老年患者美罗培南血药浓度监测结果分析及药物动力学研究

摘 要 目的：建立美罗培南体内血药浓度测定方法,对老年患者美罗培南血药浓度监测结果进行分析,并研究其药物动力学。方法: 25名老年患者静脉给予美罗培南0.5~1.0 g,不同时间采集患者血样,用HPLC法测定血清药物浓度,根据浓度测定结果,结合成人群体药动学模型,计算药动学参数,根据简易数学模拟法计算T>MIC。结果: 25例老年患者给药后的药物动力学参数为Cmax=(46.2±24.4) μg·ml^-1; t1/2=(3.3±1.8) h,CL=(8.7±5.0) L·h^-1,V=(9.8±1.3) L,AUC=(148.2±75.4)μg·h·ml^-1。与文献报道的健康受试者比较,t1/2明显延长 , V明显减小,AUC明显增加（P<0.01）。结论:美罗培南在老年患者的主要药动学参数与文献报道健康受试者有较大差异,临床应用时应注意监测美罗培南血浓度。     

盐酸左氧氟沙星片在健康人体内的药代动力学和 生物等效性研究

目的：研究已上市盐酸左氧氟沙星片在健康中国人体内的生物等效性。方法：48例健康志愿者随机分组,分别在空腹及进食高脂餐后,两周期双交叉单剂量口服盐酸左氧氟沙星片及其参比制剂左氧氟沙星片各500 mg,采用高效液相色谱-串联质谱法测定给药前与给药后48 h内不同时间点的血药浓度,计算主要药代动力学参数,评价生物等效性。结果：在空腹试验中,盐酸左氧氟沙星片及其参比制剂的AUC0~48 h分别为（50.0±8.4）、（48.8±8.6） μg·h·mL-1,Cmax分别为（6.15±1.42）、（5.98±1.55） μg·mL-1,tmax分别为（1.19±0.62）、（1.30±0.73） h,t1/2分别为（6.56±1.13）、（6.51±1.14） h-1,相对生物利用度为（103.0±8.7）%;在餐后试验中,盐酸左氧氟沙星片及其参比制剂的AUC0~48 h分别为（45.4±8.4）、（44.5±8.2） μg·h·mL-1,Cmax分别为（5.85±1.08）、（6.58±1.89） μg·mL-1,tmax分别为（1.93±0.72）、（1.82±0.81） h,t1/2分别为（6.69±0.81）、（6.63±0.76） h-1,相对生物利用度为（102.3±5.3）%。结论：盐酸左氧氟沙星片与其参比制剂具有生物等效性。     

地洛他定胶囊人体药动学和生物等效性评价

目的研究地洛他定胶囊和地洛他定片在人体的药动学和生物等效性.方法 20名健康受试者随机交叉单剂量口服地洛他定胶囊或地洛他定片20 mg后,采用高效液相色谱-质谱联用(HPLC-MS)测定血浆中地洛他定的经时血药浓度,计算其药动学参数和相对生物利用度,评价两种制剂的生物等效性.结果经3P97拟合,两者的体内过程皆符合口服给药一室模型,采用梯形法计算的两者AUC 0-72分别为(238.22±57.18) μg·h·L-1和( 247.66±73.34) μg·h·L-1,Cmax均值分别为(13.70±4.27) μg·L-1和(14.31±4.53) μg·L-1,tmax均值分别为(2.2±0.7)h和(2.3±0.9)h,地洛他定胶囊对地洛他定参比片的相对生物利用度为(96.4±6.3)%.结论两种制剂具有生物等效性.     

国产罗格列酮胶囊在健康人体的相对生物利用度

目的研究健康受试者口服罗格列酮胶囊的药代动力学。方法20名健康受试者随机服用罗格列酮受试和参比制剂各4mg,用HPLC-MS法测定血浆中罗格列酮的浓度。结果经3P97程序处理,主要药代动力学参数如下。罗格列酮胶囊剂:t1/2为(5.18±0.84)h,AUC0-24h为(2.13±0.21)μg·h·mL-1,Cmax为(305.31±38.21)ng·mL-1,tmax为(1.1±0.4)h;罗格列酮片剂:t1/2为(5.10±0.64)h,AUC0-24h为(2.20±0.20)μg·h·mL-1,Cmax为(318.84±38.38)ng·mL-1,tmax为(1.2±0.3)h。罗格列酮受试和参比制剂的相对生物利用度为(97.6±12.7)%。结论2制剂具有生物等效性。     

