Plasma kinetics and effects of 5,6-dihydro-5-azacytidine in mice and L1210 tumor

Summary The plasma kinetics of 5,6-dihydro-5-azacytidine (DHAC) was determined in mice using an HPLC method following an intravenous dose of 2000 mg/kg (LD₁₀). Pharmacokinetic parameters calculated from these single dose data were sufficient to predict steady state plasma concentrations produced by s.c. infusion of DHAC. Lethal toxicity (LD₆₆) occurred at an infusion rate of 37 mg/kg/h (111mg/m²/h), corresponding to a plasma steady-state DHAC concentration 38 ± 14 g/ml when the infusion time was 96 h; no lethality occurred at infusion times of 72 h or less. In vitro clonogenic assays and in vivo therapeutic experiments with L1210 tumor indicated that increasing the exposure time at concentrations near 25 g/ml from 24 to 72 h increased the cell kill only slightly. The maximum log cell kill of L1210 estimated from either in vitro or in vivo data was 1.5 logs.     

An in Vitro Pharmacodynamic Model to Simulate Antibiotic Behavior of Acute Otitis Media with Effusion

The purpose of this investigation was to develop an in vitro pharmacodynamic model (IVPM) that would simultaneously simulate in vivo serum and middle ear amoxicillin pharmacokinetic characteristics of acute (purulent) otitis media and then utilize the IVPM to assess amoxicillin-mediated killing of a type 7F Streptococcus pneu-moniae (MIC = 0.002 mg/L). The IVPM consisted of a sterile central compartment and a membrane-bound infected peripheral compartment. Peak peripheral compartment amoxicillin concentrations occurred within 2 hr after its introduction into the central compartment and were approximately 30% of peak central compartment concentrations. Amoxicillin elimination from the central compartment was designed to provide a 1-hr t _1/2. Amoxicillin elimination from the peripheral compartment was slower than from the central compartment, with an average half-life of 2.3 hr. Significant concentration-related differences in maximal bacterial kill rates were not detected over the range of amoxicillin concentrations studied (0.26 to 14.6 mg/L). However, at peak central compartment amoxicillin concentrations of 2 mg/L, a lag phase in killing was observed. In general, the in vitro pharmacokinetic data derived from this model compare well with published in vivo data.     

Prediction of in Vivo Tissue Distribution from in Vitro Data. 2. Correlation Between in Vitro and in Vivo Tissue Distribution of a Homologous Series of Nine 5-n-Alkyl-5-Ethyl Barbituric Acids

Purpose. To evaluate the ability to determine accurate in vivo tissue-to-unbound plasma distribution coefficients (Kpu_e) from in vitro data. Methods. Fresh pieces of fifteen rat tissues/organs were incubated at 37°C with a homologous series of nine barbiturates covering a wide range of lipophilicity (Log P 0.02 to 4.13). Steady-state in vivo Kpu _e values were estimated from the tissue and plasma concentrations following simultaneous dosing by constant rate i.v. infusion of all nine barbiturates. Drug concentrations in the tissues and media were determined by HPLC with UV or mass spectrometric detection. Results. The pharmacokinetics of the barbiturate series following constant rate i.v. infusion indicated a range of clearance (0.49 to 30 ml.min^\-1.kg^\-1) and volume of distribution at steady state (0.51 to 1.9 l.kg^\-1) values. Good agreement was observed between the in vitro and in vivo Kpu values, although for the most lipophilic barbiturates the in vitro data underpredicted the in vivo tissue distribution for all tissues. Conclusions. The in vitro system for predicting the extent of in vivo tissue distribution works well for compounds of widely differing lipophilicity, although for the most lipophilic drugs it may result in an underprediction of in vivo values.     

Prediction of Human Drug Clearance from <Emphasis Type="Italic">in Vitro</Emphasis> and Preclinical Data Using Physiologically Based and Empirical Approaches

