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1.
J Neural Transm (Vienna) ; 127(2): 291-299, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31907607

RESUMO

Olanzapine is a thienobenzodiazepine compound. It is one of the newer types of antipsychotic drugs used in the treatment of schizophrenia and other psychotic disorders. Several methods have been reported for analyzing olanzapine in its pure form or combined with other drugs and in biological fluids. These methods include high-performance liquid chromatography and liquid chromatography-tandem mass spectroscopy. Although many of the reported methods are accurate and sensitive, they require the use of sophisticated equipment, lack in situ analysis, and require expensive reagents. Moreover, several of these methods are cumbersome, require prolonged sample pretreatment, strict control of pH, and long reaction times. Here we present the development of a miniaturized electrochemical sensor that will enable minimally invasive, real-time, and in situ monitoring of olanzapine levels in microliter volumes of serum samples. For this purpose, we modified a microfabricated microelectrode with a platinum black film to increase the electrocatalytic activity of the microelectrode towards olanzapine oxidation; this improved the overall selectivity and sensitivity of the sensor. We observed in recorded voltammograms the anodic current dose response characteristics in microliter volumes of olanzapine-spiked serum samples that resulted in a limit of detection of 28.6 ± 1.3 nM and a sensitivity of 0.14 ± 0.02 µA/cm2 nM. Importantly, the platinum black-modified microelectrode exhibited a limit of detection that is below the clinical threshold (65-130 nM). Further miniaturizing and integrating such sensors into point-of-care devices provide real-time monitoring of olanzapine blood levels; this will enable treatment teams to receive feedback and administer adjustable olanzapine therapy.


Assuntos
Antipsicóticos/sangue , Eletroquímica/instrumentação , Desenho de Equipamento , Microeletrodos , Olanzapina/sangue , Platina , Adulto , Humanos , Masculino
2.
Ther Drug Monit ; 42(4): 636-642, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32039940

RESUMO

BACKGROUND: The objective of this study was to investigate the serum concentrations of olanzapine in relation to age, sex, and other factors in Chinese patients aged between 10 and 90 years. METHODS: Data for 884 olanzapine patients, deposited between 2016 and 2017, were retrieved from the therapeutic drug monitoring database of the Affiliated Brain Hospital of Guangzhou Medical University. The effects of covariates on serum olanzapine concentration, dose-normalized concentration (C/D ratio), and normalized concentration (C/D/weight) were investigated. RESULTS: Generally, male patients had lower olanzapine concentration, C/D ratio, and C/D/weight than female patients (P < 0.001). Smoking and drinking reduced olanzapine concentration, C/D ratio, and C/D/weight (P < 0.001). Coadministration with valproate decreased olanzapine concentration, C/D ratio, and C/D/weight by about 16%, 30%, and 40%, respectively (P < 0.001). Patients younger than 60 years had higher olanzapine concentrations (P < 0.05) but lower C/D ratios and C/D/weight (P < 0.001) than patients older than 60 years. Age was correlated with olanzapine concentration (r = -0.082, P < 0.05), C/D ratio (r = 0.196, P < 0.001), and C/D/weight (r = 0.169, P < 0.001). Sample timing after dose and diagnostic factors also contributed to the olanzapine concentrations. Multiple linear regression analysis revealed significant influences of dosage, age, sex, valproate comedication, smoking, postdose interval, and schizophrenia (vs bipolar affective disorders) on serum olanzapine concentrations. CONCLUSIONS: The metabolism of olanzapine may be altered by several factors. Patients characterized with a combination of factors may benefit from therapeutic drug monitoring for the adjustment of olanzapine dose to minimize adverse reactions.


Assuntos
Antipsicóticos/sangue , Olanzapina/sangue , Adolescente , Adulto , Antipsicóticos/uso terapêutico , Povo Asiático , Monitoramento de Medicamentos/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Olanzapina/uso terapêutico , Estudos Retrospectivos , Esquizofrenia/sangue , Esquizofrenia/tratamento farmacológico , Fatores Sexuais , Fumar/sangue , Ácido Valproico/sangue , Ácido Valproico/uso terapêutico , Adulto Jovem
3.
Soud Lek ; 65(4): 76-78, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33736437

RESUMO

We present here a fatal case of heatstroke, involving olanzapine and levomepromazine medications. A male in his sixties was found dead in his storage room in the middle of August, with a high rectal temperature. Autopsy revealed congestion of the lungs without any specific findings. Quantitative toxicological analysis demonstrated concentrations of olanzapine, levomepromazine, 7-aminonitrazepam, and 7-aminoflunitrazepam in a femoral blood sample of 0.433 µg/mL, 0.177 µg/mL, 0.604 µg/mL, and 0.041 µg/mL, respectively. The concentration of olanzapine exceeded toxic levels; however, levomepromazine level was within the therapeutic range. Due to the blocking mechanism of both olanzapine and levomepromazine against muscarinic receptors, they might depress sweating and impair heat dissipation. Based on autopsy findings, results of toxicological examination, and investigation by the authorities, we concluded that the cause of death was heatstroke under the influence of olanzapine and levomepromazine.


