RESUMEN
AIMS: To test the in vivo activity of Cytochrome P450 (CYP) 2E1 in obese children vs. nonobese children, aged 11-18 years. Secondly, whether the activity of CYP2E1 in these patients is associated with NALFD, diabetes or hyperlipidaemia. METHODS: Seventy children were divided into groups by body mass index (BMI) standard deviation score (SDS). All children received 250 mg oral chlorzoxazone (CLZ) as probe for CYP2E1 activity. Thirteen blood samples and 20-h urine samples were collected per participant. RESULTS: Obese children had an increased oral clearance and distribution of CLZ, indicating increased CYP2E1 activity, similar to obese adults. The mean AUC0-∞ value of CLZ was decreased by 46% in obese children compared to nonobese children. The F was was increased twofold in obese children compared to nonobese children, P < 0.0001. Diabetic biomarkers were significantly increased in obese children, while fasting blood glucose and Hba1c levels were nonsignificant between groups. Liver fat content was not associated with CLZ Cl. CONCLUSION: Oral clearance of CLZ was increased two-fold in obese children vs. nonobese children aged 11-18 years. This indicates an increased CYP2E1 activity of clinical importance, and dose adjustment should be considered for CLZ.
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Clorzoxazona/farmacocinética , Citocromo P-450 CYP2E1/metabolismo , Obesidad/metabolismo , Administración Oral , Adolescente , Área Bajo la Curva , Índice de Masa Corporal , Niño , Clorzoxazona/administración & dosificación , Diabetes Mellitus , Relación Dosis-Respuesta a Droga , Hígado Graso , Femenino , Humanos , Hidroxilación , Masculino , Tasa de Depuración Metabólica/fisiología , Obesidad/sangre , Obesidad/fisiopatología , Obesidad/orinaRESUMEN
BACKGROUND AND OBJECTIVES: The synthetic opioid tilidine is often used in chronic pain treatment. However, the activation via metabolism in patients with concomitant medication and reduced liver or kidney function is not thoroughly investigated. We therefore studied pain treatment efficacy, health-related quality of live and the metabolism of tilidine in patients with chronic pain. METHODS AND MATERIALS: In all, 48 patients, who were on a stable dose of oral prolonged release tilidine for at least 7 days, were included in this observational multicenter study. Liver and kidney function were assessed in routine blood samples, concentrations of tilidine, nortilidine and bisnortilidine were determined using a validated LC/MS/MS method. Comedication was registered and patients experience with regard to quality of life, pain, gastrointestinal symptoms and adverse events was assessed in standardised questionnaires. RESULTS: On average a daily dose of 180 mg tilidine was taken. Dose normalized plasma concentrations of the active metabolite nortilidine ranged between 1.6 ng/ml and 76.5 ng/ml (mean 29.2 ± 25.1 ng/ml). Ratios between tilidine and nortilidine were on average 0.28 (median = 0.13, standard deviation = 0.67). Patients were on 1 to 14 different concomitant medications. About 66% of the patients had sufficient pain treatment. Almost no opioid-induced constipation was observed. Only few patients had decreased kidney or liver function which did not result in elevated nortilidine concentrations. CONCLUSION: Pain treatment using tilidine resulted in variable nortilidine concentrations which are obviously not strongly influenced by comedication or reduced liver or kidney function. Only a few side effects were observed with almost no opioid-induced constipation.
