RESUMO
Dapsone is employed for both non-dermatological and dermatological indications but with non-existent population pharmacokinetics (popPK) data in Nigerians. This study was therefore designed to develop a popPK model in Nigerians. Non-compartmental analysis and nonlinear mixed effects modelling were utilized for data analysis. Eleven participants administered 50 mg dapsone tablet were included in the analysis. Derived pharmacokinetic parameters were: Cmax = 1.16 ± 0.32 µg/mL, Tmax = 3.77 ± 2.40 h, and t1/2z = 30.23 ± 11.76 h. PopPK model parameter estimates with inter-individual variability were Tlag = 0.40 h (10.0%, fixed); ka = 1.78 h-1 (75.9%); V/F = 89.25 L (21.6%); and Cl/F = 1.32 Lh-1 (27.7%). Sex was significantly associated with Cl/F, and body weight with V/F. Best popPK model was one-compartment with lag time, and first-order absorption and elimination. Sex and body weight significantly influenced the clearance and distribution volume of dapsone respectively.
Assuntos
Dapsona , Modelos Biológicos , Humanos , Dapsona/farmacocinética , Projetos Piloto , Peso CorporalRESUMO
Uveitis is the inflammation of uveal tract comprising of iris, ciliary body and choroid. Blood ocular barriers maintaining the homeostasis of eye breach during uveitis, leads to high risk for sight-threatening complications. The purpose of this study was to compare the anti-inflammatory activity enabled by two diverse pharmacological agents (prednisolone and dapsone) using their effect on aqueous humor proteome. Wistar rats of either sex (150-200g) were used and randomly divided into various groups. Normal group was injected with 0.1ml normal saline (NS), endotoxin (LPS) (200 µg/0.1ml NS) was injected into endotoxin induced inflammatory groups followed by 0.1% dapsone and 1% prednisolone treatment in endotoxin induced uveitis (EIU) groups, respectively. Aqueocentesis was performed post 24 hour inflammation and samples were subjected for clinical parameter evaluation, cytokine analysis as well as global proteomic analysis using High-resolution mass spectrometer. Following which spectrum analysis, production spectra of peptides were matched against R. Norvegicus Protein Database (Uniport) using Proteome Discoverer (v2.2). Upon clinical evaluation, the anterior segment images post dapsone and prednisolone treatment have shown marked decrease in hyperaemia, miosis and iridial vessels vasodilation in rat eyes as compared to inflammation group. The result of cytokine analysis revealed 0.1% dapsone and prednisolone both significantly decreased the TNF-α levels. HRMS studies analysis expressed 140, 160, 158 and 141 proteins unique to normal, EIU, Dapsone and prednisolone group respectively. To conclude aqueous humor pharmacoproteomic revealed the anti-inflammatory activity of the dapsone comparable to the prednisolone treatment in endotoxin induced uveitis. The topical dapsone may be used as an alternative therapeutic option in treating uveitis without elevating intraocular pressure.
Assuntos
Humor Aquoso/metabolismo , Dapsona/farmacocinética , Prednisolona/farmacocinética , Proteômica , Uveíte Anterior/tratamento farmacológico , Administração Tópica , Animais , Anti-Infecciosos/administração & dosagem , Anti-Infecciosos/farmacocinética , Dapsona/administração & dosagem , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Feminino , Glucocorticoides/administração & dosagem , Glucocorticoides/farmacocinética , Masculino , Prednisolona/administração & dosagem , Ratos , Ratos Wistar , Uveíte Anterior/metabolismoRESUMO
Leprosy is a chronic infectious disease caused my Mycobacterium leprae that primarily affects peripheral nervous system and extremities and is prevalent in tropical countries. Treatment for leprosy with multidrug regimens is very effective compared to monotherapy especially in multibacillary cases. The three major antileprosy drugs currently in use are 4, 4'-diaminodiphenyl sulfone (DDS, dapsone), rifampicin, and clofazimine. During multidrug therapy, the potent antibiotic rifampicin induces the metabolism of dapsone, which results in decreased plasma half-life of dapsone and its metabolites. Furthermore, rifampicin induces its own metabolism and decreases its half-life during monotherapy. Rifampicin upregulates several hepatic microsomal drug-metabolizing enzymes, especially cytochrome P450 (CYP) family that in turn induce the metabolism of dapsone. Clofazimine lacks significant induction of any drug-metabolizing enzyme including CYP family and does not interact with dapsone metabolism. Rifampicin does not induce clofazimine metabolism during combination treatment. Administration of dapsone in the acetylated form (acedapsone) can release the drug slowly into circulation up to 75 days and could be useful for the effective treatment of paucibacillary cases along with rifampicin. This review summarizes the major aspects of antileprosy drug metabolism and drug interactions and the role of cytochrome P450 family of drug metabolizing enzymes, especially CYP3A4 during multidrug regimens for the treatment of leprosy.
