HPLC-DAD for the determination of three different classes of antifungals: method characterization, statistical approach, and application to a permeation study.

This study describes and characterizes methods for high-performance liquid chromatography diode array detection (HPLC-DAD) analysis of formulations containing molecules with antifungal activity of three different classes: terbinafine and butenafine (allylamines), miconazole and fluconazole (azoles), and geraniol, neral and geranial (monoterpenes). All methods used the same chromatographic column (RP18 ), enabling the analysis to be performed in a single batch. The specificity was extensively discussed through the establishment of purity peak methods. The analytical parameters (linearity, precision and accuracy) were calculated and discussed in detail using specific statistical approaches. All substances showed satisfactory results for chromatographic and analytical parameters. Limits of 1.3% to mean repeatability and 2.0% for intermediate precision are suggested as acceptance criteria in validation of methods by HPLC-DAD, in situations where there is no extensive pretreatment of the samples. The methods proved to be robust and significant factors were discussed regarding their influence on chromatographic parameters (retention time, resolution, tailing factor and column efficiency). Finally, the application of the developed methods was demonstrated by the results of a permeation study of the antifungal agents through bovine hoof membranes.

Optimization and validation of an alternative method to evaluate total reactive antioxidant potential.

The total reactive antioxidant potential (TRAP) is one of the methods most employed to estimate the antioxidant capacity of samples in vitro. This method is based on the quenching of luminol-enhanced chemiluminescence derived from the thermolysis of 2,2'-azo-bis(2-amidinopropane)dihydrochloride (AAPH) as the free radical source. However, this method can present limitations when the sample does not present a lag phase. In addition, there are no studies regarding TRAP assay validation. In this context, the aim of this work was to optimize and validate this method and to propose another evaluation method using the area under the curve (AUC). The main condition established was the need for the stabilization of the system, at 7000s, before the addition of the antioxidant to be tested. Both evaluation methods were validated using Trolox (6-hydroxy-2,5,7,8-tetramethylchroman-2-carboxylic acid) as a calibrator in the range of 50 to 250nM, and all parameters showed satisfactory results: specificity, linearity (r>0.99), precision (intra and interassay relative standard deviations <5%), robustness, and the limits of detection and quantitation (low and similar for both methods). The main advantage of the use of AUC is to evaluate the antioxidant potential of samples that do not present lag phase.

Influence of beta-cyclodextrin complexation on carbamazepine release from hydroxypropyl methylcellulose matrix tablets.

The in vitro release profiles of carbamazepine and beta-cyclodextrin either complexed or simply mixed and subsequently incorporated in hydrophilic matrix tablets containing 15 or 30% hydroxypropyl methylcellulose were evaluated. Solubility studies revealed a linear relationship between the increase in carbamazepine solubility and the increase in beta-cyclodextrin concentration. Drying methods (spray-drying and freeze-drying) were used to obtain carbamazepine/beta-cyclodextrin solid complexes in order to prepare tablets. The results demonstrated that matrix tablets containing carbamazepine/beta-cyclodextrin solid complexes displayed faster carbamazepine and beta-cyclodextrin release compared to that containing simple physical mixture. Gelling and matrix formation was impaired in formulation containing 15% hydroxypropyl methylcellulose and spray-dried complex. The comparison of spray-drying and freeze-drying revealed no significant influence of both drying methods on carbamazepine and beta-cyclodextrin dissolution rate when carbamazepine/beta-cyclodextrin complexes were incorporated in 30% hydroxypropyl methylcellulose matrix tablets. The results point to the possibility of modulating carbamazepine release using a hydroxypropyl methylcellulose matrix associated to the drug complexed with beta-cyclodextrin.

Mathematical evaluation of in vitro release profiles of hydroxypropylmethylcellulose matrix tablets containing carbamazepine associated to beta-cyclodextrin.

The release kinetics of carbamazepine (CBZ) either complexed or physically mixed with beta-cyclodextrin (betaCD) from hydroxypropylmethylcellulose (HPMC) matrix tablets was investigated using different mathematical equations. The model-dependent approach was compared to the utilization of fit factors. Notwithstanding difference (f1) and similarity (f2) factors allowed the differentiation of the formulations containing CBZ complexed with betaCD from the one containing a simple physical mixture of CBZ and betaCD. The Weibull model was more useful for comparing the release profiles. Weibull parameters were more sensitive to the differences between the two release kinetic data.

