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1.
Respir Med ; 108(8): 1108-16, 2014 Aug.
Article in English | MEDLINE | ID: mdl-24993817

ABSTRACT

AIM: Prescription of inhaled corticosteroids to children with asthma is recommended at half the nominal dose of adults in order to reduce the risk of systemic side effects. However, there is a lack of pharmacokinetic trials supporting such dose reduction regimens. Therefore, we aimed to compare the systemic exposure to the active ingredients of a fixed dose combination of beclometasone-dipropionate (BDP) and formoterol after dry powder inhaler (DPI) administration in children, adolescents and adults. METHODS: The pharmacokinetic profiles of formoterol and beclometasone-17-monopropionate (B17MP; active metabolite of BDP) were evaluated over 8 h from two independent studies comprising children (6-11yrs, n = 27), adolescents (12-17 yrs, n = 28) and adults (≥18 yrs, n = 30) receiving a single, fixed dose of BDP/formoterol (children: 200 µg/24 µg, adolescents and adults: 400 µg/24 µg) via DPI. RESULTS: The systemic exposure (AUC) for children versus adults was almost doubled for formoterol and similar for B17MP despite the halved BDP dose administered in children. In adolescents the AUC for formoterol and B17MP were approximately one third higher than in adults for both compounds. Upon normalization for the BDP/formoterol dose in the three populations the AUC and peak concentration (C(max)) correlated inversely with age and body surface area of the patients (r ≤ -0.53; p < 0.0001). CONCLUSION: The systemic exposure to the active ingredients of BDP/formoterol administered as DPI correlates inversely with age and body size suggesting that dry powder dosage regimens should be adjusted for age and body size to avoid high systemic drug levels in children.


Subject(s)
Anti-Asthmatic Agents/pharmacokinetics , Asthma/drug therapy , Beclomethasone/pharmacokinetics , Ethanolamines/pharmacokinetics , Administration, Inhalation , Adolescent , Adult , Age Factors , Aged , Analysis of Variance , Anti-Asthmatic Agents/administration & dosage , Asthma/physiopathology , Beclomethasone/administration & dosage , Body Size/physiology , Child , Cross-Over Studies , Ethanolamines/administration & dosage , Forced Expiratory Volume/drug effects , Formoterol Fumarate , Half-Life , Humans , Metered Dose Inhalers , Middle Aged , Young Adult
2.
Histol Histopathol ; 26(3): 357-67, 2011 03.
Article in English | MEDLINE | ID: mdl-21210349

ABSTRACT

Increasing interest in safety evaluation of carbon nanotubes (CNTs) has risen in relation to their wide applications, together with the evidence of their cytotoxic effects. It has been shown that chemical functionalization extends the applications of CNTs, conferring them new functions that cannot otherwise be acquired by pristine CNTs, but also impacts on biological response to CNTs, modifying their toxicological profile. We assessed the onset of pulmonary toxic effects caused by pristine MW-CNTs and functionalized MW-NH2 or MW-COOH, 16 days after intratracheal instillation (1 mg/kg b.w.); major endpoints tested included (i) histopathology of lung (Haematoxylin/Eosin Staining), (ii) apoptotic/proliferating features examined by TUNEL and PCNA immunostaining, and (iii) presence/distribution of (1) Transforming Growth Factor-beta1 (TGFß1), (2) Interleukin-6 (IL-6) and (3) Collagen (Type I) investigated by immunochemical methods, as markers of lung toxicity, inflammation, and fibrosis, respectively. Lung histopathology from exposed animals showed dark, particulate-laden macrophages, reflecting carbon nanomaterial engulfing, both at alveolar and bronchiolar levels, after treatment with all the tested CNTs. Alteration of lung architecture was also observed in several areas showing collapsed thick-walled alveoli and the presence of micro-haemorrhagic foci. TUNEL and PCNA, indicative of apoptosis and cell proliferation respectively, showed a significant increase of immunopositive cells at bronchiolar, alveolar and macrophagic levels, as expression of an improved cellular turnover. Increased immunoreactivity for pulmonary TGFß1 and IL-6 was observed in treated rats, particularly in bronchiolar areas, collapsed alveoli and at stromal level, while evident changes for collagen were not detected. Taken together these findings demonstrated the general pulmonary toxicity coupled with inflammatory response after in vivo exposure to CNTs, without overt signs of fibrosis and granuloma formation, irrespectively of nanotube functionalization.


