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1.
Mol Pharm ; 21(5): 2512-2533, 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38602861

RESUMO

Parkinson's disease (PD) is a debilitating neurodegenerative disease primarily impacting neurons responsible for dopamine production within the brain. Pramipexole (PRA) is a dopamine agonist that is currently available in tablet form. However, individuals with PD commonly encounter difficulties with swallowing and gastrointestinal motility, making oral formulations less preferable. Microneedle (MN) patches represent innovative transdermal drug delivery devices capable of enhancing skin permeability through the creation of microconduits on the surface of the skin. MNs effectively reduce the barrier function of skin and facilitate the permeation of drugs. The work described here focuses on the development of polymeric MN systems designed to enhance the transdermal delivery of PRA. PRA was formulated into both dissolving MNs (DMNs) and directly compressed tablets (DCTs) to be used in conjunction with hydrogel-forming MNs (HFMNs). In vivo investigations using a Sprague-Dawley rat model examined, for the first time, if it was beneficial to prolong the application of DMNs and HFMNs beyond 24 h. Half of the patches in the MN cohorts were left in place for 24 h, whereas the other half remained in place for 5 days. Throughout the entire 5 day study, PRA plasma levels were monitored for all cohorts. This study confirmed the successful delivery of PRA from DMNs (Cmax = 511.00 ± 277.24 ng/mL, Tmax = 4 h) and HFMNs (Cmax = 328.30 ± 98.04 ng/mL, Tmax = 24 h). Notably, both types of MNs achieved sustained PRA plasma levels over a 5 day period. In contrast, following oral administration, PRA remained detectable in plasma for only 48 h, achieving a Cmax of 159.32 ± 113.43 ng/mL at 2 h. The HFMN that remained in place for 5 days demonstrated the most promising performance among all investigated formulations. Although in the early stages of development, the findings reported here offer a hopeful alternative to orally administered PRA. The sustained plasma profile observed here has the potential to reduce the frequency of PRA administration, potentially enhancing patient compliance and ultimately improving their quality of life. This work provides substantial evidence advocating the development of polymeric MN-mediated drug delivery systems to include sustained plasma levels of hydrophilic pharmaceuticals.


Assuntos
Administração Cutânea , Sistemas de Liberação de Medicamentos , Agulhas , Doença de Parkinson , Pramipexol , Ratos Sprague-Dawley , Pramipexol/administração & dosagem , Pramipexol/farmacocinética , Animais , Ratos , Doença de Parkinson/tratamento farmacológico , Sistemas de Liberação de Medicamentos/métodos , Masculino , Absorção Cutânea/efeitos dos fármacos , Pele/metabolismo , Pele/efeitos dos fármacos , Antiparkinsonianos/administração & dosagem , Antiparkinsonianos/farmacocinética , Agonistas de Dopamina/administração & dosagem , Agonistas de Dopamina/farmacocinética , Hidrogéis/química
2.
Parkinsonism Relat Disord ; 123: 106560, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38518544

RESUMO

BACKGROUND: This study aimed to verify whether the combined use of Da Dingfengzhu and Western medicine in treating Parkinson's disease (PD) can lead to therapeutic efficacy and symptom alleviation, thereby achieving a complementary and synergistic effect. METHODS: In this study, 158 patients were initially enrolled, with 116 eligible patients randomly divided into a control and an observation group. The control group received levodopa/benserazide and pramipexole, while the observation group received Da Dingfengzhu combined with levodopa/benserazide and pramipexole for 12 weeks. Baseline patient characteristics, adverse reactions, and blood samples were collected at baseline and 12 weeks post-treatment. The Unified Parkinson's Disease Rating Scale (UPDRS) was used to assess symptom severity at baseline, four weeks into treatment, and 12 weeks post-treatment. RESULTS: Adverse reactions during treatment were similar in both groups, suggesting that the combined therapy in the observation group did not increase adverse effects. Both groups showed improvements in UPDRS scores, with the observation group displaying more significant symptom alleviation at 4 and 12 weeks. Moreover, the observation group exhibited more pronounced increases in serum neurotrophic factor-3 and dopamine levels and greater reductions in oxidative stress and inflammatory response markers. CONCLUSION: In conclusion, the combination of Da Dingfengzhu with levodopa/benserazide and pramipexole for treating PD shows significant clinical potential and is worthy of broader application.