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Dolor Crónico/tratamiento farmacológico , Calidad de Vida/psicología , Tilidina/análogos & derivados , Tilidina/farmacocinética , Tilidina/uso terapéutico , Adulto , Anciano , Anciano de 80 o más Años , Dolor Crónico/psicología , Preparaciones de Acción Retardada , Interacciones Farmacológicas , Quimioterapia Combinada , Femenino , Humanos , Pruebas de Función Renal , Pruebas de Función Hepática , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVES: To assess the effect of the major efavirenz metabolizing enzyme (CYP2B6) genotype and the effects of rifampicin co-treatment on induction of CYP3A by efavirenz. PATIENTS AND METHODS: Two study arms (arm 1, n = 41 and arm 2, n = 21) were recruited into this study. In arm 1, cholesterol and 4ß-hydroxycholesterol were measured in HIV treatment-naive patients at baseline and then at 4 and 16 weeks after initiation of efavirenz-based antiretroviral therapy. In arm 2, cholesterol and 4ß-hydroxycholesterol were measured among patients taking efavirenz during rifampicin-based tuberculosis (TB) treatment (efavirenz/rifampicin) just before completion of TB treatment and then serially following completion of TB treatment (efavirenz alone). Non-linear mixed-effect modelling was performed. RESULTS: A one-compartment, enzyme turnover model described 4ß-hydroxycholesterol kinetics adequately. Efavirenz treatment in arm 1 resulted in 1.74 (relative standard error = 15%), 3.3 (relative standard error = 33.1%) and 4.0 (relative standard error = 37.1%) average fold induction of CYP3A for extensive (CYP2B6*1/*1), intermediate (CYP2B6*1/*6) and slow (CYP2B6*6/*6) efavirenz metabolizers, respectively. The rate constant of 4ß-hydroxycholesterol formation [mean (95% CI)] just before completion of TB treatment [efavirenz/rifampicin co-treatment, 7.40 × 10(-7) h(-1) (5.5 × 10(-7)-1.0 × 10(-6))] was significantly higher than that calculated 8 weeks after completion [efavirenz alone, 4.50 × 10(-7) h(-1) (4.40 × 10(-7)-4.52 × 10(-7))]. The CYP3A induction dropped to 62% of its maximum by week 8 of completion. CONCLUSIONS: Our results indicate that efavirenz induction of CYP3A is influenced by CYP2B6 genetic polymorphisms and that efavirenz/rifampicin co-treatment results in higher induction than efavirenz alone.
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Fármacos Anti-VIH/farmacocinética , Antituberculosos/farmacocinética , Benzoxazinas/farmacocinética , Citocromo P-450 CYP2B6/genética , Citocromo P-450 CYP3A/metabolismo , Hidroxicolesteroles/análisis , Rifampin/farmacocinética , Adulto , Alquinos , Fármacos Anti-VIH/uso terapéutico , Antituberculosos/uso terapéutico , Benzoxazinas/uso terapéutico , Ciclopropanos , Femenino , Genotipo , Infecciones por VIH/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Rifampin/uso terapéutico , Tuberculosis/tratamiento farmacológicoRESUMEN
We investigated the effects of pharmacogenetic variations and efavirenz pharmacokinetics on inter-individual differences in the extent of CYP3A induction by efavirenz using 4ß-hydroxycholesterol/cholesterol (4ß-OHC/Chol) as a marker for CYP3A induction. Plasma 4ß-hydroxycholesterol and cholesterol concentrations were determined at baseline, and at the 4th, 16th and 48th week of efavirenz-based highly active antiretroviral therapy in antiretroviral therapy-naive HIV patients (n=77). Efavirenz plasma concentrations were quantified at weeks 4 and 16. CYP2B6, CYP3A5, ABCB1, UGT2B7 genotyping were done. Compared with baseline, the median plasma 4ß-OHC/Chol ratio increased at the 4th (257%), 16th (291%) and 48th (165%) week (P<0.0001). CYP2B6*6 genotype significantly influenced 4ß-OHC/Chol ratio at weeks 16 (P=0.02) and 48 (P=0.04) being highest in CYP2B6*6/*6>*1/*6>*1/*1. There were positive correlations between plasma efavirenz and 4ß-OHC/Chol ratios (week 4: P=0.02, week 16: P=0.001). CYP3A enzyme induction by efavirenz is pronounced in CYP2B6 slow metabolizers who have high efavirenz plasma exposure.