Bioavailability of carbamazepine:beta-cyclodextrin complex in beagle dogs from hydroxypropylmethylcellulose matrix tablets.

The bioavailability of a carbamazepine:beta-cyclodextrin (CBZ:betaCD) complex from hydroxypropylmethylcellulose (HPMC) matrix tablets was evaluated in beagle dogs. A solubility study demonstrated the improvement of CBZ aqueous solubility by adding increasing amounts of betaCD. The 1:1 CBZ:betaCD molar ratio was chosen to produce the complex, which was obtained by spray-drying. Matrix tablets were prepared by direct compressing either a CBZ:betaCD complex or a physical mixture of both substances with HPMC. Both matrix formulations displayed a controlled-release profile when compared to the reference formulation (Tegretol CR 200). CBZ presented a significantly higher bioavailability from matrix tablets containing the CBZ:betaCD complex than that obtained from Tegretol CR 200). Although a high inter-subject variability was observed, the results pointed to the feasibility of using betaCD in order to modulate CBZ release and absorption, as well as to reduce the drug dosage maintaining the same plasma levels.

A multivariate-based wavenumber selection method for classifying medicines into authentic or counterfeit classes.

Attenuated total reflectance (ATR), a sampling technique by Fourier transform infrared (FTIR) spectroscopy, has been adopted as an analytical tool for detecting fraudulent medicines. The spectrum generated by FTIR-ATR typically relies on hundreds of equally spaced wavenumbers which may reduce the performance of techniques tailored to classify samples into classes, i.e., authentic or fraudulent. This paper proposes a novel method for selecting subsets of wavenumbers (variables) that better classify samples into such classes. For that matter, principal components analysis (PCA) is integrated to the k-nearest neighbor (KNN) classification technique. PCA is applied to FTIR-ATR data, and a variable importance index is built on the PCA outputs. An iterative backward variable elimination is started guided by that index; after each variable removal, samples are categorized into authentic or fraudulent classes using KNN, and the classification accuracy is measured. The wavenumber subset compromising high accuracy and reduced percent of retained variables is chosen. When applied to Cialis FTIR-ATR data, the proposed approach retained only average 1.84% of the original variables and increased the classification accuracy average 2.1%, to 0.9897 from 0.9689; as for Viagra data, the method increased average classification accuracy 1.56%, from 0.9135 to 0.9278, using only 7.72% of the original variables.

Effect of phonophoresis on skin permeation of commercial anti-inflammatory gels: sodium diclofenac and ketoprofen.

This study evaluated the use of ultrasound in combination with the commercial anti-inflammatory drugs ketoprofen and sodium diclofenac, according to the parameters used in physiotherapy. Ketoprofen and sodium diclofenac were used in the Franz diffusion cell model adapted to an ultrasound transducer in three conditions: no ultrasound, one application of ultrasound and two applications of ultrasound. High-performance liquid chromatography was used to quantify the total amount of drug permeating skin per unit area, as well as flux and latency. The results showed that for ketoprofen, the amount of drug permeating skin and flux increased with two ultrasound applications. Permeation of sodium diclofenac decreased in the presence of ultrasound. Ultrasound parameters and drug properties must be considered in the use of phonophoresis.

Counterfeit Cialis and Viagra fingerprinting by ATR-FTIR spectroscopy with chemometry: can the same pharmaceutical powder mixture be used to falsify two medicines?

This paper proposes a direct and efficient method to discriminate between counterfeit and authentic Cialis and Viagra samples by combining attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopy with multivariate techniques. The chemical profile of 53 commercial samples (Viagra(®), Cialis(®)) and 104 counterfeit samples (Viagra and Cialis) from distinct seizures were obtained from ATR-FTIR data derived from 10mg of crushed core tablets. Principal component analysis (PCA) technique was employed to classify samples based on the fingerprint region mid-infrared spectra (1800-525 cm(-1)) using OMNIC v.7.2 software; PCA enabled categorizing samples in groups with different chemical profiles, successfully distinguishing between authentic and counterfeits samples in forensic routine. The existence of active pharmaceutical ingredients (API) and technological adjuvant others than specified on the medicine package were also detected in counterfeit samples. In addition, we applied the similarity match (SM) method to demonstrate that a mixture of pharmaceutical powders deriving from a common origin may have been used to manufacture both counterfeit Cialis and Viagra tablets from distinct seizures.

