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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
351

Influência do etilbenzeno na farmacocinética enantiosseletiva do metoprolol em ratos / Influence of ethylbenzene on the enantioselective pharmacokinetics of metoprolol in rats

Fernanda Silva Graciani 28 May 2009 (has links)
Considerando que o metoprolol é metabolizado preferencialmente pelos CYP3A e CYP2D e que o etilbenzeno é um indutor do CYP3A em ratos, o presente estudo visa investigar a influência da exposição ao etilbenzeno, por via inalatória, na disposição cinética e no metabolismo estereosseletivos do metoprolol. Foram utilizados ratos Wistar machos, tratados com dose única de 15 mg/kg ou 30mg/kg de metoprolol racêmico (gavagem). Os animais foram divididos em 4 grupos, sendo dois controles (15 e 30mg/kg) e dois expostos ao etilbenzeno em concentrações de 434mg/m3 e 1736mg/m3 e tratados com 15mg/kg de metoprolol. Os animais foram expostos ao etilbenzeno durante 6 horas/dia, por 5 dias consecutivos, em câmara de exposição do tipo somente pelo nariz. As amostras seriadas de sangue (n=6 animais por tempo de coleta) foram coletadas até 6 horas após a administração do metoprolol. Os enantiômeros foram analisados no plasma por cromatografia líquida de alta eficiência com detecção por fluorescência e a farmacocinética do metoprolol foi avaliada empregando modelo bicompartimental. O metoprolol na dose de 30mg/kg exibe farmacocinética não linear, com acúmulo plasmático de ambos os enantiômeros do metoprolol e redução do clearance do enantiômero R-(+)-metoprolol (39,91 vs 78,37 L/h/kg) quando comparado ao grupo de animais tratados com a dose de 15mg/kg. A farmacocinética do metoprolol na dose de 15mg/kg é linear e não enantiosseletiva. A exposição ao etilbenzeno inalado na concentração de 434mg/m3 (1 LEO) não altera a farmacocinética de ambos os enantiômeros do metoprolol. A exposição ao etilbenzeno inalado na concentração de 1736mg/m3 (4 LEO) aumenta o clearance de ambos os enantiômeros do metoprolol em aproximadamente 3 vezes (224,66 vs 78,37 L/h/kg e 213,62 vs 73,63 L/h/kg), respectivamente para os enantiômeros R-(+)- e S-(-)-metoprolol. O aumento do clearance de ambos os enantiômeros do metoprolol no grupo de animais expostos ao etilbenzeno inalado na concentração de 1736mg/m3 (4 LEO) pode ser explicado pelo aumento na formação de ambos os enantiômeros dos metabólitos O-desmetilmetoprolol (AUC0-122,84 vs 61,57 ng/h/mL e 92,33 vs 58,56 ng/h/mL, respectivamente para os enantiômeros R-(+)- e S-(-)-) e ácido O-desmetilmetoprolóico (AUC0- 8592,0 vs 6812,5 ng/h/mL e 8733,0 vs 6787,0 ng/h/mL respectivamente para os enantiômeros R-(+)- e S-(-)-). Os dados permitem inferir que ratos expostos durante 5 dias, 6h/dia, ao etilbenzeno na concentração de 4 vezes o LEO, mostram indução de maneira não enantiosseletiva no metabolismo de ambos os isômeros do metoprolol. / Metoprolol is mainly metabolized by CYP3A and CYP2D and ethylbenzene is an inducer of CYP3A in rats. In view of these considerations, the objective of the present study was to investigate the influence of low-level inhalation exposure to ethylbenzene on the kinetic dispo¬sition and metabolism of metoprolol enantiomers. Male Wistar rats were received a single dose of 15 or 30 mg/kg racemic metoprolol by gavage. The animals were divided into 4 groups: two control groups (15 and 30 mg/kg) and two groups exposed to ethylbenzene at concentrations of 434 and 1736 mg/m3. The animals were exposed to ethylbenzene in a nose-only exposure chamber for 6 h/day during 5 consecutive days. Serial blood samples (n=6 animals per sampling time) were collected during the first 6 h after metoprolol administration. The isomers of metoprolol and its metabolites were analyzed in plasma samples by high-performance liquid chromatography with fluorescence detection. Pharmacokinetic analysis was performed using a two-compartment model. Metoprolol administered at a dose of 30 mg/kg showed nonlinear pharmacokinetics, with plasma accumulation of both metoprolol enantiomers and a reduction in the clearance of R-(+)-metoprolol (39.91 vs 78.37 L/h/kg) when compared to the group receiving the dose of 15 mg/kg. The kinetic disposition of the enantiomers of metoprolol administered at a dose of 15 mg/kg was linear and non-enantioselective. Exposure to 434 mg/m3 ethylbenzene did not influence the pharmacokinetics of either metoprolol enantiomer. Exposure to 1736 mg/m3 ethylbenzene increased the clearance of both metoprolol enantiomers by approximately 300% (224.66 vs 78.37 L/h/kg and 213.62 vs 73.63 L/h/kg for the R-(+)- and S-(-)-metoprolol enantiomer, respectively). These changes in clearance might be explained by an increase in the formation of the enantiomers of the two metabolites O-demethylmetoprolol (AUC0-: 122.84 vs 61.57 ng/h/mL and 92.33 vs 58.56 ng/h/mL for the R-(+)- and S-(-)- enantiomer, respectively) and O-demethylmetoprolol acid (AUC0-: 8592.0 vs 6812.5 ng/h/mL and 8733.0 vs 6787.0 ng/h/mL). In conclusion, inhalation exposure of rats to ethylbenzene at a concentration of 1736 mg/m3 for 5 days, 6 h per day, resulted in the non-enantioselective induction of the metabolism of metoprolol.
352

Influência da função renal na farmacocinética dos enantiômeros da ciclofosfamida em pacientes portadores de nefrite lúpica / Influence of glomerular filtration rate on the pharmacokinetics of cyclophosphamide enantiomers in patients with lupus nephritis.