Assuntos
Golpe de Calor/mortalidade , Metotrimeprazina/sangue , Olanzapina/sangue , Psicotrópicos/sangue , Autopsia , Evolução Fatal , Golpe de Calor/etiologia , Humanos , Masculino , Metotrimeprazina/efeitos adversos , Pessoa de Meia-Idade , Olanzapina/efeitos adversos , Psicotrópicos/efeitos adversos
4.
Int J Neuropsychopharmacol ; 22(5): 358-369, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30854556

RESUMO

BACKGROUND: Antipsychotic drugs can negatively affect the metabolic status of patients, with olanzapine as one of the most potent drugs. While patients are often medicated for long time periods, experiments in rats typically run for 1 to 12 weeks, showing olanzapine-related weight gain and increased plasma lipid levels, with transcriptional upregulation of lipogenic genes in liver and adipose tissue. It remains unknown whether metabolic status will deteriorate with time. METHODS: To examine long-term metabolic effects, we administered intramuscular long-acting injections of olanzapine (100 mg/kg BW) or control substance to female rats for up to 13 months. RESULTS: Exposure to olanzapine long-acting injections led to rapid weight gain, which was sustained throughout the experiment. At 1, 6, and 13 months, plasma lipid levels were measured in separate cohorts of rats, displaying no increase. Hepatic transcription of lipid-related genes was transiently upregulated at 1 month. Glucose and insulin tolerance tests indicated insulin resistance in olanzapine-treated rats after 12 months. CONCLUSION: Our data show that the continuous increase in body weight in response to long-term olanzapine exposure was accompanied by surprisingly few concomitant changes in plasma lipids and lipogenic gene expression, suggesting that adaptive mechanisms are involved to reduce long-term metabolic adverse effects of this antipsychotic agent in rats.


Assuntos
Antipsicóticos/efeitos adversos , Lipídeos/sangue , Olanzapina/efeitos adversos , Aumento de Peso/efeitos dos fármacos , Tecido Adiposo/efeitos dos fármacos , Tecido Adiposo/metabolismo , Animais , Animais não Endogâmicos , Antipsicóticos/sangue , Antipsicóticos/farmacologia , Glicemia/efeitos dos fármacos , Feminino , Teste de Tolerância a Glucose , Injeções Intramusculares , Insulina/metabolismo , Resistência à Insulina , Fígado/efeitos dos fármacos , Fígado/metabolismo , Olanzapina/sangue , Olanzapina/farmacologia , Distribuição Aleatória , Ratos Sprague-Dawley , Fatores de Tempo
5.
J Clin Psychopharmacol ; 39(6): 550-560, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31688449

RESUMO

BACKGROUND: Impaired subjective well-being in schizophrenia patients treated with antipsychotics has often been linked inter alia to the antidopaminergic effects of medication. Thus, it is important to capture the association between striatal dopamine D2 receptor occupancy (D2-RO) and global subjective well-being. We examined this association using data from our multicenter, randomized, double-blind Neuroleptic Strategy Study (NeSSy). METHODS: An innovative double randomization process was used for allocation of patients to the specific treatment groups. Plasma drug concentrations were measured after 6 and 24 weeks of treatment to obtain the estimated D2-RO (eD2-RO) relative to literature values. We made an exploratory analysis of associations between eD2-RO and subjective well-being scores. One hundred two blood samples from 69 patients were available for the analysis. Because of the lack of a satisfactory occupancy model for quetiapine, only haloperidol, flupentixol, and olanzapine treatment groups were pooled, whereas aripiprazole data were analyzed separately, because of its partial agonistic properties. RESULTS: In the pooled antagonist group, eD2-RO correlated negatively with the summarized well-being score. In a more detailed analysis, this association could be confirmed for all first-generation antipsychotic-treated patients, but not for the separate second-generation antipsychotic groups. In the aripiprazole group, higher eD2-RO was associated with impaired physical well-being, but had no association with mental well-being. CONCLUSIONS: Our results suggest that high plasma levels and consequently high occupancy at D2 receptors are disadvantageous for subjective well-being, as distinct from the objective extrapyramidal side effects. To minimize patients' malaise, which disfavors adherence, implementation of therapeutic drug monitoring in the clinical routine may be useful.


