用反相高效液相色谱法同时测定复方酮康唑软膏中三组分的含量

目的建立同时测定复方酮康唑软膏中酮康唑、莫匹罗星和糠酸莫米松含量的方法。方法采用反相高效液相色谱法,色谱柱为Intersil ODS-3(250 mm×4.6 mm,5μm),流动相为甲醇-pH5.5磷酸盐缓冲液(65∶35),柱温45℃,流速1.0 ml/min,检测波长248 nm。结果方法学验证表明,酮康唑、莫匹罗星和糠酸莫米松3种成分线性关系良好(r≥0.9995),日内日间精密度均小于3.0%,回收率在90%~108%之间,稳定性和重复性的RSD均小于3.0%,符合方法学要求。按照新建立的方法测定了3个批次样品中三组分的含量,结果符合要求。结论该方法简便可靠,可为复方酮康唑软膏的质量控制提供依据,也为其质量标准研究奠定了基础。     

3种咪唑类抗真菌乳膏剂微生物限度检查方法学研究

目的建立硝酸咪康唑、酮康唑、曲安奈德益康唑3种咪唑类抗真菌乳膏剂的微生物限度检查方法。方法采用含5%聚山梨酯80的pH 7.0无菌氯化钠蛋白胨缓冲液制备3种乳膏剂1：10供试液,并稀释至1：20和1：50,分别加入金黄色葡萄球菌、铜绿假单胞菌、枯草芽孢杆菌、白色念珠菌、黑曲霉接种无菌平皿中,按照《中国药典》2015年版四部1105考察平皿法及稀释-平皿法计数方法适用性;分别取3种乳膏剂加入无菌pH 7.0无菌氯化钠蛋白胨缓冲液和十四烷酸异丙酯两相系统中萃取,取萃取后的下层水相的上清液薄膜过滤处理后,分别加入5种试验菌,进行萃取-薄膜过滤法计数法适用性试验;分别取未经萃取-薄膜过滤处理和经过萃取-薄膜过滤的1：10供试液,接种至不同体积的胰酪大豆胨液体培养基中,按照《中国药典》2015年版四部1106进行控制菌检查适用性试验。结果通过平皿法或稀释处理,3种乳膏剂的3种细菌类试验菌回收率即符合要求;3种乳膏剂对白色念珠菌、黑曲霉均有较强的抑菌作用,无论是平皿法还是稀释处理后的平皿法,2种试验菌回收率均远小于0.5,不符合方法适用性要求。萃取-薄膜过滤法可有效去除3种咪唑类抗真菌乳膏剂对各试验菌的抑菌作用,3种乳膏剂的试验菌回收率均在0.5~2.0,符合计数方法适用性要求。经过萃取-薄膜过滤处理的供试液控制菌检出优于未经处理的供试液。结论采用萃取-薄膜过滤法可解决样品抑菌性的去除和滤膜堵塞的问题,适用于3种咪唑类抗真菌类乳膏剂的微生物限度检查。     

双戊烯对酮康唑透皮吸收促进作用

目的：研究双戊烯的透皮促进作用。方法：采用自制透皮扩散装置。以离体小白鼠背部皮肤为透皮屏障，紫外分光光度法测定含不同浓度双戊烯和氮酮对酮康唑的促透效果。结果：不同浓度促进剂对酮康唑的促透效果顺序为3％双戊烯＞2％双戊烯＞3％氮酮＞1％双戊烯。结论：实验证明，3％双戊烯对酮康唑具有较好的促透作用，与其它浓度的双戊烯和不同浓度的氮酮相比具有显著性差异（P＜0．05）或极显著性差异（P＜0．01）。     

In vitro ocular metabolism and bioactivation of ketoconazole in rat,rabbit and human

