It is highly recommended for women to take multivitamin/mineral supplements during the periconceptional and prenatal periods. Studies have confirmed that taking prenatal multivitamins prevents maternal iron deficiency anemia, and reduces the risk for neural tube defects (NTDs). To date, research aimed at optimizing the use of multivitamins before and during pregnancy has been minimal. My thesis focused on two challenges of periconceptional and prenatal multivitamin supplementation. The first challenge was gastrointestinal (GI) adverse events such as nausea and constipation which may be attributed to iron content and tablet size. Pregnant women are highly susceptible to GI adverse events since 80% experience nausea and vomiting of pregnancy. A prospective, randomized, controlled, open-label study was conducted to investigate whether a low-iron, small-tablet prenatal multivitamin can reduce GI adverse events, and improve supplement tolerability and adherence, relative to a high-iron, small-tablet prenatal multivitamin. We determined that low iron dose did not produce a significant difference, while small tablet size could be considered an important factor. Moreover, our results confirmed that adherence was poor in pregnant women. We were prompted to identify determinants which could predict adherence to prenatal multivitamins. Our retrospective study determined that predictors of adherence are rooted in women’s prior experiences with multivitamin use. The second challenge we addressed was achieving adequate blood folate concentrations for prevention of NTDs. If adherence is poor, standard dosing of 0.4-1 mg folic acid may not produce the blood folate concentrations needed in women prior to conception. We investigated the pharmacokinetics of 5 mg folic acid. Our prospective, parallel, open-labeled study, comparing a single dose of 5 mg to 1.1 mg folic acid, confirmed that folic acid follows linear (proportional) pharmacokinetics. However, our prospective, randomized, controlled, open-labeled, multiple-dose study determined that repeated use of folic acid at these 2 doses followed non-linear pharmacokinetics. Nevertheless, our data confirmed that 5 mg folic acid can produce higher blood folate concentrations, with a faster rate, which can counter the effect of poor adherence. In conclusion, optimal use of prenatal multivitamins requires improvements in supplement tolerability, adherence, and pharmacokinetics which depend on supplement formulations, and individualized assessment and counseling.

This study describes the pharmacokinetic profile of procaine penicillin G after intraperitoneal (IP) administration in 8 lactating dairy cows. Procaine pencillin G (PPG, 21,000 IU/kg) was deposited into the abdominal cavity of each cow following an incision in the right paralumbar fossa. Blood and milk samples were taken over the following 10 days, at which point the cows were euthanized. Plasma, milk, muscle, liver, and kidney penicillin concentrations were determined by HPLC, with a limit of detection (LOD) of 5 ppb for plasma and milk samples. Noncompartmental methods were used to analyze plasma kinetics. The mean pharmacokinetic parameters (} s.d.) were: Cmax, 5.5 } 2.6 Êg/mL; Tmax, 0.75 } 0.27 h; AUC0-, 10.8 } 4.9 Êg*h/mL; MRT, 2.2 } 0.9 h. All milk from treated cows contained penicillin residues for a minimum of 3 milkings (31 h) and maximum of 5 milkings (52 h) after administration. Concentrations of penicillin G in all muscle, liver, and kidney samples taken 10 days post-administration were below the limit of detection. Necropsy examinations revealed foci of hemorrhage on the rumenal omentum of most cows but peritonitis was not observed. Systemic inflammation as determined by altered leukograms and fibrinogen was noted in one cow. The results of this study demonstrate that IP procaine penicillin G is absorbed and eliminated rapidly in lactating dairy cows.

It is highly recommended for women to take multivitamin/mineral supplements during the periconceptional and prenatal periods. Studies have confirmed that taking prenatal multivitamins prevents maternal iron deficiency anemia, and reduces the risk for neural tube defects (NTDs). To date, research aimed at optimizing the use of multivitamins before and during pregnancy has been minimal. My thesis focused on two challenges of periconceptional and prenatal multivitamin supplementation. The first challenge was gastrointestinal (GI) adverse events such as nausea and constipation which may be attributed to iron content and tablet size. Pregnant women are highly susceptible to GI adverse events since 80% experience nausea and vomiting of pregnancy. A prospective, randomized, controlled, open-label study was conducted to investigate whether a low-iron, small-tablet prenatal multivitamin can reduce GI adverse events, and improve supplement tolerability and adherence, relative to a high-iron, small-tablet prenatal multivitamin. We determined that low iron dose did not produce a significant difference, while small tablet size could be considered an important factor. Moreover, our results confirmed that adherence was poor in pregnant women. We were prompted to identify determinants which could predict adherence to prenatal multivitamins. Our retrospective study determined that predictors of adherence are rooted in women’s prior experiences with multivitamin use. The second challenge we addressed was achieving adequate blood folate concentrations for prevention of NTDs. If adherence is poor, standard dosing of 0.4-1 mg folic acid may not produce the blood folate concentrations needed in women prior to conception. We investigated the pharmacokinetics of 5 mg folic acid. Our prospective, parallel, open-labeled study, comparing a single dose of 5 mg to 1.1 mg folic acid, confirmed that folic acid follows linear (proportional) pharmacokinetics. However, our prospective, randomized, controlled, open-labeled, multiple-dose study determined that repeated use of folic acid at these 2 doses followed non-linear pharmacokinetics. Nevertheless, our data confirmed that 5 mg folic acid can produce higher blood folate concentrations, with a faster rate, which can counter the effect of poor adherence. In conclusion, optimal use of prenatal multivitamins requires improvements in supplement tolerability, adherence, and pharmacokinetics which depend on supplement formulations, and individualized assessment and counseling.