Assuntos
Acedapsona/sangue , Clofazimina/sangue , Citocromo P-450 CYP3A/metabolismo , Dapsona/sangue , Hansenostáticos/sangue , Hanseníase/tratamento farmacológico , Rifampina/sangue , Acedapsona/farmacocinética , Acedapsona/farmacologia , Disponibilidade Biológica , Biotransformação , Clofazimina/farmacocinética , Clofazimina/farmacologia , Dapsona/farmacocinética , Dapsona/farmacologia , Interações Medicamentosas , Quimioterapia Combinada , Meia-Vida , Humanos , Hansenostáticos/farmacocinética , Hansenostáticos/farmacologia , Hanseníase/sangue , Hanseníase/microbiologia , Hanseníase/patologia , Taxa de Depuração Metabólica , Redes e Vias Metabólicas/fisiologia , Mycobacterium leprae/efeitos dos fármacos , Mycobacterium leprae/crescimento & desenvolvimento , Mycobacterium leprae/patogenicidade , Rifampina/farmacocinética , Rifampina/farmacologiaRESUMO
INTRODUCTION: In their 70-year history, dapsone and other sulfones have been used as both antibacterial and anti-inflammatory agents. Dapsone has been the main active principle in the multidrug regimen recommended by the World Health Organization for the treatment of leprosy. In addition, dapsone has been successfully used to treat a wide range of dermatological and systemic disorders, mostly characterized by neutrophilic and eosinophilic accumulation and infiltration. Areas covered: The PubMed database was searched using combinations of the following keywords: dapsone, sulfones, pharmacodynamics, pharmacology, adverse events, pharmacokinetics, drug interaction, dermatologic uses, and antimicrobial uses. This article reviews and updates the chemistry, pharmacokinetics, mechanism of action, adverse effects, drug interactions, and clinical application of sulfones. Expert opinion: Dapsone exhibits clinical efficacy in several cutaneous and systemic conditions and is now generally accepted as the therapy of choice for leprosy and for rare dermatosis, as dermatitis herpetiformis. Careful patient selection and close monitoring during treatment are mandatory to provide safe and effective use of dapsone. Familiarity with sulfones and dapsone is crucial because of this agent retains its niche in the clinician's therapeutic armamentarium.
Assuntos
Anti-Infecciosos/administração & dosagem , Dapsona/administração & dosagem , Hansenostáticos/administração & dosagem , Animais , Anti-Infecciosos/efeitos adversos , Anti-Infecciosos/farmacocinética , Dapsona/efeitos adversos , Dapsona/farmacocinética , Interações Medicamentosas , Humanos , Hansenostáticos/efeitos adversos , Hansenostáticos/farmacocinética , Hanseníase/tratamento farmacológico , Dermatopatias/tratamento farmacológicoRESUMO
PURPOSE: In vivo phenotyping of CYP isoforms involved in the metabolism of anti-HIV and antitubercular drugs is important to determine therapeutic dose levels in HIV/AIDS-TB coinfections. In this study, we used a cocktail of bupropion, losartan and dapsone for in vivo phenotyping of CYP2B6, CYP2C9 and N-acetyltransferase-2 (NAT2) in plasma. CYP2B6 is the main catalyst of anti-HIV efavirenz, while NAT2 is involved in antitubercular drug isoniazid metabolism. CYP2C9 has a significant association with antitubercular drug-induced reactions. The activity level of these isoforms has a significant bearing on therapeutic dose in rapid and poor metabolizers. METHODS: Briefly, a cocktail of probe drugs was administered to human volunteers and the drugs and metabolites were determined by an inhouse LC-MS/MS method in 250 µl plasma. The mobile phase and drug/metabolite extraction methods were optimized before analysis. Retention time, Cmax and tmax were calculated from the same sample and the values were used for phenotyping the isoforms. RESULTS: Retention time of drugs and metabolites was calculated. The method was sensitive (4.5-8.2 %CV) and no interfering peak was observed in any batch. %Accuracy of the calibrator and QC was 85-115%. %CV of storage stability testing was within FDA approved limits. Cmax and tmax were comparable to the values reported for individual drugs. CONCLUSIONS: This study advocates the use of a cocktail of bupropion, losartan and dapsone for in vivo phenotyping of CYP2B6, CYP2C9 and NAT2, which is important in determining therapeutic dose levels of anti-HIV and anti-TB drugs in HIV/AIDS-TB coinfections.
