RESUMEN
ETHNOPHARMACOLOGICAL RELEVANCE: EGb 761 is a standardized dry extract of Ginkgo biloba L. leaves traditionally used by Eastern Asia and has been associated with beneficial effects on neurodegeneration disorders, including Alzheimer's disease. AIM OF THE STUDY: Since beneficial interactions between EGb 761 and donepezil have been observed in previous clinical studies, the current study was proposed aiming to further explore related mechanisms from both pharmacokinetics and pharmacodynamics aspects. MATERIALS AND METHODS: Pharmacodynamic interactions were studied in scopolamine-induced cognitive impairment rats received two-weeks treatment of vehicle, EGb 761 and/or donepezil by the Morris water maze test and ex vivo evaluation of biomarkers of cholinergic transmission and oxidative stress in rat brain. In the meantime, pharmacokinetic profiles of donepezil and bilobalide were obtained and compared among all treatment groups. In addition, impact of the bioavailable EGb 761 components on donepezil brain penetration was evaluated with the hCMEC/D3 cell monolayer model. RESULTS: Scopolamine-induced rats with co-treatment of EGb 761 and donepezil had significantly improved cognitive function in the Morris water maze test with increased brain levels of superoxide dismutase and decreased brain levels of acetylcholinesterase and malondialdehyde than that with treatment of only EGb 761 or donepezil. Despite such beneficial pharmacodynamics outcomes, the two-week co-treatment of EGb 761 and donepezil did not alter the plasma pharmacokinetics and brain uptake of donepezil or bilobalide, which was further verified in the hCMEC/D3 monolayer model. CONCLUSION: Co-administration of EGb 761 and donepezil exerted better anti-amnestic effect via further enhanced pro-cholinergic and antioxidative effects of EGb 761 or donepezil in scopolamine-induced cognitive impairment rat without alteration in their systemic/brain exposure.
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Amnesia/tratamiento farmacológico , Antioxidantes/farmacología , Colinérgicos/farmacología , Donepezilo/farmacología , Nootrópicos/farmacología , Extractos Vegetales/farmacología , Acetilcolinesterasa/efectos de los fármacos , Animales , Antioxidantes/farmacocinética , Antioxidantes/uso terapéutico , Conducta Animal/efectos de los fármacos , Encéfalo/efectos de los fármacos , Encéfalo/metabolismo , Línea Celular , Colinérgicos/sangre , Colinérgicos/farmacocinética , Colinérgicos/uso terapéutico , Disfunción Cognitiva/inducido químicamente , Disfunción Cognitiva/tratamiento farmacológico , Ciclopentanos/sangre , Ciclopentanos/farmacocinética , Ciclopentanos/farmacología , Ciclopentanos/uso terapéutico , Modelos Animales de Enfermedad , Donepezilo/sangre , Donepezilo/farmacocinética , Donepezilo/uso terapéutico , Quimioterapia Combinada , Furanos/sangre , Furanos/farmacocinética , Furanos/farmacología , Furanos/uso terapéutico , Ginkgo biloba , Ginkgólidos/sangre , Ginkgólidos/farmacocinética , Ginkgólidos/farmacología , Ginkgólidos/uso terapéutico , Humanos , Masculino , Malondialdehído/metabolismo , Aprendizaje por Laberinto/efectos de los fármacos , Nootrópicos/sangre , Nootrópicos/farmacocinética , Nootrópicos/uso terapéutico , Extractos Vegetales/sangre , Extractos Vegetales/farmacocinética , Extractos Vegetales/uso terapéutico , Ratas Wistar , Superóxido Dismutasa/metabolismoRESUMEN
ETHNOPHARMACOLOGICAL RELEVANCE: The major terpene lactones of ginkgo biloba extract (GBE) include ginkgolide A, B, C and bilobalide are used for the protection of cardiovascular, cerebrovascular and neurodegenerative diseases. Terpene lactones are orally bioavailable and predominantly eliminated via the renal pathway. However, information on the transporters involved in the pharmacokinetics (PK) and renal excretion of terpene lactones is limited. AIM OF THE STUDY: The objective of this study is to assess the role of OAT1/3 which are important transporters in the human kidney in the PK and renal excretion ginkgolide A, B, C and bilobalide. MATERIALS AND METHODS: Uptake of ginkgolide A, B, C and bilobalide in Madin-Darby Canine Kidney (MDCK) and human embryonic kidney 293 (HEK293) cells overexpressing OAT1 or OAT3, respectively were studied. To verify the result from in vitro cell models, the studies on PK, kidney accumulation and urinary excretion of ginkgolide A, B, C and bilobalide were carried out in rats. RESULTS: The result showed that ginkgolide A, B, C and bilobalide are low-affinity substrates of OAT1/3. Following co-administration with probenecid, a typical inhibitor of OAT1/3, the rat plasma concentrations of ginkgolide A, B, C and bilobalide increased significantly. AUC showed a significant increase in the probenecid-treated rats compared to control rats (893.48 vs. 1123.85, 314.91 vs. 505.74, and 2724.97 vs. 3096.40 µg/L*h for ginkgolide A, B and bilobalide, respectively), while the clearance of these compounds significantly decreased. The accumulation of ginkgolide A, B and bilobalide in the kidney of the probenecid-treated rats was reduced by 1.8, 2.4, and 1.5-fold, respectively; further reducing the cumulative urinary recovery of these compounds. CONCLUSION: The findings indicated that ginkgolide A, B and bilobalide are excreted via OAT1/3-mediated transport in the kidney and OAT1/3 inhibitor significantly influence the PK ginkgolides and bilobalide.