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Benzoxazinas/uso terapéutico , Citocromo P-450 CYP3A/biosíntesis , Infecciones por VIH/tratamiento farmacológico , Inhibidores de la Transcriptasa Inversa/uso terapéutico , Alquinos , Ciclopropanos , Citocromo P-450 CYP3A/genética , Inducción Enzimática , Femenino , Infecciones por VIH/enzimología , Humanos , Masculino , Estudios ProspectivosRESUMEN
The objective of this study was to assess the incidence, timing and identify pharmacogenetic, efavirenz (EFV) pharmacokinetic and biochemical predictors of EFV-based antiretroviral therapy (ART) drug-induced liver injury (DILI). ART-naïve HIV patients (n = 285) were prospectively enrolled. Pretreatment laboratory evaluations included hepatitis B surface antigen and C antibody, CD4 count and viral load. Liver tests were done at baseline, 1st, 2nd, 4th, 8th, 12th, 24th and 48th weeks during ART. Plasma EFV and 8-hydroxyefvairenz concentration was determined at week 4 using liquid chromatography-mass spectrometry. CYP2B6, CYP3A5, ABCB1 3435C/T and UGT2B7*2 genotyping was done using Taqman genotyping assay. Data were analyzed using survival analysis and Cox proportional hazards model. The incidence of DILI was 15.7% or 27.9 per 100 person-years and that of severe injury was 3.4% or 6.13 per 100 person-years. The median time for the development of DILI and severe injury was 2 and 4 weeks after initiation of ART, respectively. There was significant association of DILI with lower baseline platelet, albumin, log plasma viral load and CD4 count (P = 0.031, 0.037, 0.06 and 0.019, respectively). Elevated baseline alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, plasma EFV level and CYP2B6*6 were good predictors for the development of DILI (P = 0.03, 0.01, 0.016, 0.017 and 0.04, respectively). We report for the first time CYP2B6*6 as a putative genetic marker and high plasma EFV concentration as intermediate biomarker for vulnerability to EFV-induced liver injury in HIV patients. CYP2B6 genotyping and/or regular monitoring of EFV and lever enzymes level during early therapy is advised for early diagnosis and management of DILI.
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Terapia Antirretroviral Altamente Activa/efectos adversos , Hidrocarburo de Aril Hidroxilasas/genética , Benzoxazinas/efectos adversos , Enfermedad Hepática Inducida por Sustancias y Drogas/genética , Infecciones por VIH/tratamiento farmacológico , Oxidorreductasas N-Desmetilantes/genética , Subfamilia B de Transportador de Casetes de Unión a ATP , Miembro 1 de la Subfamilia B de Casetes de Unión a ATP/genética , Adulto , Alquinos , Benzoxazinas/sangre , Estudios de Cohortes , Ciclopropanos , Citocromo P-450 CYP2B6 , Citocromo P-450 CYP3A/genética , Femenino , Genotipo , Humanos , Masculino , Modelos de Riesgos Proporcionales , Estudios ProspectivosRESUMEN
BACKGROUND: The impact of major liver resection (LR) on the detoxifying function of the remaining liver tissue as represented by CYP3A activity has yet to be assessed. Therefore, this study evaluates the changes in CYP3A activity between preoperative values and after liver resection. MATERIAL AND METHODS: To determine CYP3A activity, midazolam (MDZ) was used as a marker substance, 3 µg were applied intravenously one day before surgery and on the 3rd day after surgery. Subsequently blood was withdrawn at 0, 0.25, 0.5, 1.0, 1.5, 2.0, 2.5, 3, 4 and 6 h post application of the study drug. Plasma MDZ and 1-OH-MDZ concentration was assessed using a LC-MS/MS method. Volumetric analysis of the resected liver was done by syngo.CT liver analysis software (Siemens Healthineers) using preoperative multidetector computed tomography. RESULTS: N = 13 (8 male/5 female) patients were included in this study and received preoperative evaluation, 11 patients were studied also after liver resection. The mean age was 62 (±15.3) years with a mean BMI of 23.6 ± 4.8 kg/m2. No patient suffered from acute liver dysfunction postoperatively. None of the pharmacokinetic parameters assessed were significantly altered by liver resection. CYP3A activity over time was not significantly reduced by major liver resection. CONCLUSION: This study gives first time data on the impact of major liver resection on CYP3A activity. It was shown that MDZ clearance representing in vivo CYP3A activity is not altered by major liver resection. This suggests no dose adjustment of commonly applied drugs which are CYP3A substrates needs to be carried out.