Assuntos
Antipsicóticos/sangue , Aripiprazol/sangue , Antagonistas dos Receptores de Dopamina D2/sangue , Flupentixol/sangue , Haloperidol/sangue , Olanzapina/sangue , Satisfação Pessoal , Qualidade de Vida , Receptores de Dopamina D2/efeitos dos fármacos , Esquizofrenia/tratamento farmacológico , Psicologia do Esquizofrênico , Adulto , Método Duplo-Cego , Feminino , Humanos , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Esquizofrenia/sangue , Fatores Sexuais
6.
J Clin Psychopharmacol ; 39(6): 561-566, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31688390

RESUMO

BACKGROUND: The combination of olanzapine and valproic acid (VPA) is regularly prescribed in the treatment of bipolar or schizoaffective disorders. The VPA has been shown to reduce olanzapine concentration, but the mechanism behind this interaction remains unknown. We aimed to investigate the effect of VPA on olanzapine concentration during oral versus long-acting injectable (LAI) formulation in a real-life setting. METHODS: From a therapeutic drug monitoring service, prescribed doses and serum concentrations from 2791 olanzapine-treated patients (9433 measurements) were included. RESULTS: The number of patients on olanzapine-LAI treatment was 328, whereas 2463 were using oral olanzapine. The frequency of patients comedicated with VPA was 9.4% for olanzapine tablets and 5.8% for olanzapine-LAI. The VPA had no effect on olanzapine dose-adjusted concentrations in LAI users (1.6 vs 1.7 [ng/mL]/[mg/d]; P = 0.38), whereas in the oral group the dose-adjusted olanzapine concentration was lower in VPA users (2.2 vs 2.7 [ng/mL]/[mg/d]; P < 0.001). For smokers in the oral olanzapine group using VPA, 8.7% of the measurements were in the subtherapeutic range (<10 ng/mL) compared with 6.0% in nonusers (P = 0.003). IMPLICATIONS: These findings show that the VPA-olanzapine interaction involves a presystemic mechanism and is therefore restricted to oral olanzapine treatment. For oral treatment of olanzapine, comedication with VPA implies a risk of insufficient effect, which may be of clinical relevance in smokers in particular. Thus, it is important to be aware of the interaction potential with VPA during oral olanzapine use, whereas for LAI-treated patients fewer precautions are required from a pharmacokinetic point of view.


Assuntos
Antimaníacos/farmacologia , Antipsicóticos/administração & dosagem , Antipsicóticos/sangue , Transtorno Bipolar/tratamento farmacológico , Interações Medicamentosas , Olanzapina/administração & dosagem , Olanzapina/sangue , Transtornos Psicóticos/tratamento farmacológico , Fumar/sangue , Ácido Valproico/farmacologia , Administração Oral , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Preparações de Ação Retardada , Monitoramento de Medicamentos , Quimioterapia Combinada , Feminino , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Adulto Jovem
7.
Acta Psychiatr Scand ; 139(1): 15-25, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30112761

RESUMO

OBJECTIVE: To determine the impact of CYP1A2 genetic polymorphisms on the pharmacokinetics of CYP1A2-metabolized antipsychotic drugs in humans by means of systematic review and meta-analysis. METHOD: A systematic search was conducted in PubMed and Scopus databases as of June 26, 2018. Studies reporting the pharmacokinetic parameters of CYP1A2-metabolized antipsychotic drugs in individuals who were genotyped for CYP1A2 genetic polymorphisms were retrieved. Pharmacokinetic parameters of individuals who have mutant alleles of a CYP1A2 genetic polymorphism were compared with the wild-type individuals. Pooled-effect estimates, presented as standardized mean difference, were calculated by means of the fixed-effect or random-effects model, as appropriate. RESULTS: Ten studies involving 872 clozapine users, seven studies involving 712 olanzapine users, and two studies involving 141 haloperidol users were included. All but one study reported no associations between any CYP1A2 genetic polymorphisms and the pharmacokinetics of CYP1A2-metabolized antipsychotic drugs. The pooled-effect estimates through meta-analyses of seven studies demonstrated no significant associations between the -163C>A or -2467delT polymorphism and clozapine or olanzapine concentrations in the blood. CONCLUSIONS: This study suggests that CYP1A2 genetic polymorphisms have no significant impact on the pharmacokinetics of CYP1A2-metabolized antipsychotic drugs. CYP1A2 genotyping may have no clinical implications for personalized dosing of CYP1A2-metabolized antipsychotic drugs.