Profiling counterfeit Cialis, Viagra and analogs by UPLC-MS.

In this work, the chemical profile of 43 commercial samples of tablets for male erectile dysfunction (Viagra, Cialis, Lazar, Libiden, Maxfil, Plenovit, Potent 75, Rigix, Vimax, Pramil 75 and Pramil) and 65 counterfeit samples (Viagra and Cialis) were obtained from UPLC-MS data. Methanol extracts of crushed tablets were investigated by ultra performance liquid chromatography (UPLC) with diode array detection (DAD) coupled with eletrospray ionization in the positive ion mode (ESI(+)) quadrupole time-of-flight (Q-Tof) mass spectrometry (MS). A validated method was employed for the simultaneous determination of sildenafil citrate (SLD) and tadalafil (TAD). The ultra-chromatograms obtained with method provide high resolution of MS, and are a quick (less to 1.5 min) and reliable tool in the distinction between authentic and counterfeit tablets. It was observed in most cases the presence of other active pharmaceutical ingredients (APIs) than specified on the package (TAD and SLD). Additionally, high concentrations of TAD and SLD were detected in counterfeit samples when compare with observed values for a typical commercial product. Chemometric methods were employed and the samples were grouped in five groups as function of API content.

A new methodology for detection of counterfeit Viagra® and Cialis® tablets by image processing and statistical analysis.

This paper proposes a new approach for automatic classification of counterfeit Viagra(®) and Cialis(®) tablets using image processing and statistical analysis. A high resolution VSC 5000 is used for image acquisition in a controlled environment, and the combination of a thresholding technique with morphological operators is used to segment the tablet from the background. A statistical model based on the RGB color components of original samples is built, and the detection of counterfeit tablets was performed by checking the adherence of a test sample to the obtained distribution using the Bhattacharyya distance. Our experimental results indicated that counterfeit tablets can be effective detected using the proposed approach.

Fingerprinting of sildenafil citrate and tadalafil tablets in pharmaceutical formulations via X-ray fluorescence (XRF) spectrometry.

The production of counterfeited drugs is a criminal problem that carries serious risks to public health in the worldwide. In Brazil, Viagra and Cialis are the most counterfeit medicines, being used to inhibit the phosphodiesterase type 5 (PDE-5), treating thus, problems related to erectile dysfunction. X-ray fluorescence (XRF) is a suitable technique to control the quality of new pharmaceutical formulations and distinguish between authentic and counterfeit tablets. XRF has advantageous features like multielemental capability, good detectivity, high precision, short analysis times, and is nondestructive, which makes it suitable to be extended to a great variety of samples. In this work, the inorganic fingerprinting chemical of forty-one commercial samples (Viagra, Cialis, Lazar, Libiden, Maxfil, Plenovit, Potent 75, Rigix, V-50, Vimax and Pramil) and fifty-six counterfeit samples (Viagra and Cialis) were obtained from XRF data. XRF presented an excellent analytical methodology for semi-quantitative determination of active ingredient (in case of sildenafil citrate that presents S in its structure) and excipients such as calcium phosphate, titanium oxide and iron oxide (P, Ca, Ti and Fe). The matrix data were allied to chemometric methods (Principal Component Analysis and Hierarchical Cluster Analysis) to classify the tablets investigated between authentic and counterfeit, grouping the samples into of seven groups: A, B, C, D and E (counterfeit group) and F and G (authentic group).

Isoflurane-loaded nanoemulsion prepared by high-pressure homogenization: investigation of stability and dose reduction in general anesthesia.

