Clinical kinetics of 1, 4-dihydroxy-5,8-bis [(2-[(2-hydroxyethyl) amino] ethyl] amino ]-9, 10-anthracenedione.

The clinical kinetics of 1, 4-dihydroxy-5,8-bis[[ 2-[(2-hydroxyethyl) amino] ethyl] amino]-9,10-anthracenedione dihydrochloride (DHAQ) are reported. DHAQ, 1 to 3 mg/m2, was administered as an intravenous bolus to six patients with metastatic cancer. Plasma clearance of the drug followed a biphasic pattern with a harmonic mean initial half-life (t 1/2) of 13.7 min and a terminal t 1/2 of 37.4 hr. Recovery of unchanged drug in the urine was 6.8% at 24 hr and 7.3% at 72 hr, while the corresponding recovery of total radioactivity was 9.4% and 11.3%. Apparent volume of distribution of DHAQ was about 13.8 +/- 2.9 l/kg. Total clearance was 238.7 ml/kg/hr, twice the creatinine clearance.

Blood and tissue concentrations of Bisantrene measured by a simple fluorometric assay.

We have developed a simple sensitive fluorometric assay for the measurement of total Bisantrene in plasma, red blood cells, and tissues to facilitate preclinical and clinical pharmacologic assessment of this active anticancer agent. The assay was used to measure the plasma disappearance and tissue concentrations of Bisantrene in the rabbit. Results are comparable to those reported with HPLC assays and with measurement of radioactivity in combusted tissue following IV administration of radiolabeled Bisantrene. We demonstrated that when a plasma concentration of approximately 50 micrograms/ml is not exceeded, Bisantrene remains in solution at that concentration. If Bisantrene is introduced into plasma at a concentration exceeding 50 micrograms/ml, precipitation of the drug is initiated and continues until the plasma concentration is no greater than 15 micrograms/ml. This finding supports our previous recommendation that in clinical trials Bisantrene should be administered at low concentrations over prolonged periods of time to maximize the bioavailability of the drug by minimizing precipitation of the drug in plasma.

Regional targeting of bisantrene by directed intravascular precipitation.

Targeting of anticancer drugs to specific organs by directed intravascular precipitation was studied in calves using 9-10 anthracenedicarboxyaldehyde bis [(4,5-dihydro-lH-imidazol-2-yl) hydrazone] dihydrochloride (Bisantrene), a clinically active anticancer drug with limited solubility at physiological pH. Rapid injection of Bisantrene in solution at pH 4.5 into the internal iliac artery resulted in concentrations of drug in the urinary bladder wall supplied by the artery that were more than 1000 times those in the same tissue following injection of the same dose of drug IV, the route of administration used clinically. Localization of the orange fluorescent drug to the ipsilateral bladder wall was easily seen. Fluorescence microscopy revealed deposits of drug along the walls of the arteriolar and capillary bed supplied by the artery into which it had been injected. Concentrations of drug in the systemic circulation and in tissues not supplied by the internal iliac artery used for drug injection were lower after intraarterial (IA) drug administration than after IV administration. Pathological studies of the tissues of calves sacrificed at intervals up to four weeks following rapid injection into the internal iliac artery of the same doses of Bisantrene used IV in cancer patients did not reveal evidence of extensive cytotoxicity to the infused organs.

Clinical pharmacokinetics of 9, 10-anthracenedicarboxaldehyde-bis [(4,5-dihydro-1 H-imidazol-2-yl)hydrazone]dihydrochloride.

We studied the clinical pharmacokinetics of the anthracene derivative bisantrene using high-performance liquid chromatographic analysis. We administered the drug to ten patients at 120-250 mg/m2 IV; one of these patients also received a second dose of 120 mg/m2 6 weeks later, and another received 150 mg/m2 weekly for three doses. Bisantrene disappeared from the plasma biphasically, with an initial t1/2 of 0.6 +/- 0.3 h and a terminal t1/2 of 24.7 +/- 6.9 h after single doses. The apparent volume of distribution according to the area under the curve was 42.1 +/- 5.9 l/kg, and the total clearance was 1045.5 +/- 51.0 ml/kg/h. The 96-h cumulative urinary excretion was 3.4% +/- 1.1% of dose; thus, renal excretion was a minor route of elimination for this agent. Bisantrene pharmacokinetics in the patient who received a second dose after 6 weeks showed insignificant changes. However, in the patient who was given this drug weekly for 3 weeks, the plasma t1/2 of the drug during the terminal phase became increasingly longer, while the total clearance was significantly reduced. These results suggest that bisantrene may accumulate in the body and that caution is essential in the event of frequent administration.