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Citocromo P-450 CYP3A/metabolismo , Hepatectomía , Adulto , Anciano , Estudios Controlados Antes y Después , Femenino , Humanos , Masculino , Midazolam/sangre , Persona de Mediana Edad , Periodo Posoperatorio , Estudios ProspectivosRESUMEN
Myrcludex B acts as a hepatitis B and D virus entry inhibitor blocking the sodium taurocholate cotransporting polypeptide (SLC10A1). We investigated the effects of myrcludex B on plasma bile acid disposition, tenofovir pharmacokinetics, and perpetrator characteristics on cytochrome P450 (CYP) 3A. Twelve healthy volunteers received 300 mg tenofovir disoproxil fumarate orally and 10 mg subcutaneous myrcludex B. Myrcludex B increased total plasma bile acid exposure 19.2-fold without signs of cholestasis. The rise in conjugated bile acids was up to 124-fold (taurocholic acid). Coadministration of tenofovir with myrcludex B revealed no relevant changes in tenofovir pharmacokinetics. CYP3A activity slightly but significantly decreased by 29% during combination therapy. Myrcludex B caused an asymptomatic but distinct rise in plasma bile acid concentrations and had no relevant impact on tenofovir pharmacokinetics. Changes in CYP3A activity might be due to alterations in bile acid signaling. Long-term effects of elevated bile acids will require critical evaluation.
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Antivirales/administración & dosificación , Ácidos y Sales Biliares/sangre , Lipopéptidos/administración & dosificación , Inhibidores de la Transcriptasa Inversa/farmacocinética , Tenofovir/farmacocinética , Administración Oral , Adulto , Antivirales/efectos adversos , Antivirales/farmacocinética , Biomarcadores/sangre , Citocromo P-450 CYP3A/metabolismo , Interacciones Farmacológicas , Femenino , Humanos , Inyecciones Subcutáneas , Lipopéptidos/efectos adversos , Lipopéptidos/farmacocinética , Masculino , Persona de Mediana Edad , Transportadores de Anión Orgánico Sodio-Dependiente/antagonistas & inhibidores , Transportadores de Anión Orgánico Sodio-Dependiente/metabolismo , Estudios Prospectivos , Inhibidores de la Transcriptasa Inversa/administración & dosificación , Inhibidores de la Transcriptasa Inversa/efectos adversos , Medición de Riesgo , Simportadores/antagonistas & inhibidores , Simportadores/metabolismo , Tenofovir/administración & dosificación , Tenofovir/efectos adversos , Regulación hacia Arriba , Adulto JovenRESUMEN
CYP3A is the main enzyme subfamily involved in the metabolism of the HIV protease-inhibitor saquinavir. We hypothesized that individuals homozygous for CYP3A5*1 might have a higher oral clearance of saquinavir, compared with subjects lacking functional CYP3A5 alleles. A single-dose pharmacokinetic trial of saquinavir soft gel capsules, 1,200 mg, was performed in 16 black Tanzanian healthy volunteers with two functional CYP3A5 alleles (*1/*1) and in 18 volunteers without functional CYP3A5 alleles (both alleles being either *3, *6, or *7). The median area under the plasma concentration-time curve (AUC)0-24 reached among subjects with two functional alleles was 1,410 ng h/ml (interquartile range (IQR) 826-1,929), whereas it was 2,138 ng h/ml (IQR 1,380-3,331) in subjects without (P=0.0533, Mann-Whitney U-test). The median ratio of saquinavir over its M2 plus M3 hydroxy metabolites in urine was 64 (IQR 52-73) in subjects with two functional alleles, whereas it was 145 (IQR 89-181) in those without (P=0.000078, Mann-Whitney U-test). In conclusion, saquinavir is metabolized by CYP3A5. The median AUC0-24 for saquinavir among individuals with two functional CYP3A5 alleles was 34% lower than among those with no functional alleles. To clarify the clinical importance of the CYP3A5 polymorphism, further studies should be conducted on saquinavir, dosed to steady state, in the presence of ritonavir boosting.