Assuntos
Antiparkinsonianos , Benserazida , Medicamentos de Ervas Chinesas , Levodopa , Doença de Parkinson , Pramipexol , Deficiência da Energia Yin , Humanos , Doença de Parkinson/tratamento farmacológico , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Benserazida/farmacologia , Benserazida/administração & dosagem , Levodopa/administração & dosagem , Levodopa/farmacologia , Levodopa/efeitos adversos , Pramipexol/farmacologia , Pramipexol/administração & dosagem , Antiparkinsonianos/administração & dosagem , Medicamentos de Ervas Chinesas/administração & dosagem , Deficiência da Energia Yin/tratamento farmacológico , Combinação de Medicamentos , Quimioterapia Combinada , Avaliação de Resultados em Cuidados de Saúde
3.
Pharm Res ; 38(7): 1187-1198, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34136986

RESUMO

PURPOSE: Pulsed direct current (PDC) iontophoresis, by allowing skin depolarization, was suggested to provide more efficient ion transport, but the extent of its enhancement effect was unclear. PDC could also offer electric-customized drug delivery. This study examined the effect of PDC iontophoresis on transdermal delivery of pramipexole dihydrochloride (PXCl). METHODS: Iontophoretic delivery of PXCl across human epidermal membrane from pH 7.0 solution was conducted in vitro using continuous direct current (DC) and 6- and 12-cycle PDC iontophoresis (0.5 mA/cm2 and total applied duration of 6 h). Different parameters of PDC iontophoresis were studied, including current density (0.1, 0.2 and 0.5 mA/cm2) and on-off current dosing pattern (1 h/3 h, 0.5 h/3.5 h, and 0.2 h/3.8 h). RESULTS: Both 6- and 12-cycle PDC iontophoresis protocols provided modulation of the permeation profile but delivered smaller amounts of PXCl (396 and 400 µg/cm2, respectively) as compared with continuous DC iontophoresis (482 µg/cm2) at 24 h after 0.5 mA/cm2 and 180 mA/cm2 × min current dose application. Increasing applied current density from 0.1 to 0.5 mA/cm2 increased the PDC iontophoretic flux of PXCl linearly from 5.3 to 14.6 µg/cm2·h (R2 = 0.887). Varying the current level and duration but at the same applied current dose (36 mA/cm2 × min), the total amount of PXCl delivered by PDC iontophoresis at 24 h was independent of the on-off dosing pattern studied (114-128 µg/cm2). CONCLUSIONS: The results indicate that PDC iontophoresis can benefit transdermal delivery of PXCl in terms of controlling its permeation but does not enhance iontophoretic transport compared to continuous DC iontophoresis under the conditions studied.


Assuntos
Epiderme/metabolismo , Iontoforese/métodos , Pramipexol/farmacocinética , Administração Cutânea , Adulto , Idoso , Feminino , Humanos , Concentração de Íons de Hidrogênio , Pessoa de Meia-Idade , Pramipexol/administração & dosagem , Pramipexol/química , Absorção Cutânea , Adulto Jovem
4.
Naunyn Schmiedebergs Arch Pharmacol ; 394(9): 1893-1905, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33959780

RESUMO

The purpose of this research was to evaluate the clinical efficacy and safety of pramipexole plus levodopa/benserazide (P+LB) combination therapy in the treatment of Parkinson's disease (PD) compared to that of LB monotherapy, in order to confer a reference for clinical practice. Randomized controlled trials (RCTs) of P+LB for PD published up to April 2020 were retrieved. Heterogeneity and sensitivity analysis were executed. Twenty-nine RCTs with 3017 participants were included. Clinical efficacy of P+LB combination therapy was significantly better than LB monotherapy (RR 1.27, 95% CI 1.22 to 1.32, P<0.00001). Compared with LB monotherapy, the pooled effects of P+LB combination therapy on UPDRS score were (SMD -1.41, 95% CI -1.71 to -1.11, P<0.00001) for motor UPDRS score, (SMD -1.65, 95% CI -2.25 to -1.04, P<0.00001) for activities of daily living UPDRS score, (SMD -2.20, 95% CI -3.32 to -1.09, P=0.0001) for mental UPDRS score, and (SMD -1.60, 95% CI -2.06 to -1.15, P<0.00001) for complication UPDRS score. The HAMD score showed significant decrease in the P+LB combination therapy compared to LB monotherapy (SMD -1.32, 95% CI -1.80 to -0.84, P<0.00001). In contrast to LB monotherapy, P+LB combination therapy decreased the number of any adverse events obviously in PD patients (RR 0.53, 95% CI 0.45 to 0.63, P<0.00001). In conclusion, P+LB combination therapy is superior to LB monotherapy for improvement of clinical symptoms in PD patients. Moreover, the safety profile of P+LB combination therapy is better than that of LB monotherapy. Further well-designed, multi-center RCTs needed to identify these findings.