GLC-mass spectrometric determination of maprotiline and its major metabolite using stable isotope-labeled analog as internal standard.

A quantitative GLC-mass spectrometric assay was developed for the determination of maprotiline and its major metabolite, desmethylmaprotiline, in animal and human plasma. The assay utilizes selective-ion focusing to monitor, in a GLC effluent, the fragment ions and the base peaks of maprotiline and desmethylmaprotiline trifluoroacetamides generated by electron-impact ionization. Maprotiline-d3 was the internal standard. The assay can measure 2 ng of maprotiline (and the metabolite)/ml of plasma with approximately 5% precision. The curves relating the amounts of maprotiline and the metabolite added versus the amounts experimentally found over a large concentration range were linear with nearly zero intercepts and slopes of 0.99 +/- 0.01 and 0.98 +/- 0.02, respectively. The method was used to study the pharmacokinetic pattern of the drug in rabbits as well as to analyze intact maprotiline and the metabolite in patients maintained on therapeutic doses of maprotiline. Assay specificity was confirmed by complete consistency of the mass spectra of maprotiline and desmethylmaprotiline with those of the authentic materials.

Comparison of UV and fluorescence spectrophotometry for the quantification of a potent myotonia inducer: anthracene-9-carboxylic acid, in plasma, urine, and saline perfusion fluids.

UV and fluorescence spectrophotometry were used to establish the analytical profile of a potent myotonia inducer, anthracene-9-carboxylic acid (I). UV spectrophotometry is useful for the determination of I when it is dissolved in physiological solutions (Ringer's, Tyrode's, etc). In these fluids there is a linear relationship between UV absorption and I concentration between 500 and 2000 ng/ml (2.25-9.0 X 10(-6)M). However, in biological fluids there are interferences in the UV absorption due to organic substances. On the other hand, fluorescence spectrophotometry is more sensitive than UV for determinations in plasma and urine. Within the range of 200-1000 ng/ml (0.9-4.5 X 10(-6) M) fluorescence intensity increases linearly with concentration. Furthermore, when both emission and excitation spectra are combined there are no interferences due to organic substances normally present in those fluids. An extraction procedure of I from plasma and urine is also described, and the importance of I determinations in relation to the problem of this myotonia-inducing aromatic monocarboxylic acid is discussed.

HPLC, MS, and pharmacokinetics of melphalan, bisantrene and 13-cis retinoic acid.

High performance liquid chromatographic procedures are described for melphalan, bisantrene, and 13-cis retinoic acid, three important anticancer drugs in various stages of clinical development. The procedures require a rapid and simple sample clean-up followed by a 10-to 20-min chromatographic separation on a reversed-phase C18 column. Precisions are all less than 8% with recoveries greater than 80%. Mass spectrometry confirmation of each drug from patient sample separations is presented to provide unambiguous identification for valid pharmacokinetic parameter determination.

[Blood concentrations of maprotiline in depressive patients]. / Etude des concentrations sanguines de maprotiline chez des patients déprimés.

Blood levels of Maprotiline were analysed and their relationship to the clinical response was examined in 89 depressed inpatients, according DSM III criteria for Major Depressive Episode, given the drug treatment for 3 weeks. Maprotiline produced marked decreases in mean MADRS and COVI scale scores by the end of treatment. On day 21, no correlation between blood levels of Maprotiline and MADRS or COVI scores were found when all patients were considered. Nevertheless, significant correlations were observed on day 14 (r = .22; p less than .05 for MADRS and r = .23; p less than .05 for COVI scale). In addition, a significant correlation between MADRS or COVI scale scores and Maprotiline blood levels were observed on days 14 and 21 in subgroups of young patients, severe depression (high scores to clinical global investigations), during of at least 3 months, treated without other drug than Maprotiline and good responders.

Estimation of maprotiline in serum by gas-chromatography, with use of a nitrogen-specific detector.

We describe a gas-chromatographic procedure for estimating therapeutic concentrations of maprotiline, a new tetracyclic antidepressant, in serum by use of a nitrogen-specific detector. Desmethyldoxepin, a secondary amine similar in structure to maprotiline, is added as a mass internal standard to the specimen before extraction, to obviate the need for accurate measurements of volumes during extraction and analysis. Both maprotiline and the internal standard are converted to acetyl derivatives, to avoid the adsorption of secondary amines on the column. A highly selective liquid phase is used, which allows a very good separation of desmethyldoxepin, maprotiline, desmethylmaprotiline, and the interferences from serum and reagents.