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Ciclopentanos/farmacocinética , Furanos/farmacocinética , Ginkgólidos/farmacocinética , Riñón/metabolismo , Proteína 1 de Transporte de Anión Orgánico/metabolismo , Transportadores de Anión Orgánico Sodio-Independiente/metabolismo , Animales , Transporte Biológico , Ciclopentanos/sangre , Perros , Furanos/sangre , Ginkgólidos/sangre , Células HEK293 , Humanos , Células de Riñón Canino Madin Darby , Masculino , Proteína 1 de Transporte de Anión Orgánico/genética , Transportadores de Anión Orgánico Sodio-Independiente/genética , Ratas , Eliminación Renal , Distribución TisularRESUMEN
Pentoxyverine citrate (PEN-citrate) is an antitussive (cough suppressant) drug used for cough associated with illnesses like common cold. In this work, PEN-citrate is quantified by applying a simple, direct and accurate spectrophotometric method in pure form, pharmaceutical formulation (Cabella®, 2.13â¯mg/mL) and human serum samples. The formation of a stable yellow ion-pair with sulfonephthalein dyes; bromocresol green (BCG), bromophenol blue (BPB), bromothymol blue (BTB), bromocresol purple (BCP), bromochlorophenol blue (BChPB) and bromoxylenol blue (BXB), in three nonpolar solvents (chloroform, dichloromethane, acetonitrile) is used as the basis for this method. This is the first assay method reported for the quantification of PEN-citrate using the sulfonephthaleins as coloring agents. Diverse parameters were investigated in order to optimize the calibration curve conditions. The strategy was validated with respect to linearity range, precision, accuracy, specificity, robustness and limits of detection (LOD) and quantification (LOQ). In addition, solvents of different polarities were utilized to investigate the color reaction, light absorption and to allow for increasing the method sensitivity. Beer's law is obeyed over a wide concentration range (up to 42.05⯵g/mL in case of BTB method). LOD and LOQ values reached 0.22 and 0.72⯵g/mL, respectively, upon using BChPB. The relative standard deviation (%RSD) was ≤1.91% while correlation coefficient values (r) were ≥ 0.9974. High molar absorptivity values and low values of Sandell's sensitivity were obtained indicating that the proposed methods are highly sensitive. The validated methods were applied to the analysis of PEN-citrate in the dosage form and human serum samples where the drug was successfully resolved from the pharmaceutical additives and serum components with recoveries ≥98.98%.
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Antitusígenos/sangre , Colorantes/química , Ciclopentanos/sangre , Fenolsulfonftaleína/química , Antitusígenos/análisis , Ciclopentanos/análisis , Humanos , Límite de Detección , Solventes , Espectrofotometría/métodos , ComprimidosRESUMEN
A simple HPLC-MS/MS method has been developed for the determination of peramivir in rat plasma in the present study. The analytes were separated on a C18 column (50 × 2.1 mm, 1.7 µm) and a triple-quadrupole mass spectrometer equipped with an electrospray ionization source was applied for the detection. A phospholipid-free cartridge solid-phase extraction was used to pretreat the plasma and eliminate the endogenous phospholipid. The in-source collision-induced dissociation approach showed that this pretreatment could result in negligible ion suppression from the extracted sample and could produce cleaner samples when compared with the protein precipitation. The method was linear over the concentration range of 0.12-1200.0 ng/mL for peramivir. The method was validated and successfully applied to a pharmacokinetic study after peramivir was orally and intravenously administered to Sprague-Dawley rats.