Assuntos
Antipsicóticos/farmacocinética , Clozapina/farmacocinética , Citocromo P-450 CYP1A2/genética , Olanzapina/farmacocinética , Adulto , Alelos , Antipsicóticos/sangue , Clozapina/sangue , Citocromo P-450 CYP1A2/metabolismo , Etnicidade/genética , Etnicidade/psicologia , Feminino , Genótipo , Haloperidol/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Mutação/genética , Olanzapina/sangue , Polimorfismo Genético/genética
8.
Biomed Chromatogr ; 33(4): e4468, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30549068

RESUMO

Olanzapine is an atypical antipsychotic drug from the thienobenzodiazepine family which displays efficacy in patients with schizophrenia and related psychoses. A novel LC/MS method was developed and validated for determination of olanzapine in schizophrenia patients' plasma. A liquid-liquid extraction procedure was carried out using 5 mL diethyl ether-diisopropyl ether mixture (1:1, v/v). Average recovery of the extraction procedure was 94.8%. Chromatographic separation was performed on reversed-phase C18 column (250 × 2.0 mm, 5 µm) using mixture of deionized water (trifluoro acetic acid 0.1%)-acetonitrile (20:80, v/v) as mobile phase at a flow rate of 1 mL/min. Irbesartan was used as internal standart and total run time was 2.5 min. Mass spectrometric analysis were carried out in selective-ion montoring mode, and detected olanzapine at m/z 313.1 and IS at m/z 429.4 in all forms of the ions. The calibration curve of olanzapine was linear in the range 2-300 ng/mL (r2 > 0.9993). The interday and intraday precisions (RSD) were <7.55%, and accuracy was >7.59% (n = 6). The proposed study was successfully validated with respect to the US Food and Drug Administration guidelines.


Assuntos
Antipsicóticos/sangue , Cromatografia Líquida/métodos , Espectrometria de Massas/métodos , Olanzapina/sangue , Esquizofrenia/tratamento farmacológico , Adulto , Antipsicóticos/química , Antipsicóticos/farmacocinética , Antipsicóticos/uso terapêutico , Monitoramento de Medicamentos/métodos , Estabilidade de Medicamentos , Feminino , Humanos , Limite de Detecção , Modelos Lineares , Masculino , Olanzapina/química , Olanzapina/farmacocinética , Olanzapina/uso terapêutico , Reprodutibilidade dos Testes
9.
Molecules ; 24(2)2019 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-30654481

RESUMO

This manuscript describes a sensitive, selective, and online in-tube solid-phase microextraction coupled with an ultrahigh performance liquid chromatography-tandem mass spectrometry (in-tube SPME-UHPLC-MS/MS) method to determine chlopromazine, clozapine, quetiapine, olanzapine, and their metabolites in plasma samples from schizophrenic patients. Organic poly(butyl methacrylate-co-ethylene glycol dimethacrylate) monolith was synthesized on the internal surface of a fused silica capillary (covalent bonds) for in-tube SPME. Analyte extraction and analysis was conducted by connecting the monolithic capillary to an UHPLC-MS/MS system. The monolith was characterized by scanning electron microscopy (SEM) and Fourier transform infrared spectrometry (FTIR). The developed method presented adequate linearity for all the target antipsychotics: R² was higher than 0.9975, lack-of-fit ranged from 0.115 to 0.955, precision had variation coefficients lower than 14.2%, and accuracy had relative standard error values ranging from -13.5% to 14.6%, with the exception of the lower limit of quantification (LLOQ). The LLOQ values in plasma samples were 10 ng mL-1 for all analytes. The developed method was successfully applied to determine antipsychotics and their metabolites in plasma samples from schizophrenic patients.


Assuntos
Antipsicóticos/sangue , Metabolômica/métodos , Esquizofrenia/sangue , Microextração em Fase Sólida/métodos , Clorpromazina/sangue , Cromatografia Líquida de Alta Pressão , Clozapina/sangue , Humanos , Olanzapina/sangue , Fumarato de Quetiapina/sangue , Esquizofrenia/tratamento farmacológico , Espectrometria de Massas em Tandem
10.
Pharmacogenomics J ; 18(3): 422-430, 2018 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-28719598

RESUMO

We investigated in ninety Caucasian pediatric patients the impact of the main polymorphisms occurring in CYP3A, CYP2D6, ABCB1 and ABCG2 genes on second-generation antipsychotics plasma concentrations, and their association with the occurrence of adverse drug reactions. Patients with the CA/AA ABCG2 genotype had a statistically significant lower risperidone plasma concentration/dose ratio (Ct/ds) (P-value: 0.007) and an higher estimated marginal probability of developing metabolism and nutrition disorders as compared to the ABCG2 c.421 non-CA/AA genotypes (P-value: 0.008). Multivariate analysis revealed that the ABCG2 c.421 CA/AA genotype was found associated to a higher hazard (P-value: 0.004) of developing adverse drug reactions classified as metabolism and nutrition disorders. The ABCB1 2677TT/3435TT genotype had a statistically significant lower aripiprazole Ct/ds if compared with patients with others ABCB1 genotypes (P-value: 0.026). Information obtained on ABCB1 and ABCG2 gene variants may result useful to tailor treatments with these drugs in Caucasian pediatric patients.