Carolina de Miranda Silva 07 June 2010 (has links)
A farmacocinética dos enantiômeros da ciclofosfamida (CPA) foi avaliada em pacientes portadores de nefrite lúpica distribuídos em dois grupos de acordo com o clearance da creatinina: Grupo 1 90,6-144,6mL/min/1,73m2 e Grupo 2 42,8-76,4mL/min/1,73m2. Os pacientes foram tratados com doses de 0,75 a 1,3g de ciclofosfamida racêmica sob forma de infusão com duração de 2h e com 1mg de midazolam (MDZ) administrado via endovenosa para a avaliação da atividade in vivo do CYP3A. As concentrações plasmáticas dos enantiômeros da CPA e do MDZ foram avaliadas por LC-MS/MS. Os enantiômeros da CPA foram resolvidos na coluna Chiralcel OD-R, com fase móvel constituída por mistura de acetonitrila e água (75:25, v/v) adicionada de 0,2% de ácido fórmico. Os enantiômeros da CPA foram extraídos do plasma com recuperações maiores que 95% e o limite de quantificação obtido foi de 2,5ng de cada enantiômero da CPA/mL plasma. As seguintes diferenças (teste de Wilcoxon, p<0,05) foram observadas nos parâmetros farmacocinéticos entre os enantiômeros (S)-(-)-CPA e (R)-(+)-CPA para os pacientes do Grupo 1: AUC do tempo 0 ao infinito 152,41 vs 129,25g.h/mL; Cl 3,28 vs 3,89L/h; Vd 31,38 vs 29,74L e t1/2 6,79 vs 5,56h e para os pacientes do Grupo 2: AUC do tempo 0 ao infinito 167,20 vs 139,08g.h/mL; Cl 2,99 vs 3,59L/h e t1/2 6,15 vs 4,99h. Não foi observada diferença (teste de Mann-Whitney, p<0,05) nos parâmetros farmacocinéticos de ambos os enantiômeros entre os grupos 1 e 2. Não foi observada corrrelação entre o clearance do MDZ (2,92-16,40ml/min.kg) e o clearance de cada enantiômero da CPA. Concluindo, a farmacocinética da CPA é enantiosseletiva em pacientes portadores de nefrite lúpica com acúmulo plasmático do enantiômero (S)-(-)-CPA e a farmacocinética de ambos os enantiômeros da CPA não é alterada pela agravamento da função renal. / The pharmacokinetics of cyclophosphamide (CYC) enantiomers was evaluated in patients with lupus nephritis distributed in two groups according to creatinine clearance; Group 1 - 90.6-144.6mL/min/1.73m2 and Group 2 - 42.8- 76.4mL/min/1.73m2. All patients were treated with 0.75 to 1.3g of racemic CYC as a 2-hour infusion and with 1mg intravenous midazolam as a drug marker. CYC enantiomers and midazolam concentrations in plasma were measured by LC-MS/MS. CYC enantiomers were separated on a Chiralcel OD-R column, with the mobile phase consisting of a mixture of acetonitrile and water (75:25, v/v) plus 0.2% formic acid. Recovery rates were higher than 95% and the quantification limit was 2.5ng/ml plasma for both enantiomers. The coefficients of variation and the relative errors obtained for the validation of intra- and interassay precision and accuracy were less than 10%. The following differences in the pharmacokinetic parameters (Wilcoxon test, p<0.05) were observed between the (S)-(-) and (R)-(+) enantiomers for Group 1 AUC from time 0 to infinity 152.41 vs 129.25g.h/mL, Cl 3.28 vs 3.89L/h, Vd 31.38 vs 29.74L and t1/2 6.79 vs 5.56h and for Group 2 AUC from time 0 to infinity 167.20 vs 139.08g.h/mL, Cl 2.99 vs 3.59 L/h and t1/2 6.15 vs 4.99 h. No differences (Mann-Whitney test, p<0.05) were observed between Groups 1 and 2 in the pharmacokinetics parameters of both enantiomers. No significant relationship was observed between midazolam clearance (2.92-16.40 ml/min.kg) and clearance of each CYC enantiomer. In conclusion, CYC kinetic disposition is enantioselective resulting in higher exposure of (S)-(-)-CYC in lupus nephritis patients and the pharmacokinetic parameters of both enantiomers are not altered by the worsening of renal condition.
353

Influência da inalação de metanol na farmacocinética enantiosseletiva da fluvastatina em ratos / Inalation influence of methanol on the pharmacokinetics enantiosselective of fluvastatin in rats.

