Transdermal iontophoretic delivery of apomorphine in patients improved by surfactant formulation pretreatment.

The objective of the present study is to evaluate the efficacy and the safety of transdermal iontophoretic delivery of R-apomorphine, a potent dopamine agonist, in combination with surfactant pretreatment in patients with advanced Parkinson's disease. Iontophoresis patches were applied in 16 patients for 3.5 h, with 0.5 h of passive delivery followed by 3 h of current application at a current density of 250 microA/cm2. Eight of these patients were treated with a surfactant formulation prior to iontophoresis. The pharmacokinetics, pharmacodynamic effects, systemic and local side effects of R-apomorphine were assessed. The plasma concentration vs. time profiles upon iontophoresis of R-apomorphine were described successfully by a novel pharmacokinetic model. The model suggests that only 1.9% of the dose that has been released from the patch accumulated in the skin. The patients treated with the surfactant formulations showed a statistically significant increase of bioavailability (from 10.6+/-0.8% to 13.2+/-1.4%) and of the steady state input rate (from 75.3+/-6.6 to 98.3+/-12.1 nmol/cm2 h) compared to the control patients (iontophoresis without absorption enhancers). In five out of eight patients in the study group and in three out of eight patients in the control group, clinical improvement was observed.

Development and validation of a bioanalytical assay for (E)-5-(2-bromovinyl)-2'deoxyuridine in plasma by capillary zone electrophoresis.

A capillary zone electrophoretic method for the quantification of (E)-5-(2-bromovinyl)-2'-deoxyuridine in plasma has been developed and validated. Separation was performed with a 25 mmol/l borate buffer, pH 9.0, after an initial rinsing step with sodium hydroxide. The rinsing step was necessary for reproducible analyses of aqueous samples and plasma extracts obtained by C18 solid-phase extraction after deproteination with perchloric acid. No interferences with plasma compounds were observed. The calibration graph was linear over the range of 30 to 3000 ng/ml using 5-fluorouracil as external standard. The limit of quantification was 24 ng/ml. The CZE method is fast, reproducible, linear and is therefore a good alternative for the already established HPLC methods.

Pharmacokinetics and bioavailability of oral 5'-deoxy-5-fluorouridine in cancer patients.

AIMS: Oral administration of 5-fluorouracil (FUra), an important cytotoxic agent, is limited by a wide variation in bioavailability. 5'-deoxy-5-fluorouridine (dFUrd), a masked form of FUra, has shown promise clinically when given intravenously or orally as a solution or tablet. This study investigates the efficacy of an oral capsule formulation of dFUrd in generating continuous systemic levels of this compound in cancer patients. METHODS: Six patients with advanced intestinal or ovarian malignancies were given three cycles of dFUrd, days 1-5, at intervals of 4 weeks. The doses of dFUrd were 600 mg m-2 three times daily, 800 mg m-2 three times daily, and 1000 mg m-2 three times daily, on cycles one, two and three, respectively (total dose 36 g m-2 ). The initial dose in each cycle was given as a slow intravenous injection over 10 min, and the remainder orally. Plasma and urine levels of dFUrd and two of its metabolites, FUra and 5,6-dihydro-5-fluorouracil (FUraH2 ), were monitored in six patients at each dose level. RESULTS: All six patients completed the study, receiving three different doses over a 3 month period, following which one had achieved a partial response, one had stable disease, and four had developed progressive disease. Side-effects were negligible, and only two instances of transient diarrhoea WHO grade 1 were seen. Total body clearance (CLtot) of intravenous dFUrd decreased with increasing dose; 2.7, 2.0 and 1.3 l min-1 m-2, following doses of 600, 800 and 1000 mg m-2, respectively. The mean elimination half-life of intravenous dFUrd increased with the dose from 15 to 22 min. Oral dFUrd was rapidly absorbed with a lag time of less than 20 min. The mean elimination half-life (t1/2, z ) of oral dFUrd was 32-45 min in the dose range 600-1000 mg m-2. The AUC of FUra and FUraH2 increased overproportionally with increasing intravenous doses of dFUrd. The mean systemic bioavailability of oral dFUrd was 34-47%. CONCLUSIONS: dFUrd, which selectively releases the antimetabolite FUra in tumour cells, can be given orally at doses of 600-1000 mg m-2 three times daily for 5 days. The systemic levels achieved are equivalent to those seen following continuous infusions of dFUrd or FUra. Toxicity is tolerable, and further clinical investigation of oral dFUrd is warranted.

Liquid chromatographic determination of beta-cyclodextrin derivatives based on fluorescence enhancement after inclusion complexation.

A liquid chromatographic method using fluorescence detection for the determination of beta-cyclodextrin (beta CD) and its derivatives is presented. The chromatographic system is based on size-exclusion chromatography with the addition of the fluorophoric compound 1-naphthol to the mobile phase. Detection is based on fluorescence enhancement caused by the formation of inclusion complexes. By incorporating 10(-4) M 1-naphthol in the mobile phase, detection limits of 90, 27, 370 and 37 pmol were obtained for beta CD, hydroxypropyl-beta CD, trimethyl-beta CD and dimethyl-beta CD, respectively. The method was applied to the determination of dimethyl-beta CD in urine: the minimum detectable concentration was 0.2 microgram/ml after preconcentration of 10 ml of urine.

