedilol racêmico não mostra relação com as concentrações plasmáticas do (S)-(-)-carvedilol. / Carvedilol is an antihypertensive available as racemic mixture, the (S)-(-)- carvedilol is a ??and ?1 adrenergic blocker and (R)-(+)-carvedilol is only na ?1- adrenergic blocker. Carvedilol is metabolized primarily by glucuronidation and by CYP2D6 to hidroxifenilcarvedilol and CYP2C9 to O-desmetilcarvedilol. This study evaluates the disposition and metabolism of carvedilol, hidroxyphenilcarvedilol and Odesmethylcarvedilol enantiomers in health (n=13) and type II diabetes subjects treated with glibenclamide (5 mg/8h) and in a good glycemic control (n=13) and in a CYP2D6 poor metabolizer diabetes subject (n=1). The subjects received a single racemic carvedilol dose of 25 mg. blood samples wore collected until 24h. The heart rate was evaluated durig isometric handgrip exercise. Carvedilol and metabolites enantiomers wore evaluated in plasma sampels by LC-MS/MS. The pharmacokinetics was evaluate by noncompartimental model and higher levels of (R)-(+)-carvedilol, (R)-(+)-Odesmethylcarvedilol e (R)-(+)-hidroxiphenilcarvedilol levels are noticed. The carvedilol pharmacokinetics does not change between healthy and type II diabetes subjects. However the AUC values of both O-desmethylcarvedilol enantiomers are lower [(R)-(+): 6,92 vs 10,40 vs 11,91 ng.h/mL e (S)-(-): 2,36 vs 4,26 vs 3,98 ng/h/mL]in the diabetes subjects and the AUC values of both hidroxyphenilcarvedilol enantiomers are higher [(R)-(+): 13,89 vs 6,60 vs 4,88 ng.h/mL e (S)-(-): 7,21 vs 1,50 vs 1,45 ng/h/mL]. It is noticed in CYP2D6 poor metabolizer diabetes subject lower levels of hidroxyphenilcarvedilol but higher of O-desmetilcarvedilol and carvedilol disposition is not changed. A Non-linear mixed effects modelling was performed in NONMEM v.7.2 the model was validated by visual methods and bootstrap. The bioavailability of (S)-(-) and (R)-(+)-carvedilol was 16,43 e 25,4% and no covariate effect was noticed. The CYP2D6 clearance values were 1,65 vs 7,28 L/h to healthy and diabetes subjects, inasmuch (R)-(+)-carvedilol ones were 25,6 vs 10,5 L/h. The CYP2C9 clearance of (S)-(-)-carvedilol were 16,2 vs 7,71 L/h for healthy and diabetes subjects, while (R)- (+)-carvedilol ones were 25,6 vs 10,5 L/h. The (S)-(-)-carvedilol clearance by other metabolic routes are higher (28,2 vs 4,86 L/h) and does not change between healthy and diabetes subjects. Carvedilol total clearance also does not differ between healthy and diabetes subjects the because the lower CYP2C9 clearance are balanced by the higher CYP2D6 clearance. The cardiac frequency change induced by handgrip isometric exercise is not related with the (S)-(-)-carvedilol plasma levels.

Orientador: Cesar Costapinto Santana / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia Quimica / Made available in DSpace on 2018-09-05T13:20:08Z (GMT). No. of bitstreams: 1 Veredas_ViniciusDe_D.pdf: 13205142 bytes, checksum: 97c5009c255088bef6fcdc1fd92294c3 (MD5) Previous issue date: 2005 / Doutorado / Desenvolvimento de Processos Biotecnologicos / Mestre em Engenharia Química