Juciane Lauren Cavalcanti Cardoso 30 April 2008 (has links)
Os enantiômeros de um fármaco administrado como mistura racêmica, podem manifestar diferentes efeitos farmacológicos e toxicológicos. A fluvastatina (FV), um inibidor da HMG-CoA redutase, é comercializada como mistura racêmica dos enantiômeros (-)-3S,5R e (+)-3R,5S (eutômero) e com eliminação no homem essencialmente dependente do CYP2C9. O metanol, amplamente usado como solvente, combustível e em processos de sínteses, é um inibidor do CYP2C9 em humanos. Diante do exposto, o estudo visou avaliar a influência do metanol na farmacocinética enantiosseletiva da fluvastatina administrada sob forma racêmica a ratos. Foram investigados ratos machos Wistar tratados com dose única de 5 mg/kg de fluvastatina racêmica administrada por gavagem. Os animais foram divididos em três grupos: controle e expostos a metanol em concentrações de 262 mg/m3 e 1048 mg/m3. A exposição ao metanol foi feita em câmara de exposição do tipo apenas pelo nariz, em sessões consecutivas de 6 horas com intervalos de 2 horas, durante o período de 30 horas de coletas seriadas de sangue. Os enantiômeros da FV foram analisados em HPLC com amostrador automático e detecção por fluorescência, operando em 305 nm para excitação e 390 nm para emissão. A análise farmacocinética foi realizada por modelo bicompartimental e cinética de primeira ordem. Os resultados são reportados como medianas, médias e respectivos intevalos de confiança (95%). A farmacocinética da fluvastatina é enantiosseletiva em ratos do grupo controle com acúmulo plasmático do enantiômero (-)-3S,5R, com AUC0-? (2,97 vs 0,99 ?g.h.mL-1), volume de distribuição (9,80 vs 44,60 L.kg-1) e clearance aparente (0,85 vs 2,52 L.h-1.kg-1). A disposição cinética da fluvastatina nos animais do grupo metanol 262 mg/m3, à semelhança do grupo controle foi enantiosseletiva com observação de acúmulo plasmático do enantiômero (-)-3S,5R. Não foram observadas diferenças nas razões enantioméricas entre os animais do grupo controle e metanol 262 mg/m3. As diferenças para o eutômero (+)-3R,5S entre os grupos controle e metanol (1048 mg/m3) foram respectivamente: Cl/F 2.52 (1.64- 3.40) vs 1.51 (1.01-2.06) L.h-1.Kg-1; Vd/F 44.60 (19.20-55.49) vs 10.45 (7.20-15.96) L.Kg-1; t1/2? 10.85 (5.92-14,47) vs 5.23 (4.22-6.27) h; ? 0.06 (0.04-0.11) 0.13 (0.10- 0.16)h-1, AUC 0-? 991.79 (689.57-1491.00) vs 1647.20 (1155.30-2391.60) ng.h.mL-1,e AUC(-)/AUC(+) 2.50 (2.03-4.06) vs 1.22 (0.96-1.56). Em resumo, os dados evidenciam que a exposição ao metanol (1048 mg/m3) resulta em perda da enantiosseletividade com inibição do metabolismo somente do eutômero (+)-3R,5S, alterando portanto de maneira enantiosseletiva a disposição cinética da FV administrada a ratos. / Dislipidemia is one of the main causes of cardiovascular illness and very frequent in the adults population. Fluvastatin, a racemic mixture of the (-)-3S,5R and (+)-3R,5S enantiomers, has been shown to be a potent competitive inhibitor of HMGCoA reductase used in the hypercholesterolemia treatment and with elimination in the man essentially dependent of the CYP2C9. Methanol is used by solvent and is an inhibitor of the CYP2C9 in human beings. The present study reports the influence of methanol inhalation on the enantiosselective pharmacokinetics of fluvastatin in rats. Fluvastatin was administrated by oral gavage (5 mg/Kg) to the animals (n=6/time) and blood samples were collected until 30 hours. The enantiomers were analysed by HPLC using Chiralcel® OD-H column and fluorescence detection. The pharmacokinetics parameters were analysed by Wilcoxon and Mann-Witney tests. The results are reported as mean (95% CI). Kinetic disposition of FV for animals exposed to methanol (262mg/m3), as for control group, was enantiosselective with plasma accumulation of (-)-3S,5R enantiomer. The following differences (p< 0.05) were observed between the control and methanol (1048 mg/m3), apparent total clearance (Cl/F) of 2.52 (1.64-3.40) vs 1.51 (1.01-2.06) L.h-1.Kg-1; apparent volume of distribution (Vd/F) of 44.60 (19.20-55.49) vs 10.45 (7.20-15.96) L.Kg-1; elimination half life (t1/2?) of 10.85 (5.92-14,47) vs 5.23 (4.22-6.27) h; elimination rate constant (?) of 0.06 (0.04-0.11) 0.13 (0.10-0.16) h-1, area under the plasma concentration versus time curve (AUC 0-?) of 991.79 (689.57-1491.00) vs 1647.20 (1155.30- 2391.60) ng.h.mL-1, and AUC(-)/AUC(+) 2.50 (2.03-4.06) vs 1.22 (0.96-1.56). The data demonstrated that methanol inhalation at 1048 mg/m3 results in loss of enantioselectivity with plasmatic accumulation of (+)-3R5S, modifying the enantioselective kinetic disposition of Fluvastatin in rats.
354

Farmacocinética e PK-PD dos isômeros do nebivolol em voluntários sadios metabolizadores extensivos ou lentos para o CYP2D6 / Pharmacokinetics and PK-PD of the isomers of nebivolol in healthy volunteers extensive metabolisers or poor metabolisers for CYP2D6.

