皮肤微透析技术在药动学及药效学研究中的应用进展

目的:介绍皮肤微透析技术在药动学及药效学研究中的应用进展。方法:采用文献综述法,阐述国内、外近几年来将皮肤微透析技术应用于药动学及药效学研究的进展。结果与结论:皮肤微透析技术可以在不破坏皮肤组织的条件下对皮肤或皮下组织细胞外液物质浓度进行采样,与其他皮肤药动/药效学采样技术相比具有微创、实时、多位点等优点,可广泛应用于皮肤药动学和药效学研究。皮肤微透析技术在中药药动学及药效学研究中有很好的应用前景。     

环维黄杨星D抗心肌缺血PK-PD结合模型的研究

摘 要 目的： 应用药动学 药效学（PK-PD）结合模型的研究方法考察环维黄杨星D（CVB-D）在心肌缺血家兔体内的药动学和药效学之间的关系。方法: 以冠状动脉结扎方法制备家兔心肌缺血模型,运用微透析采样技术考察CVB-D经皮给药和灌胃给药后在心肌组织内的浓度变化,分时采血检测试验动物血浆中乳酸脱氢酶(LDH)、肌酸激酶(CK)、丙二醛(MDA)活性变化,用药物学软件拟合PK-PD模型,并计算主要参数。结果: 药理效应与药物浓度之间符合抑制性S型最大效应模型,并准确计算出PK-PD结合模型参数。结论: 建立了环维黄杨星D在心肌缺血家兔体内的PK-PD结合模型,得到药动学和药效学参数,Cp-E曲线以及各个药效指标在不同给药途径条件下的量效方程。     

脑微透析在药物监测中的应用

脑微透析是一种微创取样技术,具有多位点、实时取样和可在线等优点,在脑部药物监测中越来越受到关注。脑微透析技术为脑部药物浓度的监测提供了一种有效的新途径,可为新药研发与临床合理用药提供科学依据,在脑部给药系统研究中,特别是药动学及药效学研究中优势显著,具有很好的应用前景。本文综述了有关脑部微透析技术的特点及发展,介绍了脑微透析技术在药物监测研究中的进展,分别归纳了微透析技术在实验动物和临床患者中的应用情况。     

微透析技术在药动-药效学结合研究中的应用

微透析技术能直接、有效地对作用部位细胞外液中的内源性及外源性化合物进行持续检测,是药动-药效学结合研究的重要工具,具有不可替代的作用及广阔的应用前景。本文概述了微透析技术的基本原理及特点,并重点介绍了其在药动-药效学结合研究中的应用。     

厄贝沙坦与氢氯噻嗪联用在肾性高血压大鼠体内药动学-药效学关系研究

目的:应用药动学-药效学结合模型研究厄贝沙坦与氢氯噻嗪联用在肾性高血压大鼠体内单剂量及多剂量用药时的药动学-药效学关系。方法:将SD大鼠制备成2肾1夹型肾性高血压模型,给大鼠单剂量或多剂量灌胃给药,分别于第1天和第8天连续的预定时间点测定血药浓度,同时测定动脉收缩压(SBP)和动脉舒张压(DBP)等药物效应,建立效应室药动学-药效学结合模型并计算相关的药动学和药效学参数。对单用、联用及单剂量、多剂量的药动学-药效学规律进行定量研究。结果:厄贝沙坦的药动学特征呈二室模型,氢氯噻嗪在非稳态和稳态条件下均未改变厄贝沙坦的药动学参数,而在稳态条件下,厄贝沙坦可增高氢氯噻嗪的血药浓度及曲线下面积。厄贝沙坦和氢氯噻嗪联用降压效应优于单用的效应。药物效应和效应室浓度之间符合Sigmoid-Emax药效学模型。单剂量下药物效应与血药浓度间存在滞后现象,多剂量下滞后现象消失。Emax、EC50、Keo等药效学参数在厄贝沙坦组和两药联用组之间的差异有统计学意义。结论:建立了PK-PD定量数学模型研究厄贝沙坦和氢氯噻嗪联用在大鼠体内单剂量和多剂量用药后药动学-药效学(暴露-反应)关系的规律,并提供了相关的药动学和药效学参数,可为临床合理用药提供参考依据。     

创新课程药动学-药效学模型实验教学实践

作为药动学扩展的创新课程,首次在药学本科学员中开展药动学-药效学模型实验.选用氟比洛芬作为模型药物,HPLC法测定口服给药后家兔的血药浓度.采用内毒素发热家兔模型,考察氟比洛芬的药动学和药效学参数.与传统药物动力学实验相比,药动学-药效学模型实验是培养学生实践能力和创新能力的实验教学新模式.     