Assuntos
Fármacos Anti-HIV/metabolismo , Antituberculosos/metabolismo , Citocromo P-450 CYP2B6/genética , Citocromo P-450 CYP2C9/genética , Adulto , Fármacos Anti-HIV/uso terapêutico , Antituberculosos/uso terapêutico , Arilamina N-Acetiltransferase , Bupropiona/administração & dosagem , Bupropiona/sangue , Bupropiona/metabolismo , Bupropiona/farmacocinética , Coinfecção/tratamento farmacológico , Coinfecção/genética , Coinfecção/microbiologia , Citocromo P-450 CYP2B6/metabolismo , Citocromo P-450 CYP2C9/metabolismo , Dapsona/administração & dosagem , Dapsona/sangue , Dapsona/metabolismo , Dapsona/farmacocinética , Combinação de Medicamentos , Infecções por HIV/tratamento farmacológico , Infecções por HIV/genética , Infecções por HIV/microbiologia , Voluntários Saudáveis , Humanos , Inativação Metabólica , Isoenzimas/genética , Isoenzimas/metabolismo , Losartan/administração & dosagem , Losartan/sangue , Losartan/metabolismo , Losartan/farmacocinética , Fenótipo , Polimorfismo Genético , Espectrometria de Massas em Tandem/métodos , Tuberculose/tratamento farmacológico , Tuberculose/genética , Tuberculose/microbiologia , Adulto JovemRESUMO
Shuanghuanglian Injection (SHLI), one of the most popular herbal prescription in China, has been commonly used to treat pneumonia, tonsillitis, and other respiratory diseases caused by bacterium and virus. This study is to investigate the effects of SHLI on the activities of Cytochrome P450 (CYP) 1A2, 2C11, 2D1 and 3A1/2 in rats. Sixteen rats were randomly divided into two groups (SHLI-treated and blank control). They were administered SHLI or physiological saline for consecutive seven days. On day eight, 16 animals were administrated cocktail drugs as probe substrates of the four CYP in vivo. In addition, other four probe drugs were added, respectively, into incubation systems of rat liver microsomes (RLM) to assess the effects of SHLI on the four CYP isoforms in vitro. SHLI exhibited an inductive effect on CYP2C11 in vivo by decreasing Cmax, t1/2 and AUC0-∞ of tolbutamide, while the main pharmacokinetic parameters of caffeine, metoprolol and dapsone have no significant changes. In vitro study, SHLI showed no significant effects on the activities of CYP1A2, 2D1 and 3A1/2, but increasing the metabolism of tolbutamide in RLM. SHLI induced the activities of CYP2C11, but had no significant effects on the activities of CYP1A2, CYP2D1 and CYP3A1/2 in rats.
Assuntos
Sistema Enzimático do Citocromo P-450/metabolismo , Medicamentos de Ervas Chinesas/administração & dosagem , Medicamentos de Ervas Chinesas/farmacologia , Injeções , Animais , Cafeína/sangue , Cafeína/farmacocinética , Cafeína/farmacologia , Calibragem , Dapsona/sangue , Dapsona/farmacocinética , Limite de Detecção , Masculino , Metaboloma , Metoprolol/sangue , Metoprolol/farmacocinética , Ratos Wistar , Reprodutibilidade dos Testes , Fatores de Tempo , Tolbutamida/sangue , Tolbutamida/farmacocinéticaRESUMO
The human species is becoming increasingly obese. Dapsone, which is extensively used across the globe for dermatological disorders, arachnid bites, and for treatment of several bacterial, fungal, and parasitic diseases, could be affected by obesity. We performed a clinical experiment, using optimal design, in volunteers weighing 44-150 kg, to identify the effect of obesity on dapsone pharmacokinetic parameters based on maximum-likelihood solution via the expectation-maximization algorithm. Artificial intelligence-based multivariate adaptive regression splines were used for covariate selection, and identified weight and/or age as predictors of absorption, systemic clearance, and volume of distribution. These relationships occurred only between certain patient weight and age ranges, delimited by multiple hinges and regions of discontinuity, not identified by standard pharmacometric approaches. Older and obese people have lower drug concentrations after standard dosing, but with complex patterns. Given that efficacy is concentration-dependent, optimal dapsone doses need to be personalized for obese patients.
