Transdermal kinetics of a mercurous chloride beauty cream: an in vitro human skin analysis.

BACKGROUND: Crema de Belleza-Manning is a popular mercurous chloride-containing beauty cream used to smooth and lighten the complexion and treat acne. Hundreds of people in the Southwestern US border states have been identified with elevated (>20 microg/L) urine mercury levels believed to be secondary to using this cream. The kinetic characteristics of percutaneous mercury absorption are incompletely defined. The objective of this study was to determine the transdermal kinetics of two formulations of mercurous chloride from a beauty cream in an in vitro human skin model. METHODS: A proprietary formulation and an aqueous formulation of the beauty cream were studied using modified Franz diffusion cells. Mercury content in the skin samples and the underlying diffusion buffer was determined using atomic absorption spectrophotometry. RESULTS: A rapid initial increase in mercury content both in the skin and the buffer was noted for both formulations. Mercury concentrations in the aqueous samples were significantly (p < 0.05) higher in both the skin and the diffusion buffer compared to parallel samples containing glycerol. CONCLUSIONS: Mercury was readily absorbed through the skin in this in vitro human skin model. The aqueous preparation had a markedly increased rate and extent of mercury absorption relative to the proprietary formulation.

Stability of 5-Fluorouracil in an extemporaneously compounded ophthalmic solution.

5-Fluorouracil (5-FU) is used in the treatment of a variety of ophthalmic conditions, including glaucoma, pterygium, retinal detachment and premalignant eye lesions. Specifically for the treatment of pterygium, intravitreal injections of 5-FU have been extemporaneously compounded by pharmacists and typically stored in syringes. No data exist concerning the chemical and physical stability of these solutions. With this in mind, the stability of 5-FU (1mg/0.1mL) in 0.9% sodium chloride injection prepared in the hospital pharmacy laboratory at the University of South Carolina was studied with respect to time and temperature. Admixtures of 5-FU were aseptically prepared and stored in 1-mL tuberculin syringes. The stability of these solutions was evaluated in a freezer, in a refrigerator, at room temperature and in an oven set at 40 deg C. Immediately after prepareation, samples were collected to determine initial concentration using a stability-indicating high-performance liquid chromatography method and to assess the pH of the solution. The same tests were repeated after one, three, five and seven days of storage. Samples were also visually inspected at these times for signs of physical incompatibility. Tuberculin syringes stored at each of the temperatures showed no signs of physical incompatibility (precipitate) or loss of drug. There was also no appreciable change in pH of the solution over the study period. This study showed that aseptically prepared 5-FU ophthalmic solutions packaged in tuberculin syringes can be stored safely for up to seven days at temperatures ranging form -10 to 40 deg C/

Intraperitoneal erythropoietin in children on peritoneal dialysis: A study of pharmacokinetics and efficacy.

The pharmacokinetics and efficacy of intraperitoneal (IP) recombinant human erythropoietin (rHuEPO) were investigated in children undergoing chronic peritoneal dialysis. Eight children were administered a single dose of 100 U/kg of rHuEPO IP with 50 mL of dialysate into a dry peritoneal cavity after nighttime peritoneal dialysis. Serum erythropoietin (EPO) levels were measured at 0, 8, 12, and 24 hours. A mean peak EPO level of 187 mU/mL was obtained at 12 hours. The area under the curve was 5,818 mU/h/mL, and relative bioavailability was similar to that found using subcutaneous (SC) dosing. Nine children completed 11 to 12 weeks of IP rHuEPO therapy. The patients maintained a normal hematocrit (34% +/- 2.3%) with a mean final IP rHuEPO dosage that was not significantly greater than the mean previous SC dosage (IP, 290 +/- 194 U/kg/wk; SC, 279 +/- 126 U/kg/wk; P = not significant). There appeared to be a trend for a slightly increased risk for peritonitis compared with historical controls at our center (relative risk = 3.1; 95% confidence interval, 0.92 to 6.3). IP rHuEPO is effective in children undergoing continuous cycling peritoneal dialysis without requiring increased rHuEPO dosages, but the possibility of an increased risk for peritonitis will need to be further explored.

Influence of drug lipophilicity on terpenes as transdermal penetration enhancers.

Percutaneous absorption-enhancing effects on the skin of hairless mice of 11 monoterpenes [1, (+)-limonene; 2, (-)-menthone; 3, (+)-terpinen-4-ol; 4, alpha-terpineol; 5, 1,8-cineole; 6, (+)-carvone; 7, (-)-verbenone; 8, (-)-fenchone; 9, p-cymene; 10, (+)-neomenthol; and 11, geraniol] were investigated using three different model drugs (caffeine, hydrocortisone, triamcinolone acetonide [TA]) with varying lipophilicities. Terpenes were applied at 0.4 M in propylene glycol (PG) to mouse skin. The model drugs were applied as suspensions in PG 1 hr following enhancer pretreatment. The combination of terpenes in PG provided significant enhancement of the permeation of caffeine through mouse skin. The most active compounds 10 and 11 increased permeation by between 13-fold and 16-fold. The terpenes also enhanced the delivery of hydrocortisone, but not to as great an extent. The most active compounds 3 and 4 increased permeation between 3.9-fold and 5-fold. The compounds examined did not significantly increase the delivery of TA. The most active compound 4 only increased delivery 2.5-fold, while the next most active compound 6 only increased delivery 1.7-fold. Overall, these results indicate that the combination of terpenes with PG can significantly increase the transdermal penetration of the hydrophilic drug caffeine and the polar steroid hydrocortisone.

Evaluation of transdermal penetration enhancers using a novel skin alternative.

A novel alternative to animal skin models was developed in order to aid in the screening of transdermal penetration enhancers. The skin alternative consists of a dermal layer containing human fibroblasts dispersed in a collagen matrix and an epidermal layer of differentiated and stratified human keratinocytes. Skin alternatives were placed in modified Franz diffusion cells (receptor volume 12 mL, donor area 3.14 cm2, n = 5) and enhancer solution (0.4 M in propylene glycol (PG)) was applied. Following 1 h of pretreatment, 10 microL of saturated hydrocortisone (HC) solution in PG was applied, and the cells were occluded with Parafilm. Samples were removed from the receptor compartment over 24 h, replaced with fresh receptor solution, and analyzed for steroid content using HPLC. Skin HC content was also determined. Receptor concentration at 24 h (Q24) for full-thickness skin alternative (control) was 28.6 +/- 13.7 microM and permeability (P) was 8.3 x 10(-4) +/- 5.5 x 10(-4) cm h-1. Azone (1) produced a Q24 of 105.0 +/- 36.1 microM and a P of 11.3 x 10(-4) +/- 1.8 x 10(-4) cm h-1, while the novel penetration enhancer 1-dodecyl-2-pyrrolidinone (2) produced a Q24 of 164.8 +/- 61.2 microM and a P of 33.3 x 10(-4) +/- 6.6 x 10(-4) cm h-1. Compound 3 produced the highest values for all permeability parameters tested with a P of 48.0 +/- 36.8 cm h-1 and a Q24 of 186.1 +/- 45.1 microM. When compared to the control, compound 1 gave an enhancement ratio (ER) of 3.7 for Q24 and 1.4 for P. Compound 2 gives an ER 5.8 for Q24 and 4.0 for P. These enhancement ratios are similar to those found using HC and human skin.