Solid phase microextraction (SPME) has gained much popularity for in vivo applications recently. Thus far, there are two types of pre-equilibrium kinetic calibration that have been applied to in vivo SPME: on-fibre standardization and dominant pre-equilibrium desorption. Both of these techniques have their own advantages and disadvantages. To address the limitations presented by these two techniques, a third pre-equilibrium kinetic calibration method, the diffusion-based interface model, was investigated. The diffusion-based interface model had been successfully applied to air and water samples but was never utilized for in vivo SPME studies. For the first part of the research, on-fibre standardization, dominant pre-equilibrium desorption, and diffusion-based interface model were compared in terms of accuracy, precision, and experimental procedures, by using a flow-through system. These three kinetic calibrations were further validated by equilibrium SPME extraction and protein-plasma precipitation, a current state-of-the-art sampling method. The potential of diffusion-based interface model was yet again demonstrated in the second part of the research project. This calibration method was applied to comparative pharmacokinetic studies of two drugs, fenoterol and methoxyfenoterol, on 5 rats. To provide a constant sampling rate as required for diffusion-based interface model, a SPME animal sampling autosampler, AccuSampler®, was utilized. It custom-written program allowed the entire SPME sampling procedure excluding insertion and removal of SPME probes to be automated. Furthermore, to validate the results obtained by SPME, the AccuSampler® was programmed to withdraw blood after each SPME sampling time point for conventional method analysis using protein-plasma precipitation. The well correlated data obtained by SPME sampling and the conventional method illustrated the potential of diffusion-based interface model as an excellent choice for future in vivo SPME applications.

Liver biopsy is a very common, but invasive procedure for diagnosing liver disease. However, such a biopsy may result in severe complications and in some cases even death. Therefore, it would be highly desirable to develop a non-invasive method which would provide the same amount of information on staging of the disease and also the location of pathologies. This thesis describes the implementation of such a non-invasive method for visualizing and quantifying liver function by the combination of MRI (Magnetic Resonance Imaging), image reconstruction, and image analysis, and pharmacokinetic modeling. The first attempt involved automatic segmentation, functional clustering (k-means) and classification (kNN) of in-data (liver, spleen and blood vessel segments) in the pharmacokinetic model. However, after implementing and analyzing this method some important issues were identified and the image segmentation method was therefore revised. The segmentation method that was subsequently developed involved a semi-automatic procedure, based on a modified image forest transform (IFT). The data were then simulated and optimized using a pharmacokinetic model describing the pharmacokinetics of the liver specific contrast agent Gd-EOB-DTPA in the human body. The output from the modeling procedure was then further analyzed, using a least-squares method, in order to assess liver function by estimating the fractions of hepatocytes, extracellular extravascular space (EES) and blood plasma in each voxel of the image. The result were in fair agreement with literature values, although further analyses and developments will be required in order to validate and also to confirm the accuracy of the method.

Solid phase microextraction (SPME) has gained much popularity for in vivo applications recently. Thus far, there are two types of pre-equilibrium kinetic calibration that have been applied to in vivo SPME: on-fibre standardization and dominant pre-equilibrium desorption. Both of these techniques have their own advantages and disadvantages. To address the limitations presented by these two techniques, a third pre-equilibrium kinetic calibration method, the diffusion-based interface model, was investigated. The diffusion-based interface model had been successfully applied to air and water samples but was never utilized for in vivo SPME studies. For the first part of the research, on-fibre standardization, dominant pre-equilibrium desorption, and diffusion-based interface model were compared in terms of accuracy, precision, and experimental procedures, by using a flow-through system. These three kinetic calibrations were further validated by equilibrium SPME extraction and protein-plasma precipitation, a current state-of-the-art sampling method. The potential of diffusion-based interface model was yet again demonstrated in the second part of the research project. This calibration method was applied to comparative pharmacokinetic studies of two drugs, fenoterol and methoxyfenoterol, on 5 rats. To provide a constant sampling rate as required for diffusion-based interface model, a SPME animal sampling autosampler, AccuSampler®, was utilized. It custom-written program allowed the entire SPME sampling procedure excluding insertion and removal of SPME probes to be automated. Furthermore, to validate the results obtained by SPME, the AccuSampler® was programmed to withdraw blood after each SPME sampling time point for conventional method analysis using protein-plasma precipitation. The well correlated data obtained by SPME sampling and the conventional method illustrated the potential of diffusion-based interface model as an excellent choice for future in vivo SPME applications.