Assuntos
Benserazida/administração & dosagem , Levodopa/administração & dosagem , Doença de Parkinson/tratamento farmacológico , Pramipexol/administração & dosagem , Antiparkinsonianos/administração & dosagem , Antiparkinsonianos/farmacologia , Benserazida/farmacologia , Combinação de Medicamentos , Quimioterapia Combinada , Humanos , Levodopa/farmacologia , Pramipexol/farmacologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
5.
J Clin Psychopharmacol ; 41(4): 421-427, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33956703

RESUMO

BACKGROUND: Adults with bipolar disorder (BD) often experience neurocognitive impairment that negatively impacts functioning and quality of life. Previous trials have found that dopamine agonist agents improve cognition in healthy volunteers and that adults with BD who have stable mood and mild cognitive deficits may also benefit. We hypothesized that pramipexole, a dopamine agonist, would improve neurocognitive function in patients with BD. METHODS: We recruited 60 adults (aged 18-65 years) with a diagnosis of BD I or II for an 8-week, double-blind, placebo-controlled trial (NCT02397837). All had stable mood and clinically significant neurocognitive impairment at baseline. Participants were randomized to receive pramipexole (n = 31) or a placebo (n = 29), dose was initiated at 0.125 mg 2 times a day and increased to a target of 4.5 mg/d. RESULTS: At trial end, the primary outcome, MATRICS Consensus Cognitive Battery composite score, had not improved more in the pramipexole group (mean [SD] = 1.15 [5.4]) than in the placebo group (mean [SD] = 4.12 [5.2], Cohen's d = 0.56, P = 0.049), and mixed models, controlling for symptoms, showed no association between treatment group and MATRICS Consensus Cognitive Battery scores. No serious adverse events were reported. CONCLUSIONS: These results suggest that pramipexole is not an efficacious cognitive enhancement agent in BD, even in a sample enriched for characteristics that were associated with a beneficial response in prior work. There are distinct cognitive subgroups among adults with BD and may be related differences in neurobiology that affect response to pramipexole. Additional research to better understand the onset and nature of the cognitive deficits in people with BD will be an important step toward a more personalized approach to treatment.


Assuntos
Transtorno Bipolar , Cognição/efeitos dos fármacos , Transtornos Neurocognitivos , Pramipexol , Qualidade de Vida , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/tratamento farmacológico , Transtorno Bipolar/psicologia , Agonistas de Dopamina/administração & dosagem , Agonistas de Dopamina/efeitos adversos , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Neurocognitivos/diagnóstico , Transtornos Neurocognitivos/tratamento farmacológico , Transtornos Neurocognitivos/etiologia , Testes Neuropsicológicos , Pramipexol/administração & dosagem , Pramipexol/efeitos adversos , Resultado do Tratamento
6.
Pharm Res ; 38(4): 657-668, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33826056

RESUMO

PURPOSE: Drugs with higher molecular charges generally show higher flux enhancement when electromigration is the main mechanism in transdermal iontophoresis. This study evaluated the effect of decreasing the formulation pH to increase the positive charges of pramipexole dihydrochloride (PXCl) on its iontophoretic transport across skin. METHODS: In vitro transdermal iontophoresis of PXCl in buffer solution isotonized with either sodium chloride or mannitol were performed in a pH range of 3.0-7.0. Experiments of iontophoresis under symmetric condition with respect to donor and receiver pH and passive transport of the drugs after pretreatment with iontophoresis were conducted to investigate the transport mechanism involved. RESULTS: Iontophoretic permeation of PXCl was pH-dependent in drug solution isotonized with mannitol. The iontophoretic flux of PXCl with valence z = +2 at pH 3.0 was half of that of PXCl with z = +1 at pH 7.0. The results suggest that the decrease in PXCl delivery at higher valence at pH 3 was mainly due to pH-dependent selectivity of PX ion permeation across the skin and not electroosmosis. CONCLUSIONS: Skin permselectivity is a significant factor for iontophoretic transport of PXCl, and reducing formulation pH to increase the positive charges on PX ions did not enhance PXCl delivery.