Isoflurane is a halogenated ether which is used for general anesthesia. To stabilize a new formulation in order to evaluate the potential to reduce the dose required for general anesthesia, an isoflurane-loaded nanoemulsion was proposed. A high-pressure homogenization technique was used to develop drug-loaded nanoemulsions which presented droplet size of 150 +/- 0.78 nm with a narrow size distribution and low polydispersity index (0.08 +/- 0.01). The zeta potential was -18 +/- 2.4 mV and pH was 6.03 +/- 0.04. Rheological analysis showed Newtonian behavior for the formulations, whose physical stability was confirmed by multiple light scattering. It was verified that isoflurane volatilization did not occur in these formulations. The preclinical evaluation, carried out via the end-tidal isoflurane concentration, showed that the dose required for anesthetic maintenance significantly decreased when the nanostructured formulation was administered compared to inhaled isoflurane. There was no significant difference (p < 0.05) between experimental groups (inhaled isoflurane and intravenous isoflurane-loaded nanoemulsion) in terms of the cardiac rate, oxygen hemoglobin saturation, and arterial blood pressure, as well as the biomarkers of renal, hepatic and skeletal muscle system functionalities. Slight tachypnea, edema, and erythema were observed after isoflurane-loaded or unloaded-nanoemulsion. The stability and significant dose reduction observed for drug-loaded nanoemulsion render this formulation a promising option for intravenous delivery of isoflurane.

Antifungal activity and mechanism of action of monoterpenes against dermatophytes and yeasts

Dermatomycosis causes highly frequent dermal lesions, and volatile oils have been proven to be promising as antifungal agents. The antifungal activity of geraniol, nerol, citral, neral and geranial (monoterpenes), and terbinafine and anidulafungin (control drugs) against seven opportunistic pathogenic yeasts and four dermatophyte species was evaluated by the Clinical and Laboratory Standards Institute microdilution tests. Monoterpenes were more active against dermatophytes than yeasts (geometric mean of minimal inhibitory concentration (GMIC) of 34.5 and 100.4 µg.ml-1, respectively). Trichophyton rubrum was the fungal species most sensitive to monoterpenes (GMIC of 22.9 µg.ml-1). The trans isomers showed higher antifungal activity than the cis. The mechanism of action was investigated evaluating damage in the fungal cell wall (Sorbitol Protection Assay) and in the cell membrane (Ergosterol Affinity Assay). No changes were observed in the MIC of monoterpenes in the sorbitol protection assay.The MIC of citral and geraniol was increased from 32 to 160 µg.ml-1 when the exogenous ergosterol concentrations was zero and 250 µg.ml-1, respectively. The monoterpenes showed an affinity for ergosterol relating their mechanism of action to cell membrane destabilization.

Physical profile of counterfeit tablets Viagra® and Cialis®

The profile of tablets containing an active pharmacological ingredient can be obtained using different sets of properties, including physical and chemical aspects. The first measurements carried out on tablets are the physical characteristics also called post-tabletting batch (post-TB) characteristics. These data may be valuable to assist in the detection of pharmaceutical product forgery and may also be used in a forensic intelligence perspective when inserted into databases. This work is focused on the physical characteristics of Cialis® and Viagra® tablets seized by the Brazilian Federal Police in the Rio Grande do Sul state. Using the F-test (ANOVA), all samples of counterfeit Viagra® (n = 28) and Cialis® (n = 40) were well distinguished from authentic samples by the following post-TB characteristics: length (major and minor), thickness, and mass. Using the exploratory statistical technique of Hierarchical Cluster Analysis (HCA), tablets with similar physical profiles were grouped. This result may indicate a common illicit production. We observed the validity of using post-TB properties to generate - in a fast and reliable manner and with no sample preparation - a technological profile that joins itself to the other analytical methods assisting in routine forensic detection of counterfeit Viagra® and Cialis®.

Perfil para medicamentos na forma farmacêutica comprimidos contendo uma substância ativa pode ser obtido usando diferentes conjuntos de propriedades, incluindo aspectos físicos e químicos. As primeiras medições realizadas em comprimidos são de características físicas, também chamadas características pós-compressão. Tais dados podem ser valiosos para auxiliar na detecção de falsificações de medicamentos e ser utilizados em uma perspectiva de inteligência forense, quando inseridos em bancos de dados. Este trabalho está focado nas características físicas dos comprimidos de Cialis® e Viagra® apreendidos pela Polícia Federal no Estado brasileiro do Rio Grande do Sul. Com o emprego do Teste de Fisher (ANOVA), todas as amostras falsificadas de Viagra® (n = 28) e de Cialis® (n = 40) foram diferenciadas das amostras autênticas pelas seguintes características pós-compressão: comprimento (maior e menor), espessura e massa. Utilizando-se a Análise Hierárquica de Cluster (AHC), os comprimidos com perfis físicos semelhantes foram agrupados, o que pode indicar uma produção ilícita em comum. Observou-se a validade da utilização das características pós-compressão para gerar, de um modo rápido, confiável e sem preparo de amostra, um perfil tecnológico que se una aos demais métodos analíticos utilizados na rotina forense de detecção de falsificações de Cialis® e de Viagra®.