Oral ketoconazole is clinically administered for treatment of severe cases for fungal keratitis. Pharmacodynamics and efficacy of oral and topical (ocular) ketoconazole have been explored in rabbit. However, metabolism of ketoconazole in the eye in any species is not well explored in any preclinical species or human. An understanding of ocular drug metabolism in the eye is crucial for ocular therapeutics to facilitate the risk assessment and development of potential drug candidates for the clinic. We aimed to investigate the metabolism of ketoconazole in rat, rabbit and human ocular S9 fractions. Metabolism in liver S9 fractions was also studied for a direct comparison. Eleven putative metabolites were identified in the in vitro incubations. Of these metabolites, six were present in rat ocular S9 whereas eight were present in rabbit and human ocular matrices. Metabolic pathways in rabbit and human ocular fractions suggested the formation of reactive intermediates in rabbit and human liver and ocular S9 incubations, which was confirmed with trapping studies. Herein, we report eight human ocular metabolites of ketoconazole for the first time. To the best of our knowledge, this is the first report of ocular metabolic pathways and ocular bioactivation of ketoconazole in preclinical species and human.     

复方酮康唑软膏的制备与稳定性考察

目的 制备复方酮康唑软膏并考察其稳定性。方法 以酮康唑、莫匹罗星和糠酸莫米松为主药,以聚乙二醇（PEG）为基质制备软膏;利用影响因素试验考察软膏中药物的稳定性。结果 PEG400和PEG3350的比例为2：1时,软膏的黏度最佳,易于涂展。制成软膏后,高温下糠酸莫米松和莫匹罗星稳定性良好;酮康唑有少许分解,加入0.5%的抗坏血酸棕榈酸酯（L-A）后,酮康唑的含量明显提高。加速试验发现,放置6个月后软膏的颜色无变化,3种药物的含量均在98%以上。结论 本实验成功制备了新型复方酮康唑软膏,药物稳定性良好。     

单、复凝聚法制备酮康唑微囊的性状和包封率比较

目的:比较单、复凝聚法制备微囊的外观性状和包封率,为进一步研究微囊的制备工艺打下基础。方法:以酮康唑作为囊芯物,用明胶和阿拉伯胶作囊材,采用常规的单、复凝聚法分别制备酮康唑微囊,并在光学显微镜下比较其外观性状;采用单波长紫外分光光度法建立微囊中酮康唑含量测定方法,在此基础上计算其药物包封率。结果:2种方法所得的微囊均为白色粉末,采用单凝聚法得到的微囊平均粒径为32.20μm, 相对包封率为56.11%;复凝聚法制备的微囊则分别为7.99μm和83.42%。结论:采用相分离-凝聚法制备微囊时,复凝聚法所得结果较好。     

口服伊曲康唑与外用酮康唑洗剂联合治疗糠秕孢子菌性毛囊炎

目的:观察口服伊曲康唑与外用酮康唑洗剂联合治疗糠秕孢子菌性毛囊炎的疗效。方法:选择临床症状典型,经真菌学检查确诊的糠秕孢子菌性毛囊炎病人52例,分为2组。治疗组27例中男性18例,女性9例,年龄(28±s11)a,与餐同服或餐后即服伊曲康唑200mg,qd,连续7d,同时外用2%酮康唑洗剂,qd,连续用药4wk。对照组25例中男性19例,女性6例,年龄(29±10)a,单纯口服伊曲康唑200mg,qd,疗程同上。观察用药后1,4wk,2组疗效。结果:对照组1,4wk有效率分别为52%和68%,治疗组分别为59%和96%,2组1wk疗效差异无显著意义,4wk疗效治疗组优于对照组。结论:口服伊曲康唑与外用酮康唑洗剂治疗糠秕孢子菌性毛囊炎疗效好。     

Inhibitory effect of isavuconazole,ketoconazole, and voriconazole on the pharmacokinetics of methadone in vivo and in vitro