法罗培南钠胶囊和颗粒剂在健康人体的相对生物利用度及生物等效性

目的比较同一厂家生产的3种法罗培南钠(β内酰胺类抗生素)制剂中法罗培南在人体的药代动力学参数,评价3种制剂的生物等效性。方法 21名健康受试者随机交叉单剂量口服法罗培南钠胶囊剂、颗粒剂和参比制剂片剂300 mg后,采用HPLC法测定血浆中法罗培南的浓度,计算其药代动力学参数,AUC、Cmax经对数转换后进行方差分析,计算90%置信区间,并评价2种受试制剂和参比制剂的生物等效性。结果单剂量口服法罗培南钠胶囊、颗粒剂和参比制剂片剂后,血浆中法罗培南的AUC0-6分别为(5.28±2.35),(4.78±2.40)和(4.93±2.19)μg.h.mL-1;Cmax分别(2.75±0.89),(2.79±1.24)和(2.81±1.04)μg.mL-1;tmax分别为(1.06±0.44),(0.79±0.22)和(0.89±0.43)h;t1/2分别为(0.89±0.11),(0.87±0.11)和(0.97±0.10)h。法罗培南钠胶囊和颗粒中法罗培南的相对生物利用度分别为(111.5±35.0)%和(97.8±35.0)%。结论受试制剂法罗培南钠胶囊和颗粒剂与参比制剂片剂具有生物等效性。     

伊伐布雷定及其代谢物的血药浓度测定及人体药动学研究

目的：建立伊伐布雷定（IVA）及其活性代谢产物N-去甲基伊伐布雷定（M1）人体血药浓度的HPLC-MS/MS同时测定方法,研究盐酸伊伐布雷定片经健康受试者口服后IVA及M1的人体药代动力学特征。方法：12名健康受试者单次口服盐酸伊伐布雷定片2.5 mg、5 mg和7.5 mg,多次口服5 mg后,采用HPLC-MS/MS测定不同时间点血浆中IVA和M1浓度,并计算其主要药动学参数。结果：IVA和M1血药浓度标准曲线线性范围分别为0.03~80 ng·mL^-1和0.03~10 ng·mL^-1。单次给药2.5、5、7.5 mg后IVA的C_max分别为（9.661±3.832）、（20.63±9.31）、（34.95±19.46） ng·mL^-1,AUC0-48分别为（42.16±19.53）、（85.86±44.85）、（133.6±65.7） μg·h·L^-1;M1的C_max分别为（1.007±0.189）、（2.683±0.675）、（4.064±1.172） ng·mL^-1,AUC_0-48分别为（10.78±1.35）、（26.02±4.91）、（36.24±7.90） μg·h·L^-1。多次给药5 mg后IVA的稳态平均血药浓度Cav为（6.494±2.385） ng·mL^-1,稳态血药浓度波动度DF为（3.3±0.7）,累积常数R_AUC为（1.1±0.2）;M1的C_av为（1.959±0.186） ng·mL^-1,DF为（1.4±0.3）,R_AUC为（1.5±0.2）。结论：建立的人血浆中IVA和M1的LC-MS/MS同时测定方法适用于人体药代动力学研究。单次给药后,在2.5~7.5 mg范围内IVA和M1均呈线性药动学特征;多次给药5 mg后,IVA人体内的暴露量约增加10%,M1人体内的暴露量约增加50%。     

法罗培南钠片在健康人体中的药代动力学研究

目的研究健康志愿者单次口服3个剂量法罗培南钠片的药代动力学。方法 12名健康志愿者,男女各半,随机分为3组,分别口服150、300和600 mg法罗培南钠片后,采用HPLC法测定血浆和尿液中法罗培南的浓度,应用DAS软件计算其药代动力学参数。结果单次口服3个剂量组(150、300和600 mg)法罗培南钠片,血浆中法罗培南的主要药代动力学参数:AUC0～t分别为(3.73±2.77)、(6.72±4.12)和(13.1±8.04)μg.h/mL;Cmax分别为(1.89±0.93)、(3.19±1.14)和(6.95±3.37)μg/mL;Tmax分别为(0.97±0.54)、(0.83±0.38)和(0.93±0.45)h;t1/2分别为(0.92±0.26)、(0.94±0.14)和(0.98±0.15)h。累积尿药排泄率分别为(6.23±7.09)%、(4.69±4.32)%和(4.14±2.95)%。结论健康人口服150～600 mg法罗培南钠片后,法罗培南在体内符合线性药代动力学特征。     

