Dried blood spots for the quantification simultaneous administration of the antipsychotic and antidepressant drugs.

Liquid chromatography-tandem mass (LC MS/MS) was used for the determination of therapeutic drug monitoring (TDM) of the three antipsychotics (aripiprazole, quetiapine and olanzapine) and three antidepressants (paroxetine, Escitalopram and sertraline) drugs simultaneously. Both groups of drugs can be concurrently used to treat behavioral disorders. It appears that there is no test for the rapid detection of all six compounds simultaneously using LC MS/M, despite the fact that several analysis publications found these drugs individually. 50µl of taken from finger pricks as dried blood spots (DBS) spiked with sample solution containing the six understudied drugs was extracted. A C18-BEH column with a mobile phase made up of gradient elution ammonium acetate with acetonitrile in methanol. The total run time of this method is about 5.5 min. LC MS/MS showed an excellent linearity in the range of 5-100ng ml-1 with a correlation coefficient (r) >0.992. The values of the intra- and inter-day precision of the tested drugs satisfy the regulatory requirements' acceptance criteria. The test was approved in accordance with accepted standards for bioanalytical procedures and it can be successfully applied for therapeutic drug monitoring studies for the tested drugs if they administered concurrently or individually.

Stealth Amphotericin B nanoparticles for oral drug delivery: In vitro optimization.

PURPOSE: Amphotericin B (AmB) is an effective anti-fungal and anti-leishmanial agent. However, AmB has low oral bioavailability (0.3%) and adverse effects (e.g., nephrotoxicity). The objectives of this study were to improve the oral bioavailability by entrapping AmB in pegylated (PEG) poly lactide co glycolide copolymer (PLGA-PEG) nanoparticles (NPs). The feasibility of different surfactants and stabilizers on the mean particle size (MPS) and entrapment efficiency were also investigated. MATERIALS AND METHODS: NPs of AmB were prepared by a modified emulsification diffusion method employing a vitamin E derivative as a stabilizer. Physicochemical properties and particle size characterization were evaluated using Fourier Transform Infra-Red spectroscopy (FTIR), differential scanning calorimetry, scanning electron microscopy and transmission electron microscopy. Moreover, in vitro dissolution profiles were performed for all formulated AmB NPs. RESULTS: MPS of the prepared spherical particles of AmB ranged from 26.4 ± 2.9 to 1068 ± 489.8 nm. An increased stirring rate favored AmB NPs with a smaller MPS. There was a significant reduction in MPS, drug content and drug release, when AmB NPs were prepared using the diblock polymer PLGA-PEG with 15% PEG. Addition of three emulsifying agents poly vinyl pyrrolidone (PVP), Vitamin E (TPGS) and pluronic F-68 to AmB formulations led to a significant reduction in particle size and increase in drug entrapment efficiency (DEE) compared to addition of PVP alone. FTIR spectroscopy demonstrated a successful loading of AmB to pegylated PLGA-PEG copolymers. PLGA-PEG copolymer entrapment efficiency of AmB was increased up to 56.7%, with 92.7% drug yield. After a slow initial release, between 20% and 54% of AmB was released in vitro within 24 h phosphate buffer containing 2% sodium deoxycholate and were best fit Korsmeyer-Peppas model. In conclusion, PLGA-PEG diblock copolymer with 15% PEG produced a significant reduction (>70%) in MPS with highest drug content. The percentage of PEG in the copolymer and the surfactant/stabilizer used had a direct effect on AmB release in vitro, entrapment efficiency and MPS. These developed formulations are feasible, effective and improved alternatives to other carriers for oral delivery of AmB.

Therapeutic monitoring of amphotericin B in Saudi ICU patients using UPLC MS/MS assay.

Amphotericin B (AmB) is the first-line agent for the treatment of life-threatening invasive fungal infections. The aim of this study was to monitor AmB in critically ill Saudi patients in ICU after i.v. administration of 0.68 ± 0.1 mg/kg/day Fungizone®. A selective, sensitive and precise UPLC MS/MS method was developed to measure AmB concentrations in these patients. Seven ICU patients with creatinine clearance (ClCr) >40 mL/min were included. AmB levels were analyzed using a Waters Aquity UPLC MS/MS system, a BEH Shield RP18 column and detection via electrospray ionization source with positive ionization mode. The precision and accuracy of the developed UPLC method in the concentration range of 200-4000 ng/mL show no significant difference among inter- and-intra-day analysis (p > 0.05). Linearity was observed over the investigated range with correlation coefficient, r > 0.995 (n = 6/day). The pharmacokinetics of AmB in these patients, at steady state, showed a high terminal half-life of 124.6 ± 73.4 h, with a highest concentration of 513.9 ± 281.1 ng/mL, a lowest concentration 316.4 ± 129.0 ng/mL and a mean clearance 91.1 ± 39.2 mL/h/kg. The pharmacokinetics of AmB in critically ill Saudi patients in ICU was studied using a fully validated assay. A weak correlation (r = -0.22) of AmB Cl with ClCr was obtained, which suggests the need for further investigation in a larger population.