中国健康志愿者单剂静脉滴注甲磺酸帕珠沙星氯化钠注射液的药动学研究

目的对中国健康成年志愿者单剂静脉滴注甲磺酸帕珠沙星氯化钠注射液的药动学研究。方法按GcP指导原则设计试验方案,选择10名健康受试者分别在30min内空腹静脉滴注甲磺酸帕珠沙星氯化钠注射液300和500mg,用HPLC-荧光法测定血浆、尿液中帕珠沙星的浓度,并采用3P97软件进行试验数据统计处理,求出药动学参数。结果帕珠沙星的血药浓度经时变化符合二房室模型,300和500mg的主要药动学参数如下：峰浓度Cmax分别为(7．716±1．373)和(11．652±2．197)μg／ml；半衰期t1/2分别为(2．00±0．26)h和(2．13±0．22)h；药时曲线下面积AUCo-∞分别为(14．170±3．244)和(25．370±3．234)μg·h／ml；表观分布容积Vc分别为(28．83±12．92)L和(31．62±8．91)L。尿药浓度测定结果表明,帕珠沙星0-24 h累积排出量分别为(261．82±30．92)mg和(452．27±32．35)mg,0-24 h累积排出百分比分别为(87．27±10．31)％和(90．45±6．47)％。结论帕珠沙星单次给药在中国健康人体耐受性良好,药时曲线符合二房室模型,帕珠沙星在300-500mg剂量范围内药物体内过程呈线性动力学特征,药物主要经肾脏排泄。     

甲磺酸帕珠沙星氯化钠注射液健康志愿者单剂给药药动学

目的研究健康志愿者静脉滴注单剂甲磺酸帕珠沙星氯化钠注射液后药动学特征,为该药Ⅱ期临床试验提供依据。方法采用2剂量2周期交叉试验设计。10名健康受试者单剂静脉滴注甲磺酸帕珠沙星氯化钠注射液300、500mg,HPLC法测其血清、尿药物浓度。结果受试者静脉滴注甲磺酸帕珠沙星氯化钠注射液后,人体耐受良好,体内过程符合二室开放模型。主要药动学参数与给药剂量呈线性关系,cmax分别为8.3和11.07μg/ml,AUC0-∞分别为13.66和24.04μg.h/ml,V值分别为28.9和40L,t1/2β分别为1.77和2.27h,36h尿药累积回收率约为79%。结论甲磺酸帕珠沙星氯化钠注射液静脉滴注血峰浓度高,组织分布较广,消除半衰期短,300mg每日2次可用于治疗敏感菌感染。     

甲磺酸帕珠沙星注射液人体药动学研究

目的研究单次及多次静脉滴注甲磺酸帕珠沙星注射液的药动学特点。方法筛选健康受试者12名,q12h静脉滴注甲磺酸帕珠沙星注射液每次500m g,连续5d,共9次;用反向高效液相色谱-紫外法测定血药浓度,用DA Sver1.0软件拟合药动学参数。结果受试者静脉滴注甲磺酸帕珠沙星注射液后体内过程符合二室模型;单次给药后的药动学参数:Tm ax为(0.47±0.09)h,cm ax为(13.71±1.81)m g/L,AUC0-t为(24.60±4.15)m g.h/L,t1/2为(1.46±0.64)h,M RT、CL和Vd分别为(2.14±0.33)h、(0.09±0.04)L/(h.kg)和(0.17±0.03)L/kg。q12h静脉滴注帕珠沙星500m g连续5d(共9次),第2、3、4、5d晨测得谷浓度分别为0.13、0.16、0.17和0.14m g/L,提示血药浓度已达稳态。末剂给药后的药动学参数:Tm ax为(0.48±0.10)h,cm ax为(15.41±1.67)m g/L,AUC0-t为(28.42±4.90)m g.h/L,t1/2为(1.33±0.49)h,CL为(0.09±0.06L/)h,(css)av为(2.34±0.43)m g/L,DF为(99.48±0.38)%,以上参数与单次给药比较除cm ax外均无统计学差异,且累积系数小,说明本品多次给药无体内蓄积。女性和男性受试者主要药动学参数比较均无统计学差异。受试者给药期间未出现严重不良反应。结论500m g q12h静脉滴注,在人体内可达到有效血药浓度,可以作为临床应用的推荐方案。     