The aim of this study was to investigate the possible effect of orally administered isavuconazole, ketoconazole, or voriconazole on the pharmacokinetics of methadone in rats. Twenty Sprague–Dawley (SD) rats were divided randomly into four groups: Group A (control), group B (5 mg/kg isavuconazole), group C (5 mg/kg ketoconazole), and group D (5 mg/kg voriconazole). A single dose of methadone was administrated half an hour later. Methadone in plasma concentrations and its metabolite EDDP in microsomes were determined by ultra‐high‐performance liquid chromatography–tandem mass spectrometry method (UPLC–MS/MS), and pharmacokinetic parameters were calculated by DAS version 3.0. The C_max of methadone in groups C and D increased to 2.7‐fold and 5‐fold, respectively. While AUC increased in three groups and group D increased the most. Also, isavuconazole, ketoconazole, and voriconazole showed inhibitory effect on human and rat microsomes. The inhibition ratios of isavuconazole, ketoconazole, and voriconazole in rat liver microsome were 97.87%, 96.74% and 78.9%, respectively (p < 0.01), while in human liver microsome, inhibition ratios were 86.97%, 96.46%, and 53.11%, respectively. And the IC₅₀ for inhibition activity of isavuconazole, ketoconazole, and voriconazole in rat microsomes were 7.76 μM, 8.33 μM, and 4.45 μM, respectively. Our study indicated that taking methadone combine with ketoconazole, isavuconazole, or voriconazole could reduce the metabolism rate of methadone and prolong the pharmacological effects in vivo and in vitro.     

酮康唑治疗真菌性角膜溃疡的疗效观察

目的探讨酮康唑治疗真菌性角膜溃疡的效果.方法酮康唑口服0.2 g每日2次,酮康唑0.2加入生理盐水5 ml中点眼,0.5 h一次,治疗22例真菌性角膜溃疡病人.结果治愈19例,治愈率86.4%;有效1例,占4.5%;失败2例,占9.1%.病情轻重及治疗早晚与愈后关系密切.结论酮康唑治疗真菌性角膜溃疡疗效明显,给药途径方便,值得推广.     

Pharmacokinetics and electrocardiographic pharmacodynamics of artemether-lumefantrine (Riamet) with concomitant administration of ketoconazole in healthy subjects

AIMS: To evaluate whether the potent CYP3A4 inhibitor ketoconazole has any influence on the pharmacokinetic and electrocardiographic parameters of the antimalarial co-artemether (artemether-lumefantrine) in healthy subjects. METHODS: Sixteen subjects were randomized in an open-label, two period crossover design study. Subjects received a single dose of co-artemether (day 1) either alone or in combination with multiple oral doses of ketoconazole (400 mg on day 1 followed by 200 mg o.d. for 4 additional days). Serial blood samples were taken and assayed for artemether and its main active metabolite dihydroartemisinin (DHA), and lumefantrine. RESULTS: The pharmacokinetics of artemether, its metabolite DHA, and lumefantrine were influenced by the presence of ketoconazole. AUC(0, infinity ) was increased from 320 to 740 ng ml-1 h (ratio 2.4, 90% CI 2.00, 2.86) for artemether, from 331 to 501 ng ml-1 h (ratio 1.7, 90% CI 1.40, 1.98) for DHA, and from 207 to 333 micro g ml-1 h (ratio 1.7, 90% CI 1.23, 2.21) for lumefantrine in the presence of ketoconazole. Cmax also increased in similar proportions for the three compounds (ratio 2.2 (90% CI 1.78, 2.83), 1.4 (90% CI 1.12, 1.74), and 1.3 (90% CI 0.96, 1.64), respectively). The terminal elimination half-life was increased for artemether (2.5 vs 1.9 h, 90% CI 1.12, 1.72) and DHA (3.1 vs 2.1 h, 90% CI 0.02, 3.36), but remained unchanged for lumefantrine (88 vs 95 h, 90% CI 0.81, 1.04). These increases in exposure to the antimalarial combination were much smaller than observed with food intake (up to 16 fold), and were not associated with increased side-effects or changes in electrocardiographic parameters. The study medications were well tolerated. CONCLUSIONS: The concurrent administration of ketoconazole with co-artemether led to modest increases in artemether, DHA, and lumefantrine exposure in healthy subjects. Dose adjustment of co-artemether is probably unnecessary in falciparum malaria patients when administered in association with ketoconazole or other potent CYP3A4 inhibitors.