No HeadingPurpose. The aim of this study is to compare the accuracy of five methods for predicting in vivo intrinsic clearance (CL_int) and seven for predicting hepatic clearance (CL_h) in humans using in vitro microsomal data and/or preclinical animal data.Methods. The human CL_int was predicted for 33 drugs by five methods that used either in vitro data with a physiologic scaling factor (SF), with an empirical SF, with the physiologic and drug-specific (the ratio of in vivo and in vitro CL_int in rats) SFs, or rat CL_int directly and with allometric scaling. Using the estimated CL_int, the CL_h in humans was calculated according to the well-stirred liver model. The CL_h was also predicted using additional two methods: using direct allometric scaling or drug-specific SF and allometry.Results. Using in vitro human microsomal data with a physiologic SF resulted in consistent underestimation of both CL_int and CL_h . This bias was reduced by using either an empirical SF, a drug-specific SF, or allometry. However, for allometry, there was a substantial decrease in precision. For drug-specific SF, bias was less reduced, precision was similar to an empirical SF. Both CL_int and CL_h were best predicted using in vitro human microsomal data with empirical SF. Use of larger data set of 52 drugs with the well-stirred liver model resulted in a best-fit empirical SF that is 9-fold increase on the physiologic SF.Conclusions. Overall, the empirical SF method and the drug-specific SF method appear to be the best methods; they show lower bias than the physiologic SF and better precision than allometric approaches. The use of in vitro human microsomal data with an empirical SF may be preferable, as it does not require extra information from a preclinical study.     

Lyophilized Paclitaxel Magnetoliposomes as a Potential Drug Delivery System for Breast Carcinoma via Parenteral Administration: <Emphasis Type="Italic">In Vitro</Emphasis> and <Emphasis Type="Italic">in Vivo</Emphasis> Studies

No HeadingPurpose. The study reports in vitro and biological evaluation of lyophilized negatively charged paclitaxel magnetic liposomes as a potential carrier for breast carcinoma via parenteral administration.Methods. Paclitaxel in magnetoliposomes were extracted by centrifugation and quantified by high-performance liquid chromatography (HPLC). Biological properties were studied using pharmacokinetics, in vivo distribution and cytotoxicity assays, as well as a mouse model of EMT-6 breast cancer.Methods. Pharmacokinetic studies showed that encapsulation of paclitaxel in magnetoliposomes produced marked difference over the drug in Cremophor EL/ethanol pharmacokinetics, with an increased t_1/2 19.37 h against 4.11 h. For in vivo distribution, paclitaxel concentration of lyophilized magnetoliposomes in the tumor was much higher than that of lyophilized conventional liposomes or Cremophor EL/ethanol, whereas in heart it was much lower than the latter two formulations via s.c. and i.v. administration. Lyophilized paclitaxel magnetic liposomes showed more potency on the therapy of breast cancer than other formulations via s.c. and i.p. administration.Conclusions. The current study demonstrates that paclitaxel magnetoliposomes can effectively be delivered to tumor and exert a significant anticancer activity with fewer side effects in the xenograft model.     

Effect of Nanonization on Absorption of 301029: Ex Vivo and In Vivo Pharmacokinetic Correlations Determined by Liquid Chromatography/Mass Spectrometry

Purpose. To compare Caco-2 monolayer permeability and in vivo bioavailability of microparticle with nanoparticle 301029, a thiadiazole derivative, and to determine whether nanonization could improve oral bioavailability of the poorly soluble compound. Methods. The mean particle size of 301029 was reduced from 7 m to 280 nm by pearl milling. In the ex vivo assay, both microparticle and nanoparticle 301029 at the same concentration were separately added to apical side and were collected from basolateral side of Caco-2 monolayer. In the bioavailability study, the two particle sizes of 301029 were orally administered to rats, respectively, and blood samples were collected. Nanoparticle 301029 in culture medium and rat serum was detected by a liquid chomatography-mass spectrometer (LC/MS) coupled with atmospheric pressure chemical ionization (APCI). Results. Permeability rate and permeated amounts of nanoparticle 301029 across the Caco-2 monolayer were about four times higher than those of microparticle 301029. In a pharmacokinetic study, nanoparticle 301029 showed T_max about 1 h, whereas the microparticle 301029 showed T_max at 4 h. The C_max and AUC of nanoparticle 301029 were 3- to 4-fold greater than those of microparticle 301029, resulting in a significant increase in oral bioavailability of 301029 as compared with microparticle 301029. The ex vivo permeability and in vivo pharmacokinetic data indicate that nanoparticle formulation improves both absorption rate and absorption extent of the poorly soluble drug. Conclusions. Nanoparticle formulation enhances both Caco-2 monolayer permeability and rat oral bioavailability of the poorly soluble 301029. The result also demonstrates a close correlation between ex vivo Caco-2 permeability model and in vivo gastrointestinal absorption.     