Subject(s)
Lung Diseases/chemically induced , Lung Diseases/pathology , Nanotubes, Carbon/toxicity , Administration, Inhalation , Animals , Collagen Type I/metabolism , Female , Immunohistochemistry , In Situ Nick-End Labeling , Interleukin-6/metabolism , Intubation, Intratracheal , Lung/pathology , Male , Nanotubes, Carbon/chemistry , Particle Size , Pneumonia/chemically induced , Pneumonia/pathology , Proliferating Cell Nuclear Antigen/metabolism , Pulmonary Fibrosis/chemically induced , Pulmonary Fibrosis/pathology , Rats , Rats, Sprague-Dawley , Transforming Growth Factor beta1/metabolism
3.
Toxicol In Vitro ; 24(1): 217-23, 2010 Feb.
Article in English | MEDLINE | ID: mdl-19747537

ABSTRACT

Haemato- and myelotoxicity are adverse effects caused by mycotoxins. Due to the relevance of aflatoxins to human health, the present study, employing CFU-GM-, BFU-E- and CFU-E-clonogenic assays, aimed at (i) comparing, in vitro, the sensitivity of human vs. murine haematopoietic progenitors to AFB1 and AFM1 (0.001-50microg/ml), (ii) assessing whether a single AFB1 in vivo treatment (0.3-3mg/kgb.w.) alters the ability of murine bone marrow cells to form myeloid and erythroid colonies, and (iii) comparing the in vitro with the in vitro ex-vivo data. We demonstrated (i) species-related sensitivity to AFB1, showing higher susceptibility of human myeloid and erythroid progenitors (IC(50) values: about 4 times lower in human than in murine cells), (ii) higher sensitivity of CFU-GM and BFU-E colonies, both more markedly affected, particularly by AFB1 (IC(50): 2.45+/-1.08 and 1.82+/-0.8microM for humans, and 11.08+/-2.92 and 1.81+/-0.20microM for mice, respectively), than the mature CFU-E (AFB1 IC(50): 12.58+/-5.4 and 40.27+/-6.05microM), irrespectively of animal species, (iii) regarding AFM1, a species- and lineage-related susceptibility similar to that observed for AFB1 and (iv) lack of effects after AFB1 in vivo treatment on the proliferation of haematopoietic colonies.


Subject(s)
Aflatoxin B1/toxicity , Aflatoxin M1/toxicity , Bone Marrow Cells/drug effects , Hematopoietic Stem Cells/drug effects , Mutagens/toxicity , Animals , Blood Cell Count , Body Weight/drug effects , Cell Lineage/drug effects , Cell Separation , Colony-Forming Units Assay , Erythroid Precursor Cells/drug effects , Humans , Leukocytes/drug effects , Male , Mice , Species Specificity
4.
G Ital Med Lav Ergon ; 30(2): 119-27, 2008.
Article in English | MEDLINE | ID: mdl-19068859

ABSTRACT

Serum carbohydrate-deficient transferrin (CDT) is the most specific marker of chronic alcohol abuse so far. The performance of commercial HPLC over the ELISA method for measurement of CDT was evaluated on a series of 105 serum samples obtained from subjects referred to the Toxicology Laboratory of Salvatore Maugeri Hospital for alcohol-related problems. Compared to ELISA, HPLC analysis was more valuable for determining alcohol-related patterns of CDT isoforms and quantifying serum levels of disialotransferrin that better reflect chronic heavy drinking. Other significant advantages of the HPLC method included reproducible separation and easier detection of glycoform types and genetic transferrin variants that are known to cause falsely high or low results in sera examined by immunoassay. Current scientific evidence indicates that disialotransferrin is the target analyte for CDT determination and HPLC the current CDT analysis reference method. Systematic studies for early assessment of excessive alcohol intake or abuse of alcoholic substances in workers are recommended by the Italian legislation in accordance with the European Alcohol Action Plan (EAAP) launched by the WHO Regional Committee for Europe. These studies are advisable given their potential role in preventing negative effects of alcohol abuse in workplace. A research strategy combining CDT and other laboratory markers with questionnaire and physician interview is recommended for examining subjects with alcohol related problems and the diagnosis of alcoholism. This approach can be applied for alcohol abuse in workplace surveillance.


Subject(s)
Alcohol-Related Disorders/blood , Chromatography, High Pressure Liquid , Enzyme-Linked Immunosorbent Assay , Occupational Health , Transferrin/analogs & derivatives , Female , Humans , Male , Protein Isoforms , Risk , Transferrin/analysis
5.
Pulm Pharmacol Ther ; 20(3): 290-303, 2007.
Article in English | MEDLINE | ID: mdl-16890465