Assuntos
Dapsona/farmacocinética , Obesidade/sangue , Adulto , Fatores Etários , Idoso , Peso Corporal , Dapsona/sangue , Cálculos da Dosagem de Medicamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aprendizado de Máquina Supervisionado , Adulto JovemRESUMO
BACKGROUND: Reducing the dosing frequency of topical acne treatments to once daily may improve adherence. OBJECTIVE: Evaluate pharmacokinetics (PK), safety, and tolerability of 3 formulations of once-daily dapsone gel, 7.5% and of twice-daily dapsone gel, 5% over 28 days in patients with moderate acne vulgaris. METHODS: This phase 1, multicenter, parallel-group study randomized males and females aged 16 to 35 years to 1 of 3 dapsone gel, 7.5% formulations (DAP-11078, DAP-11079, or DAP-11080 double-blind; applied once daily) or to dapsone gel, 5% (investigator-blinded only, applied twice-daily). Blood samples were collected for PK assessments of dapsone and its metabolites, N-acetyl dapsone (NAD) and dapsone hydroxylamine (DHA), before the morning dose on days 1, 7, 14, 18, 21, 26, 27, and 28, and at several follow-up time points (days 29-32). Safety profile assessments included adverse events (AEs), physical examinations, laboratory tests, and local tolerability assessments. RESULTS: Steady-state dapsone, NAD, and DHA concentrations were reached within 7 days of the first dose in all treatment groups. Daily systemic exposures of the 3 dapsone gel, 7.5% formulations were approximately 25% to 40% lower than that for dapsone gel, 5%, and these differences were statistically significant. Among the 3 dapsone gel, 7.5% formulations, the highest daily exposure of dapsone (per the AUC) was observed with DAP-11080, with respective Cmax and AUC0-24 being approximately 28.6% and 28.7% lower relative to dapsone gel, 5%. Most AEs were mild to moderate in intensity. The safety profiles for all 3 formulations of once-daily dapsone, 7.5% gel and twice-daily dapsone gel, 5% were similar following 28 days of topical administration. All 4 dapsone formulations were well tolerated. CONCLUSIONS: This study demonstrated lower systemic exposure with all 3 once-daily dapsone gel, 7.5% formulations than with twice-daily dapsone gel, 5%. All 4 formulations were well tolerated and demonstrated similar safety profiles.
J Drugs Dermatol. 2016;15(10):1250-1259.
Assuntos
Acne Vulgar/tratamento farmacológico , Acne Vulgar/metabolismo , Anti-Infecciosos/administração & dosagem , Anti-Infecciosos/farmacocinética , Dapsona/administração & dosagem , Dapsona/farmacocinética , Acne Vulgar/diagnóstico , Administração Tópica , Adolescente , Adulto , Anti-Infecciosos/efeitos adversos , Dapsona/efeitos adversos , Método Duplo-Cego , Esquema de Medicação , Composição de Medicamentos , Eritema/induzido quimicamente , Feminino , Géis , Humanos , Masculino , Adulto JovemRESUMO
INTRODUCTION: Intentional dapsone intoxication can be life-threatening. There is limited data on the clinical effect of extracorporeal treatments (ECTRs) on dapsone elimination. We describe a case of severe dapsone toxicity treated with different ECTRs. CASE DETAILS: A 23-year-old woman was admitted 2.5 h after ingesting 2.2 g of dapsone. She developed methemoglobinemia (39.9%) and showed signs of toxicity (hemodynamic instability and altered mental status) despite multiple-activated charcoal, methylene blue, vasopressors and endotracheal intubation. Continuous venovenous hemofiltration (CVVH) was then initiated for 5 h, followed by intermittent hemodialysis with hemoperfusion (IHD-HP) for 4 h, and CVVH for another 48 h. The platelet count decreased to 32 × 109/L 3 h after IHD-HP. The elimination half-life of dapsone was 2.0 h during IHD-HP, and 14.2 h during CVVH. Mean dapsone clearance with IHD was 62 mL/min versus 22 mL/min with CVVH. IHD removed 95.3 mg, and CVVH removed 67.8 mg over 3.8 h. No rebound occurred following ECTR cessation. The toxicokinetics of dapsone metabolites were also accelerated during ECTR. The patient was extubated after 3.5 days and discharged without sequelae after 7 days. DISCUSSION: Dapsone clearance was enhanced by ECTR, especially by IHD-HP. However, HP was associated with severe asymptomatic thrombocytopenia.
Assuntos
Dapsona/intoxicação , Hemofiltração/métodos , Hemoperfusão/métodos , Diálise Renal/métodos , Antídotos/administração & dosagem , Dapsona/farmacocinética , Overdose de Drogas , Feminino , Meia-Vida , Humanos , Metemoglobinemia/induzido quimicamente , Metemoglobinemia/terapia , Resultado do Tratamento , Adulto JovemRESUMO
The aim of the present work was to develop and optimize surface-functionalized solid lipid nanoparticles (SLNs) for improvement of the therapeutic index of dapsone (DAP), with the application of a design of experiments. The formulation was designed to target intestinal microfold (M-cells) as a strategy to increase internalization of the drug by the infected macrophages. DAP-loaded SLNs and mannosylated SLNs (M-SLNs) were successfully developed by hot ultrasonication method employing a three-level, three-factor Box-Behnken design, after the preformulation study was carried out with different lipids. All the formulations were systematically characterized regarding their diameter, polydispersity index (PDI), zeta potential (ZP), entrapment efficiency, and loading capacity. They were also subjected to morphological studies using transmission electron microscopy, in vitro release study, infrared analysis (Fourier transform infrared spectroscopy), calorimetry studies (differential scanning calorimetry), and stability studies. The diameter of SLNs, SLN-DAP, M-SLNs, and M-SLN-DAP was approximately 300 nm and the obtained PDI was <0.2, confirming uniform populations. Entrapment efficiency and loading capacity were approximately 50% and 12%, respectively. Transmission electron microscopy showed spherical shape and nonaggregated nanoparticles. Fourier transform infrared spectroscopy was used to confirm the success of mannose coating process though Schiff's base formation. The variation of the ZP between uncoated (approximately -30 mV) and mannosylated formulations (approximately +60 mV) also confirmed the successful coating process. A decrease in the enthalpy and broadening of the lipid melting peaks of the differential scanning calorimetry thermograms are consistent with the nanostructure of the SLNs. Moreover, the drug release was pH-sensitive, with a faster drug release at acidic pH than at neutral pH. Storage stability for the formulations for at least 8 weeks is expected, since they maintain the original characteristics of diameter, PDI, and ZP. These results pose a strong argument that the developed formulations can be explored as a promising carrier for treating leprosy with an innovative approach to target DAP directly to M-cells.