Pharmacokinetics and Metabolism of Transdermal Oxybutynin: In Vitro and in Vivo Performance of a Novel Delivery System

Purpose. The purpose of this work was to characterize in vitro/in vivo delivery and pharmacokinetics of oxybutynin (OXY) and its active metabolite, N-desethyloxybutynin (DEO), by a novel matrix transdermal system (TDS). Methods. Two in vivo, randomized, three-way crossover trials examined single/multiple OXY TDS doses. Abdomen, buttock, and hip application sites were compared and dose proportionality was evaluated. Model independent pharmacokinetics, elimination rate constants, and metabolite/drug ratios were derived from both plasma OXY and DEO concentrations. Results. Single/multiple applications of the OXY TDS to the abdomen yielded mean C _max OXY concentrations of 3.4 ± 1.1/6.6 ± 2.4 ng/mL and median t _max of 36/10 h, with steady state achieved during the second application. Plasma OXY and DEO concentrations decreased gradually after C _max until system removal. Buttock and hip applications resulted in bioequivalent OXY absorption. AUC ratios of DEO/OXY were 1.5 ± 0.4 (single dose) and 1.3 ± 0.3 (multiple dose). Mean in vitro OXY skin absorption (186 g/h) was comparable to the estimated in vivo delivery (163 g/h) over 96 h. Conclusions. Sustained delivery over 4 days and multiple sites allow a convenient, well-tolerated, twice-weekly OXY TDS dosing. A low incidence of anticholinergic side effects is expected during clinical use because of the avoidance of presystemic metabolism and low DEO plasma concentrations. The consistent delivery, absorption, and pharmacokinetics should result in an effective treatment of patients with overactive bladder.     

Disparity of in Vitro and in Vivo Oleic Acid-Enhanced β-Estradiol Percutaneous Absorption Across Human Skin

The permeation enhancing property of 5% oleic acid in ethanol on -estradiol was investigated in vitro and in vivo using symmetrical and asymmetrical side-by-side diffusion cells and the human skin sandwich flap, respectively. -Estradiol permeability in vitro and in vivo was similar in 75% ethanol (ETOH). Oleic acid (5%) did not alter -estradiol permeability in vivo but increased permeability sixfold in vitro in symmetrical diffusion cells. -Estradiol permeability in oleic acid was not different from that in ETOH, however, using asymmetrical diffusion cells. Stratum corneum-to-vehicle partition coefficients of -estradiol in the vehicles were similar, yet fourfold more steroid was detected in skin biopsies from the in vitro symmetrical diffusion cells. Thus, oleic acid increased -estradiol permeability in vitro only when skin was equilibrated with fatty acid. Attention to in vitro diffusion cell design and its relevance in vivo is critical to defining the mechanisms of enhanced solute permeation.     

Analysis of nonlinear tissue distribution of quinidine in rats by physiologically based pharmacokinetics

The nonlinear tissue distribution of quinidine in rats was investigated by a physiologically based pharmacokinetic model. Serum protein binding of quinidine showed a nonlinearity over thein vivo plasma concentration range. The blood-to-plasma concentration ratio (C _b/C _p) of quinidine also showed a concentration dependence. The steady-state volume of distribution (V _ss) determined over the plasma concentration range from 0.5 to 10 g/ml was 6.0 ±0.45 L/kg. The tissue-to-plasma partition coefficient (Kp) of muscle, skin, liver, lung, and gastrointestinal tract (GI) showed a nonlinearity over thein vivo plasma concentration range of quinidine, suggesting saturable tissue binding. The concentration of quinidine in several tissues and plasma was predicted by a physiologically based pharmacokinetic model usingin vitro plasma protein binding and theC _b/C _p of quinidine. The tissue binding parameters were estimated fromin vivo Kp values. The predicted concentration curves of quinidine in each tissue and in plasma showed good agreement with the observed values.This study was supported by a grant-in-aid for Scientific Research provided by the Ministry of Education, Science and Culture of Japan.     