Assuntos
Aripiprazol/sangue , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/genética , Risperidona/sangue , Esquizofrenia/sangue , Subfamília B de Transportador de Cassetes de Ligação de ATP/genética , Membro 2 da Subfamília G de Transportadores de Cassetes de Ligação de ATP/genética , Adolescente , Aripiprazol/administração & dosagem , Criança , Pré-Escolar , Citocromo P-450 CYP2D6/genética , Citocromo P-450 CYP3A/genética , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/sangue , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/patologia , Feminino , Genótipo , Humanos , Masculino , Proteínas de Neoplasias/genética , Olanzapina/administração & dosagem , Olanzapina/sangue , Pediatria/tendências , Polimorfismo Genético , Fumarato de Quetiapina/administração & dosagem , Fumarato de Quetiapina/sangue , Risperidona/administração & dosagem , Esquizofrenia/tratamento farmacológico , Esquizofrenia/patologia , Adulto Jovem
11.
J Clin Psychopharmacol ; 38(6): 570-576, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30300295

RESUMO

PURPOSE: Olanzapine is a commonly prescribed antipsychotic available as oral and long-acting injectable (LAI) formulations. Data are lacking on the use and safety of olanzapine-LAI in older patients. The aim of this study was to investigate the effect of increasing age on olanzapine exposure during oral versus LAI administration in a real-life setting. METHODS: This observational study was based on routine therapeutic drug monitoring data collected during 2005-2017. As a measure of exposure, absolute concentrations and concentration/dose ratios of olanzapine were defined as outcome variables. Linear mixed-model analyzes were used to allow for inclusion of multiple samples per patient and adjustment for covariate effects. RESULTS: Olanzapine concentrations and doses from 8,288 patients (21,378 measurements) were included. The number of patients on oral treatment was 7,893 (42%, 50 years or older), while 395 were using olanzapine-LAI (27%, 50 years or older). In contrast to oral use, where the dose-adjusted concentration of olanzapine increased significantly for patients 50 years or older (P < 0.001), increasing age had no effect on olanzapine concentration following LAI administration (P = 0.550). The effects of smoking habits and gender were equal in oral and olanzapine-LAI users. CONCLUSION: While the dose-adjusted systemic exposure of olanzapine increases by age after oral administration, these novel findings from a large patient population show that systemic exposure of olanzapine-LAI is unaffected by age, probably due to the lacking influence of age-related changes in gastrointestinal absorption and/or presystemic metabolism. From a pharmacokinetic point of view, it is therefore no reason to restrict the use of olanzapine-LAI in older patients requiring long-term treatment.


Assuntos
Antipsicóticos/administração & dosagem , Transtornos Mentais/tratamento farmacológico , Olanzapina/administração & dosagem , Administração Oral , Adolescente , Adulto , Idoso , Antipsicóticos/sangue , Preparações de Ação Retardada , Feminino , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Olanzapina/sangue , Adulto Jovem
12.
Arch Womens Ment Health ; 21(5): 587-589, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29637404

RESUMO

We present one case of a woman treated with the intramuscular depot formulation of the atypical antipsychotic, olanzapine pamoate (ZypAdhera®), during pregnancy and breastfeeding. Data on olanzapine distribution in breast milk as well as on plasma concentration in the nursed infant are provided. The present case report demonstrates that olanzapine was excreted in the breast milk, but the breast-fed infant had very low olanzapine concentrations, which did not result in any adverse effects.