This study describes the pharmacokinetic profile of procaine penicillin G after intraperitoneal (IP) administration in 8 lactating dairy cows. Procaine pencillin G (PPG, 21,000 IU/kg) was deposited into the abdominal cavity of each cow following an incision in the right paralumbar fossa. Blood and milk samples were taken over the following 10 days, at which point the cows were euthanized. Plasma, milk, muscle, liver, and kidney penicillin concentrations were determined by HPLC, with a limit of detection (LOD) of 5 ppb for plasma and milk samples. Noncompartmental methods were used to analyze plasma kinetics. The mean pharmacokinetic parameters (} s.d.) were: Cmax, 5.5 } 2.6 Êg/mL; Tmax, 0.75 } 0.27 h; AUC0-, 10.8 } 4.9 Êg*h/mL; MRT, 2.2 } 0.9 h. All milk from treated cows contained penicillin residues for a minimum of 3 milkings (31 h) and maximum of 5 milkings (52 h) after administration. Concentrations of penicillin G in all muscle, liver, and kidney samples taken 10 days post-administration were below the limit of detection. Necropsy examinations revealed foci of hemorrhage on the rumenal omentum of most cows but peritonitis was not observed. Systemic inflammation as determined by altered leukograms and fibrinogen was noted in one cow. The results of this study demonstrate that IP procaine penicillin G is absorbed and eliminated rapidly in lactating dairy cows.

The purpose of this study was to design a dosing regimen and evaluate the safety of zonisamide (ZNS) following multiple dosing and to determine appropriate monitoring methods. Clinical pharmacokinetics were studied in 8 adult dogs (4 male and 4 female) ranging from 3 to 4 years of age using a randomized crossover design following single intravenous (IV) and oral administration, 6.85 and 10.25 mg/kg, respectively. Samples were collected intermittently for 48 hours. Dogs were then dosed orally (10.17 mg/kg) twice daily for 8 weeks. Blood samples were collected weekly and at discontinuation of the drug. Additionally, urine was collected to determine 24 hour urine ZNS clearance following IV administration. Safety was based on clinical pathology, thyroid and urine testing during both studies. ZNS was measured using high performance liquid chromatography in serum, plasma, erythrocytes (RBC) and whole blood. Data were subjected to standard non-compartmental pharmacokinetic analysis using computer assisted linear regression (WinNonLin?). Comparisons were made in different compartments using one-way ANOVA to identify any differences. Safety parameters at study beginning and end were compared using a Student t-test. ZNS concentrations differed among blood compartments after single dosing, with oral maximum concentration (Cmax) being greatest in RBC (28.73?g/ml) and least (14.36?g/ml) in plasma. Volume of distribution also differed, being greater (1096.05ml/kg) in plasma and least in (379.23ml/kg) RBC. Clearance of ZNS was 57.55ml/hr/kg from plasma and 5.06ml/hr/kg from RBC. Elimination half- life in plasma was 16.4 hr in serum and 57.4 hr in RBC. Bioavailability was 126.8% for RBC and 189.6% for plasma. Following multiple dosing, at steady-state, Cmax averaged 65.8?g/ml with fluctuations of 17.2% between dosings. Accumulation of ZNS was 3.5 (plasma) and 4.3 (RBC). Concentrations did not differ among blood compartments at the end of multiple dosing. Although differences did occur across time in clinical pathology tests, all were within normal limits at study end except for T4. In conclusion, ZNS dosed at 10 mg/kg twice daily for dogs would maintain therapeutic levels (10 to 70?g/ml) recommended in human epileptic patients. Therapeutic monitoring would be best measured in serum or plasma accompanied with thyroid and urine testing.

Thesis supervisor: Maureen D. Donovan. Includes bibliographic references (p. 239-247).

Thesis (Ph.D.)--Virginia Commonwealth University, 2009. / Prepared for: Dept. of Pharmaceutics. Title from title-page of electronic thesis. Bibliography: leaves 123-135.