ABSTRACT

Inhaled corticosteroids (ICS) and long-acting beta-agonists (LABA) are currently used in the management of asthma and chronic obstructive pulmonary disease (COPD). Localized targeted delivery of these drugs into the lungs is achieved by means of two types of inhalation devices; pressurized metered-dose inhalers (pMDIs) and dry powder-inhalers (DPIs). For environmental reasons, the chlorofluorocarbon (CFC) propellants used in pMDIs are now being replaced by ozone friendly hydrofluoroalkanes (HFAs). These new generation HFA-based pMDIs, developed to provide effective lung deposition of the active moiety, have a favorable safety and tolerability profile. However, HFA-based re-formulation of LABAs and ICS for pMDIs presents particular technical difficulties, especially in terms of ensuring dose content uniformity. This review focuses on the technology and clinical efficacy of the HFA solution pMDIs using Modulite platform technology (Chiesi Farmaceutici S.p.A). Modulite technology allows the development of HFA solution formulations that can mimic the established CFC-based drug formulations on a microgram to microgram basis and provides formulations with novel particle size distributions that improve on existing delivery systems; by manipulation of aerosol clouds and particle size, the delivery of HFA-formulated drugs can be optimized to either achieve fine particle fractions and deposition patterns similar to established CFC-based drug formulations, thus facilitating the transition to new environment-friendly pMDIs in the clinical setting, or achieve finer drug particles able to penetrate deeper into the bronchi for targeted drug delivery as medical need may dictate. Long-term, multiple-dose clinical studies of Modulite formulations of beclomethasone dipropionate (BDP), budesonide and formoterol have been demonstrated to be therapeutically equivalent to their respective previously established CFC or DPI formulations. As a result, a number of Modulite pMDIs have either recently gained regulatory approval in several European countries, or have completed clinical trials and are in the regulatory submission phase. Availability, in pMDI form, of drugs like formoterol, ICSs, and ICS/LABA combinations, all central to the effective management of asthma and COPD, is therefore expected to impact positively in assuring the continued availability of vital treatment options to patients and physicians.


Subject(s)
Asthma/drug therapy , Pulmonary Disease, Chronic Obstructive/drug therapy , Adrenal Cortex Hormones/administration & dosage , Adrenergic beta-Agonists/administration & dosage , Asthma/diagnosis , Drug Delivery Systems/instrumentation , Drug Delivery Systems/methods , Humans , Meta-Analysis as Topic , Pulmonary Disease, Chronic Obstructive/diagnosis , Randomized Controlled Trials as Topic , Respiratory Therapy/instrumentation , Respiratory Therapy/methods
6.
Br J Clin Pharmacol ; 58(4): 359-66, 2004 Oct.
Article in English | MEDLINE | ID: mdl-15373928

ABSTRACT

BACKGROUND: In response to the phasing out of chlorofluorocarbon (CFC) inhalers, a metered dose hydrofluoroalkane (HFA) formulation, Modulite (Chiesi Farmaceutici S.p.A, Parma, Italy), to be delivered with a pressurized metered dose inhaler (pMDI), has been developed. Modulite is a HFA formulation technology that has been designed to provide stable and uniform dose delivery of HFA-based formulations to enable an easy transition from CFC to HFA inhalers. OBJECTIVES: The aim of this study was to compare the bronchoprotective and bronchodilator effects of a single dose of 12 microg of formoterol from the HFA Modulite inhaler with the Foradil Aerolizer (dry powder inhaler, DPI) and the Foradil CFC inhalers (Novartis Health Consumer, Basel, Switzerland). METHODS: This was a double blind, double dummy, randomized, placebo-controlled, crossover study conducted in 38 subjects with mild to moderate asthma (mean forced expiratory volume in 1 s [FEV1] 87.5% predicted). The primary endpoint was methacholine challenge provocative dose required for 20% fall in the FEV1 (PD20) 90 min post dose. Bronchodilation was assessed with spirometry (FEV1, FVC, FEF25-75) and impulse oscillometry (resistance at 5 and 20 Hz, reactance at 5 Hz and resonant frequency) over the 90 min post dose. In a subset of 12 subjects formoterol plasma levels, serum potassium and glucose were determined up to 480 min post dose. RESULTS: The three formoterol formulations demonstrated significant (P < or = 0.05) improvements in bronchoprotection compared to placebo and non-inferiority of the HFA preparation compared to the CFC and DPI preparations was demonstrated. Geometric mean PD20 values were 0.51 mg with HFA, 0.62 mg with DPI, 0.62 mg with CFC and 0.2 mg with placebo. The log transformed mean differences in PD20 doubling dose between HFA and (a) DPI was -0.28 (95% CI -0.84-0.29, P = 0.57) (b) CFC was -0.28 (95% CI -0.84-0.28, P = 0.57) and (c) placebo was 1.38 (95% CI 0.82-1.94, P < 0.001). Serum potassium, glucose and formoterol plasma profiles were comparable for the CFC, HFA and DPI devices. CONCLUSION: Our findings of similar efficacy, pharmacokinetics and systemic effects of the HFA formoterol inhaler compared to the CFC and DPI preparations supports the potential use of this novel formulation in the treatment of asthma.