Assuntos
Agonistas de Dopamina/farmacocinética , Epiderme/metabolismo , Iontoforese , Pramipexol/farmacocinética , Administração Cutânea , Adulto , Idoso , Agonistas de Dopamina/administração & dosagem , Agonistas de Dopamina/química , Eletro-Osmose , Epiderme/química , Feminino , Humanos , Concentração de Íons de Hidrogênio , Adesão à Medicação , Pessoa de Meia-Idade , Doença de Parkinson/tratamento farmacológico , Pramipexol/administração & dosagem , Pramipexol/química , Absorção Cutânea , Adulto Jovem
7.
Neurochem Int ; 146: 104972, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33493581

RESUMO

BACKGROUND: Parkinson's disease is a common neurodegenerative problem. Pramipexole (PPX) plays protective role in Parkinson's disease. Nevertheless, the mechanism of PPX in Parkinson's disease-like neuronal injury is largely uncertain. METHODS: 1-methyl-4-phenylpyridinium (MPP+)-stimulated neuronal cells and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced mice were used as the model of Parkinson's disease. MPP+-induced neuronal injury was assessed via cell viability, lactic dehydrogenase (LDH) release and apoptosis. microRNA-96 (miR-96) and BCL2/adenovirus E1B 19 kDa interacting protein 3 (BNIP3) abundances were examined by quantitative reverse transcription polymerase chain reaction (qRT-PCR) or Western blotting. Mitophagy was tested by Western blotting and immunofluorescence staining. MPTP-induced neuronal injury in mice was investigated via behavioral tests and TUNEL. RESULTS: PPX alleviated MPP+-induced neuronal injury via increasing cell viability and decreasing LDH release and apoptosis. PPX reversed MPP+-induced miR-96 expression and inhibition of mitophagy. miR-96 overexpression or BNIP3 interference weakened the suppressive role of PPX in MPP+-induced neuronal injury. miR-96 targeted BNIP3 to inhibit PTEN-induced putative kinase 1 (PINK1)/Parkin signals-mediated mitophagy. miR-96 overexpression promoted MPP+-induced neuronal injury via decreasing BNIP3. PPX weakened MPTP-induced neuronal injury in mice via regulating miR-96/BNIP3-mediated mitophagy. CONCLUSION: PPX mitigated neuronal injury in MPP+-induced cells and MPTP-induced mice by activating BNIP3-mediated mitophagy via directly decreasing miR-96.


Assuntos
Antiparkinsonianos/administração & dosagem , Proteínas de Membrana/metabolismo , MicroRNAs/metabolismo , Proteínas Mitocondriais/metabolismo , Mitofagia/efeitos dos fármacos , Transtornos Parkinsonianos/metabolismo , Pramipexol/administração & dosagem , Animais , Linhagem Celular Tumoral , Relação Dose-Resposta a Droga , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , MicroRNAs/antagonistas & inibidores , Mitofagia/fisiologia , Neurônios/efeitos dos fármacos , Neurônios/metabolismo , Transtornos Parkinsonianos/induzido quimicamente , Transtornos Parkinsonianos/tratamento farmacológico
8.
J Clin Neurosci ; 79: 219-223, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33070900

RESUMO

INTRODUCTION: Several treatment strategies have been claimed for Parkinson's disease (PD) so far. However, there remains controversies over the best possible treatment. The aim of this study is to compare Levodopa monotherapy versus Pramipexole in combination with Levodopa L in patients with PD with regards to the efficacy and side effects. METHODS: Patients being treated with levodopa alone and Pramipexole add-on therapy to Levodopa were enrolled in the study. Factors regarding efficacy and side effects were assessed and analyzed between both groups by appropriate tests. RESULTS: 176 Patients were enrolled in the study. Results showed significant higher total MDS-UPDRS (worse total disease severity score) among patients being treated with Pramipexole add-on therapy which was particularly higher in parts 1 (Mentation, behavior and mood), 2 (Activity of daily living) and 3 (Motor examination) (P-values < 0.05). Psychosis global score with significantly higher frequency of hallucination and depression, statistically higher in combination therapy group compared to Levodopa monotherapy group (P-value < 0.05). Patients in the Pramipexole add-on group reported lower scores of Health-related quality of life (HRQoL) (P-value < 0.05). Significant correlation was between disease duration and psychosis score among Levodopa monotherapy group (P-value < 0.05). CONCLUSIONS: Compared to Levodopa monotherapy, Add-on therapy with Pramipexole shows less efficiency yet more side effects. This indicates that single administration of Levodopa still remains the best available treatment for Parkinson's disease.