Educational level, socio-economic status and relationship with quality of life in elderly residents of the city of Porto Alegre/RS, Brazil

The objective of this study was to verify the index of quality of life of elderly individuals belonging to groups, from different socioeconomic strata in the city of Porto Alegre, Rio Grande do Sul State. The research adopted a transversal model, used to collect data from the SF-36 questionnaire. The sampling is the intentional type and comprised: 61 elderly people in Class A, 80 in Class C, and 84 in Class E. The research was approved by the Committee of Ethics in Research/UFRGS. In relation to the quality of life, Class A presented higher scores than did Classes C and E on the pain, vitality, social aspect and mental health areas. The results also showed a significant difference in quality of life among university educated individuals versus the other schooling groups, on the pain, vitality, mental health and social aspect fields. Quality of life is a complex concept to study, but essential to improve the perception of health and welfare by the elderly.

O objetivo deste trabalho foi verificar o índice de qualidade de vida de idosos participantes de grupos de convivência, de diferentes estratos socioeconômicos do município de Porto Alegre/RS. A pesquisa seguiu um modelo de estudo transversal e utilizou para coleta de dados o questionário SF-36. A amostragem foi do tipo intencional e foi composta por: 61 idosos na classe A, 80 na classe C e de 84 na classe E. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da UFRGS. Em relação à qualidade de vida, a classe A apresentou escores melhores que a classe C e E nos domínios dor, vitalidade, aspecto social e saúde mental. Houve diferença significativa de qualidade de vida no ensino superior completo, em relação aos demais estratos de escolaridade, nos domínios dor, vitalidade, saúde mental e aspecto social. A qualidade de vida é um conceito complexo de ser estudado, mas essencial para que haja melhora na percepção de saúde e do bem-estar pelos idosos.

Carbamazepine/betaCD/HPMC solid dispersions. I. Influence of the spray-drying process and betaCD/HPMC on the drug dissolution profile.

The aim of this study was to compare carbamazepine (CBZ) solid dispersions prepared by spray-drying of aqueous dispersions with the corresponding physical mixtures. The influence of the association of beta-cyclodextrin (betaCD) and hydroxypropyl methylcellulose (HPMC) on the CBZ dissolution profile of the preparations was investigated. Results demonstrated that CBZ release from solid dispersions is dependent on the ratio of betaCD and HPMC. The spray-drying process confers better homogeneity to CBZ polymeric dispersions than the physical mixture process. In summary, we demonstrated the feasibility of obtaining a homogeneous polymeric solid dispersion of CBZ from an aqueous media by spray-drying and a clear influence of the betaCD:HPMC ratio on the release profile of CBZ.

Terapêutica na terceira idade e o uso racional de medicamentos

O envelhecimento é um processo biológico e muitas doenças se desenvolvem nesta época da vida, devido à suscetibilidade natural do organismo. Existe uma falsa crença de que os medicamentos podem curar tudo, inclusive a velhice. A terapia medicamentosa, quando realmente necessária ao tratamento de algum estado patológico do paciente idoso, deve ser aplicada com restrições e de forma individualizada, pois a metabolização dos fármacos pode estar bastante diversa do esperado quando comparada à de adultos jovens. Ao contrário desta lógica, vemos um excesso de prescrições destinadas aos idosos, quando a prevenção das doenças seria mais coerente, mais saudável e menos onerosa. Além disto, outros elementos intrínsecos ao paciente idoso e ao seu comportamento são determinantes na terapêutica da terceira idade. A pesquisa sobre a utilização de fármacos (tipo, dose, indicação e uso) por parte desta população é necessária a fim de estabelecer a racionalização e otimização destes. Desta forma, o objeto central deste trabalho é fazer uma breve reflexão sobre os aspectos envolvidos na terapêutica da terceira idade, buscando com isto promover o uso racional de medicamentos por esta faixa da população (AU)