三种估算药动学—药效学参数方法的比较及应用

根据三种估算药动学和药效学结合模型参数的方法编制了软件。参数法包括十个药动学模型和三种药效学模型,可以同时求算药动学和药效学参数;非参数药效模型法不必预先假设药效学模型就可估算出反映药物效应的消除速率常数(K_(eo));非参数药效模型法中,药动学模型也用非参数方法描述,只要输入药动—药效数据就可求出K_(ro)。对6例吸入大麻的健康志愿者的药动—药效数据,用以上方法进行验算,结果表明三种方法各有优点,应比较使用。     

黄连解毒汤“方证对应”的PK-PD研究和数据挖掘技术的应用

目的:基于"方证对应"理论,探讨黄连解毒汤在药动学和药效学方面的研究思路及方法。方法:查阅近年来国内、外学者在黄连解毒汤药动学和药效学方面的研究成果,论述药动-药效学(PK-PD)结合模型和数据挖掘技术在中药复方物质基础研究和药动学研究中的重要性。结果:通过引入PK-PD结合模型和数据挖掘技术,有助于揭示方剂与证候之间的对应关系。结论:在"方证对应"理论的指导下,黄连解毒汤的药动学和药效学研究还需进一步深入。     

肾移植术后泼尼松/泼尼松龙的临床药动学/药效学研究进展

目的:综述近年来肾移植术后糖皮质激素泼尼松/泼尼松龙临床药动学(PK)和药效学(PD)研究现状,为进一步优化其免疫抑制治疗方案提供参考。方法:检索国内外相关文献,总结泼尼松/泼尼松龙在肾移植术后药动学/药效学相关研究情况及未来发展方向。结果:糖皮质激素已应用多年,但其临床给药方案通常凭医生经验制定,缺乏临床药动学/药效学研究指导,因而在进行冲击治疗和长期给药时往往出现多种毒副作用。目前泼尼松/泼尼松龙肾移植术后的临床药动学和药效学研究局限:大部分药动学数据采用非房室分析方法以及两步统计法计算,大多数研究中测定血药浓度为总药物浓度而非实际起效的游离药物浓度,药效学研究多限于药物暴露与毒副作用之间的相关性研究。结论:泼尼松/泼尼松龙肾移植术后的临床药动学、药效学研究具有一定基础但尚不全面,有待考察其系统的定量关系用于指导个体化用药方案的制定。     

心血管疾病的时间节律与时辰给药

药物在体内的动态分布和机体对药物的反应常常受机体生物节律的影响,即机体生物节律性在药动学和药效学等方面表现出明显的差别,这在心血管系统药物显得尤为重要。许多疾病的发生是由于正常生理节律发生了异常节律,掌握人体疾病的节律变化并根据疾病的发病时间规律,结合药物的药动学、药效学等变化规律,设计出不同的给药时间和剂量方案,选择适合的剂型,进行时辰给药治疗,将减少药物的毒副作用,达到最佳疗效。     

Application of microdialysis in clinical pharmacology

Microdialysis has been developed during the last 25 years by several authors primarily to study brain function and changes in levels of endogenous compounds such as neurotransmitters or metabolites in different laboratory animals. However, in the last ten years microdialysis sampling has been introduced as a versatile technique in the clinical setting. Although, microdialysis sampling has been extensively used for metabolic monitoring in patients, it was also employed for the study of distribution of different therapeutic agents especially anti-infective and antineoplasic drugs. In addition, clinical effect of drugs in patients could be also determined by means of microdialysis. So, this article reviewed the vast applications of the microdialysis technique for the study of pharmacokinetic and pharmacodynamic properties of drugs in the clinical setting.     

Microdialysis in drug discovery

Microdialysis has been developed during the last 25 years by several authors primarily to study brain function and changes in levels of endogenous compounds such as neurotransmitters or metabolites. The development of microdialysis for the purpose of measuring drugs was initiated during the late eighties. This technique provides a means of continuous plasma sampling without repeated blood sampling and the applicability to the study of drug metabolism and pharmacokinetics in experimental animals and human. Also, the microdialysis technique allows the study of plasma protein binding and the saturation of protein binding. The implantation of the microdialysis probe in other tissues and organs, like central nervous system, adipose tissue and heart, allows the study of drug distribution. On the other hand, the measurement of endogenous substances using the microdialysis technique permits the study of the effect of drugs on neurotransmission and metabolism. Moreover, as this technique allows the simultaneous determination of different physiological parameters such as blood pressure, locomotor and convulsive activity, it is a suitable tool for pharmacokinetic-pharmacodynamic studies of drugs and pharmacokinetic-pharmacodynamic (PK-PD) modeling. Lastly, the reverse microdialysis is a powerful technique for the study of local actions of drugs in different tissues such as specific brain nuclei, myocardium, liver or skeletal muscle. So, this article reviewed the vast applications of the microdialysis technique for the study of pharmacokinetic and pharmacodynamic properties of drugs.     