Comparison of thein vitro andin vivo release of digoxin from four different soft gelatin capsule formulations

A blinded, four-treatment crossover study in 16 normal adult male volunteers compared plasma concentrations and urinary excretion of digoxin, measured by radioimmunoassay, after oral administration of soft gelatin capsule formulations of digoxin. Four 0.4-mg formulations with different in vitroburst times and dissolution rates were administered, with 2- week intervals between treatments. The two capsules with lowest in vitroburst times (2.9 and 16 min) gave comparable in vivoresults. The other two capsules, with in vitroburst times of 62 and 229 min, produced significant delays in digoxin absorption. In vitro-in vivocorrelations were obtained by comparing the logarithm of the in vitro burst time with time to peak plasma level and the time to the first measurable plasma level ( 0.05 ng/ml). Also, the mean time to peak plasma level correlated with the logarithm of the time required to release either 50% or 85% of the digoxin in vitro. No significant changes were found in the amount of digoxin absorbed from each capsule as determined by urinary excretion or AUC_0-.This work was supported by Arnar-Stone Laboratories, Inc., McGraw Park, Illinois.     

Pharmacokinetics of the Transdermal Reservoir Membrane System Delivering β-Estradiol: In Vitro/In Vivo-Correlation

Purpose. The aim of our study was to investigate the high fluctuations of Estradiol (E₂) plasma levels transdermally delivered in postmenopausal women by a commercially available membrane controlled reservoir system (MCRS). Methods. The transdermal E₂ flux either out of a complete MCRS or across its membrane out of defined ethanol water mixtures was determined, as well as E₂ plasma profiles in 6 postmenopausal women produced by a MCRS. Results. The transdermal in vitro E₂ flux rate out of a complete MCRS, claimed to deliver 25 g/day, increased steadily, reaching a maximum value of 2.06 ± 0.58 (g/h at 30 to 40 hours and decreased to a rate of about 0.5 (g/h from 60 to 90 hours. No statistically significant differences between plasma profiles calculated from the in vitro investigation and derived from a clinical study could be identified. The E₂ flux in defined ethanol/water mixtures across MCRS-membrane, adhesive and skin layer increased with increasing ethanol concentrations up to a maximum of 227 ± 34 ng/cm²/h at an ethanol concentration of 62.5% (V/V) and decreased with further increase in the volume fraction of ethanol. Conclusions. In vitro as well as in vivo investigations showed high fluctuation of E₂ plasma profiles in postmenopausal women produced by the MCRS. These fluctuations are caused by a non-constant input rate of E₂ which may be due to changing ethanol concentrations in the reservoir of the MCRS.     

Prediction of In Vivo Tissue Distribution from In Vitro Data 1. Experiments with Markers of Aqueous Spaces

Purpose. The aim of this study was to evaluate the ability of anin vitro method of tissue distribution to accurately predict total water andextracellular aqueous spaces using marker compounds urea and inulin. Methods. Slices (50–200 mg) of all the major tissues in the rat wereincubated with Hanks/HEPES pH7.4 buffer containing ¹⁴C-urea and³H-inulin for 2 h at 37°C. Tissue weight was noted before and afterincubation and the tissue-to-buffer ratios determined. Results. ¹⁴C-Urea Kp estimates were generally greater than total tissuewater due to tissue swelling, which varied widely among the tissues,up to 41% in muscle. In most cases, Kp values were much closer toin vivo values after correcting for the ¹⁴C-urea in the imbibed media(Kp_corr). The method was able to distinguish between ¹⁴C-urea and³H-inulin Kp values and indicated that inulin occupied a smaller spacethan urea, which for the majority of tissues corresponded to theextracellular space. Conclusions. The Kp _corr values for¹⁴C-urea and Kp for ³H-inulin wereconsistent with total tissue water and extracellular space for the majorityof tissues studied, indicating their suitability as marker compounds forchecking the viability of this in vitro method for estimating tissuedistribution.     

Drug Distribution in Human Skin Using Two Different In Vitro Test Systems: Comparison with In Vivo Data