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Sistema Enzimático del Citocromo P-450/genética , Inhibidores de la Proteasa del VIH/metabolismo , Saquinavir/metabolismo , Adulto , Alelos , Área Bajo la Curva , Cápsulas , Citocromo P-450 CYP3A , Determinación de Punto Final , Femenino , Humanos , Hidroxilación , Masculino , Persona de Mediana Edad , Polimorfismo Genético/genética , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
OBJECTIVE: Urinary caffeine metabolic ratios used to quantify the activity of numerous drug-metabolizing enzymes are an established component of cocktail approaches for metabolic phenotyping. Because in vitro evidence suggests that 1-methylxanthine (1-MX), a major caffeine metabolite, is actively secreted into urine by organic anion transporters (hOATs), coadministration of renal hOAT inhibitors like probenecid may impair these procedures. METHODS: In a randomized, placebo-controlled, double-blind crossover design, single oral doses of 300 mg caffeine with oral coadministration of placebo or 500 mg probenecid 3 times daily for 2 days were administered to 7 healthy men. The plasma and urine concentrations of caffeine and its major metabolites 1,7-dimethylxanthine (1,7-DMX) and 1-MX were determined by high-performance liquid chromatography. RESULTS: Coadministration of probenecid resulted in a 34% reduction of the renal clearance of 1-MX (mean +/- SD 190 +/- 42 versus 290 +/- 83 ml min(-1), 95% CI on difference 0.2, 200, p = 0.04) with a 41% reduction in its estimated non-glomerular clearance. The renal clearances of caffeine and 1,7-DMX and the area under the plasma concentration-time curves of all substances were not significantly changed. CONCLUSIONS: 1-MX undergoes renal tubular secretion which is substantially reduced by probenecid, possibly due to inhibition of renal hOATs. This inhibition may explain the influence of probenecid on urinary caffeine metabolic ratios and, thus, its impact on the assessment of enzyme activities. It also suggests that 1-MX might serve as a model substrate for the renal tubular transport of organic anions.
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Cafeína/farmacocinética , Estimulantes del Sistema Nervioso Central/farmacocinética , Riñón/metabolismo , Probenecid/farmacología , Fármacos Renales/farmacología , Xantinas/metabolismo , Adulto , Área Bajo la Curva , Arilamina N-Acetiltransferasa/metabolismo , Cromatografía Líquida de Alta Presión , Creatinina/sangre , Creatinina/orina , Estudios Cruzados , Citocromo P-450 CYP1A2/metabolismo , Depresión Química , Método Doble Ciego , Femenino , Humanos , Masculino , Espectrofotometría Ultravioleta , Xantina Oxidasa/metabolismoRESUMEN
For differentiation-defective malignancies, compounds that modulate transcription, such as retinoic acid and histone deacetylase (HDAC) inhibitors, are of particular interest. HDAC inhibitors are currently under investigation for the treatment of a broad spectrum of cancer diseases. However, one clinical drawback is class-specific toxicity of unselective inhibitors, limiting their full anticancer potential. Selective targeting of individual HDAC isozymes in defined tumor entities may therefore be an attractive alternative treatment approach. We have previously identified HDAC family member 8 (HDAC8) as a novel target in childhood neuroblastoma. Using small-molecule inhibitors, we now demonstrate that selective inhibition of HDAC8 exhibits antineuroblastoma activity without toxicity in two xenograft mouse models of MYCN oncogene-amplified neuroblastoma. In contrast, the unselective HDAC inhibitor vorinostat was more toxic in the same models. HDAC8-selective inhibition induced cell cycle arrest and differentiation in vitro and in vivo. Upon combination with retinoic acid, differentiation was significantly enhanced, as demonstrated by elongated neurofilament-positive neurites and upregulation of NTRK1. Additionally, MYCN oncogene expression was downregulated in vitro and tumor cell growth was markedly reduced in vivo. Mechanistic studies suggest that cAMP-response element-binding protein (CREB) links HDAC8- and retinoic acid-mediated gene transcription. In conclusion, HDAC-selective targeting can be effective in tumors exhibiting HDAC isozyme-dependent tumor growth in vivo and can be combined with differentiation-inducing agents.