Simultaneous determination of furosemide and amiloride in plasma using high-performance liquid chromatography with fluorescence detection.

A high-performance liquid chromatographic method using fluorescence detection for the simultaneous determination of furosemide and amiloride is described. The chromatographic system is based on reversed-phase ion-pair chromatography with sodium dodecylsulphate as ion-pairing agent. The same counter-ion is used for the ion-pair liquid-liquid extraction to ethyl acetate. The minimum detectable concentration amounts to 0.3 ng of furosemide and 0.03 ng of amiloride per ml of plasma. The applicability of the method is demonstrated by the analysis of plasma samples taken from volunteers receiving both drugs.

Bioanalysis of suramin in human plasma by ion-pair high-performance liquid chromatography.

A liquid chromatographic method is described that can be used for the determination of suramin in plasma samples from cancer patients treated with this drug. The chromatographic system is based on the use of tetrabutylammonium bromide as an ion-pairing agent, while ultraviolet detection is applied. The sample pretreatment is a simple deproteination step by an organic solvent. The same counter-ion as used in the phase system is added in order to increase the recovery of the almost complete protein-bound suramin. The minimum detectable concentration in plasma is ca. 0.1 microgram/ml, thus allowing the monitoring of patients treated with this drug. One example of a plasma concentration-time course after administration of suramin is given.

Reversed-phase ion-pair analysis of 5-fluorouracil in pig bile, liver homogenate, plasma and urine after administration by isolated liver perfusion.

5-Fluorouracil is at present one of the most administered cytostatic drugs in cancer chemotherapy. However, due to its high toxicity, local administration of the drug, e.g. by isolated liver perfusion, may be advantageous. A bioanalytical procedure, suitable for the routine analysis of 5-fluorouracil in pig bile, liver homogenates, plasma and urine is described using reversed-phase ion-pair chromatography with absorbance detection at 268 nm. Using a protein precipitation procedure with acetonitrile, a determination limit of 3500 ng g-1 was achieved for liver samples, and 5 ng ml-1 for plasma samples using a liquid-liquid extraction step.

Bioanalysis of (E)-5-(2-bromovinyl)-2'-deoxyuridine.

(E)-5-(2-Bromovinyl)-2'-deoxyuridine is an antiviral drug that is experimentally used for modulation of the antitumour effect of fluoropyrimidines, such as ftorafur and 5-fluorouracil. The isolation of the analyte, in the presence of 5-fluorouracil, from the matrix is performed either by means of a simple protein precipitation (plasma) or by means of a liquid-liquid extraction with ethyl acetate (urine). Following pretreatment, the analyte is analysed by reversed-phase chromatography and quantified by absorbance detection at 307 nm. The minimum detectable concentration in plasma and urine samples is ca. 6 ng/ml. The recovery after deproteination of plasma samples is 75%, while after liquid-liquid extraction of urine the recovery amounts 92%. The degree of protein binding of the analyte, measured by ultrafiltration, is found to be 97%. These data allow the bioanalysis of (E)-5-(2-bromovinyl)-2'-deoxyuridine for pharmacokinetic studies.

High-performance liquid chromatography of tetracyclines.

The possibilities of two non-ionogenic resins (XAD-2 and PRP-1) in the chromatography of tetracyclines and their degradation products are described. It appears that, in contrast to silica-based materials, this type of column material produces linear calibration curves, even in the low nanogram range. Two different methods of sample pretreatment in bioanalysis of tetracyclines and their degradation products are compared with respect to selectivity towards the matrix background and recovery.

Pharmacology of 5'-deoxy-5-fluorouridine in patients with resistant ovarian cancer.

The pharmacokinetics of the new fluoropyrimidine 5'-deoxy-5-fluorouridine (5'-dFUrd) was investigated in twelve patients. The kinetics of the main metabolite 5-fluorouracil (5-FUra) was studied in eight patients and those of 5,6-dihydro-5-fluorouracil (5-FUraH2) in five patients. The patients participated in a Phase II study performed to investigate the response rate of 5'-dFUrd in advanced ovarian cancer. The pharmacokinetic data were compared with the clinical effects of the drug. The parent drug and 5-FUra were measured in both plasma and urine by high performance liquid chromatography. 5-FUraH2 concentrations in plasma were determined by capillary gas chromatography using electron capture detection and nitrogen-phosphorus specific detection. Several pharmacokinetic parameters such as elimination half-life, mean residence time, and steady state volumes of distribution are presented for 5'-dFUrd, 5-FUra, and 5-FUraH2. Two patients showed a partial response, four had stable disease, and five had progressive disease; one patient died due to myelotoxicity. The severity of the side effects correlated with the mean residence times of 5'-dFUrd and 5-FUra. Low pretreatment serum creatinine clearance (due to renal impairment) correlated with low renal excretion of 5'-dFUrd and a long mean residence time of 5'-dFUrd with the sum of observed toxicity. However, the extent of degradation of 5-FUra to 5-FUraH2 may also be related to the severity of the toxicity of 5'-dFUrd.