Liquid chromatographic separation of antidepressant drugs: II. Amoxapine and maprotiline.

The simultaneous serum analysis of amoxapine (AMOX) and its major metabolite 8-hydroxyamoxapine (8-OH AMOX), and maprotiline (MAP) and its major metabolite desmethylmaprotiline (D-MAP) by high-performance liquid chromatography (HPLC) and ultraviolet detection is described here. AMOX and 8-OH AMOX were detected at 254 nm at 0.01 absorbance units full scale (AUFS). MAP and D-MAP were detected at 214 nm at 0.05 AUFS. Serum (1.0 ml collected in plastic) extraction was by Bond-Elut C18 columns. The compounds of interest were eluted from the columns with 10 mM methanolic ammonium acetate. The eluates are evaporated at 56-58 degrees C and reconstituted with 200 microliter of mobile phase. The mobile phase was absolute ethanol-acetonitrile-tert-butylamine (98:2:0.05, vol/vol), and the flow rate was 2.0 ml/min. Absolute recoveries range from 97 to 100% for all compounds. HPLC was done on a 5-micron (4.6 X 250 mm) silica-packing column (normal phase). Separations on a 10-micron silica column (3.9 X 300 mm) are also discussed. Peak height ratios using trimipramine as the internal standard were linear for each drug between 25 and 1080 ng/ml. AMOX and 8-OH AMOX ratios with promazine as the internal standard were linear between 25 and 1080 ng/ml. Detection limits were 3 ng/ml for AMOX and 8-OH AMOX, 12 ng/ml for D-MAP, and 15 ng/ml for MAP. Coefficients of within-day and day-to-day variation at three concentration levels were less than 10.8% and 10.5%, respectively, for all compounds. Correlations of AMOX, 8-OH AMOX, and MAP sample assays using gas chromatography (or gas chromatography-mass spectrometry) and this method were compared. Steady-state daily dosages and corresponding serum levels are presented for seven patients. AMOX and 8-OH AMOX concentrations for 37 patients are given; these show that the ratios of these compounds are highly variable between patients. MAP and D-MAP concentrations for 30 patients show that D-MAP can be a significant fraction of the circulating drug. Assay time for 8-OH AMOX/AMOX was 6.5 min and less than 13 min for D-MAP/MAP.(ABSTRACT TRUNCATED AT 250 WORDS)

Fluorimetric determination of levoprotiline in human plasma after thin-layer chromatographic or high performance liquid chromatographic separation.

The quantitative determination of the new antidepressant drug levoprotiline, the R-(-)-enantiomer of oxa-protiline (a-[methylamino)methyl)-9,10-ethanoanthracene-9(10H)-ethanol), in human biological material is described. Analysis is performed by alkaline extraction with n-heptane-isopropanol, subsequent fluorescence derivatisation with NBD chloride (4-chloro-7-nitrobenzofurazan), thin layer or high performance liquid chromatography, and fluorimetric measurement of the derivatisation product (lambda max ex. = 470 nm, lambda max em. = 525 nm). The sensitivity of the procedure (detection limit less than 1 ng/ml) permits the performance of pharmacokinetic studies after therapeutic doses.

Gas chromatographic analysis of therapeutic concentrations of maprotiline in serum, using flame-ionization detection.

For the measurement of the tetracyclic antidepressant maprotiline in human serum, a gas chromatographic method with flame-ionization detection has been developed. The assay specifications obtained are as follows: a precision (C.V) of 3.5-6.4%, and a relative recovery of 97-109% using amitriptyline as internal standard. The sensitivity of the assay from serum was 40 nmol/l. The applicability of the method has been shown by measuring steady-state serum levels of five inpatients. The steady-state serum levels of maprotiline given at a daily dosage of 75 mg varied from 272 to 570 nmol/l.

Clinical analysis for the anti-neoplastic agent 1,4-dihydroxy-5,8-bis((2-[(2-hydroxyethyl)amino]ethyl)-amino)9,10-anthracenedio ne dihydrochloride (NSC 301739) in plasma. Application of temperature control to provide selectivity in paired-ion high-performance liquid chromatography.