Subject(s)
Aerosol Propellants , Bronchodilator Agents/administration & dosage , Chlorofluorocarbons , Ethanolamines/administration & dosage , Hydrocarbons, Fluorinated , Administration, Inhalation , Adult , Cross-Over Studies , Double-Blind Method , Female , Forced Expiratory Volume/drug effects , Formoterol Fumarate , Humans , Male , Middle Aged , Nebulizers and Vaporizers , Powders , Vital Capacity
7.
Respir Med ; 97 Suppl B: S5-9, 2003 Feb.
Article in English | MEDLINE | ID: mdl-12593521

ABSTRACT

Pharmacokinetic properties of a drug, and selection and correct usage of an appropriate delivery device, are factors that can affect the outcome of inhaled therapyThe use of nebulization can overcome problems that are associated with other delivery systems used for inhalation therapyThe objective of this open, randomized, single-dose study was to compare the systemic exposure and safety of beclometasone dipropionate (BDP) suspension for nebulization with BDP via metered-dose inhaler (MDI) in healthy subjects. Following a run-in period to assess basal 24-h serum cortisol levels and cortisol urinary excretion, 12 healthy males were administered BDP 1,600 microg given via MDI and were then randomized to receive a single dose of either 1,600 microg (n = 6) or 3,200 microg BDP (n = 6) suspension for nebulization given via a nebulizer Results with respect to systemic exposure to beclometasone-17-monopropionate (B17MP) (the active metabolite of BDP) and systemic effects on the hypothalamic-pituitary-adrenal (HPA) axis were determined by evaluation of a number of pharmacokinetic parameters for plasma B17MP and serum and urinary cortisol, respectively. A statistically significantly greater peak plasma concentration (Cmax) of B17MP was reported with BDP via MDI (1,587 pg ml(-1)) compared with BDP 1,600 microg (455 pg ml(-1)) and BDP 3,200 microg suspensions for nebulization (758 pg ml(-1)), and was achieved more rapidly (Tmax) (1.3 h, 3 h, and 2.5 h, respectively). In addition, elimination half-life (t 1/2(el)) was statistically significantly shorter with BDP via MDI (4.6 h) than with both dosages of BDP suspensions for nebulization (7.4 h and 6.3 h with 1600 microg and 3,200 microg, respectively), as was mean residence time (MRT) (5.4 h, 11.1 h, and 10.0 h, respectively). Total systemic exposure to B17MP (as determined by the area under the concentration-time curve: AUCinfinity) was comparable for BDP via MDI (6,883 pg ml(-1) h(-1)) and BDP 3,200 microg suspension for nebulization (8,201 pg ml(-1) h(-1)), but significantly greater than with BDP 1,600 microg suspension for nebulization (4,870 pg ml(-1); P < 0.05 vs BDP via MDI). All treatments were well tolerated, and no significant differences were found between them with respect to the serum or urinary cortisol pharmacokinetic parameters assessed. In conclusion, the results of this study demonstrate that BDP suspension for nebulization 3,200 microg given via a nebulizer and BDP 1,600 microg given via an MDI are equivalent in terms of systemic exposure to B17MP and systemic effects on the HPA axis, with BDP suspension for nebulization having a potentially more prolonged activity. It confirms that use of a double dose of BDP suspension for nebulization administered by nebulizer compared with BDP given via metered-dose inhalation is justified and poses no risk with regard to safety.


Subject(s)
Anti-Asthmatic Agents/administration & dosage , Beclomethasone/administration & dosage , Administration, Inhalation , Adult , Anti-Asthmatic Agents/blood , Anti-Asthmatic Agents/pharmacokinetics , Beclomethasone/blood , Beclomethasone/pharmacokinetics , Biological Availability , Half-Life , Humans , Hydrocortisone/urine , Male , Metered Dose Inhalers
8.
Respir Med ; 96 Suppl D: S9-15, 2002 Aug.
Article in English | MEDLINE | ID: mdl-12201080

ABSTRACT

In the drive to replace chlorofluorinated hydrocarbons (CFCs) by alternative more environmentally friendly propellants in pressurized metered dose inhalers (pMDIs), Chiesi has developed new inhalers using Modulite technology. The aim was to obtain CFC-free pMDIs which are equivalent, in terms of safety and efficacy, to the previous CFC devices at the same dose. When beclometasone dipropionate (BDP) and budesonide Modulite formulations were compared to the equivalent CFC products there was no significant difference in morning serum cortisol or urinary cortisol excretion, at the maximum recommended daily dose (2000 micrograms or 1600 micrograms respectively). Single dose pharmacokinetic studies in both healthy volunteers and asthmatic patients compared systemic exposure (B17MP levels) for BDP-CFC with BDP Modulite and extrafine BDP-HFA (QVAR). B17MP levels for BDP-CFC and BDP Modulite were comparable, but substantially less than that seen with extrafine BDP-HFA. After 6 weeks of treatment in asthmatic patients, B17MP AUC after inhalation of BDP (1000 micrograms twice-daily) from BDP Modulite was comparable with that obtained after BDP-CFC (Becloforte). Plasma profile of BDP and B17MP were similar after inhalation from BDP Modulite with standard actuator or delivered via a spacer, suggesting that pulmonary delivery of BDP to the lung is similar with both actuators.