Application of Microdialysis in Pharmacokinetic Studies

The objective of this review is to survey the recent literature regarding the various applications of microdialysis in pharmacokinetics. Microdialysis is a relatively new technique for sampling tissue extracellular fluid that is gaining popularity in pharmacokinetic and pharmacodynamic studies, both in experimental animals and humans. The first part of this review discusses various aspects of the technique with regard to its use in pharmacokinetic studies, such as: quantitation of the microdialysis probe relative recovery, interfacing the sampling technique with analytical instrumentation, and consideration of repeated procedures using the microdialysis probe. The remainder of the review is devoted to a survey of the recent literature concerning pharmacokinetic studies that apply the microdialysis sampling technique. While the majority of the pharmacokinetic studies that have utilized microdialysis have been done in the central nervous system, a growing number of applications are being found in a variety of peripheral tissue types, e.g. skin, muscle, adipose, eye, lung, liver, and blood, and these are considered as well. Given the rising interest in this technique, and the ongoing attempts to adapt it to pharmacokinetic studies, it is clear that microdialysis sampling will have an important place in studying drug disposition and metabolism.     

Microdialysis: current applications in clinical pharmacokinetic studies and its potential role in the future

Microdialysis is a probe-based sampling method, which, if linked to analytical devices, allows for the measurement of drug concentration profiles in selected tissues. During the last two decades, microdialysis has become increasingly popular for preclinical and clinical pharmacokinetic studies. The advantage of in vivo microdialysis over traditional methods relates to its ability to continuously sample the unbound drug fraction in the interstitial space fluid (ISF). This is of particular importance because the ISF may be regarded as the actual target compartment for many drugs, e.g. antimicrobial agents or other drugs mediating their action through surface receptors. In contrast, plasma concentrations are increasingly recognised as inadequately predicting tissue drug concentrations and therapeutic success in many patient populations. Thus, the minimally invasive microdialysis technique has evolved into an important tool for the direct assessment of drug concentrations at the site of drug delivery in virtually all tissues. In particular, concentrations of transdermally applied drugs, neurotransmitters, antibacterials, cytotoxic agents, hormones, large molecules such as cytokines and proteins, and many other compounds were described by means of microdialysis. The combined use of microdialysis with non-invasive imaging methods such as positron emission tomography and single photon emission tomography opened the window to exactly explore and describe the fate and pharmacokinetics of a drug in the body. Linking pharmacokinetic data from the ISF to pharmacodynamic information appears to be a straightforward approach to predicting drug action and therapeutic success, and may be used for decision making for adequate drug administration and dosing regimens. Hence, microdialysis is nowadays used in clinical studies to test new drug candidates that are in the pharmaceutical industry drug development pipeline.     

Microdialysis in peripheral tissues

The objective of this review is to survey the recent literature regarding the applications of microdialysis in pharmacokinetic studies and facilitating many other studies in peripheral tissues such as muscle, subcutaneous adipose tissue, heart, lung, etc. It has been reported extensively that microdialysis is a useful technique for monitoring free concentrations of compounds in extracellular fluid (ECF), and it is gaining popularity in pharmacokinetic and pharmacodynamic studies, both in experimental animals and humans. The first part of this review discusses the use of microdialysis technique for ECF sampling in peripheral tissues in animal studies. The second part of the review describes the use of microdialysis for ECF sampling in peripheral tissues in human studies. Microdialysis has been applied extensively to measure both endogenous and exogenous compounds in ECF. Of particular benefit is the fact that microdialysis measures the unbound concentrations in the peripheral tissue fluid which have been shown to be responsible for the pharmacological effects. With the increasing number of applications of microdialysis, it is obvious that this method will have an important place in studying drug pharmacokinetics and pharmacodynamics.     

Clinical pharmacokinetics of anxiolytics and hypnotics in the elderly. Therapeutic considerations (Part II).