Purpose. Two in vitro test systems used to study drug penetration into human skin—the Franz diffusion cell (FD-C) and the Saarbruecken penetration model (SB-M)—were evaluated, and the results were compared with data gained under analogous in vivo conditions. Methods. Excised human skin was used in all in vitro experiments. Flufenamic acid dissolved in wool alcohols ointment, was chosen as a model drug, and the preparation was applied using infinite dose conditions. To acquire quantitative information about the drug penetration, the skin was segmented into surface parallel sections at the end of each experiment, first by tape stripping the stratum corneum (SC), and second by cutting the deeper skin layers with a cryomicrotome. The flufenamic acid was extracted from each sample and assayed by high performance liquid chromatography (HPLC). For in vivo experiments, only the tape stripping technique was used. Results. a) Drug penetration into the SC: In both in vitro test systems the total drug amounts detected in the SC were found to increase over the different incubation times. Similar conditions were obtained in vivo, but on a lower level. Using Michaelis-Menten kinetics, the m_max value was calculated for the skin of two donors. The relations of the m_max values for the FD-C and the SB-M closely correspond (1.26 [donor 1] and 1.29 [donor 2]). A direct linear correlation of the drug amount in the SC and the time data were found for in vivo with both in vitro test systems.%b) Drug penetration into the deeper skin layers: The detected drug amounts in the deeper skin layers continuously increased with the incubation time in the SB-M, while in the FD-C, only very small drug amounts were observed after incubation times of 30 and 60 minutes. It was also noticed, that the drug amounts rose steeply at time points 3 and 6 hours. Additional studies showed a remarkable penetration of water into the skin from the basolateral acceptor compartment in the FD-C. This could explain the different drug transport into the deeper skin layers between the two in vitro test systems. Conclusions. Both in vitro models showed comparable results for the drug penetration into the SC and a robust correlation with in vitro data. Different results were obtained for the deeper skin layers. Whether a correlation between in vitro and in vivo data is also possible here has to be investigated by further experiments.     

Inotropic Effect of Digoxin in Humans: Mechanistic Pharmacokinetic/Pharmacodynamic Model Based on Slow Receptor Binding

Purpose. The purpose of this study was to construct a mechanistic pharmacokinetic/pharmacodynamic (PK/PD) model for digoxin that describes the relationship between plasma concentration and inotropic response. Methods. On the basis of results obtained in the isolated perfused rat heart, a PK/PD model for digoxin in humans was developed. In fitting the model to previously published bolus dose and concentration clamp data (shortening of electromechanical systole), the plasma concentration-time curves were used as forcing functions in the computer program ADAPT II. Results. The mechanistic approach allowed a modeling of digoxin pharmacodynamics which is consistent with available inotropic response data. The estimates of the receptor binding parameters were in the same order of magnitude as those measured in vitro for ouabain. The mechanistic model explained the parameters of the empirical link model (EC₅₀, E _max and delay time ) in terms of the underlying processes, suggesting that the long equilibration half-time of 13 h is due to slow receptor binding. The empirical link model, in contrast, is not compatible with a noninstantaneous receptor binding process and led to estimates of the delay time that were dependent on the digoxin administration schedule. Conclusions. The new, mechanistic model may provide a rationale for better understanding of digoxin pharmacodynamics and could become a tool to bridge the gap between in vitro and in vivo studies.     

Application of a Combined “Effect Compartment/Indirect Response Model” to the Central Nervous System Effects of Tiagabine in the Rat

Pharmacological inhibition of GABA uptake transporters provides a mechanism for increasing GABAergic transmission, which may be useful in the treatment of various neurological disorders. The purpose of our investigations was to develop an integrated pharmacokinetic–pharmacodynamic (PK/PD) model for the characterization of the pharmacological effect of tiagabine, R-N-(4,4-di-(3-methylthien-2-yl)but-3-enyl)nipecotic acid, in individual rats in vivo. The tiagabine-induced increase in the amplitude of the EEG 11.5–30 Hz frequency band (), was used as pharmacodynamic endpoint. Chronically instrumented male Wistar rats were randomly allocated to four groups which received an infusion of 3, 10, or 30 mg kg ^–1 ml min ^-1 kg^–1, 1.50.1 L kg^–1 and 200.2 min.A time delay was observed between the occurrence of maximum plasma drug concentrations and maximal response. A physiological PK/PD model has been used to account for this time delay, in which a biophase was postulated to account for tiagabine available to the GABA uptake carriers in the synaptic cleft and the increase in EEG effect was considered an indirect response due to inhibition of GABA uptake carriers. The population values for the pharmacodynamic parameters characterizing the delay in pharmacological response relative to plasma concentrations were k_eo=0.030 min ^–1 and k_out=81 min^–1, respectively. Because of the large difference in these values the PK/PD model was simplified to the effect compartment model. Population estimates were E₀=155 6 V, E_max=100 5 V, EC₅₀=287 7 ng ml^–1, Hill factor=1.8 0.2 and k_eo=0.030 0.002 min ^–1. The results of this analysis show that for tiagabine the combined effect compartment-indirect response model can be simplified to the classical effect compartment model.     