Assuntos
Dapsona/administração & dosagem , Manose/química , Nanopartículas/administração & dosagem , Nanopartículas/química , Varredura Diferencial de Calorimetria , Química Farmacêutica/métodos , Dapsona/química , Dapsona/farmacocinética , Estabilidade de Medicamentos , Concentração de Íons de Hidrogênio , Mucosa Intestinal/citologia , Mucosa Intestinal/efeitos dos fármacos , Hansenostáticos/administração & dosagem , Hansenostáticos/química , Hansenostáticos/farmacocinética , Lipídeos/química , Microscopia Eletrônica de Transmissão , Modelos Estatísticos , Nanoestruturas/química , Tamanho da Partícula , Espectroscopia de Infravermelho com Transformada de FourierRESUMO
Cytochrome P450s (CYPs) are the main catalytic enzymes for metabolism by a variety of endogenous and exogenous substrates in mammals, fish, insects, etc. We evaluated the application of a multidrug cocktail on changes in CYP1, CYP2, and CYP3 activity in Turbot Scophthalmus maximus. The probe drugs were a combination of caffeine (5 mg/kg body weight), dapsone (5 mg/kg), and chlorzoxazone (10 mg/kg). After a single intraperitoneal injection of the cocktail, the concentration of all three probe drugs in the plasma increased quickly to a peak and then decreased gradually over 24 h. Pharmacokinetic profiles of the three probe drugs were determined using a noncompartmental analysis, and the typical parameters were calculated. In the assay for CYP induction, pretreatment with rifampicin significantly reduced the typical pharmacokinetic metrics for caffeine and chlorzoxazone, but not dapsone, indicating that the activity of CYP1 and CYP2 in turbot were induced by rifampicin.
Assuntos
Cafeína/farmacocinética , Clorzoxazona/farmacocinética , Sistema Enzimático do Citocromo P-450/metabolismo , Dapsona/farmacocinética , Linguados/metabolismo , Animais , Antituberculosos/sangue , Antituberculosos/metabolismo , Antituberculosos/farmacocinética , Área Sob a Curva , Cafeína/sangue , Cafeína/metabolismo , Clorzoxazona/sangue , Clorzoxazona/metabolismo , Sistema Enzimático do Citocromo P-450/genética , Dapsona/sangue , Dapsona/metabolismo , Indução Enzimática/efeitos dos fármacos , Antagonistas do Ácido Fólico/sangue , Antagonistas do Ácido Fólico/metabolismo , Antagonistas do Ácido Fólico/farmacocinética , Relaxantes Musculares Centrais/sangue , Relaxantes Musculares Centrais/metabolismo , Relaxantes Musculares Centrais/farmacocinética , Inibidores da Síntese de Ácido Nucleico/farmacologia , Inibidores de Fosfodiesterase/sangue , Inibidores de Fosfodiesterase/metabolismo , Inibidores de Fosfodiesterase/farmacocinética , Rifampina/farmacologiaRESUMO
Red blood cell (RBC) transfusions are the gold standard in cases of massive hemorrhage, but induce hepatic ischemia-reperfusion injury, a serious complication associated with hemorrhage and RBC resuscitation. Thus, the development of a novel resuscitable fluid that is not associated with hepatic ischemia-reperfusion injury would be desirable. It was reported that exogenous carbon monoxide (CO) treatment ameliorated hepatic ischemia-reperfusion injury accompanying liver transplantation. This suggests that transfusions with CO-bound RBC (CO-RBC) might protect against hepatic ischemia-reperfusion injury following massive hemorrhage and resuscitation compared with RBC resuscitation. To investigate this, we created a hemorrhagic shock model rat, followed by resuscitation with RBC and CO-RBC. Hepatic ischemia-reperfusion injury and the destruction of hepatic cytochrome P450 (CYP) were significantly ameliorated in the CO-RBC resuscitation group compared with the RBC resuscitation group. The free heme derived from the destruction of hepatic CYP was correlated with hepatic oxidation and injury, suggesting that CO-RBC was a major factor in the amelioration of hepatic ischemia-reperfusion injury induced by hemorrhage and resuscitation via hepatic CYP protection. These results indicate that CO-RBC has potential for use as a resuscitative fluid in blood transfusion and does not suffer from the limitations associated with the RBC transfusions that are currently in use.