Assuntos
Antiparkinsonianos/efeitos adversos , Benzotiazóis/efeitos adversos , Alucinações/epidemiologia , Levodopa/efeitos adversos , Doença de Parkinson/tratamento farmacológico , Pramipexol/efeitos adversos , Transtornos Psicóticos/epidemiologia , Idoso , Antiparkinsonianos/administração & dosagem , Antiparkinsonianos/uso terapêutico , Benzotiazóis/administração & dosagem , Benzotiazóis/uso terapêutico , Depressão/epidemiologia , Depressão/etiologia , Combinação de Medicamentos , Feminino , Alucinações/etiologia , Humanos , Levodopa/administração & dosagem , Levodopa/uso terapêutico , Pessoa de Meia-Idade , Movimento , Pramipexol/administração & dosagem , Pramipexol/uso terapêutico , Transtornos Psicóticos/etiologia , Qualidade de Vida
9.
J Neuroimmunol ; 347: 577328, 2020 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-32721557

RESUMO

Parkinson's disease (PD), the second most frequent neurodegenerative disease, has been linked to increased central and peripheral inflammation. Although the response of the immune system to dopaminergic treatment remains to be fully understood, dopaminergic agonists are known to exhibit immunoregulatory properties which may, at least in part, explain their therapeutic effect in PD. This highlights the need of analyzing immune parameters in longitudinal studies on PD patients receiving specific therapeutic regimes. In this work, PD patients were included in a two-year prospective study comparing the effect of levodopa alone and a levodopa/pramipexole combo therapy on several regulatory and pro-inflammatory immune cell populations. We demonstrated that PD patients show decreased circulating levels of several important regulatory subpopulations, as determined by flow cytometry. Notably, when administered alone, levodopa decreased the levels of functional Bregs and SLAMF1+ tolerogenic DCs and increased the levels of total and HLA-DR+ classical monocytes, while the pramipexole/levodopa combo may promote Treg- and tolerogenic DC-mediated regulatory responses. These results suggest that a regime based on levodopa alone may promote a pro-inflammatory-type response in PD patients, but when combined with pramipexole, it promotes a clinically beneficial regulatory-type environment.


Assuntos
Antiparkinsonianos/administração & dosagem , Fatores Imunológicos/administração & dosagem , Levodopa/administração & dosagem , Doença de Parkinson/tratamento farmacológico , Pramipexol/administração & dosagem , Quimioterapia Combinada , Seguimentos , Humanos , Estudos Longitudinais , Doença de Parkinson/diagnóstico , Doença de Parkinson/imunologia , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento
10.
Psychopharmacology (Berl) ; 237(8): 2419-2431, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32440779

RESUMO

RATIONALE: Impulse control disorders (ICD) and other impulsive-compulsive behaviours are frequently found in Parkinson's disease (PD) patients treated with dopaminergic agonists. To date, there are no available animal models to investigate their pathophysiology and determine whether they can be elicited by varying doses of dopaminergic drugs. In addition, there is some controversy regarding the predispositional pattern of striatal dopaminergic depletion. OBJECTIVES: To study the effect of two doses of pramipexole (PPX) on motor impulsivity, delay intolerance and compulsive-like behaviour. METHODS: Male rats with mild dopaminergic denervation in the dorsolateral striatum (bilateral injections of 6-hydroxidopamine (6-OHDA)) treated with two doses of PPX (0.25 mg/kg and 3 mg/kg) and tested in the variable delay-to-signal paradigm. RESULTS: Partial (50%) dopaminergic depletion did not induce significant changes in motor impulsivity or delay intolerance. However, 0.25 mg/kg of PPX increased motor impulsivity, while 3 mg/kg of PPX increased both motor impulsivity and delay intolerance. These effects were independent of the drug's antiparkinsonian effects. Importantly, impulsivity scores before and after dopaminergic lesion were positively associated with the impulsivity observed after administering 3 mg/kg of PPX. No compulsive-like behaviour was induced by PPX administration. CONCLUSIONS: We described a rat model, with a moderate dorsolateral dopaminergic lesion resembling that suffered by patients with early PD, that develops different types of impulsivity in a dose-dependent manner dissociated from motor benefits when treated with PPX. This model recapitulates key features of abnormal impulsivity in PD and may be useful for deepening our understanding of the pathophysiology of ICD.