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Cromatografía Líquida de Alta Presión/métodos , Ciclopentanos/sangre , Ciclopentanos/aislamiento & purificación , Guanidinas/sangre , Guanidinas/aislamiento & purificación , Fosfolípidos/química , Extracción en Fase Sólida/métodos , Espectrometría de Masas en Tándem/métodos , Ácidos Carbocíclicos , Animales , Ciclopentanos/química , Guanidinas/química , Modelos Lineales , Masculino , Ratas , Ratas Sprague-Dawley , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
BACKGROUND: Intravenous peramivir is a potent neuraminidase (NA) inhibitor with activity against influenza A and B viruses. The early use of NA inhibitors has been shown to reduce mortality in influenza patients. METHODS: To evaluate the pharmacokinetics of peramivir and confirm the safety and tolerability of multiple infusions of peramivir in healthy Japanese subjects, two Phase I, single-centre, randomized, double-blind and placebo-controlled studies consisting of a multiple-dose study and a high-dose study were conducted. RESULTS: Multiple intravenous infusions of peramivir were well tolerated up to 800 mg once a day and 400 mg twice daily for 6 days. Dose proportionalities for maximum plasma concentration (Cmax) and area under the plasma concentration-time curve (AUC) were established up to the 800 mg dose. Approximately 90% of unchanged peramivir was excreted into urine within 12 h after treatment with 800 mg of peramivir. The peramivir plasma and upper respiratory tract fluid levels were significantly higher than the 50% inhibition concentrations for NA enzyme activity (IC50) of epidemic influenza viruses, including those harbouring the H274Y mutation. CONCLUSIONS: The pharmacokinetic properties obtained here for intravenous peramivir are consistent with the previously reported clinical efficacy and safety of this antiviral.
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Antivirales/farmacocinética , Ciclopentanos/farmacocinética , Inhibidores Enzimáticos/farmacocinética , Guanidinas/farmacocinética , Ácidos Carbocíclicos , Administración Intravenosa , Adulto , Antivirales/sangre , Área Bajo la Curva , Ciclopentanos/sangre , Método Doble Ciego , Esquema de Medicación , Inhibidores Enzimáticos/sangre , Femenino , Expresión Génica , Guanidinas/sangre , Voluntarios Sanos , Humanos , Virus de la Influenza A/efectos de los fármacos , Virus de la Influenza A/enzimología , Gripe Humana/tratamiento farmacológico , Masculino , Neuraminidasa/antagonistas & inhibidores , Neuraminidasa/genética , Neuraminidasa/metabolismo , Seguridad del Paciente , Proteínas Virales/antagonistas & inhibidores , Proteínas Virales/genética , Proteínas Virales/metabolismoRESUMEN
A simple, rapid, and specific high-performance liquid chromatograph coupled with a tandem mass spectrometry method has been developed and validated for the quantification of ginkgolides in rat plasma, and the main pharmacokinetic parameters of ginkgolides after oral administration of Ginkgo biloba extract (GBE) was acquired. Methods: Plasma samples were pretreated with ethyl acetate extraction. Sulfamethoxazole was used as the internal standard (IS). Chromatographic separation was achieved on an Eclipse XDB-C18 column (2.1 mm×150 mm, 5 µm) with a mobile phase consisting of methanol/0.1% formic acid water (gradient elution: 0~25 min (77:23)â(60:40), V/V) at a flow rate of 0.3 mL·min-1. The detection was performed on a triple quadruple tandem mass spectrometer using an electrospray ionization (ESI) source for 25 min. The detection was operated by multiple reaction monitoring(MRM) under negative ionization mode of the transitions of m/z 325â163 for BB, 469â423 for GJ, 439â125 for GC, 453â351 for GA, 423â367 for GB and of m/z 252â156 for sulfamethoxazole (IS) respectively. Results: The pharmacokinetic properties of BB, GJ, GA, GB and GC were in line with the open 2-compartment model after oral administration of GBE in rats; The pharmacokinetic parameters of various lactones were calculated, and drugs-time curve and the curve fitting diagram of 5 ginkgolides were drew; The absorption and distribution rate of BB, GJ, GA, GB and GC were fast in rats in vivo, and half-life of absorption was less than 3 h. Conclusion: The developed LC-ESI (-)/MS/MS (QQQ) method was successfully applied to assess the pharmacokinetic parameters and oral bioavailability of ginkgolides in rats after administration of GBE, which can provide basis for further clinical efficacy studies.
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Ciclopentanos/farmacocinética , Furanos/farmacocinética , Ginkgo biloba/química , Ginkgólidos/farmacocinética , Extractos Vegetales/farmacocinética , Animales , Disponibilidad Biológica , Cromatografía Líquida de Alta Presión , Ciclopentanos/sangre , Furanos/sangre , Ginkgólidos/sangre , Masculino , Extractos Vegetales/química , Ratas , Espectrometría de Masa por Ionización de Electrospray , Espectrometría de Masas en TándemRESUMEN
UNLABELLED: Peramivir is an intravenous anti-influenza agent that inhibits viral growth by selectively inhibiting neuraminidase in human influenza A and B viruses. To characterize its pharmacokinetics, a population pharmacokinetic analysis of peramivir was performed using 3,199 plasma concentration data samples from 332 subjects in six clinical studies in Japan and the United States, including studies with renal impairment subjects, elderly subjects, and influenza patients. A three-compartment model well described the plasma concentration data for peramivir, and creatinine clearance was found to be the most important factor influencing clearance. Age and body weight were also found to be covariates for clearance and the volume of distribution, respectively. No difference in pharmacokinetics was found between genders or between Japanese and U.S. SUBJECTS: Small differences in pharmacokinetics were observed between uninfected subjects and influenza patients (clearance was 18% higher and the volume of distribution was 6% lower in influenza patients). Monte Carlo simulations indicated that single adjusted doses of 1/3- and 1/6-fold for patients with moderate and severe renal impairment, respectively, would give areas under the curve comparable to those for patients with normal renal function. The population pharmacokinetic model developed for peramivir should be useful for understanding its pharmacokinetic characteristics and for dose adjustment on the basis of renal function.