An analytical method is described which permits monitoring of plasma level of the anti-tumor agent 1,4-dihydroxy-5,8-bis((2-[(2-hydroxyethyl)amino]ethyl)amino)9,10-antracenedione dihydrochloride (DHAD) following its intravenous administration to cancer patients. The drug cannot be efficiently extracted from plasma into water-immiscible solvents, but is effectively separated from the biological matrix by retention on hydrophobic XAD-2 beads packed in a disposable glass cartridge. DHAD is subsequently selectively eluted from this column and then analyzed by reversed-phase partition chromatography with spectrophotometric detection of the analyte. Resolution of overlapping bands during high-performance liquid chromatographic separation was achieved by systematic optimization of mobile phase, ion-pairing agent and temperature. A possible explanation for the observed selectively provided by temperature adjustment is offered. Plasma levels in the range of 75--3000 ng of DHAD per ml (7.5--300 ng applied to the column) can be analyzed with a precision of less than +/- 10%. Total recovery of drug from plasma is ca. 95%.

[Metabolism of antipsoriatic anthrone derivatives]. / Untersuchungen zum Stoffwechsel antipsoriatisch wirksamer Anthron-Derivate.

The metabolisation of the antipsoriatically active molecules 1,8,9-triacetoxy-anthracene und 1,8-diacetoxy-9-anthrone by serum is described. Under these conditions 1,8-dihydroxy-9-anthrone, 1-hydroxy-8-acetoxy-9-anthrone, 1,8,1',8'-tetrahydroxy-bisanthrone, 1,8-dihyroxy-anthraquinone, 1,8-diacetoxy-anthraquinone and 1-hydroxy-8-acetoxy-anthraquinone arise from both educts. Quantitative determinations of these metabolites indicate that hydrolytic reactions occur prior to oxidation. Contrary to 1,8-dihydroxy-9-anthrone, 1,8,9-triacetoxyanthracene and 1,8-diacetoxy-9-anthrone are effective against psoriatic lesions without accompanying inflammations of the skin. 1,8,9-Trimethoxy-anthracene, however, is ineffective, also indicating that at least 1,8,9-triacetoxy-anthracene is a prodrug.--In agreement with Krebs' hypothesis 10,10-dialkylated 1,8-dihydroxy-9-anthrones described in this paper are ineffective against psoriasis.

Selected ion monitoring assay for the antidepressant maprotiline.

A procedure is described which permits the determination of maprotiline in biological fluids at concentrations ranging from 0.5 to 150 ng ml-1. It relies on the use of N-desmethylclomipramine or isotope labeled maprotiline as the internal standard, on derivatization of the secondary amines with heptafluorobutyric anhydride, and on the combined use of gas chromatography with chemical ionization mass spectrometry and computerized data handling. The assaying procedure is specific, accurate and precise. It is suitable for routine analyses and has sufficient sensitivity to permit monitoring the human blood levels expected from a single therapeutic dose for a week or longer. The method, which can monitor simultaneously isotope labeled and unlabeled maprotiline, can be used to great advantage for reducing variability problems encountered in bioavailability studies.

Analysis of amoxapine, 8-hydroxyamoxapine, and maprotiline by high-pressure liquid chromatography.

Two high-pressure liquid chromatography procedures are presented for the routine analysis of two new antidepressant drugs, amoxapine (Asendin) as well as its active metabolite and maprotiline (Ludiomil). Recovery rates were excellent with both methods of extraction. Method 1, for amoxapine and its metabolites, was linear up to 1,000 ng/ml. Sensitivity for the parent drug was 10 ng/ml and, for the active metabolite, 25 ng/ml. Within-run coefficients of variation (CV) were 4.57% for 8-hydroxyamoxapine and 3.84% for amoxapine. Method 2, for maprotiline, was linear from 10 to 1,000 ng/ml. Intraassay CV was 3.2%. Reliable, yet simple, methods for monitoring these drugs are needed in order to establish firmly the pharmacological data important to appropriate patient therapy.

Measurement of maprotiline and oxaprotiline in plasma by high-performance liquid chromatography of fluorescent derivatives.

The antidepressant maprotiline and its hydroxylated analogue oxaprotiline were assayed in plasma by solvent extraction and formation of fluorescent derivatives, which were purified by thin-layer chromatography and quantitated by high-performance liquid chromatography with fluorescence monitoring. The procedure possesses a high sensitivity, accuracy and reproducibility, and metabolites of the drugs did not interfere.