Assuntos
Antipsicóticos/sangue , Antipsicóticos/uso terapêutico , Leite Humano/metabolismo , Olanzapina/sangue , Olanzapina/uso terapêutico , Esquizofrenia/tratamento farmacológico , Adulto , Antipsicóticos/farmacocinética , Aleitamento Materno , Preparações de Ação Retardada , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Humanos , Lactente , Injeções Intramusculares , Leite Humano/química , Olanzapina/farmacocinética , Gravidez , Resultado da Gravidez , Resultado do Tratamento
13.
Biomed Pharmacother ; 172: 116236, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38325263

RESUMO

AIMS: By meta-analysing pooled studies and available individual participant data, we aim to provide new insight on olanzapine therapeutic drug monitoring in schizophrenia. METHOD: We conducted a computerized search of bibliographic databases (Pubmed, Cochrane library, Web of Science and PsycINFO) to identify studies that assessed the relationship between olanzapine plasma concentration and the change in patients' clinical scores. We investigated this relationship with olanzapine plasma level 12h00 post-intake using a random-effects model. RESULTS: 7 studies were included in the pooled data analysis (781 patients). We found no difference in oral dose between responders and non-responders but a significantly higher concentration of 4.50 µg/L in responders (p < 0.01). Olanzapine concentration above the thresholds identified in each study was associated with response (odd ratio = 3.50, p = 0.0007). We identified that non-responder patients showed greater inter-individual variability than responders. In the individual data analysis (159 patients), we found no relationship between dose and clinical response but an association between plasma level and response in the shape of a parabolic curve. The Receiver Operating Characteristic curve found a threshold of 22.07 µg/L to identify responders (96% sensitivity, 86% specificity) and a threshold of 56.47 µg/L to identify a decreased probability of response. CONCLUSION: In contrast to oral dose, our work confirmed that plasma olanzapine levels are associated with clinical response and should therefore be used to optimise treatment. We determined a treatment response threshold of 22.07 µg/L and suggest that a concentration above the therapeutic window may result in a decreased response.


Assuntos
Olanzapina , Esquizofrenia , Humanos , Análise de Dados , Razão de Chances , Olanzapina/sangue , Olanzapina/uso terapêutico , Plasma , Curva ROC , Esquizofrenia/tratamento farmacológico
14.
Talanta ; 278: 126476, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-38950501

RESUMO

In this paper, paper microfluidic channel fabricated by directly screen-printing of polydimethylsiloxane (PDMS) is proposed for paper spray mass spectrometry analysis of therapeutic drugs in the blood samples. Compared with traditional paper spray, PDMS-printed paper spray (PP-PS) allows fluid to flow to the tip of paper with less sample loss which significantly improved the signal intensity of target compounds in blood samples. As paper can reduce the matrix effect, PP-PS also has a greater advantage than electro-spray Ionization (ESI) when directly analyzing complex biological sample in terms of the detection efficiency. Linearity and limits of detection (LOD) were evaluated for five psychotropic drugs: olanzapine, quetiapine, 9-hydroxyrisperidone, clozapine, risperidone. As a result, PP-PS improved the signal intensity of the psychotropic drugs at a concentration of 250 ng/ml in blood samples by a factor of 2-5 times and lowered the relative standard deviation (RSD) by a factor of 2-5.6 times compared with traditional paper spray. And PP-PS also improved signal intensity by a factor of 9-33 times compared with ESI. Quantitative experiments of PP-PS mass spectrometry indicated that the linear range was 5-500 ng/ml and the LOD were improved by a factor of 5-71 times for all these drugs compared with traditional paper spray. In addition, PP-PS was applied to the home-made miniaturized mass spectrometer and the precursor ions of all five psychotropic drugs (250 ng/ml) in the mass spectrometry results were obtained as well. These could prove that PP-PS has the potential to analyze complex biological samples in application on the miniaturized mass spectrometer which can be used outside the laboratory.


Assuntos
Dimetilpolisiloxanos , Espectrometria de Massas , Papel , Humanos , Dimetilpolisiloxanos/química , Espectrometria de Massas/métodos , Limite de Detecção , Clozapina/sangue , Risperidona/sangue , Fumarato de Quetiapina/sangue , Palmitato de Paliperidona/sangue , Olanzapina/sangue , Psicotrópicos/sangue , Impressão
15.
Spectrochim Acta A Mol Biomol Spectrosc ; 322: 124838, 2024 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-39032233

RESUMO

In this work, the xanthene dye, erythrosine B, was employed as a probe for the determination of olanzapine using two fast and highly simple analytical approaches. The assay was based on the formation of a binary complex between the drug and erythrosine B in a slightly acidic aqueous buffered solution. In the first method, the absorbance of the formed product was monitored at 558 nm. The reaction stoichiometry was investigated, and the stability constant of the formed complex was estimated. The linear range of the method that obeyed Beer's law was in the concentration range of 0.6-8.0 µg/ml. The calculated detection and quantitation limits were 0.2 and 0.6 µg/mL. Upon adding the drug solution to erythrosine B, the native fluorescence of the dye was quenched and monitored at 550 nm after excitation at 528 nm. Thus, the fluorescence quenching was utilized as the quantitative signal in the spectrofluorimetric approach. The extent of quenching in the fluorescence intensity was rectilinear with the drug concentration in a range of 0.1-2.5 µg/ml with a detection limit of 0.032 µg/ml. Both approaches were analytically validated based on the guiding rules of the ICH with acceptable results, and were utilized efficiently in the analysis of olanzapine in commercial tablets containing the cited drug. In addition, owing to its high sensitivity and selectivity, the spectrofluorimetric method was applied for drug analysis in spiked human plasma with satisfactory % recoveries. Finally, the greenness of the methods was confirmed using eco-score scale and Analytical Green Evaluation metrics.