Subject(s)
Aerosol Propellants/pharmacokinetics , Anti-Asthmatic Agents/pharmacokinetics , Beclomethasone/pharmacokinetics , Budesonide/pharmacokinetics , Hydrocarbons, Fluorinated/pharmacokinetics , Administration, Inhalation , Adult , Aerosol Propellants/pharmacology , Anti-Asthmatic Agents/administration & dosage , Asthma/drug therapy , Asthma/metabolism , Beclomethasone/administration & dosage , Budesonide/administration & dosage , Chemistry, Pharmaceutical , Cross-Over Studies , Double-Blind Method , Drug Delivery Systems , Female , Humans , Hydrocarbons, Fluorinated/pharmacology , Hydrocortisone/blood , Hydrocortisone/urine , Male , Nebulizers and Vaporizers , Therapeutic Equivalency
9.
Eur J Pharm Biopharm ; 53(2): 227-32, 2002 Mar.
Article in English | MEDLINE | ID: mdl-11880007

ABSTRACT

A versatile oral controlled release system for the simultaneous delivery of levodopa methyl ester and carbidopa, consisting of a three-layer matrix tablet, has been studied and developed. Each individual layer of the matrix exhibited a different release mechanism, i.e. the first layer was swellable (S), the second one was erodible (E) and the third one was disintegrating (D). The three layers have been assembled in the monolithic matrix in different relative positions. It was found that in the monolith the three layers could interact, producing in vitro release profiles depending on their relative position. The monoliths having the configurations DSE and SDE were administered to human volunteers in order to determine the plasma profiles. The pharmacokinetic data showed a significant difference between the early time plasma curves: the monolith DSE, having the fast release profile, gave rise to a rapid appearance of a high levodopa plasma level, whereas the slower releasing monolith SDE produced a smoothed plasma concentration profile.


Subject(s)
Antiparkinson Agents/pharmacokinetics , Carbidopa/pharmacokinetics , Drug Delivery Systems/methods , Levodopa/analogs & derivatives , Levodopa/pharmacokinetics , Administration, Oral , Antiparkinson Agents/administration & dosage , Antiparkinson Agents/blood , Biological Availability , Carbidopa/administration & dosage , Carbidopa/blood , Chemistry, Pharmaceutical , Cross-Over Studies , Humans , Levodopa/administration & dosage , Levodopa/blood , Pilot Projects , Tablets, Enteric-Coated
10.
J Mass Spectrom ; 36(12): 1287-93, 2001 Dec.
Article in English | MEDLINE | ID: mdl-11754120

ABSTRACT

Ganstigmine, a new acetylcholinesterase inhibitor, was incubated with rat liver microsomes and the resulting metabolites were identified by high-performance liquid chromatographic/mass spectrometric (HPLC/MS) and HPLC/MS/MS analyses. The results showed the formation of eight main metabolites, among which geneseroline and molecules corresponding to mono-hydroxylated, demethylated and reduced ganstigmine. The metabolic profile drawn for humans, dog and monkey showed a pattern very similar to that of rat: only in the case of liver dog microsomes higher amounts of geneseroline and of a metabolite identified as demethylated and reduced drug were detected.


Subject(s)
Alkaloids/metabolism , Carbamates/metabolism , Cholinesterase Inhibitors/metabolism , Chromatography, High Pressure Liquid/methods , Mass Spectrometry , Microsomes, Liver/metabolism , Alzheimer Disease/drug therapy , Animals , Dogs , Humans , Hydroxylation , Macaca fascicularis , Male , Methylation , Oxidation-Reduction , Rats , Rats, Sprague-Dawley , Species Specificity
11.
Eur J Drug Metab Pharmacokinet ; 23(2): 172-7, 1998.
Article in English | MEDLINE | ID: mdl-9725477

ABSTRACT

Ipriflavone (IP) is an isoflavone derivative with antiosteoporotic activity. This drug is extensively metabolized in humans and only negligible concentrations of unchanged IP can be detected in plasma. Metabolites M1 and M5 are predominant, while met abolites M2 and M3 are detected in minor amounts. The aim of this study was to compare the bioavailability of IP and its metabolites M1, M2, M3, and M5 at steady-state after administration of 200 mg tablets three times daily and 300 mg Scherer capsules twice daily during meals. IP plasma levels were below the limit of quantitation in 6 subjects out of 12 after administration of IP 200 mg tablets. On the other hand, after administration of the Scherer capsules IP plasma levels were quantifiable in all the volunteers. As regards IP metabolites, a mean increase in bioavailability, equal to 35%, was observed after administration of the Scherer capsules. Plasma level fluctuations, reflecting changes in absorption rate at steady-state, remained unvaried. The good bioavailability and fluctuation indexes of the Scherer capsules permit a simplification of the dosage scheme, reducing the daily administrations from three times to twice daily, thus improving the patients' compliance. In clinical practice this characteristic is not negligible, con sidering the mean age of the patients and the long-term treatment. Due to the high therapeutic index of IP, the increase in bioavailability does not cause any risk of accumulation or overdosage.