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Ciclopentanos/sangre , Ciclopentanos/farmacocinética , Guanidinas/sangre , Guanidinas/farmacocinética , Gripe Humana/sangre , Ácidos Carbocíclicos , Voluntarios Sanos , Humanos , Japón , Modelos Teóricos , Método de Montecarlo , Estados UnidosRESUMEN
AIM: Peramivir is a newly approved selective neuraminidase inhibitor designed to inhibit influenza virus infection. METHODOLOGY/RESULTS: We report a robust and sensitive method utilizing simple precipitation extraction with LC-MS/MS for the high-throughput quantification. Addition of 0.06 M of ammonium formate and 0.1% formic acid in mobile phase could help reduce the matrix effect. This method uses 100 µl of plasma and covers a linear concentration range from 5 to 10,000 ng/ml. Other validation parameters are also evaluated and meet regulatory expectations by US FDA guidelines. CONCLUSION: The developed HPLC-MS/MS method has been successfully applied to support a clinical pharmacokinetic study. The strategy presented here can be applied elsewhere and may be useful for other amphiphilic drugs.
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Métodos Analíticos de la Preparación de la Muestra/economía , Precipitación Química , Ciclopentanos/análisis , Ciclopentanos/aislamiento & purificación , Guanidinas/análisis , Guanidinas/aislamiento & purificación , Espectrometría de Masas en Tándem , Ácidos Carbocíclicos , Adulto , Cromatografía Liquida , Ciclopentanos/sangre , Ciclopentanos/farmacocinética , Guanidinas/sangre , Guanidinas/farmacocinética , Humanos , Masculino , Factores de TiempoRESUMEN
1.The aim of the study was to evaluate the pharmacokinetics of peramivir after single intravenous (i.v.) doses in healthy Chinese subjects. 2.In a cross-over study, 12 subjects were given 300 and 600 mg peramivir by i.v. infusion. Blood and urine samples were collected at 17 designated time points and 7 designated intervals up to 36 h post-dose. Plasma and urine concentrations of peramivir were quantified by LC-MS/MS. 3.After single i.v. doses of 300 and 600 mg peramivir, Cmax and AUC0-t of peramivir were 21.4 ± 3.7, 41.1 ± 5.3 mgcL(-1) and 55.90 ± 10.62, 112.1 ± 13.2 mgch L(-1), respectively. Cmax and AUC increased in proportion to the dose. Within 12 h, accumulative urinary recoveries of peramivir after single i.v. doses of 300 and 600 mg peramivir were 84.31 ± 11.75% and 88.10 ± 7.39%, respectively. 4.In healthy Chinese subjects, peramivir displayed linear pharmacokinetics in the range of 300-600 mg, and was primarily excreted via urine as unchanged drug.
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Pueblo Asiatico , Ciclopentanos/administración & dosificación , Ciclopentanos/farmacocinética , Guanidinas/administración & dosificación , Guanidinas/farmacocinética , Voluntarios Sanos , Ácidos Carbocíclicos , Administración Intravenosa , Adulto , China , Ciclopentanos/sangre , Ciclopentanos/química , Demografía , Relación Dosis-Respuesta a Droga , Femenino , Guanidinas/sangre , Guanidinas/química , Humanos , Masculino , Adulto JovenRESUMEN
The underlying mechanisms for the action of caramiphen used in local anesthesia are not well understood. The purpose of this study was to evaluate the block of caramiphen on voltage-gated Na⺠channels and in spinal anesthesia. We investigated the effect of caramiphen on voltage-gated sodium channels in differentiated neuronal NG108-15 cells as well as on rat motor function, proprioception, and pain behavior (when administered intrathecally). In in vitro experiments, lidocaine produced concentration- and state-dependent effects on tonic block of voltage-gated Na⺠currents (IC50 of 66.2 and 212.9 µM at holding potentials of -70 and -100 mV, respectively). Caramiphen exhibited a milder state-dependence of block (IC50 of 52.1 and 99.5 µM at holding potentials of -70 and -100 mV, respectively). Lidocaine showed a much stronger frequency-dependence of block than caramiphen: with high frequency stimulation (3.33 Hz), 50 µM caramiphen elicited an additional 20% blockade, whereas the same concentration of lidocaine produced 50% more block. In in vivo experiments, caramiphen with a more sensory-selective action over motor blockade was more potent than lidocaine (P<0.05) in spinal anesthesia. On an equipotent basis (25% effective dose (ED25), ED50, and ED75), the duration of caramiphen at producing spinal anesthesia was longer than that of lidocaine (P<0.01). Our data revealed that caramiphen had a more potent, prolonged spinal blockade with a more sensory/nociceptive-selective action over motor blockade in comparison with lidocaine. Spinal anesthesia with caramiphen could be through the suppression of voltage-gated Na⺠currents.