Assuntos
Limite de Detecção , Olanzapina , Espectrometria de Fluorescência , Olanzapina/sangue , Olanzapina/análise , Humanos , Espectrometria de Fluorescência/métodos , Eritrosina/química , Reprodutibilidade dos Testes , Antipsicóticos/sangue , Antipsicóticos/química , Benzodiazepinas/sangue , Benzodiazepinas/análise , Benzodiazepinas/química
16.
Basic Clin Pharmacol Toxicol ; 135(5): 607-619, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39314029

RESUMO

Long-term sample stability of five atypical antipsychoticdrugs risperidone, paliperidone, clozapine, quetiapine and olanzapine and the antidepressant drug mirtazapine in serum was studied by use of a newly developed and validated analytical method based on solid-phase extraction and liquid chromatography-tandem mass spectrometry. Ascorbic acid was used as an antioxidative agent to stabilize olanzapine during storage and sample preparation. We assessed analyte stability on long-term storage in serum samples at 25°C, 5°C, -20°C and -80°C, and during five freeze-thaw cycles. Analytes were stable for 23 days at room temperature except for olanzapine and mirtazapine (17 days). All analytes were stable for at least 30 days at 5°C. All analytes were stable for 270 days at -20°C, except for paliperidone and mirtazapine with 60 days and 180 days, respectively. All analytes were stable for 270 days at -80°C. Furthermore, all analytes were stable for five freeze-thaw cycles. We recommend storage at -80°C when samples drawn for analysis of antipsychotic drugs are stored for more than 60 days, whereas a temperature of -20°C is sufficient for storage less than 60 days.


Assuntos
Antipsicóticos , Clozapina , Estabilidade de Medicamentos , Mirtazapina , Olanzapina , Palmitato de Paliperidona , Fumarato de Quetiapina , Risperidona , Extração em Fase Sólida , Espectrometria de Massas em Tandem , Humanos , Espectrometria de Massas em Tandem/métodos , Mirtazapina/sangue , Antipsicóticos/sangue , Olanzapina/sangue , Fumarato de Quetiapina/sangue , Palmitato de Paliperidona/sangue , Cromatografia Líquida/métodos , Clozapina/sangue , Risperidona/sangue , Antidepressivos/sangue , Benzodiazepinas/sangue , Mianserina/análogos & derivados , Mianserina/sangue , Fatores de Tempo , Espectrometria de Massa com Cromatografia Líquida
17.
Indian J Pharmacol ; 53(1): 2-5, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33975992

RESUMO

AIM: The current work establishes an easy, reliable technique for the estimation of serum Olanzapine concentration which correlates it clinically. SUBJECTS AND METHODS: The work was agreed in 61 schizophrenic patients who were on olanzapine. Serum drug amount was estimated by normal-phase high-performance liquid chromatography and brief psychiatry rating scale was used to determine disease progression. RESULTS: Samples provided 61 patients, 40 were under sub-therapeutic range, 18 were under therapeutic range and 3 were above the therapeutic range. CONCLUSION: Therapeutic drug monitoring must be a part of clinical practice in psychiatric hospitals for optimizing the dose of an individual patient along with the correlation of serum concentration with the clinical assessment scales.


Assuntos
Antipsicóticos/uso terapêutico , Olanzapina/uso terapêutico , Esquizofrenia/tratamento farmacológico , Adolescente , Adulto , Idoso , Antipsicóticos/administração & dosagem , Antipsicóticos/sangue , Antipsicóticos/farmacocinética , Esquema de Medicação , Monitoramento de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Olanzapina/administração & dosagem , Olanzapina/sangue , Olanzapina/farmacocinética , Escalas de Graduação Psiquiátrica , Psicologia do Esquizofrênico , Adulto Jovem
18.
Psychopharmacology (Berl) ; 238(3): 665-676, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33230696