Subject(s)
Analgesics/pharmacokinetics , Isoflavones/pharmacokinetics , Administration, Oral , Adult , Analgesics/administration & dosage , Analgesics/blood , Biological Availability , Cross-Over Studies , Dose-Response Relationship, Drug , Female , Humans , Isoflavones/administration & dosage , Isoflavones/blood , Male
12.
Eur J Drug Metab Pharmacokinet ; 23(2): 197-202, 1998.
Article in English | MEDLINE | ID: mdl-9725481

ABSTRACT

The effect of food on the oral bioavailability of a manidipine 20 mg tablet was studied after a single administration in 12 male healthy subjects. The clinical trial was conducted as an open, randomised, crossover study. In two different administration sessions, the subjects received a 20 mg manidipine tablet either in the fasting state or after a standardized breakfast. Plasma samples were collected before and at different times after each administration for up to 24 h. The concentrations of manidipine and its pyridine metabolite (M-XIII metabolite) were determined by HPLC with coulometric detection. The tolerability of manidipine was good. Only two cases of mild headache, one with each treatment, were reported. Food significantly improved the absorption, with an increase in AUC from 19.1 to 27.2 ng.h/ml (geometric mean, p<0.01) but did not modify the rate of absorption (tmax unchanged, median = 1.5 h). Peak plasma concentration was also increased (from 6.2 to 7.8 ng/ml), but the difference was not statistically significant (p=0.18). Other pharmacokinetic parameters (apparent elimination half-life and mean residence time) remained unchanged. The increase in bioavailability of manidipine administered with food is related to its high lipophilicity and may be explained through a solubilization effect produced by food and bile secretions.


Subject(s)
Dihydropyridines/pharmacokinetics , Food-Drug Interactions , Adult , Antihypertensive Agents/metabolism , Antihypertensive Agents/pharmacokinetics , Biological Availability , Calcium Channel Blockers/adverse effects , Calcium Channel Blockers/metabolism , Calcium Channel Blockers/pharmacokinetics , Dihydropyridines/adverse effects , Dihydropyridines/metabolism , Double-Blind Method , Humans , Male , Nitrobenzenes , Piperazines
13.
Eur J Drug Metab Pharmacokinet ; 23(2): 223-9, 1998.
Article in English | MEDLINE | ID: mdl-9725486

ABSTRACT

The absorption, excretion and tissue distribution of radioactivity after repeated oral equimolar doses of 14C-valproic acid sodium salt (NaVP) or 14C-valproic acid pivaloyl oxymethyl ester (PEV) was investigated in male rats treated once a day for 14 consecutive days. The 14th day plasma time-course of radioactivity after PEV administrations was characterised by a slow absorption rate with a delayed peak (tmax 2 h, Cmax 7.52 +/- 1.35 microg eq./ml), followed by a plateau lasting up to 8 h. After NaVP treatment, the main peak of radioactivity was observed 0.5 h after administration (Cmax 8.30 +/- 1.26 microg eq./ml) followed by a secondary peak due to biliary enterohepatic recycling. Starting from 4 h onwards, radioactivity levels after PEV treatment were higher than those after NaVP (AUCtau = 113.3 h.microg eq./ml after PEV vs 71.9 h.microg eq./ml after NaVP), but concentrations declined with similar terminal half-lives (52.8 h for PEV and 49.7 h for NaVP). Radioactivity recovered (0-432 h interval) in urine accounted for 79.3% (PEV) and 56.1% (NaVP) while, in faeces accounted for 9.1% (PEV) and 26.1% (NaVP) of total administered dose (14 days). The difference is attributable to a higher excretion of radioactivity in the bile for NaVP. The missing fraction in the total radioactivity balance is probably excreted in expired air, as observed in single dose studies. Radioactivity excreted in bile (0-8 h interval of the last 14th day) accounted for 5.1% (NaVP) and 0.23% (PEV) of the total administered dose (14 days). A possible explanation of this difference may be a different metabolism pattern for the two compounds. The negligible biliary excretion observed after PEV administration is probably due to an inhibition of the glucuronation of valproic acid (or other metabolites) caused by the pivalic acid. Due to the presence of the enterohepatic recycle, the radioactivity levels in intestine, 0.5 and 2 h after administration, were higher after NaVP administration. According to higher plasma levels, the radioactivity concentrations in liver, kidneys and some fat tissues were found to be slightly higher after PEV administration. At 120 h after the last treatment of both compounds, relevant tissue concentrations were observed in mesenteric lymphnodes, perirenal and brown fat. The tissue-plasma radio activity ratio appeared quite similar for the two compounds.