Assuntos
Transtornos Disruptivos, de Controle do Impulso e da Conduta/induzido quimicamente , Agonistas de Dopamina/administração & dosagem , Comportamento Impulsivo/efeitos dos fármacos , Oxidopamina/toxicidade , Transtornos Parkinsonianos/induzido quimicamente , Pramipexol/administração & dosagem , Animais , Corpo Estriado/efeitos dos fármacos , Corpo Estriado/metabolismo , Transtornos Disruptivos, de Controle do Impulso e da Conduta/psicologia , Dopamina/metabolismo , Relação Dose-Resposta a Droga , Comportamento Impulsivo/fisiologia , Masculino , Atividade Motora/efeitos dos fármacos , Atividade Motora/fisiologia , Transtornos Parkinsonianos/tratamento farmacológico , Transtornos Parkinsonianos/psicologia , Ratos , Ratos Sprague-Dawley
11.
J Clin Pharmacol ; 60(8): 999-1010, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32090332

RESUMO

Pramipexole is the first-line medication recommended by the British National Institute for Health and Care Excellence. Pramipexole is predominantly eliminated by renal excretion. The aim was to develop a physiologically based pharmacokinetic (PBPK) model of pramipexole, providing a basis for its individualized administration. The role of glomerular filtration and organic cation transporter 2 (OCT2) in renal tubular secretion was considered. Plasma concentration-time profiles of pramipexole were predicted and validated, first in healthy populations and then in PD patients with varied renal function. Finally, the pharmacokinetics of PD patients with different degrees of renal impairment were predicted. The simulated pharmacokinetic parameters, including maximum plasma concentration (Cmax ), area under the plasma concentration-time curve (AUC), time to maximum plasma concentration (tmax ), and steady-state trough plasma concentration values, obtained using the PBPK model were validated using fold error values, which were all smaller than 2. The successfully validated model supported that OCT2-mediated tubular secretion was affected proportionally to changes in glomerular filtration for various degrees of renal impairment. The predicted AUC0-inf values were increased 1.16-, 1.76-, 3.26-, and 9.48-fold in mild, moderate, and severe renal impairment and end-stage renal disease (ESRD) subjects, resepctively, compared with PD patients with normal renal function. It appears that PD patients with mild renal impairment are unlikely to require dose adjustment (0.125 mg 3 times a day). The pramipexole dose should be reduced to approximately 0.125 mg twice daily, 0.125 mg once daily, and 0.0375 mg once daily in PD patients with moderate renal impairment, severe renal impairment, and ESRD, respectively.


Assuntos
Doença de Parkinson/tratamento farmacológico , Doença de Parkinson/metabolismo , Pramipexol/farmacocinética , Insuficiência Renal/metabolismo , Administração Oral , Adulto , Idoso , Área Sob a Curva , Simulação por Computador , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Transportador 2 de Cátion Orgânico/metabolismo , Pramipexol/administração & dosagem , Pramipexol/sangue , Eliminação Renal , Distribuição Tecidual , Adulto Jovem
14.
CNS Drugs ; 33(7): 707-718, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31243728

RESUMO

Rotigotine (Neupro®), a non-ergolinic dopamine agonist (DA), is administered once daily via a transdermal patch (TP) that delivers the drug over a 24-h period. In the EU, the rotigotine TP is approved as monotherapy for the treatment of early Parkinson's disease (PD) and as combination therapy with levodopa throughout the course of the disease. It is also approved for the treatment of PD in numerous other countries, including Australia, the USA, China and Japan. Rotigotine TP effectively improved motor and overall functioning in clinical trials in Caucasian and Asian patients with early PD (as monotherapy) or advanced PD (in combination with levodopa); treatment benefits appeared to be maintained in open-label extensions that followed patients for up to 6 years. Rotigotine TP was not consistently non-inferior to ropinirole and pramipexole in studies that included these oral non-ergolinic DAs as active comparators. Rotigotine TP variously improved some non-motor symptoms of PD, in particular sleep disturbances and health-related quality of life (HRQOL), based on findings from individual studies and/or a meta-analysis. Rotigotine TP was generally well tolerated, with an adverse event profile characterized by adverse events typical of dopaminergic stimulation and transdermal patch application. Available for more than a decade, rotigotine TP is a well-established, once-daily DA formulation for use in the short- and longer-term treatment of PD. It offers a convenient alternative when non-oral administration of medication is preferred and may be particularly useful in patients with gastrointestinal disturbances that reduce the suitability of oral medication.