Carolina Pinto Vieira 31 August 2011 (has links)
O nebivolol, um fármaco com quatro centros quirais, está disponível na clínica como mistura racêmica dos isômeros d-nebivolol (SRRR) e l-nebivolol (RSSS). A atividade -adrenérgica do nebivolol reside no isômero d-nebivolol, enquanto o l-nebivolol promove a liberação de óxido nítrico das células endoteliais. O nebivolol é eliminado por metabolismo dependente do CYP2D6. O estudo avalia a farmacocinética e a relação farmacocinética-farmacodinâmica (PK-PD) dos isômeros do nebivolol em voluntários sadios. Foram investigados 15 voluntários sadios (10 homens e 5 mulheres) fenotipados com metoprolol como metabolizadores extensivos (EM, n=13) ou metabolizadores lentos para o CYP2D6 (PM, n=2). Os voluntários sadios foram tratados com dose única oral de 10 mg de nebivolol racêmico. As amostras seriadas de sangue foram coletadas até 48 h após a administração do fármaco. Os isômeros do nebivolol foram resolvidos na coluna Chirobiotic® V e analisados nas amostras de plasma empregando LC-MS/MS. Os parâmetros farmacocinéticos foram calculados por modelo bicompartimental com lag time, empregando o programa WinNonLin. A farmacodinâmica do nebivolol foi avaliada empregando como parâmetro a variação da frequência cardíaca entre os períodos final e anterior ao teste de esforço isométrico durante 2 min utilizando o handgrip a 30% da contratilidade voluntária máxima. A análise PK-PD relacionando o efeito na variação da frequência cardíaca induzida pelo exercício isométrico com as concentrações plasmáticas do isômero d-nebivolol foi avaliada empregando o modelo Emax sigmóide inibitório. A disposição cinética do nebivolol é enantiosseletiva nos voluntários sadios EM, com razões isoméricas de AUCl/ AUCd de 1,41. Os valores de concentração plasmática máxima (1,46 vs 0,79 ng/mL), área sob a curva concentração plasmática versus tempo (6,45 vs 3,99 ng.h/mL), clearance aparente (774,51 vs 1252,70 L/h) e volume de distribuição aparente (10936 vs 19082 L) mostram diferenças com significância estatística (Teste de Wilcoxon, p<0,05) entre os isômeros l-nebivolol e d-nebivolol para os voluntários sadios EM. A disposição cinética do nebivolol não é enantiosseletiva nos voluntários sadios PM investigados, com razões isoméricas de AUCl/AUCd de 0,93 e 0,98. Os valores de clearance aparente obtidos para os voluntários PM (87-350 vs 81-344 L/h, respectivamente para o l-nebivolol e d-nebivolol) são menores do que para os EM (775 vs 1253 L/h). O modelo Emax sigmóide inibitório descreveu a análise PK-PD relacionando o efeito na variação da frequência cardíaca induzida pelo exercício isométrico com as concentrações plasmáticas do isômero d-nebivolol em voluntários sadios EM com valores de Emax de 4,47 bpm (IC 95% 1,37-7,57) e de EC50 de 222,16 pg/mL (IC 95% 96,29-540,60 pg/mL). / Nebivolol is a drug with four chiral centers. It is administered in clinical practice as a racemic mixture of the isomers d-nebivolol (SRRR) and l-nebivolol (RSSS). The - blocking activity of nebivolol is attributed to d-nebivolol, whereas l-nebivolol promotes the release of nitric oxide from endothelial cells. Nebivolol is eliminated by metabolism dependent on CYP2D6. The present study evaluates the pharmacokinetic and pharmacokinetic-pharmacodynamic (PK-PD) of nebivolol isomers in healthy volunteers (10 men and 5 women) phenotyped with metoprolol as extensive metabolisers (EM, n=13) or poor metabolisers for CYP2D6. The healthy volunteers receveid a single oral dose of 10mg of racemic nebivolol. Serial blood samples were collected from 0 to 48 h after the administration of nebivolol. The isomers of nebivolol were analyzed by LC-MS-MS on a Chirobiotic® V column and the pharmacokinetic parameters (bicompartment model, micro, lag time, first order) were calculated by the software Winnonlin. The pharmacodynamic of nebivolol was evaluated using the variation of heart rate as parameter between the end and one minute before the handgrip exercise. Thus, the patients were oriented to conduct the isometric exercise with handgrip for 2 min at 30% of their maximum voluntary contractility. The PK-PD analysis relating the effect on the variation of heart rate induced by the isometric exercise and the plasma concentrations of the isomer d-nebivolol were evaluated using the Inhibitory effect sigmoid Emax model. The kinetic disposition of nebivolol is enantioselective on healthy volunteers EM, with isomeric ratios of AUCl/ AUCd of 0,93 e 0,98. The values of maximum plasma concentration (1,46 vs 0,79 ng/mL), area under the concentration time curve (6,45 vs 3,99 ng.h/mL), apparent clearance(774,51 vs 1252,70 L/h) and volume of distribution (10936 vs 19082 L) show statistically significant differences (p<0.05, Wilcoxon test) between the isomers l-nebivolol and d-nebivolol for the healthy volunteers EM. The kinetic disposition of nebivolol is not enantioselective on the healthy volunteers PM investigated, with isomeric ratios of AUCl/ AUCd of 1,07. The values of apparent clearance obtained for the volunteers pm (87-350 vs 81-344 L/h, respectively to l-nebivolol and d-nebivolol) are smaller than that for EM (775 vs 1253 L/h). The Inhibitory effect sigmoid Emax model described the PK-PD analysis described the effect on the variation of heart rate induced by handgrip isometric exercise with the plasma concentrations of the isomer d-nebivolol in healthy volunteers EM with Emax values of 4,47 bpm (IC 95% 1,37-7,57) and EC50 of 222,16 pg/mL (IC 95% 96,29-540,60 pg/mL).
355

Farmacocinética da vancomicina em pacientes no período pós-operatório cardíaco / Vancomycin pharmacokinetics in patients during the cardiac post operative period