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Histona Desacetilasas/metabolismo , Neuroblastoma/metabolismo , Proteínas Represoras/metabolismo , Tretinoina/farmacología , Animales , Western Blotting , Línea Celular Tumoral , Supervivencia Celular/efectos de los fármacos , Femenino , Inhibidores de Histona Desacetilasas/farmacología , Histona Desacetilasas/genética , Humanos , Ácidos Hidroxámicos , Indoles/farmacología , Ratones , Ratones Desnudos , Proteínas Represoras/genética , Ensayos Antitumor por Modelo de XenoinjertoRESUMEN
A 15-year-old patient with acute lymphoblastic leukemia and Fusarium infection was treated with voriconazole. She developed asymptomatic bradycardia, QT interval prolongation, and nonsustained, polymorphic ventricular tachycardia, which recurred upon rechallenge with the drug. Voriconazole levels and metabolism were within expected normal values. This non-concentration-dependent, voriconazole-associated ventricular tachycardia mandates cardiac rhythm monitoring during voriconazole treatment.
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Antifúngicos/efectos adversos , Bradicardia/inducido químicamente , Pirimidinas/efectos adversos , Taquicardia Ventricular/inducido químicamente , Triazoles/efectos adversos , Adolescente , Femenino , Fusarium , Humanos , Micosis/tratamiento farmacológico , Infecciones Oportunistas/tratamiento farmacológico , Torsades de Pointes/inducido químicamente , VoriconazolRESUMEN
BACKGROUND: The antidiarrheal drug loperamide is frequently used to treat ritonavir-associated diarrhea in patients with human immunodeficiency virus. The absence of marked central opioid effects has been attributed to its low bioavailability and its poor penetration of the blood-brain barrier, both of which might be altered by ritonavir, a potent P-glycoprotein and cytochrome P4503A inhibitor. METHODS: A 16-mg dose of loperamide was administered to 12 healthy male and female volunteers together with either 600 mg of ritonavir or placebo. Detailed pharmacokinetics of loperamide and its metabolites were determined over 72 hours. Central opioid effects were measured by evaluation of pupil diameter, cold pressor test, and transcutaneous PCO2 and PO2. RESULTS: Ritonavir caused a major pharmacokinetic interaction, increasing the area under the concentration-time curve of loperamide from 104 +/- 60 h x pmol/ml after placebo to 276 +/- 68 h. pmol/ml and delayed formation of the major metabolite desmethylloperamide (time to reach maximum concentration after drug administration [t(max)], 7.1 +/- 2.6 hours versus 19.6 +/- 9.1 hours). The urinary metabolic ratio of loperamide increased 3 times whereas the total molar amount of loperamide and metabolites excreted in urine remained unchanged. No central pharmacodynamic effects were observed after coadministration of loperamide with either ritonavir or placebo. CONCLUSION: This study demonstrates a major metabolic interaction probably by cytochrome P4503A4 with no evidence of P-glycoprotein involvement. This might explain the lack of central effects after ritonavir.
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Miembro 1 de la Subfamilia B de Casetes de Unión a ATP/fisiología , Antidiarreicos/sangre , Hidrocarburo de Aril Hidroxilasas , Inhibidores de la Proteasa del VIH/farmacología , Loperamida/sangre , Ritonavir/farmacología , Adulto , Área Bajo la Curva , Estudios Cruzados , Citocromo P-450 CYP3A , Inhibidores Enzimáticos del Citocromo P-450 , Sistema Enzimático del Citocromo P-450/fisiología , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Oxidorreductasas N-Desmetilantes/antagonistas & inhibidores , Oxidorreductasas N-Desmetilantes/fisiologíaRESUMEN
Toxaphene residues in cod liver and fish oil samples from different countries have been analyzed by HRGC-ECD and HRGC-MS as well as with multidimensional gas chromatography. The results have been compared to patterns obtained by photolysis and microbial degradation of selected single chlorobornanes and technical toxaphene. Enantiomeric ratios of the components Parlar #44 and #62 showed significant deviations from 1, indicating metabolism in cod fish and perhaps other species at least for some congeners. Parlar #50 was found to be a racemate, which corresponds to its known stability under biotic and abiotic conditions.