RESUMO

INTRODUCTION: The role of Olanzapine therapeutic drug monitoring is controversial. The present study explores the associations of Olanzapine plasma concentrations with clinical response and metabolic side effects in first episode psychosis (FEP) after 2 months of treatment. METHODS: Forty-seven patients were included. Improvement in clinical symptomatology was assessed using the PANSS. Metabolic assessment included weight, blood pressure, waist circumference, blood glucose, total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides. RESULTS: The Olanzapine plasma concentrations after 2 months of treatment were positively correlated with weight gain (r = 0.49, p = 0.003), and a concentration > 23.28 ng/mL was identified as a positive predictor of weight gain (≥ 7%). The Olanzapine concentration to dose (C/D) ratio was positively correlated with the percentage of improvement in the total PANSS (r = 0.46, p = 0.004), and a C/D ratio > 2.12 was identified as a positive predictor of a good response (percentage of improvement > 30%) after 2 months of treatment. We also identified several factors that could alter Olanzapine pharmacokinetics: gender (p = 0.03), diagnosis (p = 0.05), smoking habit (p = 0.05), and co-medications such as valproic acid (p = 0.05) and anxiolytics (p = 0.01). DISCUSSION: In conclusion, our results suggest that therapeutic drug monitoring of Olanzapine could be helpful to evaluate therapeutic efficacy and metabolic dysfunction in FEP patients treated with Olanzapine.


Assuntos
Antipsicóticos/sangue , Monitoramento de Medicamentos/métodos , Olanzapina/sangue , Transtornos Psicóticos/tratamento farmacológico , Adulto , Antipsicóticos/uso terapêutico , Glicemia/análise , Pressão Sanguínea/efeitos dos fármacos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Olanzapina/uso terapêutico , Transtornos Psicóticos/sangue , Transtornos Psicóticos/psicologia , Fumar/sangue , Resultado do Tratamento , Aumento de Peso/efeitos dos fármacos
19.
Bioanalysis ; 12(9): 597-613, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32441535

RESUMO

Background: Olanzapine (OLZ) is one of most recommended drugs for the treatment of schizophrenia while metformin (MET) is the most commonly used hypoglycemic agent. Aim: Development and validation of two green, sensitive and accurate chromatographic methods for the simultaneous determination of OLZ along with the co-prescribed, MET. Materials & methods: TLC-densitometric method with a developing system consisting of methylene chloride:methanol:ethyl acetate:triethylamine (4:4:5:0.1, by volume) and a reversed-phase (RP)-HPLC method where the chromatographic separation was performed using ethanol:water mixture (50: 50, v/v) as a mobile phase. Results: TLC-densitometric method had linearity over concentration ranges of 160-4000 ng/band for OLZ and 150-4500 ng/band for MET, while RP-HPLC method was linear and validated over concentration range of 300-20000 ng/ml for OLZ and MET. Conclusion: Pharmacokinetic study was successfully performed and suggested the possibility of co-administration of MET with OLZ and their further formulation in one pharmaceutical preparation to enhance patient's compliance.


Assuntos
Metformina/sangue , Olanzapina/sangue , Animais , Cromatografia Líquida de Alta Pressão , Cromatografia de Fase Reversa , Cromatografia em Camada Fina , Feminino , Metformina/química , Estrutura Molecular , Olanzapina/química , Ratos , Ratos Wistar
20.
J Chromatogr Sci ; 58(2): 117-126, 2020 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-31950982

RESUMO

One major challenge in quantifying drugs in biological matrices is to manage interfering compounds. A technique such liquid chromatography coupled to mass spectrometry in tandem (LC-MS/MS) is especially suitable for this application due to its high sensitivity and selectivity in detecting low concentrations of analytes in a complex system. Due to the complexity of LC-MS/MS systems, a number of experimental parameters must be optimized to provide an adequate separation and detection of the analyte. In the present work, a design of experiments approach was developed to optimize an LC-MS/MS-based bioanalytical method to extract olanzapine (OLZ) and quetiapine (QTP) from human plasma. Three steps for the optimization process were conducted: central composite face-centered design to optimize chromatographic parameters (Step 1), ionization in mass spectrometry (Step 2) and a full 32 factorial design to optimize analyte extraction conditions (Step 3). After the optimization process, resolutions and QTP and OLZ retention time (2.3 and 4, respectively) were optimum with pH of 4.7 and 85.5% of acetonitrile for the chromatographic step. Mass spectrometry optimization step provided an increase of (±50%) in the average peak area with high signal-to-noise relationship for the analytes studied. The proposed extraction method was 70% more efficient than the initial method for all drugs analyzed.


Assuntos
Cromatografia Líquida de Alta Pressão/métodos , Olanzapina/sangue , Fumarato de Quetiapina/sangue , Espectrometria de Massas em Tandem/métodos , Antipsicóticos/sangue , Humanos , Plasma/química
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