Carla Viotto Belli 28 July 2000 (has links)
Investigaram-se 108 pacientes, entre 20 a 85 anos, com internação no pós-operatório em unidades de recuperação cardíaca. Pacientes submetidos a procedimentos cirúrgicos e portadores de quadros infecciosos diversos - broncopneumonia, endocardite, mediastinite e sepse - causados por agentes etiológicos sensíveis à terapia com vancomicina, foram selecionados para este estudo retrospectivo. A vancomicina é um antibiótico muito utilizado, principalmente na terapia de infecções hospitalares graves, predominantemente causadas por Staphylococcus aureus, microorganismo gram positivo resistente à meticilina e oxacilina. Na primeira fase do estudo realizou-se o desenvolvimento e validação da metodologia analítica para dosagem das concentrações plasmáticas da vancomicina pela técnica de cromatografia líquida de alta eficiência (CLAE). O método consiste em simples purificação das amostras biológicas em acetonitrila e detecção em ultravioleta (UV 230 nm). Empregou-se, para a quantificação do fármaco, coluna analítica Shimpack® CLC-ODS, 150 x 6 mm, 5 µm e fase móvel constituída por tampão fosfato 0,05 M, pH 4,5, metanol e acetonitrila, na proporção 80:15:5, pH da fase móvel entre 4,0-4,5, em sistema isocrático de diluição, fluxo 0,8 ml/minuto. Solução metanólica de b-etil-hidroxiteofilina foi utilizada como padrão interno no ensaio. Na fase seguinte da investigação, coletaram-se 2 amostras de sangue de cada paciente, em níveis de pico (Css MÁX), 2 horas após o início da infusão e vale (Css MÍN), imediatamente antes da infusão subsequente, na terapia de manutenção - \"steady state\". As concentrações plasmáticas da vancomicina foram determinadas e utilizadas para estimativa dos parâmetros farmacocinéticos, por meio de modelagem cinética monocompartimental. Determinou-se a meia-vida biológica de eliminação (t(1/2)b) pelo método gráfico e calcularam-se a depuração plasmática ou ?clearance? total (ClT) e o volume de distribuição (Vd) do fármaco no organismo. Estimou-se o índice de acúmulo da vancomicina, pela razão vale/pico (V/P). Efetuou-se, na última etapa do protocolo, o estudo comparativo da cinética da vancomicina, com a população dividida em grupos, classificados de acordo com a idade, função renal, tipo de infecção e dose total diária. Utilizou-se a estatística não paramétrica para análise de significância (teste de Kruskall Wallis). A função renal é o fator determinante da farmacocinética da vancomicina e das doses da antibioticoterapia, sendo responsável pelo acúmulo do fármaco em pacientes no pós-operatório cardíaco. Idade e tipo de infecção não demonstram influência significativa na disposição cinética da vancomicina nos indivíduos estudados. / In this study, 108 patients were investigated, aged 20 to 85 years old, admitted in the intensive care units during the post-operative period. Patients submitted to surgical procedures and with several infectious - bronchopneumonia, endocarditis, mediastinitis, and sepsis - caused by agents sensitive to vancomycin therapy, were selected for this retrospective study. The vancomycin is a widely prescribed antibiotic, mainly for therapy of serious hospital infections caused by Staphylococcus aureus, gram positive microorganism resistant to meticilin and oxacilin. Firstly, the analytic methodology was developed and validated for dosage of the vancomycin plasmatic concentrations by the technique of high efficiency liquid chromatography (HPLC). The method consists of biological samples simple purification in acetonitrile and detection in ultraviolet (UV 230 nm). It was used for quantification of the drug analytical column Shimpack® CLC-ODS, 150 x 6 mm, 5 mm and mobile phase constituted by phosphate buffer 0,05 M, pH 4,5, methanol and acetonitrile, proportion 80:15:5, mobile phase pH 4,0-4,5, in isocratic dilution system, flow 0,8 ml/min. Solution of b-ethil-hydroxitheophylline in methanol was used as internal standard. In the following investigation phase, 2 blood samples from each patient were collected, at peak levels (Css MÁX - 2 hours after the infusion beginning), and at trough (Css MÍN - immediately before the subsequent infusion) in the maintenance therapy - steady state. Plasmatic vancomycin concentrations were used to estimate pharmacokinetics parameters, by monocompartimental kinetic model. Biological half-life of elimination (t(1/2)b) was determined by graphic method. The plasmatic purification or total clearance (ClT) and drug distribution volume (Vd) in the organism were calculated. It was estimated the vancomycin accumulation index, the reason trough/peak (V/P). Comparative study of vancomycin kinetics was performed with groups of patients, classified according to their age, renal function, infection type and daily total dose. Non parametric statistic were used for significancy analysis (Kruskall Wallis test). Renal function is a decisive factor of the vancomycin kinetics disposition and therapy doses, being responsible for drug accumulation in cardiac post-operative patients. Age and infection type did not demonstrate significant influence in the vancomycin pharmacokinetics in this study.
356

Influência do nifedipino na disposição cinética dos enantiômeros da venlafaxina e seus metabólitos em voluntários sadios / Influence of nifedipine on the kinetic disposition of venlafaxine enantiomers and its metabolites in healthy volunteers