甲磺酸帕珠沙星氯化钠注射液在健康人体的药代动力学

目的研究甲磺酸帕珠沙星氯化钠注射液在健康人体的药代动力学。方法8名健康受试者单次静脉滴注甲磺酸帕珠沙星300,600mg后,用高效液相色谱法测定体内帕珠沙星的血药浓度,用DAS统计软件进行数据处理。结果结果符合一级消除药代动力学的二室模型,300,600mg2个剂量组的药代动力学参数:Cmax分别为(7.38±0.85),(18.36±2.39)mg·L-1;AUC0-t分别为(31.34±5.67),79.20±18.43)mg·h·L-1;t1/2β分别为(1.63±0.31),(1.71±0.21)h;CL/F分别为(0.10±0.02),(0.08±0.01)L·kg·h-1,V/F分别为(0.23±0.03),(0.19±0.05)L·kg-1。24h尿药累积排泄率分别为(92.2±2.6)%和(93.2±3.0)%。结论甲磺酸帕珠沙星每日给药300mg,每日2次,可达到有效治疗浓度,在600mg内可安全耐受。     

甲磺酸帕珠沙星注射液健康人体单次给药的药动学研究

目的:研究甲磺酸帕珠沙星注射液在健康人体内单次给药的药动学特征。方法:12例受试者按拉丁法随机分为三组,先后静脉点滴甲磺酸帕珠沙星注射液250,500,750 mg,采用高效液相色谱法测定给药后不同时间的血、尿浓度,计算主要药动学参数。结果:受试者静脉点滴250,500,750 mg的甲磺酸帕珠沙星后,C_(max)分别是(7．23±1．56),(13．50±2．15)和(21．97±3．62)mg·L~(-1);AUC_(0-∞)分别为(17．72±3．91),(35．92±5．71)和(61．23±18．08)mg·L~(-1)·h;t_(1/2)β为(2．03±0．12),(2．06±0．30)和(1．99±0．26)h;CL为(15．63±2．99),(14．76±2．63)和(13．22±3．03)L·h~(-1)·kg~(-1);V_1为(16．48±5．65),(17．29±9．01)和(14．87±8．04)L,除C_(max)和AUC_(0-∞)外,其他参数3个剂量组之间的差异经统计学处理无显著性差异(P＞0．05)。250,500和750 mg的甲磺酸帕珠沙星静脉点滴12 h后尿中原形药物累积排泄百分率分别为(93．85±1．71)%,(93．14±1．82)%和(93．24±1．74)%,表明给药后有＞90%的药物以原形从尿中排出。结论:根据药动学参数计算,结合体外抗菌活性结果,认为采用bid,每次静脉点滴帕珠沙星500 mg的给药方式,预期对临床常见细菌感染能够取得良好的疗效。     

哌拉西林钠对甲磺酸帕珠沙星在大鼠体内药代动力学的影响

目的研究哌拉西林钠对甲磺酸帕珠沙星在大鼠体内药代动力学的影响。方法 12只健康雄性SD大鼠随机分成2组(分别为单独和联合给药组),用HPLC法测定血浆中甲磺酸帕珠沙星的浓度。结果单独用药与联合用药组ρmax分别为(33.54±4.68)和(37.83±3.43)mg.L-1,AUC0-t分别为(43.32±15.91)和(41.98±9.19)mg.h.L-1,t1/2分别为(1.00±0.31)和(0.80±0.24)h,无显著性差异(P>0.05)。结论与哌拉西林钠联合用药后甲磺酸帕珠沙星在大鼠体内的药动学参数均不存在显著性差异。     