Assuntos
Monóxido de Carbono/sangue , Sistema Enzimático do Citocromo P-450/metabolismo , Transfusão de Eritrócitos/efeitos adversos , Eritrócitos/metabolismo , Fígado/irrigação sanguínea , Traumatismo por Reperfusão/prevenção & controle , Choque Hemorrágico/terapia , Animais , Dapsona/sangue , Dapsona/farmacocinética , Modelos Animais de Doenças , Transfusão de Eritrócitos/métodos , Heme/metabolismo , Fígado/enzimologia , Fígado/metabolismo , Testes de Função Hepática , Masculino , Estresse Oxidativo , Ratos Sprague-Dawley , Espécies Reativas de Oxigênio/metabolismo , Traumatismo por Reperfusão/enzimologia , Traumatismo por Reperfusão/etiologia , Ressuscitação , Choque Hemorrágico/complicações , Choque Hemorrágico/enzimologiaRESUMO
BACKGROUND: The physiological changes in obese subjects can modify the pharmacokinetic profiles of drugs influencing the therapeutic efficacy. METHODS: In this study, the authors compare plasma dapsone trough levels of multibacillary leprosy subjects stratified by body mass index (BMI) to evaluate if obesity plays a significant role on drug levels. The relationship between drug levels and BMI was also determined. Dapsone was measured by high-performance liquid chromatography and BMI based on World Health Organization criteria. RESULTS: At steady state, the median plasma dapsone trough level was significantly lower in obesity class 2 group, when compared with other groups, but they were similar between normal weight and preobesity groups. A weak association between drug levels and BMI was observed. CONCLUSIONS: Obesity promotes a significant reduction in plasma dapsone trough levels of subjects with multibacillary leprosy with a weak association between drug levels and BMI.
Assuntos
Índice de Massa Corporal , Dapsona/sangue , Dapsona/farmacocinética , Hansenostáticos/sangue , Hansenostáticos/farmacocinética , Hanseníase Multibacilar/sangue , Adulto , Cromatografia Líquida de Alta Pressão , Humanos , Hanseníase Multibacilar/complicações , Hanseníase Multibacilar/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Obesidade/sangue , Obesidade/complicaçõesRESUMO
ETHNOPHARMACOLOGICAL RELEVANCE: Schisandra chinensis (SC) is a well-known traditional Chinese herbal medicine that has been used in clinical practices for thousands of years. However, the differences between the effects of unprocessed and vinegar-processed Schisandra chinensis (VSC) on cytochrome P450 (CYP450) activities are poorly understood. AIM OF THE STUDY: To evaluate the differences between processed and unprocessed SC on the metabolism of CYP1A2, CYP2E1 and CYP3A4 substrates in rats using a cocktail method based on a developed and validated HPLC method. We also investigate the influence of processing on the levels of CYP mRNA. MATERIALS AND METHODS: Three probe substrates (theophylline, dapsone and chlorzoxazone) were delivered simultaneously into rats treated with single or multiple doses of processed or unprocessed SC extract. The plasma concentrations of the three probes were profiled by HPLC, and their corresponding pharmacokinetic parameters were calculated. Real-time RT-PCR was performed to determine the effects of processed and unprocessed SC on the mRNA expression of CYP1A2, CYP2E1 and CYP3A4 in the liver. RESULTS: Treatment with single or multiple doses of either extract of SC induced CYP3A4 enzyme activity and inhibited CYP1A2 enzyme activity in rats. Furthermore, the inhibitory effect of SC was more potent after vinegar processing than without vinegar processing. CYP2E1 enzyme activity was induced after treatment with a single dose but was inhibited after multiple doses. The mRNA expression results were in accordance with the pharmacokinetic results. CONCLUSIONS: These results provide useful scientific data for the safe clinical application of either extract of SC in combination with other drugs, which should lack the side effects induced by other herb-drug interactions.