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Anestésicos Locales/farmacocinética , Ciclopentanos/farmacocinética , Proteínas del Tejido Nervioso/antagonistas & inhibidores , Neuronas/efectos de los fármacos , Bloqueadores del Canal de Sodio Activado por Voltaje/farmacocinética , Canales de Sodio Activados por Voltaje/metabolismo , Anestesia Raquidea , Anestésicos Locales/administración & dosificación , Anestésicos Locales/sangre , Anestésicos Locales/farmacología , Animales , Conducta Animal/efectos de los fármacos , Línea Celular , Ciclopentanos/administración & dosificación , Ciclopentanos/sangre , Ciclopentanos/farmacología , Relación Dosis-Respuesta a Droga , Humanos , Inyecciones Espinales , Masculino , Potenciales de la Membrana/efectos de los fármacos , Ratones , Actividad Motora/efectos de los fármacos , Proteínas del Tejido Nervioso/metabolismo , Neuronas/metabolismo , Nocicepción/efectos de los fármacos , Técnicas de Placa-Clamp , Ratas Sprague-Dawley , Bloqueadores del Canal de Sodio Activado por Voltaje/administración & dosificación , Bloqueadores del Canal de Sodio Activado por Voltaje/sangre , Bloqueadores del Canal de Sodio Activado por Voltaje/farmacología , Canales de Sodio Activados por Voltaje/químicaRESUMEN
Peramivir is a novel influenza neuraminidase inhibitor used for anti-influenza. In this article, a novel method was developed to determine peramivir in dog plasma using a derivatization treatment step to increase the retention time and enhance the signal intensity. The sample preparation consisted of a protein precipitation extraction followed by derivatization with 10M hydrochloric acid-methanol (10:90, v/v) and determined by liquid chromatography coupled with tandem mass spectrometry. The selected reaction monitoring mode of the positive ion was performed and the precursor to the product ion transitions of m/z 343â284 and m/z 299â152 were used to measure the derivative of peramivir and Ro 64-0802 (internal standard, an active metabolite of oseltamivir). The chromatographic separation was achieved using a ZORBAX RX-C8 (2.0mm×150mm×5µm) analytical column with an isocratic mobile phase composed of acetonitrile-water-formic acid (30:70:0.1, v/v/v, 0.2mL/min). The method was linear over a concentration range of 0.25-250ng/mL. The average intra-day/inter-day precision values were 4.04-8.17% and 3.02-7.08%, respectively, while the average accuracy value was 93.99-106.48%. This method has been successfully applied to the preclinical dog research of peramivir following intragastric administration.
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Cromatografía Liquida/métodos , Ciclopentanos/sangre , Guanidinas/sangre , Espectrometría de Masas en Tándem/métodos , Ácidos Carbocíclicos , Animales , Ciclopentanos/química , Ciclopentanos/farmacocinética , Perros , Estabilidad de Medicamentos , Esterificación , Guanidinas/química , Guanidinas/farmacocinética , Análisis de los Mínimos Cuadrados , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
Equine influenza A virus (EIV) of the H3N8 subtype is an important pathogen causing acute respiratory disease in horses. Peramivir is a selective inhibitor of the influenza virus neuraminidase (NA). The characteristics of peramivir are not only its capacity for parenteral administration, but also its strong affinity for NA and slow off-rate from the NA-peramivir complex, suggesting that it could lead to a prolonged inhibitory effect and thus allow a lower dosing frequency. The aims of this study were to evaluate the inhibitory efficacy of peramivir against the NA activities of EIV in vitro and the treatment efficacy of a single intravenous dose of peramivir in horses experimentally infected with EIV. Peramivir inhibited the activities of NA from the seven contemporary EIV strains in vitro, with 50% inhibitory concentrations ranging from 0.10 to 0.20 nmol/L. Horses treated with a single IV dose of peramivir (3,000 mg/600 mL/animal, 7.8-9.3mg/kg of bodyweight) showed significantly milder clinical signs (pyrexia, nasal discharge and cough) with a shorter duration than control horses injected with normal saline. Moreover, the mean duration of virus shedding for the horses treated with peramivir was significantly shorter than for the control horses. These findings suggested that a single IV administration of peramivir had good potential for the treatment of equine influenza, and may help to limit the spread of the disease in the horse population.