Subject(s)
Valproic Acid/analogs & derivatives , Valproic Acid/pharmacokinetics , Administration, Oral , Animals , Carbon Radioisotopes/analysis , Male , Radiopharmaceuticals/pharmacokinetics , Rats , Rats, Sprague-Dawley , Tissue Distribution , Valproic Acid/blood
14.
Int J Clin Pharmacol Ther ; 36(7): 386-91, 1998 Jul.
Article in English | MEDLINE | ID: mdl-9707354

ABSTRACT

The pharmacokinetics and safety of a single oral dose of 20 mg manidipine dihydrochloride have been studied in 8 patients with mild to moderate hepatic impairment (grade A or B in Child's classification, or score < or = 7 in Pugh's modification of Child's classification), and in 12 healthy subjects. They received one 20 mg manidipine dihydrochloride tablet with 100 ml of tap water after a standard breakfast. Manidipine was determined using HPLC with electrochemical detection from plasma samples taken up to 24 or 36 h after dosing. The medication was well tolerated. A trend toward higher Cmax, AUC, and MRT was observed in patients with a more severe hepatic impairment, as a consequence of reduction in the liver metabolic function. Patients with grade A hepatic impairment did not exhibit significantly altered pharmacokinetics with respect to healthy subjects, while grade B impairment patients had significantly higher AUC and MRT. Tmax values pointed to reduced absorption rate in patients compared to healthy subjects; the changes were more evident in grade B than grade A patients, although statistical significance was not reached. The reduction in absorption rate in grade B patients is probably related to their higher mean age, since this effect has been reported for manidipine. The pharmacokinetics of manidipine seem only modified in patients with a certain degree of hepatic impairment (at least Pugh grade 6 and Child grade B); therefore, adaptation of the dosing regimen does not seem to be generally recommendable, but should be modulated according to the liver status of the patient.


Subject(s)
Antihypertensive Agents/pharmacokinetics , Dihydropyridines/pharmacokinetics , Liver Cirrhosis, Alcoholic/metabolism , Administration, Oral , Adult , Aged , Antihypertensive Agents/administration & dosage , Antihypertensive Agents/blood , Area Under Curve , Biological Availability , Chromatography, High Pressure Liquid , Dihydropyridines/administration & dosage , Dihydropyridines/blood , Half-Life , Humans , Liver Cirrhosis, Alcoholic/classification , Male , Middle Aged , Nitrobenzenes , Piperazines , Reference Values , Severity of Illness Index
16.
Biol Neonate ; 71(5): 337-44, 1997.
Article in English | MEDLINE | ID: mdl-9167855

ABSTRACT

Although lysophospholipids are normally found in the lung and their presence is connected to the metabolic pathway of surfactant phospholipids, several studies have reported that their intratracheal instillation is able to induce severe alveolar epithelial injury. Since lysophospholipids are normally present in exogenous surfactants as a consequence of the nonenzymatic hydrolysis of parent phospholipids during their production and shelf-life, the aim of this study was to test the potential toxicity of surfactant lysophospholipids in artificially ventilated newborn rabbits in comparison with that of pure lysophosphatidylcholine (Lyso-PC) suspensions. In premature (surfactant-deficient) animals, a commercially available Curosurf batch (0.56 mg Lyso-PC/ml) improved lung-thorax compliance and reduced lactate dehydrogenase (LDH), total protein and hemoglobin contents in bronchoalveolar lavage (BAL) fluid. The same batch submitted to thermal stress in order to increase the Lyso-PC content (10.2 mg Lyso-PC/ml) failed to improve lung mechanics but did not induce any significant change in biochemical markers in BAL fluid. When suspended in saline, pure Lyso-PC had a dramatic and dose-dependent tissue-damaging effect with increased LDH, hemoglobin and protein contents in BAL and a fall in the lungthorax compliance, in both immature and mature (near-term) animals. The lack of toxicity of Lyso-PC in Curosurf might be explained by an interaction with surfactant phospholipids.