Assuntos
Ácido Acético/química , Citocromo P-450 CYP2E1 , Sistema Enzimático do Citocromo P-450 , Citocromos , Medicamentos de Ervas Chinesas/química , Medicamentos de Ervas Chinesas/farmacocinética , Schisandra/química , Animais , Clorzoxazona/sangue , Clorzoxazona/farmacocinética , Cromatografia Líquida de Alta Pressão , Citocromo P-450 CYP1A2 , Citocromo P-450 CYP2E1/biossíntese , Citocromo P-450 CYP2E1/metabolismo , Citocromo P-450 CYP3A , Sistema Enzimático do Citocromo P-450/biossíntese , Sistema Enzimático do Citocromo P-450/metabolismo , Citocromos/biossíntese , Citocromos/metabolismo , Dapsona/sangue , Dapsona/farmacocinética , Relação Dose-Resposta a Droga , Composição de Medicamentos , Medicamentos de Ervas Chinesas/administração & dosagem , Indução Enzimática , Interações Ervas-Drogas , Masculino , RNA Mensageiro/biossíntese , Ratos , Ratos Sprague-Dawley , Reação em Cadeia da Polimerase em Tempo Real , Especificidade por Substrato , Teofilina/sangue , Teofilina/farmacocinéticaRESUMO
BACKGROUND: Topical administration of dapsone can be an alternative route for treatment of leprosy and can also provide new therapeutic applications for an established drug. However, the physicochemical properties of dapsone make it difficult to incorporate into conventional formulations. The current study was directed toward developing a stable nanoemulsion that contains dapsone which can be adapted for topical use. METHODS: Nanoemulsions were prepared using isopropyl myristate or n-methyl-pyrrolidone as the oil phase, and characterized according to their mean droplet size, conductivity, refractive index, pH, drug content, and stability. The in vitro release of dapsone and its ability to permeate the epidermis were also evaluated. RESULTS: Physicochemical characterization demonstrated that nanosystems were formed, which had a uniform droplet distribution and a pH compatible with the skin surface. Use of n-methyl-pyrrolidone provided a greater nanoemulsion region and higher solubilization of dapsone, and increased the in vitro release rate when compared with a nanoemulsion prepared using isopropyl myristate. However, use of isopropyl myristate promoted an increase in in vitro epidermal permeation that followed the Higuchi model. This demonstrates the ability of a nanosystem to influence permeation of dapsone through the skin barrier. Furthermore, the nanoemulsions developed and evaluated here had ideal physicochemical stability over a 3-month period. CONCLUSION: Incorporation of dapsone into a nanoemulsion may be a promising system for enabling topical delivery of dapsone, while minimizing skin permeation, for the treatment of acne. The method developed here used isopropyl myristate as the oil phase, and promoted permeation of dapsone through the skin barrier for the treatment of leprosy upon use of n-methyl-pyrrolidone as the oil phase.
Assuntos
Dapsona/administração & dosagem , Epiderme/metabolismo , Nanopartículas/administração & dosagem , Administração Cutânea , Análise de Variância , Animais , Dapsona/química , Dapsona/farmacocinética , Estabilidade de Medicamentos , Condutividade Elétrica , Emulsões/administração & dosagem , Emulsões/química , Emulsões/farmacocinética , Concentração de Íons de Hidrogênio , Miristatos/química , Nanomedicina/métodos , Nanopartículas/química , Tamanho da Partícula , Pirrolidinonas/química , Reprodutibilidade dos Testes , Absorção Cutânea , SuínosRESUMO
ETHNOPHARMACOLOGICAL RELEVANCE: Cooked rhubarb and wine processed rhubarb are the processed rhubarbs of raw rhizomes from Rheum palmatum L., Rheum tanguticum Maxim. ex Balf. or Rheum officinale Baill. They are clinically used in traditional Chinese medicine to compose anti-diabetic formulas and remove pathogenic heat or toxin from the body. AIM OF THE STUDY: To elucidate potential influences processed rhubarbs might have on the activities of four cytochrome P450 (CYP) isozyme in rats (CYP1A2, CYP2C6, CYP2E1, and CYP3A1) and on the pharmacokinetics of saxagliptin. MATERIALS AND METHODS: Relative activity estimation of four isozymes or influence on saxagliptin was carried out by comparing plasma pharmacokinetics of four respective substrates (theophylline for CYP1A2, tolbutamide for CYP2C6, chlorzoxazone for CYP2E1, and dapsone for CYP3A1) or saxagliptin between control and processed rhubarbs pretreated groups. Plasma concentrations of substrates and saxagliptin were quantified using UPLC-UV and UPLC-MS/MS methods, respectively. RESULTS: Wine processed rhubarb induced CYP1A2 activity; both the processed rhubarbs inhibited the CYP2C6 activity and induced CYP2E1; cooked rhubarb induced CYP3A1 activity. Both the processed rhubarbs reduced the absorbance and bioavailability, but increased the clearance of saxagliptin. CONCLUSIONS: Processed rhubarbs can either induce or inhibit activities of CYP1A2, CYP2C6, CYP2E1, and CYP3A1, and modify the metabolism of saxagliptin. The results indicated that drug co-administrated with processed rhubarbs may need dose adjustment.