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Insecticidas/farmacocinética , Toxafeno/farmacocinética , Contaminantes Químicos del Agua/farmacocinética , Animales , Biodegradación Ambiental , Peces/fisiología , Microbiología del AguaRESUMEN
The applicability of online trace enrichment with custom-made coated capillaries combined with tandem mass spectrometry was demonstrated for the target analysis of selected pesticides (mainly herbicides, e.g., triazines, phenylureas, and acetanilides) in water. The developed method allows rapid determination of several widely used plant protectants within a total analysis time of 11 min. Good linearity (r > or = 0.995) was obtained for the selected pesticides in the range of 0.050-50 microg/L. The relative standard deviations (RSDs) of the peak areas were < or = 3.8% for spiked Milli-Q water (5 microg/L). The RSDs obtained in analyses of spiked (1 microg/L) water samples (brook water, river water, sewage plant effluent) ranged from 2.9 to 6.8%, indicating low influence of the matrix on enrichment and detection. The detection limits, which ranged from 10 to 90 ng/L, fulfilled the requirements of the European regulations for drinking water. The polyacrylate coating of the extraction capillary showed good stability in the presence of water and acetonitrile and allowed > or = 100 extractions with 1 capillary.
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Cromatografía Liquida/métodos , Espectrometría de Masas/métodos , Plaguicidas/análisis , Contaminantes Químicos del Agua/análisisRESUMEN
Subsequent to irradiation with a xenon lamp simulating sunlight, fluoroquinolone carboxylic acids in aqueous solution form polar pyridone dicarboxylic and tricarboxylic acids. After liquid/liquid partition with chloroform/water these substances can be isolated by ion exchange chromatography of the aqueous phase. They can be regarded as intermediate compounds on the route to a complete photomineralization. The structural elucidation is performed by such mass spectroscopic methods as MS, GC/MS and HPLC/MS, whereby HPLC/MS shows the highest reliability. Additionally(1)H- and(13)C-NMR measurements confirm the structure of the main polar degradation product.
RESUMEN
The photolytically induced decomposition of fluoroquinolone carboxylic acids (enrofloxacin, danofloxacin, ciprofloxacin and norfloxacin) at concentrations of 10 mg/l in pure water and an irradiation intensity of 200 W/m(2) (xenon lamp) led to half-lives from 20.6 min (danofloxacin) to 105.9 min (norfloxacin). The environmental half-life of enrofloxacin was calculated by the GCSOLAR program and resulted in 1.8 to 55.4 hours, depending on the season and degree of latitude. During the irradiation procedure, products were built up which primarily demonstrated alterations involving the piperazine ring as compared with the parent compounds. The amount of(14)CO(2) evolved by the photomineralization of(14)C-labeled enrofloxacin reached 26.4 % of the applied radioactivity. The main photoproducts were isolated by HPLC and their structural elucidation was carried out by different spectroscopic methods (MS, GC/MS and(1)H-NMR).