Part I of this article, which appeared in the previous issue of the Journal, discussed the scope of and scientific basis for special pharmacokinetic studies of anxiolytic and hypnotic drugs in the elderly, and examined the methodology and results of such studies and the prediction of pharmacokinetic changes. In Part II the authors continue their review, focusing on age-related pharmacodynamic changes in the effects of these drugs, the attempts to correlate pharmacokinetic with pharmacodynamic findings, and the clinical applications of these data.     

An integrated microdialysis rat model for multiple pharmacokinetic/pharmacodynamic investigations of serotonergic agents

INTRODUCTION: Integrated in vivo models applying intracerebral microdialysis in conjunction with automated serial blood sampling in conscious, freely moving rodents are an attractive approach for pharmacokinetic (PK) and simultaneous pharmacokinetic/pharmacodynamic (PK/PD) investigations of CNS active drugs within the same animal. In this work, the ability to obtain and correlate data in this manner was evaluated for the selective serotonin (5-HT) reuptake inhibitor (SSRI) escitalopram. METHODS: An instrumented rat model equipped with an intracerebral hippocampal microdialysis probe and indwelling arterial and venous catheters was applied in the studies. Concomitant with brain microdialysis, serial blood sampling was conducted by means of an automated blood sampling device. The feasibility of the rat model for simultaneous PK/PD investigations was examined by monitoring plasma and brain extracellular concentrations of escitalopram along with SSRI-associated pharmacological activity, monitored as changes in brain 5-HT levels and plasma corticosterone levels. RESULTS: Combining intracerebral microdialysis and automated blood sampling did not cause any detectable physiological changes with respect to basal levels of plasma corticosterone or brain 5-HT levels. Furthermore, the PK of escitalopram in hippocampus following intravenous injection was not influenced by the presence of vascular catheters. Conversion of escitalopram dialysate concentrations into absolute extracellular levels by means of in vivo retrodialysis was verified by the no-net-flux method, which gave similar recovery estimates. The PK of escitalopram could be characterized simultaneously in plasma and the hippocampus of conscious, freely moving rats. Concomitantly, the modulatory and functional effects of escitalopram could be monitored as increases in brain 5-HT and plasma corticosterone levels following drug administration. DISCUSSION: The applicability of intracerebral microdialysis combined with arterial blood sampling was demonstrated for simultaneous PK/PD investigations of escitalopram in individual rats under non-stressful conditions. Together, these temporal relationships provide multiple PK/PD information in individual animals, hence minimizing inter-animal variation using a reduced number of animals.     

Microdialysis as a tool in local pharmacodynamics

In many cases the clinical outcome of therapy needs to be determined by the drug concentration in the tissue compartment in which the pharmacological effect occurs rather than in the plasma. Microdialysis is an in vivo technique that allows direct measurement of unbound tissue concentrations and permits monitoring of the biochemical and physiological effects of drugs throughout the body. Microdialysis was first used in pharmacodynamic research to study neurotransmission, and this remains its most common application in the field. In this review, we give an overview of the principles, techniques, and applications of microdialysis in pharmacodynamic studies of local physiological events, including measurement of endogenous substances such as acetylcholine, catecholamines, serotonin, amino acids, peptides, glucose, lactate, glycerol, and hormones. Microdialysis coupled with systemic drug administration also permits the more intensive examination of the pharmacotherapeutic effect of drugs on extracellular levels of endogenous substances in peripheral compartments and blood. Selected examples of the physiological effects and mechanisms of action of drugs are also discussed, as are the advantages and limitations of this method. It is concluded that microdialysis is a reliable technique for the measurement of local events, which makes it an attractive tool for local pharmacodynamic research.     

聚乙二醇修饰小分子药物的研究进展

聚乙二醇修饰技术是目前药物化学修饰的研究热点,它能够显著提高药物分子水溶性,同时改善药物的药动学和药效学特性,增加了药物临床应用的范围和疗效,具有较好的开发应用前景;但同时也存在诸多问题,有待改进,目前在国内研究相对较少,值得进一步研究开发。本文从聚乙二醇修饰技术被修饰的小分子药物种类、连接臂类型、聚乙二醇载体以及修饰后药物药动学性质和药效学性质改变等方面进行系统综述。     

手性药物的对映体选择性与临床应用

目的 :探讨临床应用手性药物的对映体选择性问题。方法 :从手性药物的药动学特性、药效学特性及临床应用几方面举例说明。结果与结论 :手性药物对映体表现出错综复杂的药代动力学和药效学特征。手性药物对映体的深入研究 ,将对临床合理应用手性药物产生深远的影响