LC-MS/MS法测定人血浆中法罗培南的浓度

目的:建立以高效液相色谱串联质谱电喷雾检测(LC-MS/MS)法测定人血浆中法罗培南浓度的方法。方法:采用API3200型四极杆串联质谱仪进行检测,色谱柱为Zorbax Eclipse C18,流动相为乙腈-水(70∶30),流速为0.4mL·min-1,离子源为电喷雾离子化源,检测方式为负离子方式,扫描方式为多重反应监测。结果:法罗培南血药浓度在50～2000ng·mL-1范围内线性关系良好(r=0.9991),最低检测浓度为1ng·mL-1(S/N>3);日内RSD<10%,日间RSD<12%,平均回收率为86.96%。结论:本方法简便、快速、精密度好,可用于法罗培南血药浓度的监测及药动学研究。     

LC-MS/MS法测定大鼠血浆中亚胺培南浓度及其药动学研究

目的：建立了一种测定大鼠血浆中亚胺培南（IMP）浓度的LC-MS/MS方法，研究不同剂量的IMP在SD大鼠中的药代动力学特征。方法：大鼠血浆样品使用乙腈蛋白沉淀，色谱柱采用Phenomenex Kinetex@ HILIC柱（50 mm × 2.1 mm，2.6 μm），流动相为0.1%甲酸水溶液（含5 mmol·L-1乙酸铵）-乙腈，行梯度洗脱。采用电喷雾离子源（ESI），正离子多反应监测模式（MRM），IMP定量离子对为m/z 300.0 → m/z 142.0。大鼠腹腔注射IMP（50、100和200 mg·kg-1）后于不同时间采血并检测其血药浓度，计算药代动力学参数。结果：测定血浆中IMP的线性范围为0.20 ~ 200 μg·mL-1，日内及日间精密度（RSD）均< 11.46%，准确度为91.67% ~ 105.38%，基质效应为91.33% ~ 104.63%，回收率为88.90% ~ 101.55%，均符合生物样品的分析要求。大鼠腹腔注射50、100和200 mg·kg-1 IMP后主要药动学参数Cmax分别为（86.15 ± 31.59）、（165.59 ± 23.57）和（322.32 ± 63.97）μg·mL-1；t1/2分别为（26.31 ± 6.87）、（29.90 ± 2.27）和（49.71 ± 5.25）min；AUC0-∞分别为（5 261.40 ± 1 513.08）、（13 803.56 ± 1 308.5）和（36 412.38 ± 6 309.41）μg·min-1·mL-1。结论：本法准确、灵敏，适用于大鼠腹腔注射不同剂量IMP后的浓度检测及药代动力学研究。     

高脂肪饮食对法罗培南药代动力学的影响

目的:研究比较空腹和餐后单剂量口服法罗培南的药动学和生物利用度。方法:采用双交叉给药设计,12名健康志愿者空腹及餐后单剂量口服300 mg法罗培南,HPLC法测定血药浓度,BAPP 2．3软件程序处理药动学参数。结果:法罗培南空腹和餐后单剂量给药的达峰时间T_(max)分别为(0．8±0．2),(1．8±0．7)h,峰浓度C_(max)分别为(5．24±2．58),(3．71±1．38)μg·mL~(-1),药-时曲线下面积AUC_(0-τ),分别为(8．04±3．84),(8．32±3．26)μg·h·mL~(-1)。2种给药方案的C_(max)和AUC取自然对数后经方差分析,T_(max)经非参数检验,发现C_(max)和T_(max)差异有显著性统计学意义(P＜0．05)。但AUC_(0-τ),值相近(P>0．05),餐后给药的相对生物利用度为103．5％。结论:与空腹给药相比,进食使法罗培南的吸收速率减慢、消除半衰期延长,但吸收总量差异不大。     

Human somatotropin

Different mixtures of reduced-alkylated thrombin fragments of human and sheep somatotropin have been tested for binding affinity to liver membranes. The bioassay data correlated well with the abilities of the fragments to form noncovalent recombinants as shown in separate biochemical studies.     