RESUMEN
The objective of the study was to establish an in vivo method for assessing cytochrome P450 3A (CYP3A) activity using therapeutically inert nanogram doses of midazolam. We administered four escalating single doses of oral midazolam (0.0001-3 mg) to 12 healthy participants, stratified according to CYP3A5 carrier status, to assess pharmacokinetics linearity. We then evaluated the interactions with the CYP3A inhibitor ketoconazole (400 mg q.d.) after nanogram and regular doses of midazolam. Area under the plasma concentration-time curve (AUC) and peak plasma concentration (C(max)) were linear over the entire range of doses. Ketoconazole reduced midazolam oral clearance by 92.8%. AUC and C(max) increased by 1,540 and 363%, respectively. CYP3A5 carrier status had no influence on midazolam oral clearance or its inhibition by ketoconazole. This is the first study showing that midazolam pharmacokinetics is linear in a 30,000-fold concentration range, and therefore that nano- and microgram doses of midazolam can reliably predict the pharmacokinetics of midazolam in therapeutic doses and can be used to assess CYP3A activity even in the presence of strong CYP3A inhibitors.
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Citocromo P-450 CYP3A/genética , Citocromo P-450 CYP3A/metabolismo , Cetoconazol/farmacología , Midazolam/administración & dosificación , Midazolam/farmacología , Adolescente , Adulto , Alelos , Área Bajo la Curva , Inhibidores del Citocromo P-450 CYP3A , Relación Dosis-Respuesta a Droga , Interacciones Farmacológicas/genética , Femenino , Genotipo , Humanos , Cetoconazol/administración & dosificación , Masculino , Midazolam/farmacocinética , Persona de Mediana Edad , Caracteres SexualesRESUMEN
We established a new limited sampling strategy to assess CYP3A activity and evaluated the time course of reversible (voriconazole) and irreversible (ritonavir) CYP3A inhibition. In this randomized trial, two groups, each with eight healthy participants, received CYP3A inhibitors voriconazole or ritonavir orally for 9 days, with 3 mg midazolam (MDZ) administered before the inhibitor treatment, on days 1, 2, 3, 5, 8, and 9 during inhibitor treatment, and on days 10, 11, and 12 (3 days) after discontinuation. Plasma MDZ area under the curve (AUC) between 2 and 4 h after oral administration in the form of a solution strongly correlated with MDZ clearance. Using this parameter, maximum inhibition of voriconazole and ritonavir was calculated to have occurred only 48 h after starting of the inhibitor (percentage of baseline MDZ clearance, voriconazole: 10.6%; ritonavir: 8.4%). Recovery of CYP3A activity occurred with a half-life of 24 h after voriconazole, whereas ritonavir inhibition was still strong 3 days after discontinuation. These findings underscore the substantial and gradual alterations in dose requirements in the first days of and after such combination therapies.
Asunto(s)
Inhibidores del Citocromo P-450 CYP3A , Inhibidores Enzimáticos/farmacología , Pirimidinas/farmacología , Ritonavir/farmacología , Triazoles/farmacología , Administración Oral , Adolescente , Adulto , Área Bajo la Curva , Citocromo P-450 CYP3A/metabolismo , Interacciones Farmacológicas , Femenino , Semivida , Humanos , Masculino , Midazolam/administración & dosificación , Midazolam/farmacocinética , Persona de Mediana Edad , Factores de Tiempo , Voriconazol , Adulto JovenRESUMEN
We performed a prospective comparative study to examine, from a pharmacogenetics perspective, the effect of rifampicin (RIF) on long-term efavirenz (EFV) autoinduction and kinetics. In a study population of patients with HIV receiving EFV with RIF (arm 2, n = 54) or without RIF (arm 1, n = 128 controls), intraindividual and interindividual plasma EFV and 8-hydroxyefavirenz levels were compared at weeks 4 and 16 of EFV therapy. In arm 2, RIF was initiated 4 weeks before starting EFV. In controls (arm 1), the plasma EFV was significantly lower whereas 8-hydroxyefavirenz was higher at week 16 as compared to week 4. By contrast, there were no significant differences in plasma EFV and 8-hydroxyefavirenz concentrations over time in arm 2. At week 4, the plasma EFV concentration was significantly lower in arm 2 as compared to arm 1, but no significant differences were observed by week 16. When stratified by CYP2B6 genotype, significant differences were observed only with respect to CYP2B6*1/*1 genotypes. Ours is the first report of the CYP2B6 genotype-dependent effect of RIF on long-term EFV autoinduction.