Subject(s)
Animals, Newborn/physiology , Lysophosphatidylcholines/toxicity , Pulmonary Alveoli/drug effects , Respiratory Mechanics/drug effects , Animals , Body Weight/drug effects , Bronchoalveolar Lavage Fluid/chemistry , Epithelial Cells , Epithelium/drug effects , Intubation, Intratracheal , Lung/chemistry , Lung/physiopathology , Lysophosphatidylcholines/administration & dosage , Pulmonary Alveoli/pathology , Rabbits , Survival Rate
18.
Chirality ; 8(5): 381-9, 1996.
Article in English | MEDLINE | ID: mdl-8900027

ABSTRACT

A new chiral derivatization procedure for the HPLC resolution of chiral catecholamines and structurally related compounds is described. The homochiral reagent, (+)-(R)-1-phenylethyl isocyanate (RPEIC), was added to separate and quantitate the enantiomers of rac-5,6-dihydroxy-2-methyl-aminotetralin, the main metabolite of rac-5, 6-diisobutyryl-2-methyl-aminotetralin, a potent dopamine agonist, by reversed-phase HPLC analysis. To avoid catecholamine degradation in the basic reaction medium and to obtain the selective and quantitative derivatization of the amino group of the compound, the reversible complex formation between diphenylborinic acid (DPBA) and the catechol group, in alkaline medium, was performed before homochiral isocyanate addition. The RPEIC derivatization was completed in 30 min and then the DPBA complex was dissociated by adding dilute acid. The structure of intermediates and urea derivatives was confirmed by mass spectometry. The use of an electrochemical detector, operating in redox mode, allowed HPLC quantitation of enantiomers at the nanogram level in plasma and urine. The derivatization procedure is also suitable for other catecholamine-related compounds.


Subject(s)
Body Fluids/chemistry , Tetrahydronaphthalenes/chemistry , Animals , Boron Compounds , Chromatography, High Pressure Liquid , Indicators and Reagents , Rats , Stereoisomerism , Tetrahydronaphthalenes/isolation & purification , Tetrahydronaphthalenes/pharmacokinetics
19.
Arch Toxicol ; 70(3-4): 145-9, 1996.
Article in English | MEDLINE | ID: mdl-8825670

ABSTRACT

The influence of pivalic acid (PIV), a compound often used to make pro-drugs, and of the structurally related trichloroacetic acid (TCA), on several hepatic and renal enzymes was investigated in Sprague-Dawley rats, following a 4-day treatment period. The PIV and TCA treatments resulted in a similar and selective induction (2-3 times) of peroxisomal palmitoyl-CoA oxidase and the cytochrome P-450 4A dependent microsomal (omega)- and (omega-1)-lauric acid activities, both in liver and kidney. Western blot analysis of liver and kidney microsomes from PIV- and TCA-treated rats, using antibody to the P-450 4A1, revealed induction of members of the P-450 4A subfamily. These results suggest that PIV, like TCA, is a renal and hepatic peroxisome proliferator in rats, and further support the previously indicated close association between the peroxisomal fatty acid beta-oxidation enzymes and microsomal P-450 4A sub-family enzymes.


Subject(s)
Cytochrome P-450 Enzyme System/biosynthesis , Kidney/enzymology , Liver/enzymology , Microbodies/drug effects , Microbodies/enzymology , Mixed Function Oxygenases/biosynthesis , Pentanoic Acids/pharmacology , Trichloroacetic Acid/pharmacology , Animals , Cytochrome P-450 CYP4A , Cytochrome P-450 Enzyme System/physiology , Enzyme Induction/drug effects , Kidney/drug effects , Liver/drug effects , Male , Mixed Function Oxygenases/physiology , Oxidation-Reduction/drug effects , Rats , Rats, Sprague-Dawley
20.
Am J Cardiol ; 75(18): 7F-12F, 1995 Jun 16.
Article in English | MEDLINE | ID: mdl-7778536

ABSTRACT

Delapril is a carboxy-alkyl-dipeptide mainly converted in animals and humans to an active diacid derivative (M-I), which in turn is converted to an active 5-hydroxy-indane diacid (M-III). In humans these metabolites are excreted in the urine. The presence of the indanyl-glycine moiety gives delapril a high lipophilicity, greater than several other angiotensin-converting enzyme (ACE) inhibitors, such as captopril and enalapril. Due to its greater lipophilicity, delapril has been shown to exert a more effective inhibition of vascular ACE than captopril and enalapril, both in vitro and in vivo. The activity of delapril on tissue ACE also lasts longer than on the circulating enzyme. At doses ranging from 1-10 mg/kg orally, delapril exerts a marked and long-lasting antihypertensive action in various experimental models of hypertension. The blood pressure reduction has been shown to be accompanied by suppression of angiotensin II release from the vascular wall. In stroke-prone spontaneously hypertensive rats (SHR-SP) and in SHR with chronic renal failure, besides reducing hypertension, delapril significantly improves survival rate and prevents the development of stroke, cardiac hypertrophy, and renal sclerosis. The ability of delapril to reduce hypertrophy in vascular and cardiac tissue has been demonstrated in both in vitro and in vivo experiments.


Subject(s)
Angiotensin-Converting Enzyme Inhibitors/pharmacology , Indans/pharmacology , Angiotensin-Converting Enzyme Inhibitors/pharmacokinetics , Animals , Humans , Indans/pharmacokinetics
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