Human Ochratoxicosis

Ochratoxin A (OTA) produced by Aspergillus and Penicillium genera contaminates a diversity of foods in the normal diet, including cereals and cereal-made foods, dned fruits, beans, cocoa, coffee, beer, wine (red essentially) and foodstuffs of animal ongin mainly poultry eggs, pork and milk including human breast milk. OTA is nephrotoxic to all animal species studied so far and most likely to humans. who show the longest half-life time for elimination of this toxin among all species examined. Among other toxic effects OTA IS teratogenic, immunotoxic, genotoxic, mutagenic and carcinogenic, all of which lead to life-threatening pathologies. Thus. OTA acts through several molecular pathways leading to different chronic toxic lesions

To assess OTA in human blood, the immunoaffinity column and ELISA techniques have recently been emerging along with HPLC for separation and fluorimetnc quantification. They should be followed by confirmation with one or two derivatives of OTA which have a profile shift on the chromatogram. For a complete diagnosis of human ochratoxicosis it is necessary to identify the origin of the toxin to relate its presence in human blood with at least a pathology one can cure or prevent. This is still a very difficult task. since humans may be exposed to several toxins simultaneously with synergistic or antagonistic effects. Also, conditions of exposure can vary from place to place or individual to individual whether the route of administration is via digestive tract or the respiratory system. This difficult situation is somehow worse in developing countries, where in the early eighties several groups initiated investigations on the prevalence of OTA in human blood, followed by or directly combined with a food survey for OTA in commodities. Interestingly, OTA is found In human blood everywhere. However, the prevalence is different, as well as the OTA blood levels, due to the diversity of health and economic situations, and to preventive measures that have been implemented. Important factors affecting body burdens and pathologies include the quality of the diet in providing antioxidants, vitamins, and amino acids, such as phenylalanine in the sweetener Aspartame. To clarify the situation with human ochratoxicosis several studies and reports will be presented and discussed.     

Human microdialysis

Microdialysis has been used extensively in animal studies for decades and in human pharmacokinetic studies for about 10 years. Microdialysis is based on the passive diffusion of a compound along its concentration gradient from the tissue through the membrane into the dialysate. Microdialysis samples from the interstitial space which is a defined, anatomical compartment; there is no net loss of body fluid; the sample is "purified" and no enzymatic degradation takes place because proteins do not pass through the probe membrane into the dialysate; microdialysis data relate to the intact molecule; time resolution is high compared to biopsy and skin blister techniques; radioabelling or induction of a magnetic response is not needed; microdialysis is also an alternative method to determine protein binding of a compound in vivo; microdialysis can readily be set up in clinical research units without expensive infrastructure. Microdialysis has been used to measure tissue concentrations of endogenous compounds and to investigate the tissue penetration of drugs in a variety of tissues in humans in vivo in both healthy volunteers and patients. Microdialysis data have also been used in PK-PD modelling and to obtain concentration-response relationships locally in tissues in vivo. There are also studies combining microdialysis with imaging techniques, e.g. PET. Microdialysis data may be used in early studies to select the appropriate compound, to optimise dosing regimens and to investigate the kinetic and dynamic consequences in the tissues of drug-drug and drug-disease interactions. Microdialysis can also be used in late phase studies to provide tissue concentration data in support of therapeutic efficacy trials or to create a niche for an already marketed drug. FDA and CPMP documents emphasise the value and importance of human tissue drug concentration data and support the use of microdialysis in humans to obtain such information. Microdialysis can satisfy regulatory requirements by providing data on drug concentrations in a well-defined anatomical tissue compartment at or close to the effect target site. Microdialysis is a versatile technique because of its multifaceted utility, low cost, ease of use, adaptability to different types of compounds and its feasibility for a number of organs and tissues. Equipment and probes for use in various organs have been commercially available for years.     

Human influenza

Human influenza is one of the most common human infectious diseases, contributing to approximately one million deaths every year. In Germany, each year between 5.000 and 20.000 individuals die from severe influenza infections. In several countries, the morbidity and mortality of influenza is greatly underestimated. This is reflected by general low immunization rates. The emergence of avian influenza against the background of the scenario of a human influenza pandemic has revived public interest in the disease. According to the World Health Organisation, it is only the question on the beginning of a new influenza pandemic. The virus type of the new pandemic is still uncertain and it is also unclear, if a pandemic spread of the virus may be prevented by consistent controlling of avian influenza.