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Antivirales/uso terapéutico , Ciclopentanos/uso terapéutico , Guanidinas/uso terapéutico , Enfermedades de los Caballos/tratamiento farmacológico , Subtipo H3N8 del Virus de la Influenza A/efectos de los fármacos , Infecciones por Orthomyxoviridae/veterinaria , Ácidos Carbocíclicos , Animales , Antivirales/sangre , Cromatografía Liquida/veterinaria , Ciclopentanos/sangre , Guanidinas/sangre , Enfermedades de los Caballos/virología , Caballos , Inyecciones Intravenosas/veterinaria , Neuraminidasa/antagonistas & inhibidores , Infecciones por Orthomyxoviridae/tratamiento farmacológico , Infecciones por Orthomyxoviridae/virología , Espectrometría de Masas en Tándem/veterinariaRESUMEN
STUDY OBJECTIVE: To determine the pharmacokinetics of intravenous peramivir-an investigational neuraminidase inhibitor for the treatment of 2009 H1N1 infection or nonsubtypable influenza A thought to be the 2009 H1N1 virus-in patients concurrently receiving continuous renal replacement therapy (CRRT). DESIGN: Pharmacokinetic analysis. SETTING: Critical care unit at a university-affiliated hospital. PATIENTS: Two critically ill women with 2009 H1N1 influenza A treated with compassionate-use intravenous peramivir administered as a daily infusion of 600 mg over 30 minutes while receiving continuous venovenous hemodiafiltration (CVVHDF), a form of CRRT. MEASUREMENTS AND MAIN RESULTS: Plasma samples were collected from the two patients before and 30 minutes after the fourth (first patient) and ninth (second patient) peramivir infusion to estimate minimum (C(min)) and maximum (C(max)) plasma concentrations, respectively. Two additional postinfusion concentrations were measured from each patient to estimate noncompartmental pharmacokinetic parameters of peramivir while receiving CVVHDF. In the two patients, respectively, C(min) was 2170 and 251 ng/ml, C(max) was 18,400 and 20,300 ng/ml, area under the plasma concentration-time curve from 0-24 hours (AUC(0-24)) was 178,000 and 94,400 ng·hour/ml, drug clearance was 56 and 106 ml/minutes, and plasma half-life was 7.6 and 3.7 hours. The volume of distribution adjusted for ideal body weight at steady state was 0.51 and 0.54 L/kg, respectively. CONCLUSION: The first patient had a slower peramivir plasma clearance compared with the second patient, but both patients had higher peramivir clearances as calculated from AUC(0-24) than those predicted by CRRT. Thus, the dosage of intravenous peramivir was appropriate in these patients. Additional pharmacokinetic data are needed to confirm these results and help guide dosing in patients receiving various forms of CRRT.
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Ciclopentanos/farmacocinética , Guanidinas/farmacocinética , Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/tratamiento farmacológico , Neuraminidasa/farmacocinética , Terapia de Reemplazo Renal , Ácidos Carbocíclicos , Adulto , Área Bajo la Curva , Ensayos de Uso Compasivo , Ciclopentanos/sangre , Femenino , Guanidinas/sangre , Semivida , Humanos , Neuraminidasa/antagonistas & inhibidores , Neuraminidasa/sangre , Adulto JovenRESUMEN
A sensitive and specific liquid chromatography-electrospray ionization-mass spectrometry method for the identification and quantification of pentoxyverine citrate and guaifenesin in human plasma has been developed. After extraction from plasma samples by ethyl acetate, the internal standard and analytes were separated by high-performance liquid chromatographic on a Shim-pack VP-ODS C(18) column (150 x 2.0 mm) using a mobile phase consisting of A (methanol) and B (0.4% glacial acetic acid and 4 mmol/L ammonium acetate) (A:B, 43 : 57). Analysis was performed on a Shimadzu LC/MS-2010A in selected ion monitoring mode with a positive electrospray ionization interface. The method was linear in the concentration range of 1.0-640.0 ng/mL for pentoxyverine citrate and 0.025-6.4 microg/mL for guaifenesin. The inter- and intra- precision were all within 12% and accuracy ranged from 85 to 115%.The lower limits of quantification were 1.0 ng/mL for pentoxyverine citrate and 25.0 ng/mL for guaifenesin. The extraction recovery was on average 81.95% for pentoxyverine citrate and 89.03% for guaifenesin. This is the first assay method reported for the simultaneous determination of pentoxyverine citrate and guaifenesin in plasma using one chromatographic run.