Assuntos
Agonistas de Dopamina/administração & dosagem , Doença de Parkinson/tratamento farmacológico , Tetra-Hidronaftalenos/administração & dosagem , Tiofenos/administração & dosagem , Administração Cutânea , Humanos , Indóis/administração & dosagem , Pramipexol/administração & dosagem , Qualidade de Vida , Adesivo Transdérmico
15.
Eur J Pharm Biopharm ; 141: 1-11, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31100429

RESUMO

Parkinson's disease (PD) is associated with symptoms such as tremor and bradykinesia which, together with a rigorous dosing regimen, can place an untenable burden on patients. These issues underscore the need for triggerable, modulated drug delivery systems. Currently, pramipexole (PRX) is the most widely used non-ergot dopamine agonist for the treatment of PD. In this study, near-infrared light-responsive PRX and hollow gold nanospheres (HGNS)-loaded biodegradable poly (D, L-lactide-co-glycolide) (PLGA) microspheres (PRX/HGNS MS) were fabricated using solid-in-oil-in-water (S/O/W) and water-in-oil-in-water (W/O/W) emulsion-solvent evaporation techniques to achieve modulated drug release. The PRX/HGNS MS were uniform, with an average diameter of approximately 24 µm, favorable PRX and HGNS encapsulation efficiencies (51.71 ±â€¯0.54% and 65.15 ±â€¯2.30%, respectively) and rapid, controllable drug release both in vitro and in vivo. Cytotoxicity tests revealed no significant differences between HGNS and PRX/HGNS MS when compared with a negative control. Pharmacodynamics and immunohistochemistry studies revealed a more rapid recovery of striatum in the group treated with PRX/HGNS MS produced using the S/O/W method. The results clearly demonstrate that light-responsive PRX/HGNS MS produced using the S/O/W method have the potential to address PD patients' mobility problems in a smart, controllable and remotely triggerable manner.


Assuntos
Plásticos Biodegradáveis/química , Nanosferas/química , Doença de Parkinson/tratamento farmacológico , Copolímero de Ácido Poliláctico e Ácido Poliglicólico/química , Pramipexol/administração & dosagem , Pramipexol/química , Cápsulas/química , Sistemas de Liberação de Medicamentos/métodos , Liberação Controlada de Fármacos/efeitos dos fármacos , Emulsões/química , Humanos , Raios Infravermelhos , Microesferas , Tamanho da Partícula , Solventes/química
16.
PLoS One ; 14(12): e0226893, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31891605

RESUMO

Generosity is a human behavior common in social contexts. However, humans are not equally generous to everyone alike. Instead, generosity decreases as a function of social distance, an effect called social discounting. Studies show that such social discounting effect depends on diverse factors including personality traits, cultures, stress or hormonal levels. Recently, the importance of the neurotransmitter dopamine in regulating social interactions has been highlighted. However, it remains unclear how exactly dopamine agonist administration modulates generous behavior as a function of social discounting. Here, we investigate the causal effect of dopamine agonist administration on social discounting in a pharmacological intervention study. We employ a randomized, double-blind, within-subject design to investigate the impact of the D2/D3 receptor agonist pramipexole on social discounting by keeping gender constant. We apply hyperbolic social discount model to the data and provide evidence that women under pramipexole become less generous in general, especially towards close others. Our results highlight the crucial role of dopamine in social decision making.


Assuntos
Desvalorização pelo Atraso/fisiologia , Agonistas de Dopamina/administração & dosagem , Dopamina/fisiologia , Pramipexol/administração & dosagem , Distância Psicológica , Desvalorização pelo Atraso/efeitos dos fármacos , Método Duplo-Cego , Feminino , Voluntários Saudáveis , Humanos , Adulto Jovem
17.
BMC Neurol ; 18(1): 221, 2018 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-30591018

RESUMO

BACKGROUND: Dopamine agonists (DAs) are efficacious for the treatment of motor and nonmotor symptoms in patients with Parkinson's disease (PD). The treatment of PD with DAs is often complicated by adverse drug reactions (ADRs) of dopaminergic and non-dopaminergic origins. The DA piribedil is widely used in Asian, European, and Latin American countries; therefore, its ADRs are pertinent to clinicians. Here we present a rare case of hypotension and bradycardia that is significantly related to the dosage of piribedil. CASE PRESENTATION: A middle-aged male, diagnosed with PD, received dopamine replacement with piribedil. When taking 50 mg piribedil daily dose, the patient didn't feel any discomfort. Two hours after taking 100 mg piribedil he presented with serious concomitant hypotension and bradycardia with a blood pressure (BP) reading of 85/48 mmHg and a heart rate (HR) of 45 beats/min when sitting. After taking 75 mg piribedil, the patient showed the same symptoms with BP reading at 70/45 mmHg and HR of 47 beats/min in the same position. Upon replacing treatment with pramipexole 0.125 mg, 0.25 mg, and 0.375 mg three times a day, no further cardiovascular effects persisted. CONCLUSIONS: No studies have previously reported the simultaneous observation of position-unrelated hypotension and bradycardia after taking small doses of piribedil. More studies are needed to explore the effects of DAs on BP and HR, especially piribedil. Piribedil is efficacious for the treatment of PD, but it is important to weigh the potential risk of hypotension and bradycardia against the clinical benefits of this drug.