Simplified methods for the evaluation of the parameters of the time course of plasma concentration in the one-compartment body model with first-order invasion and first-order drug elimination including methods for ascertaining when such rate constants are equal

The many limitations in determining the pharmacokinetic parameters of firstorder invasion of, and elimination from, the onecompartment body model by the method of residuals or by feathering Ct data can be minimized by applying the simplified methods outlined herein. Comparisons of the apparent volumes of distribution, V, calculated on the premises that the Bateman Function represents k_a>k_e or its converse, k_e>k_a,i.e., flip-flop, can permit a proper choice of the correct version. Estimation of k_e can be obtained by regression of (A₀/V)/C(oncentration) on AUC₁/ Cwhere A₀/Vis estimable from knowledge of C_max and t_max since .The ratio of the magnitude of the rate constant of invasion to that of elimination, m=k_a/k_e,is related to k_et_max by the expression k_et_max=ln m/ (m–1)for all possible values of m.A table for the determination of m from values of k_et_max is given. When bioavailability, =A₀/Dose,is known or complete, k_e and Vcan be determined from the respective ordinate and abscissa of the intersection of and Cl(clearance)/k_e,both plotted against arbitrary k_e values. The two functions may not intersect at low values of mdue to errored C-t values but the k_e value when the two curves are closest (k_min)may approximate k_e.The intersections of and k_eAUCT (AUC_trap)plotted against variable k_e values (Method A) provide estimates of k_e from their abscissa values and A/Vfrom their ordinate values when is unknown. Method B appears to give more reliable estimates of k_e at the k_min of the difference plotted against k_e.Since k_min of this plot is 1/t_max when m=1,the identity of the mas unity underlying the C-t data is indicated when either k_mint_max is approximately unity or k_min ispractically synonymous with 1/t_max.This was clearly shown when 12 constructed m=1,C-t cases with 10% random error were evaluated by Method B. Better estimates were effected by all procedures when the raw C-t data were smoothed.We regretfully announce that Dr. Edward Garrett passed away on October 25, 1993, after an extended illness.     

In Vivo Pharmacokinetics of Felodipine Predicted from in Vitro Studies in Rat,Dog and Man

Abstract: The elimination of felodipine in liver microsomes from dog and man were characterized by K_m and V_max. The results were compared with previous data reported for rat. In all species studied, felodipine was primarily metabolized to its corresponding pyridine analogue. The elimination rate order was rat> dog> man. The same species difference was observed in vivo for the oral plasma clearance which was; rat 26 1/hr/kg, dog 7.5 1/hr/kg and man 4.3 1/hr/kg. The intrinsic hepatic clearance of felodipine was predicted in vitro from V_max over K_m. The in vitro values were not significantly different from those observed in vivo. Felodipine is a high-clearance drug and the in vivo extraction ratios were about the same in all species: rat 0.80, dog 0.83 and man 0.84. The extraction ratios predicted from the in vitro studies, rat 0.91, dog 0.70 and man 0.80, agreed well with those observed in vivo.     

Use of in Vitro Critical Inhibitory Concentration, a Novel Approach to Predict in Vivo Synergistic Bactericidal Effect of Combined Amikacin and Piperacillin Against Pseudomonas aeruginosa in a Systemic Rat Infection Model

Purpose This study was undertaken to explore the use of in vitro critical inhibitory concentration (CIC) as a surrogate marker relating the pharmacokinetic (PK) parameters to in vivo bactericidal synergistic effect [pharmacodynamic (PD)] of amikacin + piperacillin combination against Pseudomonas aeruginosa in a systemic rat infection model. Methods The in vitro antibacterial activities of amikacin and piperacillin, alone and in combinations at various ratios of the concentrations, were tested against a standard [5 × 10⁵ colony-forming units (CFU)/ml] and a large (1.5 × 10⁸ CFU/ml) inoculum of P. aeruginosa ATCC 9027 using a modified survival-time method. The CIC of each individual antibiotic for the different combinations was determined using a cup-plate method. In vivo studies were performed on Sprague-Dawley rats using a systemic model of infection with P. aeruginosa ATCC 9027. PK profiles and in vivo killing effects of the combination at different dosing ratios were studied. Results An inoculum effect was observed with the antibiotics studied. Synergy was seen against both the inocula at the following concentration ratios: 70% C_ami + 30% C_pip and 75% C_ami + 25% C_pip, where C_ami and C_pip are the concentrations of amikacin and piperacillin to produce a 1000-fold decrease in bacterial population over 5 h, respectively. The CIC values determined corroborated with the order of in vitro bacterial killing observed for the antibiotic combinations. The dosing ratio of 12.6 mg/kg amikacin + 36 mg/kg piperacillin (a 70:30 ratio of the individual doses) exhibited the greatest killing in vivo when compared to the other ratios. The PK–PD relationships were described by simple, linear regression equations using the area under the in vivo killing curve as a PD marker and the AUCIC_ami/CIC_ami + AUCIC_pip/CIC_pip, AUC_ami/CIC_ami + AUC_pip/CIC_pip, C_max,ami/CIC_ami + C_max,pip/CIC_pip, and AUCIC_ami/MIC_ami + AUCIC_pip/MIC_pip as PK markers for the amikacin + piperacillin combination. Conclusion The combination of amikacin and piperacillin exhibited synergistic killing effect on P. aeruginosa that could be modeled using CIC as a surrogate marker relating the PK parameters to in vivo bactericidal effect.     