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Cromatografía Líquida de Alta Presión/métodos , Ciclopentanos/sangre , Expectorantes/farmacocinética , Guaifenesina/farmacocinética , Espectrometría de Masa por Ionización de Electrospray/métodos , Ciclopentanos/química , Ciclopentanos/farmacocinética , Estabilidad de Medicamentos , Expectorantes/análisis , Expectorantes/química , Guaifenesina/análisis , Guaifenesina/química , Humanos , Modelos Lineales , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Equivalencia TerapéuticaRESUMEN
Standardized extracts of Ginkgo biloba L. leaves are widely used in clinical practice for the symptomatic treatment of mild to moderate dementia syndromes, cerebral insufficiency and for the enhancement of cognitive function. The main active components present in G. biloba extracts are flavonol-glycosides and terpene-lactones. In recent investigations, the sesquiterpene trilactone bilobalide has been described to exert an interesting neuroprotective effect when administered systemically to experimental animals. Oral administration of terpene-lactones either as standardized extracts or purified products is characterized by a low bioavailability. While preparing phospholipidic complex of G. biloba extracts or bilobalide, plasma levels of terpenes and sesquiterpene increase. In the present study, phospholipidic complex of bilobalide (IDN 5604) has been administered orally to rats and bilobalide levels have been determined in plasma and brain by means of a validated method based on liquid chromatography coupled to atmospheric pressure chemical ionization ion trap mass spectrometry (LC/APCI-ITMS). Due to its sensitivity (about 3pmol/ml) and specificity, LC/APCI-ITMS method proved to be a very powerful tool for pharmacokinetic studies of Ginkgo terpene-lactones. The results of the present study clearly confirm the improvement of oral bioavailability of bilobalide administered as phospholipidic complex and, for the first time, demonstrate the detection of significative amounts of bilobalide in brain. This last finding agrees with the neuroprotective activity observed for bilobalide.
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Encéfalo/metabolismo , Ciclopentanos/metabolismo , Furanos/metabolismo , Ginkgólidos/metabolismo , Espectrometría de Masas/métodos , Fosfolípidos/administración & dosificación , Administración Oral , Animales , Presión Atmosférica , Disponibilidad Biológica , Calibración , Ciclopentanos/administración & dosificación , Ciclopentanos/sangre , Furanos/administración & dosificación , Furanos/sangre , Ginkgólidos/administración & dosificación , Ginkgólidos/sangre , Masculino , Ratas , Estándares de ReferenciaRESUMEN
Diabetic neuropathic pain remains an unmet clinical problem and is poorly relieved by conventional analgesics. N-methyl-D-aspartate (NMDA) receptors play an important role in central sensitization in neuropathic pain. Although NMDA antagonists are highly effective in reducing neuropathic pain, these agents cause severe side effects at therapeutic doses, which limit their clinical uses. Neramexane and memantine are uncompetitive NMDA antagonists with minimal side effects at therapeutic doses. Here we determined the antinociceptive effect of chronic administration of neramexane and compared its effect with that of memantine and gabapentin in a rat model of diabetic neuropathic pain. Mechanical hyperalgesia was measured with a noxious pressure stimulus, and tactile allodynia was assessed with von Frey filaments in diabetic rats induced by streptozotocin. Compared with vehicle-treated rats, treatment with neramexane (12.3, 24.6, and 49.2 mg/kg/day) for 2 weeks via an osmotic minipump produced dose-dependent and sustained effects on mechanical hyperalgesia and allodynia. Administration of memantine (20 mg/kg/day) or gabapentin (50 mg/kg/day) for 2 weeks also produced significant and persistent antinociceptive effects on mechanical hyperalgesia and allodynia. The magnitude of the antinociceptive effect produced by the intermediate and high doses of neramexane was comparable to that of gabapentin and memantine. The plasma level achieved by neramexane at 12.3, 24.6, and 49.2 mg/kg/day was 0.26 +/- 0.04, 0.50 +/- 0.05, and 1.21 +/- 0.16 microM, respectively. These data suggest that neramexane at therapeutically relevant doses attenuates diabetic neuropathic pain. Our study provides valuable information about the therapeutic potential of chronic administration of neramexane and memantine for painful diabetic neuropathy.
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Analgésicos/farmacología , Neuropatías Diabéticas/tratamiento farmacológico , Antagonistas de Aminoácidos Excitadores/uso terapéutico , Dolor/tratamiento farmacológico , Receptores de N-Metil-D-Aspartato/antagonistas & inhibidores , Aminas/sangre , Aminas/farmacología , Aminas/uso terapéutico , Analgésicos/sangre , Analgésicos/uso terapéutico , Animales , Ácidos Ciclohexanocarboxílicos/sangre , Ácidos Ciclohexanocarboxílicos/farmacología , Ácidos Ciclohexanocarboxílicos/uso terapéutico , Ciclopentanos/sangre , Ciclopentanos/farmacología , Ciclopentanos/uso terapéutico , Diabetes Mellitus Experimental/complicaciones , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Antagonistas de Aminoácidos Excitadores/sangre , Antagonistas de Aminoácidos Excitadores/farmacología , Gabapentina , Masculino , Memantina/sangre , Memantina/farmacología , Memantina/uso terapéutico , Dimensión del Dolor , Estimulación Física , Ratas , Ratas Sprague-Dawley , Estreptozocina , Factores de Tiempo , Ácido gamma-Aminobutírico/sangre , Ácido gamma-Aminobutírico/farmacología , Ácido gamma-Aminobutírico/uso terapéuticoRESUMEN
Peramivir is a novel influenza neuraminidase inhibitor. In this article, hydrophilic interaction chromatography coupled with tandem mass spectrometry was developed to determine peramivir in human plasma. The positive ion MRM mode was performed and the precursor to the product ion transitions of m/z 329-->100 and 285-->138 were used to measure peramivir and Ro 64-0802 (I.S.). Chromatographic separation was performed on an Amide-80 column with acetonitrile-water-formic acid (70:30:0.1, v/v/v, 0.5mL/min). The method was linear over a concentration range of 10-10,000ng/mL. The average inter-day/intra-day precision values were 3.7+/-1.8% and 4.3+/-1.8%, respectively, while the accuracy values were 97.0+/-4.8%. This method has been successfully applied to Phase I of clinical research of peramivir.