Assuntos
Adamantano/análogos & derivados , Sistema Enzimático do Citocromo P-450/metabolismo , Dipeptídeos/farmacocinética , Inibidores da Dipeptidil Peptidase IV/farmacocinética , Extratos Vegetais/farmacologia , Rheum , Adamantano/farmacocinética , Animais , Clorzoxazona/farmacocinética , Dapsona/farmacocinética , Ativadores de Enzimas/farmacologia , Inibidores Enzimáticos/farmacologia , Interações Ervas-Drogas , Isoenzimas/metabolismo , Masculino , Ratos , Ratos Wistar , Teofilina/farmacocinética , Tolbutamida/farmacocinética , VinhoRESUMO
A specific ultra-performance liquid chromatography tandem mass spectrometry method has been described for the simultaneous determination of caffeine, tolbutamide, metoprolol and dapsone in rat plasma, which are the four probe drugs of the four cytochrome P450 (CYP450) isoforms CYP1A2, CYP2C9, CYP2D6 and CYP3A4. The chromatographic separation was achieved using a Waters Acquity UPLC BEH HILIC C(18) column (2.1 × 50 mm, 1.7 µm). The mobile phase consisted of acetonitrile and water (containing 0.1% formic acid) (15:85, v/v). The triple quadrupole mass spectrometric detection was operated by positive electrospray ionization. Phenacetin was chosen as internal standard. Plasma samples were extracted with dichloromethane-butanol (10:1, v/v). The recoveries ranged from 67.5% to 98.5%. The calibration curves in plasma were linear in the range of 2.5-1,000 ng/mL for caffeine and dapsone, 5-5,000 ng/mL for tolbutamide and 2.5-250 ng/mLfor metoprolol, with correlation coefficient (r(2)) of 0.9936, 0.9966, 0.9990 and 0.9998, respectively. The method was successfully applied to pharmacokinetic studies of the four probe drugs of the four CYP450 isoforms and used to evaluate the effects of breviscapine on the activities of CYP1A2, CYP2C9, CYP2D6 and CYP3A4 in rats.
Assuntos
Cafeína/sangue , Cromatografia Líquida de Alta Pressão/métodos , Sistema Enzimático do Citocromo P-450/metabolismo , Dapsona/sangue , Metoprolol/sangue , Espectrometria de Massas em Tandem/métodos , Tolbutamida/sangue , Animais , Cafeína/química , Cafeína/farmacocinética , Dapsona/química , Dapsona/farmacocinética , Estabilidade de Medicamentos , Modelos Lineares , Masculino , Metoprolol/química , Metoprolol/farmacocinética , Ratos , Ratos Wistar , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Tolbutamida/química , Tolbutamida/farmacocinéticaRESUMO
BACKGROUND: The current practice of using calibration curves with narrow concentration ranges during bioanalysis of new chemical entities has some limitations and is time consuming. In the present study we describe a split calibration curve approach, where sample dilution and repeat analysis can be avoided without compromising the quality and integrity of the data obtained. RESULTS: A split calibration curve approach is employed to determine the drug concentration in plasma samples with accuracy and precision over a wide dynamic range of approximately 0.6 to 15,000 ng/ml for dapsone and approximately 1 to 25,000 ng/ml for cyclophosphamide and glipizide. A wide dynamic range of concentrations for these three compounds was used in the current study to construct split calibration curves and was successfully validated for sample analysis in a single run. CONCLUSION: Using this method, repeat analysis of samples can be avoided. This is useful for the bioanalysis of toxicokinetic studies with wide dose ranges and studies where the sample volume is limited.
Assuntos
Cromatografia Líquida de Alta Pressão , Ciclofosfamida/sangue , Dapsona/sangue , Glipizida/sangue , Espectrometria de Massas em Tandem , Administração Oral , Animais , Calibragem , Cromatografia Líquida de Alta Pressão/normas , Ciclofosfamida/farmacocinética , Ciclofosfamida/normas , Dapsona/farmacocinética , Dapsona/normas , Glipizida/farmacocinética , Glipizida/normas , Meia-Vida , Masculino , Ratos , Ratos Sprague-Dawley , Espectrometria de Massas em Tandem/normasRESUMO
BACKGROUND: Dapsone is described as being active against Mycobacterium leprae, hence its role in the treatment of leprosy and related pathologies. Despite its therapeutic potential, the low solubility of dapsone in water results in low bioavailability and high microbial resistance. Nanoemulsions are pharmaceutical delivery systems derived from micellar solutions with a good capacity for improving absorption. The aim of this work was to develop and compare the permeability of a series of dapsone nanoemulsions in Caco-2 cell culture against that of effective permeability in the human body simulated using Gastroplus™ software. METHODS AND RESULTS: The release profiles of the dapsone nanoemulsions using different combinations of surfactants and cosolvent showed a higher dissolution rate in simulated gastric and enteric fluid than did the dispersed dapsone powder. The drug release kinetics were consistent with a Higuchi model. CONCLUSION: This comparison of dapsone permeability in Caco-2 cells with effective permeability in the human body simulated by Gastroplus showed a good correlation and indicates potential improvement in the biodisponibility of dapsone using this new system.