甲磺酸帕珠沙星的人体药动学

目的:研究甲磺酸帕珠沙星在健康人体内的药动学特征。方法:12名健康志愿者(男女各6名)单剂量和多剂量静脉滴注甲磺酸帕珠沙星氯化钠注射液300mg,滴注时间30min。血浆用20%高氯酸水溶液沉淀蛋白,上清液直接用高效液相色谱-荧光检测血浆中帕珠沙星药物浓度。结果:最小检测限小于0.028mg.L-1,提取回收率大于90%,日内、日间变异(RSD小于10%)。静脉滴注甲磺酸帕珠沙星在健康人体内的药动学特征用3P97程序拟合为二房室模型,其主要药动力学参数单剂量时和多剂量时的Cmax,t1/2β,AUC0-t,AUC0-∞,Vc和CL分别为(7.2±0.8)mg.L-1和(7.3±0.8)mg.L-1,(2.04±0.17)h和(2.24±0.23)h,(14.0±1.5)mg.L.h-1和(14.3±1.5)mg.L.h-1,(13.1±1.5)mg.L.h-1和(13.3±1.2)mg.L.h-1,(27.2±4.6)L和(25.3±8.8)L,(22.1±2.6)L.h-1和(23.7±2.1)L.h-1。单剂量时和多剂量间的药动学参数,除了t1/2β和MRT有性别差异外,其余无明显差异。结论:静脉滴注甲磺酸帕珠沙星后无论单剂量和多剂量的药动学参数基本一致,说明连续300mg,bid,静脉滴注5d体内无明显累积,药动学参数如t1/2β,MRT可能存在性别差异,其原因尚不清。     

中国健康志愿者单剂静滴甲磺酸加替沙星注射液的药代动力学研究

目的研究中国健康成年男性志愿者单剂静滴甲磺酸加替沙星注射液的药代动力学.方法按GCP指导原则设计试验方案,获得伦理委员会批准,受试者须自愿签署知情同意书.选择经体检及实验室检查均正常的健康成年男性志愿者.9名试者按拉丁方随机分组,分别依次单剂静滴100mg、200mg、400mg 3个剂量的甲磺酸加替沙星注射液后,应用HPLC测定血药浓度,采用3P97软件进行数据处理,求出药代动力学参数.结果血浆及尿中甲磺酸加替沙星分别在0.0156～1mg·L1和0.434～111.11mg·L1浓度范围内良好的线性关系,日内、日间变异系数及绝对和相对回收率均符合临床药代动力学研究的要求.受试者分别单剂静滴加替沙星注射液100mg、200mg、400mg后,药-时曲线符合二房室模型,主要药代动力学参数Gmax分别为1.098±0.19mg·L-1、2.17±0.329mg·L-1、和3.164±0.473mg·L-1;t1/2β分别为7.415±1985h、8.41±2.722h和8.462±2.832h;AUC0～∞分别为4.45±0.712mg·L-1·h、11.102±1.814mg·L-1· h和23.029±3835mg·L-1·h;Vd分别为82.120±36.216L、71.254±38.740L和80.504±33.721L;CL分别为24.151±3.787L·h1、18.747±4.256L·h1和19.598±4.250 L·h1.单剂静滴100mg、200mg、400mg甲磺酸加替沙星主要经肾排泄,48h尿药累积排泄率分别为43.08%±15.79%、51.33%±23.69%和45.67%±18.22%.结论9名健康受试者按拉丁方设计分别自身前后静滴甲磺酸加替沙星注射液100mg、200mg、400mg后,药-时曲线符合二房室模型,Cmax与AUC0～∞随剂量加大而增加;t1/2β、tmax、β、Vd、Cl与给药剂量无关.提示甲磺酸加替沙星在100mg～400mg剂量范围内药物体内过程呈线性动力学特征而无饱和性,主要排泄途径为肾脏.     