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Antivirales/sangre , Cromatografía Líquida de Alta Presión/métodos , Ciclopentanos/sangre , Guanidinas/sangre , Espectrometría de Masas en Tándem/métodos , Ácidos Carbocíclicos , Antivirales/farmacocinética , Ciclopentanos/farmacocinética , Guanidinas/farmacocinética , Humanos , Sensibilidad y EspecificidadRESUMEN
A rapid and sensitive liquid chromatography-electrospray ionization-mass spectrometry (LC-ESI/ MS) method for quantification of pentoxyverine citrate in human plasma has been developed and applied for the bioequivalence and pharmacokinetics study. After extracted from plasma samples with ethyl acetate, analysis was performed in selected ion monitoring (SIM) mode with a positive electrospray ionization (ESI) interface with a mobile phase consisted of methanol and water (0.4% glacial acetic acid and 4 mmol x L(-1) ammonium acetate, 43 : 57, v/v). The linear concentration range of the calibration curves was 1.0-160.0 ng x mL(-1) for pentoxyverine citrate, inter- and intra-precision (RSD) was less than 12.5%, accuracy (RE) was in +/- 13.5% and absolute recovery was more than 80%. The method was proved simple, rapid, sensitive, specific and suitable for pharmacokinetic and bioequivalence study of Yufenweilin capsule containing pentoxyverine citrate.
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Cromatografía Liquida/métodos , Ciclopentanos/sangre , Espectrometría de Masa por Ionización de Electrospray/métodos , Ciclopentanos/farmacocinética , Humanos , Masculino , Sensibilidad y Especificidad , Equivalencia TerapéuticaRESUMEN
An assay for the analysis for the quantification of the anti-influenza drug peramivir in human plasma using high-throughput zwitterionic (ZIC) hydrophilic interaction liquid chromatography (HILIC) solid-phase extraction (SPE) in a 96-wellplate format and liquid chromatography coupled to positive tandem mass spectroscopy has been developed and validated. The ZIC-HILIC SPE efficiently removed sources of interference present in the supernatant after protein precipitation of plasma proteins. The main advantage of the ZIC-HILIC SPE sample preparation step was that it allowed load and elution conditions to be optimised to extract only peramivir and minimize co-extraction of lipophilic phospholipids. The method was validated according to published US Food and Drugs Administration guidelines and showed excellent performance. The assay was validated over two calibration ranges (0.952-500 and 50-50,000 ng/mL) to support analysis of peramivir after intra-venous administration. The lower limit of quantification for peramivir in plasma was 1 ng/mL and the upper limit of quantification was 50,000 ng/mL. The within-day and between-day precisions expressed as RSD, were lower than 8% at all tested quality control concentrations and below 11% at the lower limit of quantification. Validation of over-curve samples ensured that it would be possible with dilution if samples went outside the calibration range.
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Antivirales/sangre , Cromatografía Liquida/métodos , Ciclopentanos/sangre , Guanidinas/sangre , Espectrometría de Masas en Tándem/métodos , Ácidos Carbocíclicos , Humanos , Estándares de Referencia , Reproducibilidad de los ResultadosRESUMEN
A new liquid chromatography tandem mass spectrometry (LC-MS/MS) method for the simultaneous determination of ginkgolides (includes ginkgolide C for the first time) and bilobalide in plasma is presented. Ketoprofen was used as an internal standard, and sample pre-treatment consisted of a liquid-liquid extraction. Chromatographic separation was achieved on a 5 microm Shiseido C8 column (150 mm x 2.0 mm i.d., particle size 5 microm) with a mobile phase consisting of methanol/ 6 mM ammonium acetate (60/40, v/v) at a flow rate of 0.3 ml/min. A tandem mass spectrometric detection was conducted using multiple reaction monitoring (MRM) under negative ionization mode with an atmospheric pressure chemical ionization (APCI) interface. The method was validated in terms of intra- and inter-day precision (<12.7%), accuracy (within +/- 7.0%), linearity, specificity and stability. In addition, matrix effects of ginkgolides and bilobalide in plasma were evaluated in different reconstitution solvents. Smaller matrix effects were observed for reconstitution solvents containing less organic solvent. The method has been successfully applied to a pharmacokinetic study of Ginkgo biloba extract in rats after intravenous administration. This is the first report of pharmacokinetic data for ginkgolide C.