Evaluation of the in Vivo Disintegration of Solid Dosage Forms of a Bile Acid Sequestrant in Dogs Using γ-Scintigraphy and Correlation to in Vitro Disintegration

Purpose. To evaluate the in vivo disintegration behavior of tablets and capsules of a bile acid sequestrant, DMP 504, in beagle dogs and to assess the significance of the in vitro disintegration of the dosage forms on subsequent in vivo behavior in order to draw possible in vitro-in vivo correlations. Methods. Tablet and capsule formulations of a bile acid sequestrant, DMP 504, were formulated with samarium oxide and neutron activated to produce radioactive ¹⁵³Sm to noninvasively evaluate their in vivo behavior in beagle dogs by -scintigraphy. A four-way crossover design was completed (n = 4) in which (a) tablets from two different batches were administered under the fasted condition and manufactured using different lots of drug substance where one batch exhibited relatively faster in vitro disintegration time (30 min) than the other tablet batch, which resulted in slower disintegration (45 min), (b) a capsule formulation was administered to fasted beagles, and (c) the tablet having slower in vitro disintegration was also administered in the fed state, and its in vivo disintegration was compared to that observed in the fasted state. Results. Tablets manufactured using a lot of DMP 504 having relatively fast in vitro disintegration (30 min) resulted in relatively rapid in vivo disintegration time (15 min) in the fasted condition. This in vivo disintegration time was comparable to the in vivo disintegration of the capsules (17 min) even though the in vitro capsule disintegration time was considerably faster (2 min). Tablets prepared using a drug substance that provided a longer in vitro disintegration time (45 min) resulted in a slower in vivo disintegration (63 min). There was no difference observed in the in vivo disintegration behavior in fasted and fed dogs for the tablets that provided slower in vitro disintegration. Conclusion. In vivo disintegration of tablets of the bile acid sequestrant DMP 504 correlated with in vitro disintegration times. -Scintigraphy continues to be a good tool to use during early stages of product development to investigate in vivo performance of dosage forms. The results of this study provided evidence that the physical chemical specifications of the drug substance may not always be indicative of in vitro or in vivo performance of tablet dosage form, even when formulation and process are not changed.     

Effect of pregnancy on hepatic microsomal drug metabolism in rabbits and rats

In Dutch-belted rabbits, pregnancy caused several-fold decrease of in vitro hepatic microsomal aminopyrine, benzphetamine, and hexobarbital biotransformations. In pregnant Sprague-Dawley rats, various kinds of expressing the in vitro rates of hexobarbital biotransformation (per mg of microsomal protein, g of liver, 100 g of body weight) indicated unchanged or slightly elevated microsomal enzyme activity. In vivo, the course of hexobarbital blood levels after i. p. hexobarbital sodium, 100 mg/kg, indicated that the fate of hexobarbital was not primarily determined by the small changes of microsomal enzyme activity but, rather, by changed hexobarbital distribution. Different ways of expressing in vitro rates of aniline biotransformation showed decreased or unchanged enzyme activity during pregnancy and in vivo experiments indicated that these changes did not affect aniline metabolism in living rats. The results pointed out marked species differences in the effect of pregnancy on drug metabolism. Interpretation of in vitro biotransformation data for living animals suggested that with different substrates, microsomal enzyme activity and distribution, respectively, may exert different effects playing either significant or apparently minor role in drug disposition.Supported in part by U.S. Public Health Grant NIGMS 12,675.