国产甲磺酸帕珠沙星注射剂在健康人体的药代动力学

目的研究甲磺酸帕珠沙星注射剂在健康人体的药代动力学。方法用 双周期交叉试验设计,12名健康受试者分别给予甲磺酸帕珠沙星300,500 mg, 用HPLC法测定给药后不同时间的血药浓度。结果 静脉滴注:300,500 mg 后,血清中甲磺酸帕珠沙星的Cmax分别为(12．52±3．36)和(23．56±4．66)μg ·mL-1;t1／2分别为(1．54±0．36)和(2．11±1．83)h;AUC(model)分别为(21．73± 6．09)和(57．82±74．94)μg·h·mL-1;CL分别为(244．83±57．89)和(233．03 ±101．16)mL·min-1;Vc分别为(12．41±4．77)和(11．12±5．25)L;Vss分别 为(28．22±8．60)和(26．88±8．08)L。结论国产甲磺酸帕珠沙星在人体内的 代谢符合二室模型,药物吸收量与给药剂量基本呈线性关系;90％以上的药物 以原形从尿中排出。     

中国健康志愿者单剂口服甲磺酸加替沙星片的药代动力学研究

目的研究中国健康成年志愿者单剂口服甲磺酸加替沙星片的药代动力学.方法按GCP指导原则设计试验方案,选择9名健康受试者分别依次单剂口服200mg、400mg、600mg 3个剂量的甲磺酸加替沙星片后,应用HPLC测定血药浓度,采用3P97软件进行数据处理,求出药代动力学参数.结果受试者分别给药后,药-时曲线符合二房室模型,主要药代动力学参数Cmax分别为2.028±0.362 mg.L-1、3.749±0.446 mg.L-1、4.876±0.569 mg.L-1;t1/2β分别为7.489±0.806h、7.063±0.890h、7.735±0.8701h;AUC0～t分别为12.24±1.51mg·h·L-1、26.02±3.38 mg·h·L-1、39.22±6.57 mg·h·L-1;原型药主要经肾排泄,48h尿药累积排泄率分别为61.90%±7.70%、60.90%±5.70%和58.74%±13.49%.结论9名健康受试者分别口服给药后,药-时曲线符合二房室模型,甲磺酸加替沙星在200mg～600mg剂量范围内药物体内过程呈线性动力学特征而无饱和性,主要排泄途径为肾脏.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Trichinellosis in immigrants in Switzerland

We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia.     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Hyperkalaemia in patients in hospital

A survey of all laboratory blood specimens with a plasma potassium concentration greater than or equal to 5.5 mmol/L was conducted over a three month period. Of 331 specimens with hyperkalaemia, 71 were excluded because the specimens was haemolysed, old or contaminated. The laboratory served a population of 348,561 and during this time measured the plasma potassium on 25,016 occasions. Sixty-six outpatients and 20 neonates were not evaluated. The survey was undertaken on 86 of 102 inpatients (46 males), 48 of whom were over 66 years of age. Fifty-seven patients were admitted under a medical service and 29 under a surgical service. Fifty-nine had a single episode of hyperkalaemia. Thirty-two underwent a surgical procedure. The commonest contributing factor was impaired renal function which was present in 71 (83%) patients. Although a definitive causative role for drugs could be identified in only five patients, in 52 (60%) patients drugs were a contributing factor (potassium supplements 24, ACE inhibitors 16, nonsteroidal antiinflammatory drugs 12). Thirty-five of the 86 (41%) patients died during their hospital admission. Nineteen of the 35 deaths occurred within three days of the hyperkalaemia being recorded. A normal plasma potassium was eventually documented in 50 of the 86 patients. Of the remaining 36 patients, 25 (69%) subsequently died. In general the treatment of patients with hyperkalaemia focused on identifying and treating the underlying cause. Hyperkalaemia must always be considered seriously and regard given to the overall clinical status of the patient, with particular attention to drug therapy, renal and cardiac function, acid base status and the possibility of sepsis.