Eduardo Tozatto 01 June 2012 (has links)
A venlafaxina é um fármaco usado no tratamento da depressão e dos transtornos de ansiedade generalizada. É disponível na clínica na forma de mistura racêmica dos enantiômeros S-(+) e R-(-) em formulação de liberação controlada. O enantiômero S-(+) inibe a recaptação da serotonina, enquanto o enantiômero R-(-) inibe a recaptação da serotonina e da norepinefrina. A venlafaxina é biotransformada pelo CYP2D6 e CYP2C19 em seu principal metabólito, O-desmetilvenlafaxina, o qual apresenta atividade farmacológica semelhante à venlafaxina. Outros metabólitos da venlafaxina, dependentes do CYP3A4, incluem a N-desmetilvenlafaxina e a N,O-di-desmetilvenlafaxina. A absorção e a distribuição da venlafaxina são moduladas pela ação da glicoproteina-P. O nifedipino, um fármaco da classe dos inibidores dos canais de cálcio, é descrito como inibidor da glicoproteina-P. O presente estudo investiga a influência do nifedipino na disposição cinética e no metabolismo da venlafaxina em voluntários sadios caracterizados como portadores de atividade normal do CYP3A (omeprazol como fármaco marcador) e fenotipados como metabolizadores rápidos do CYP2C19 (omeprazol como fármaco marcador) e do CYP2D6 (metoprolol como fármaco marcador). Os voluntários investigados receberam, em estudo cruzado e randomizado, dose única oral de 150 mg de venlafaxina racêmica (Fase 1) e 40 mg de nifedipino associada com dose única oral de 150 mg de venlafaxina racêmica (Fase 2). Foram coletadas amostras seriadas de sangue até 72 horas após a administração dos fármacos para o estudo farmacocinético. As concentrações plasmáticas dos enantiômeros da venlafaxina e de seus metabólitos foram determinadas por LC-MS/MS utilizando a coluna Chirobiotic V com fase móvel constituída de mistura de metanol: solução aquosa de acetato de amônio 15 mmol/L pH 6,0 (80:20, v/v). A farmacocinética da venlafaxina mostrou-se enantiosseletiva com acúmulo plasmático (AUC 526,0 vs 195,7 ng.h/mL) e menores valores de clearance (Cl/f 142,67 vs 408,01 L/h) para o enantiômero S-(+). A disposição cinética do metabólito ativo O-desmetilvenlafaxina apresentou enantiosseletividade apenas no parâmetro concentração plasmática máxima com observação de maiores valores para o enantiômero R-(-) (Cmax 69,33 vs 56,94 ng/mL). A disposição cinética da N,O-di-desmetilvenlafaxina também mostrou-se enantiosseletiva apenas para o parâmetro concentração plasmática máxima, mas com observação de maiores valores para o enantiômero S-(+) (Cmax 7,08 vs 4,61 ng/mL). A administração de dose única oral de 40 mg de nifedipino não alterou a farmacocinética de ambos os enantiômeros da venlafaxina e de seus metabólitos O-desmetilvenlafaxina e N,O-di-desmetilvenlafaxina, seja utilizando teste estatístico não paramétrico (teste de Wilcoxon para dados pareados, p < 0,05), seja avaliando o IC 90% das razões das médias geométricas de AUC e Cmax (Fase 2/Fase 1). Os dados obtidos evidenciam que o nifedipino na dose de 40 mg não age como um inibidor da P-gp / Venlafaxine is a drug used to treat depression and generalized anxiety disorders. It is available in clinical practice in the form of a racemic mixture of S-(+) and R-(-) enantiomers, in controlled release formulation. The S-(+) enantiomer inhibits the reuptake of serotonin, while the R-(-) enantiomer inhibits the reuptake of both serotonin and norepinephrine. Venlafaxine is biotransformed by CYP2D6 and CYP2C19 in its major metabolite, O-desmethylvenlafaxine, which has similar pharmacological activity when compared to venlafaxine. Other metabolites of venlafaxine, dependent of CYP3A4, include N-desmethylvenlafaxine and N, O-di-desmethylvenlafaxine. The absorption and distribution of venlafaxine are modulated by the action of P-glycoprotein. Nifedipine, a calcium channel blocker drug, is described as an inhibitor of P-glycoprotein. The present study investigates the influence of nifedipine on the kinetic disposition of venlafaxine enantiomers and its metabolites in healthy volunteers characterized as having normal activity of CYP3A (omeprazole as a probe drug) and phenotyped as rapid metabolizers of CYP2C19 (omeprazole as a probe drug) and CYP2D6 (metoprolol as a probe drug). The enrolled volunteers received, in a randomized, two-way study, a single 150 mg oral dose of racemic venlafaxine (Phase 1) and 40 mg oral dose of nifedipine associated with a single 150 mg oral dose of racemic venlafaxine (Phase 2). Serial blood samples were collected until 72 hours after drug administration to the pharmacokinetic study. Plasma concentrations of venlafaxine enantiomers and its metabolites were determined by LC-MS/MS using a Chirobiotic V column and a mobile phase constituted of methanol: aqueous 15 mmol/L ammonium acetate solution pH 6.0 (80:20, v/v). The venlafaxine pharmacokinetics is enantioselective with plasma accumulation (AUC 526.0 vs 195.7 ng h/mL) and lower clearance values (CL/f 142.67 vs 408.01 L/h) for the S-(+) enantiomer. The kinetic disposition of the active metabolite O-desmethylvenlafaxine exhibits enantioselectivity only in the maximum plasma concentration parameter with higher values for the R-(-) enantiomer (Cmax 69.33 vs 56.94 ng/mL). The kinetic disposition of N,O-di-desmethylvenlafaxine is also enantioselective only for the maximum plasma concentration parameter, but with higher values for the S-(+) enantiomer (Cmax 7.08 vs 4.61 ng/ml). Administration of a 40 mg single oral dose of nifedipine do not alter the pharmacokinetics of both enantiomers of venlafaxine and its metabolites O-desmethylvenlafaxine and N,O-di-desmethylvenlafaxine, using non-parametric statistical test (Wilcoxon test for paired data, p <0.05), or evaluating the 90% CI of the AUC and Cmax geometric mean ratios (Phase 2/Phase 1). The obtained data show that nifedipine in a 40 mg oral dose does not act as a P-gp inhibitor.
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Caracterização morfológica de nanocápsulas de lidocaína e prilocaína e desenvolvimento clínico de produto nanoanestésico / Morphological characterization of lidocaine and prilocaine nanocapsules and clinical development of nanoanesthetic product