Assuntos
Bradicardia/induzido quimicamente , Hipotensão/induzido quimicamente , Piribedil/efeitos adversos , Dopamina/metabolismo , Agonistas de Dopamina/administração & dosagem , Agonistas de Dopamina/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/tratamento farmacológico , Piribedil/administração & dosagem , Pramipexol/administração & dosagem
19.
J Pharmacol Sci ; 138(1): 31-37, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30241783

RESUMO

Parkinson's disease (PD) is characterized by the selective death of dopaminergic neurons. To avoid inconvenience of frequent administration caused by short half life and recurrence of symptoms such as tremor and bradykinesia incurred by drug elimination, a novel long-acting pramipexole transdermal patch has been made. In the present study, we evaluated the neuroprotective effects and underlying mechanisms of pramipexole patch (PPX patch) in a subacute PD mouse model induced by 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). The results showed that PPX patch treatment improved dyskinesia. MPTP-induced reduction of DA as well as its metabolites DOPAC and HVA in the striatum were prevented by PPX patch in a dose-dependent manner. PPX patch also restored the activity of antioxidant enzymes including SOD, GSH-Px and CAT in the striatum while reduced the content of MDA. Furthermore, PPX patch upregulated Nrf2/HO-1 expression. The protective effects of PPX patch was also associated with downregulation of the Bax/Bcl-2 ratio and Apaf-1, inhibition of cytochrome c release and inactivation of caspase-9 and caspase-3. In conclusion, our studies demonstrated that the long-acting pramipexole patch exerts its neuroprotective effects, at least in part, by inhibiting oxidative stress and mitochondrial apoptosis pathway and holds promise as a candidate drug.


Assuntos
1-Metil-4-Fenil-1,2,3,6-Tetra-Hidropiridina/efeitos adversos , Preparações de Ação Retardada/administração & dosagem , Preparações de Ação Retardada/farmacologia , Fármacos Neuroprotetores , Doença de Parkinson/tratamento farmacológico , Doença de Parkinson/etiologia , Pramipexol/administração & dosagem , Pramipexol/farmacologia , Adesivo Transdérmico , Administração Cutânea , Animais , Apoptose/efeitos dos fármacos , Corpo Estriado/metabolismo , Modelos Animais de Doenças , Dopamina/metabolismo , Relação Dose-Resposta a Droga , Masculino , Camundongos Endogâmicos C57BL , Mitocôndrias/patologia , Estresse Oxidativo/efeitos dos fármacos , Doença de Parkinson/metabolismo , Superóxido Dismutase/metabolismo
20.
Eur J Pharm Sci ; 124: 80-88, 2018 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-30076954

RESUMO

The purpose of the study was to improve transdermal delivery of pramipexole via nanocrystals and investigate the enhancement micro-mechanism. Pramipexole nanocrystals were prepared using wet media milling method and incorporated into carbomer gel. In vitro permeation studies through rabbit ear skin indicated that the cumulative permeation amount of pramipexole from nanocrystals in 24 h was 2.75 times more than that from coarse suspension. Investigations of selective follicular closing technique indicated that approximately 33.88% of the total permeation from nanocrystals was contributed to the follicular pathway, which was confirmed by scanning electron microscopy images. In vitro permeation and in vivo pharmacokinetic studies indicated that pramipexole from nanocrystal gel showed a higher permeation profile than that from coarse suspension gel. Overall, nanocrystals could improve transdermal delivery of pramipexole through transepidermal and transfollicular pathways by the nanosized particles.


Assuntos
Antiparkinsonianos/administração & dosagem , Agonistas de Dopamina/administração & dosagem , Sistemas de Liberação de Medicamentos , Nanopartículas/administração & dosagem , Pramipexol/administração & dosagem , Administração Cutânea , Animais , Antiparkinsonianos/farmacocinética , Agonistas de Dopamina/farmacocinética , Masculino , Pramipexol/farmacocinética , Coelhos , Pele/metabolismo , Absorção Cutânea
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