Rosa Castelli, Maisa, 1989- 09 April 2014 (has links)
Orientador: Gilberto De Nucci / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-25T22:09:32Z (GMT). No. of bitstreams: 1 RosaCastelli_Maisa_M.pdf: 2792033 bytes, checksum: 8d7ee3cc5a3af831f35e49968b355af5 (MD5) Previous issue date: 2014 / Resumo: A anestesia tópica é uma das estratégias mais usadas para minimizar a ansiedade, dor e o desconforto no local da inserção da agulha ou de procedimentos cirúrgicos. As formulações tópicas têm como objetivo promover a permeação no local de aplicação e obter um rápido início de ação. Para tanto, é necessário que a permeação cutânea atravesse de forma efetiva as camadas dérmicas, principalmente o estrato córneo. Os sistemas de liberação de fármacos representam uma parcela importante dentre as estratégias de otimização terapêutica, tendo como objetivo a manipulação racional do perfil farmacológico das drogas e, concomitantemente, seus índices terapêuticos. Os sistemas de liberação nanoestruturados, ou nanocarreadores, podem ser empregados para a melhora de distintos caracteristicas: solubilidade, biodistribuição, biocompatibilidade, biodegradabilidade e liberação da droga. São estruturas com escala nanométrica, com tamanho variando de 1 a 100 nanometros. O objetivo deste trabalho foi a caracterização morfológica das nanocápsulas poliméricas que compõem o nanoanestésico e o desenvolvimento clínico do nanoanestésico, compreendendo a avaliação de eficácia e de segurança do produto. O nanoanestésico é um hidrogel composto pela mistura eutética de 2.5% de lidocaína e 2.5% de prilocaína. Metade desta concentração está nanoencapsulada, enquanto que o restante do ativo encontra-se livre no gel, através dos respectivos sais cloridratos. A suspensão de nanocápsulas foi analisada através de microscopia eletrônica de transmissão e foram identificadas estruturas correspondentes com as nanocápsulas poliméricas e com tamanhos condizentes ao esperado a partir dos dados de diâmetro médio proveniente do Espalhamento de Luz Dinâmico. O produto final, o nanoanestésico, foi analisado a partir da técnica de criofratura e também foram identificas estruturas correspondentes as nanocápsulas em meio ao hidrogel. Foi realizado o desenvolvimento clínico do nanoanestésico, compreendendo a avaliação do perfil farmacocinético (n=8 voluntários) e estudos de eficácia (n= 100 voluntários). O nanoanestésico atinge concentrações plasmáticas seguras de lidocaína e prilocaína: 6,5 ng.mL-1 e 1,7 ng.mL-1, respectivamente. Verificou-se também que o nanoanestésico possui eficácia não inferior ao EMLA® (Aztrazeneca) quando comparado após 1 (uma) hora de permanência sobre a pele e submetido a estimulo doloroso de inserção de agulha de venopunção. Além disso, de forma controlada por placebo, os voluntários foram submetidos a um estimulo doloroso em tempos inferiores a 1 hora e verificou-se que o nanoanestésico apresenta eficácia significativa a partir de 10 minutos da aplicação. Os resultados obtidos demonstram que o nanoanestésico pode ser uma alternativa dentre os anestésicos tópicos já estabelecidos no mercado e otimizar os procedimentos nos quais ele é necessário / Abstract: Topical anesthetic is the most used strategy to minimize anxiety, pain and local discomfort on the site of needle stick. The topical formulations aim to promote permeation on the application site and obtain a rapid onset of action. To achieve this, the skin permeation must cross the layers of skin, mainly the stratum corneum. Drug delivery systems are an important part of therapy optimization strategies, which target to improve the drug pharmacological profile and its therapeutic ratio. The nanostructured systems, like polymeric nanocapsules, may be used to improve a many features: solubility, biodistribution and drug release. They are nanoscale structures, with size ranging from 1 to 100 nanometers. This present study comprised morphologic characterization of polymeric nanocapsules which compose the nanoanesthetic and its clinical development with evaluation of efficacy and safety. The nanoanesthetic is a hydrogel with 2.5% lidocaine and 2.5% prilocaine, which are 50% of the active products in polymeric nanocapsules. The remaining 50% of the drugs are in the form of their chloridrate salts. The suspension of nanocapsules was examined by Transmission Electron Microscopy (TEM) and the identified structures correspond to the polymer nanocapsule and the size results matched the expected Dynamic Light Scattering data. The finished product, the nanoanesthetic, was evaluated by cryofracture, and the polymeric nanocapsules were observed. The clinical development was performed with pharmacokinetics profile (n= 8 healthy volunteers) and efficacy study (n=100 healthy volunteers). The nanoanesthesic security reaches plasmatic concentrations of lidocaine and prilocaine: 6,5 ng.mL-1 e 1,7 ng.mL-1, respectively. EMLA® (Astrazeneca) and the nanoanesthetic were left on the skin for one hour, and then exposed to needle insertion. It was observed that the nanoanesthetic efficacy is not lower than EMLA® product. Beyond that, a placebo-controlled study was performed. The volunteers were submitted to a painful stimulus for periods shorter than one hour and it was verified that the nanoanesthetic has a significant efficacy after 10 minutes of application. The results showed that the nanoanesthetic can be an alternative as a topical anesthetics among the ones that have already been commercialized in the market and it can also optimize the procedures in which it is needed / Mestrado / Farmacologia / Mestra em Farmacologia
358

Biopharmaceutics of phenylpropanolamine

Dowse, Roslind January 1984 (has links)
Phenylpropanolamine (PPA), a sympathomimetic amine, has been widely used over the past 40 years as a decongestant and, in much larger dosages, as an appetite suppressant. Considerable interest has recently been shown in this drug due to its increasing popularity as an over-the-counter anorectic agent. Much controversy exists concerning the unfavourable side-effects of PPA resulting from the higher doses required for appetite suppression and the potential of this drug for abuse. A literature search revealed a paucity of information concerning the determination of PPA in biological fluids and, most noticeably, on the pharmacokinetics of this drug. An original method for determining PPA in serum and urine using high performance liquid chromatography (HPLC) which has increased sensitivity over other published HPLC methods is presented here. The simplicity of the extraction from biological fluids and subsequent determination by HPLC, enables concentrations of PPA to be monitored after a single dose of the drug. This method is therefore readily applicable to bioavailability and pharmacokinetic studies. The dissolution profiles of 4 sustained-release formulations of PPA were determined in a modified USP rotating paddle apparatus and the samples analysed using HPLC. A mathematical equation was applied to these data which are expressed in terms of dissolution parameters. Oral test dosage forms and solutions of PPA were investigated in bioavailability trials using the developed HPLC method to analyse the urine and serum samples. Linear one body compartment kinetics were assumed and the WagnerNelson method used to transform in vivo serum data to absorption plots which were then fitted to the well known Weibull equation. In order to more appropriately characterize the kinetic processes of absorption, distribution and elimination, a more complex model was utilized which involved numerical integration of a series of differential equations. The data were fitted to these models using nonlinear regression techniques. The pharmacokinetics of PPA are shown to exhibit some evidence of nonlinearity. The absorption of the drug appears to be di scontinuous and PPA seems to favour a two body compartment model.
359

In search of models for hepatic and placental pharmacokinetics

Myllynen, P. (Päivi) 09 May 2003 (has links)
Abstract Several in vitro methods using both human and animal tissues have been developed to study hepatic metabolism and placental transfer. The pressure to minimize animal studies has increased during the past few decades due to the public opinion and ethical considerations. However, these methods need further evaluation of their predictive power when applied in vivo. The aim of this work was to produce new information of the metabolism and transplacental passage of several anticonvulsants as well as to evaluate the usefulness of the placental perfusion method and several in vitro methods for analyzing metabolism in the prediction of clinical pharmacokinetics. Carbamazepine (CBZ) metabolism was studied using human and mouse liver microsomes, human hepatocytes, human liver slices and yeast cells expressing recombinant enzymes. All test systems predicted well the major metabolite carbamazepine-10,11-epoxide (CBZ-E). Also, minor metabolites were produced in slightly variable amounts in all systems except cells with recombinant enzymes. All human liver systems demonstrated that CYP3A4 is the principal CBZ metabolising enzyme. However, our results on CBZ-treated mice suggested that the metabolism of CBZ to CBZ-E is mainly mediated by CYP1A1 in C57/BL6 mice. Autoinduction of CBZ metabolism was seen in hepatocytes and in incubations using microsomes from CBZ-treated mice. Human liver and mouse liver microsomes metabolized oxcarbazepine (OCBZ) mainly to its active metabolite, 10-hydroxy-10,11-dihydro-carbamazepine (10-OH-CBZ). Also, 10,11-trans-dihydroxy-10,11-dihydro-carbamazepine (10,11-D) and an unknown metabolite were detected. Placental transfer of lamotrigine (LTG) and diazepam (DZP) was considerable in the human placental perfusion system, indicating marked fetal exposure in vivo. The OCBZ, 10-OH-CBZ and 10,11-D analyzed from maternal venous and cord blood also suggested significant fetal exposure. The placental perfusion system predicts well the transplacental passage of LTG and OCBZ and its major metabolite. However, in vivo cord blood concentrations of DZP are higher than maternal concentrations. Placental perfusion studies did not predict this. Still, even with its limitations, the human placental perfusion method provides information that can be used to evaluate the risk factors associated with drug use during pregnancy because understanding of specific transport characteristics is a good basis for rational risk assessment. In conclusion, all of the tested in vitro systems were useful in the prediction of at least some aspects of in vivo pharmacokinetics and metabolism, but validation and refinement are still essential, as is also the need to keep in mind the limitations characteristic of each in vitro method.
360

Formulation of a nevirapine co-crystal as a liquid dosage form

Injety, Sahana January 2016 (has links)
Magister Pharmaceuticae - MPharm / Co-crystals are a solid phase phenomena that could enhance the physicochemical properties of an active pharmaceutical ingredient. A co-crystal has never been incorporated into a liquid dosage form with the assurance of maintaining its co-crystal state until absorption under defined conditions. This study aims to develop a liquid formulation with a nevirapine co-crystal. A protocol was developed to investigate all the five co-formers that were used to make the nevirapine co-crystals to-date. The most appropriate co-former was selected for a liquid dosage form to study the integrity and the scaling up of the co-crystal in a suspension formulation. Co-formers used were viz. saccharin, glutaric acid, salicylic acid, rac-tartaric acid and maleic acid. These were characterized according to their physical, chemical, pharmacological and pharmaceutical properties. A grading scale was used to select the most appropriate co-former for a suspension formulation. Comparatively, saccharin produced the best combination of physical, chemical, pharmacological and pharmaceutical properties, especially with regard to the particle size and the specific gravity which proved to be very useful as optimal criteria for suspension formulation. Upon selection of the ideal co-former, scale-up of the nevirapine saccharin co-crystal was performed from a small scale of 350 mg to a large scale of 5 g. Nevirapine-saccharin (NVSC) co-crystals were prepared utilizing the slow evaporation technique, using methanol as the solvent and the percentage yield of the co-crystals were > 80 %. The identity of co-crystals was confirmed using hot stage microscopy (HSM), differential scanning calorimetry (DSC), fourier transform infra- red (FTIR) and thermogravimetric analysis (TGA). Three co-crystal suspension formulations were prepared using the excipients identified in the branded, Viramune® suspension, with each formulation containing viscosity enhancers such as aerosil 200, carbopol 971G and carbopol 974P. To ascertain the co- crystal integrity in the suspension, it was filtered and the filtrate was identified with DSC and FTIR while the filtered solution was identified with ultraviolet spectroscopy (UV). The co-crystal suspension formulation with optimal pH, viscosity and assurance of co-crystal integrity was the carbopol 974P formulation. The UV and DSC of the filtrate of the suspension revealed that the co-crystal had not separated into its individual components and remained intact while in suspension form irrespective of the excipients added. This formulation proceeded to the quality control stage. It was assessed for its pH, viscosity and dissolution according to the USP 32 standards and compared to the branded nevirapine suspension, Viramune ®, presently on the market. The suspension was characterized for particle size, zeta potential and polydispersity index. The dissolution results assayed by High Performance Liquid Chromatography (HPLC) revealed a drug release of 86 % in the Viramune® suspension while the NVSC co- crystal suspension achieved a drug release of 94% within 30 minutes of dissolution. / National Research Foundation (NRF)

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