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Large B-cell lymphoma of the leg (LBCLL) accounts for 2 % of primary cutaneous lymphomas, and the EORTC considers it to be of intermediate prognosis. It usually presents in elderly patients, and manifests clinically as erythematous nodules or tumors, often unilateral, on the lower third of the legs. On rare occasions, it presents with extracutaneous dissemination. We present the case of a 77-year-old male who consulted his physician because of an asymptomatic indurated erythematous papule which had appeared one month earlier on his left leg and had quickly and progressively increased in size. Concurrently, other similar lesions had been appearing on the thigh and back of the same leg. Histological analysis detected a large cell lymphoid infiltrate positive for CD20 and bcl-2 throughout the dermis. The extension study was normal. The patient was treated with an intravenous infusion of rituximab for four consecutive weeks, with full remission of the lesions.

The relative bioavailability of a new 750 mg tablet formulation of ciprofloxacin (test formulation supplied by Dr. August Wolff GmbH and Co., Germany) was compared with that of Ciprobay tablets 750 mg (reference formulation from Bayer Vital GmbH and Co., Germany). Twenty-four healthy volunteers (12 male and 12 female) were included in this single-dose, 2-sequence, crossover randomized study. Blood samples were obtained prior to dosing and at 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 18, 24 and 30 hours after drug administration. Plasma concentrations of ciprofloxacin were determined by HPLC. No differences were found when the in vitro dissolution profiles of both formulations were compared. The pharmacokinetic parameters AUC(0-t), AUC(0-infinity), Cmax and Cmax/AUC(0-infinity) were tested for bioequivalence after log-transformation of data, and ratios of tmax were evaluated nonparametrically. The parametric analysis revealed the following mean values for the test/reference ratios (90% standard confidence intervals in parenthesis (ln-transformed data): 1.01 (0.95-1.07) for AUC(0-t), 0.99 (0.93-1.05) for AUC(0-infinity), 1.05 (0.97-1.14) for Cmax and 1.06 (0.97-1.15) for Cmax/AUC(0-infinity). The nonparametric confidence interval for tmax was 0.77-1.15. All parameters showed bioequivalence between both formulations as their confidence intervals were within the bioequivalence acceptable range of 0.80-1.25 limits; the 90% confidence interval for tmax slightly exceeded limits of bioequivalence. We conclude that both formulations show bioequivalence for both the rate and the extent of absorption.

The immunogenicity of the synthetic malaria vaccine SPf66 has been recently improved by the application of new adjuvants as QS-21 saponin or poly-D,L-lactide-co-glycolide (PLGA) polymers. The search for less invasive administration routes made us test the immunogenicity of SPf66-loaded microparticles by the nasal route in Balb/c mice. We report here that the intranasal administration of the adequate PLGA vaccine formulations greatly improves and maintains higher antibody levels compared to the conventional alum adjuvant and to the administration of the particles by other routes (subcutaneous, oral). Systemic immune responses were characterized as mixed Th1/Th2-type: IFN-gamma and IgG2a isotype were found as signs of Th1 activation, whilst IgE and IgG1 secretions indicate Th2 response. Since both types of response have been associated to protective immunity in malaria, we postulate that this new approach supposes an advantage over the traditional adjuvants and routes.

Aim: Two formulations of lisinopril/hydrochlorothiazide (20 mg/12.5 mg) were evaluated for bioequivalence after single dosing in healthy volunteers., Methods: The study was conducted according to an open, randomized, 2-period crossover design with a 2-week washout interval between doses. Twenty-four volunteers participated and all completed the study successfully. Lisinopril and hydrochlorothiazide were determined in plasma by HPLC. The pharmacokinetic parameters AUC(0-t), AUC(0-infinity), Cmax and Cmax/AUC(0-infinity) were tested for bioequivalence after logarithmic transformation of data and ratios of tmax were evaluated non-parametrically., Results: For lisinopril, the parametric analysis revealed the following test/reference ratios and their confidence intervals (90% CI): 1.01 (0.84-1.22) for AUC(0-t), 0.98 (0.81-1.19) for AUC(0-infinity), 1.02 (0.83-1.25) for Cmax and 1.03 (0.99-1.08) for Cmax/AUC(0-infinity). The 90% CI for tmax was 0.94-1.07. All parameters showed bioequivalence between both formulations. As for hydrochlorothiazide, test/reference ratios and their confidence intervals (90% CI) were: 1.05 (0.95-1.17), 1.02 (0.93-1.12) for AUC(0-infinity), 0.99 (0.89-1.07) for Cmax and 0.97 (0.90-1.04) for Cmax/AUC(0-infinity). The 90% CI for tmax was 1.00-1.41. All parameters showed bioequivalence between both formulations except for tmax. A discrete fall in both systolic (SBP) and diastolic (DBP) blood pressure was observed after drug administration. The time course of both parameters was similar for the 2 formulations. Heart rates also followed a similar time profile., Conclusions: The bioequivalence of the 2 formulations of lisinopril/hydrochlorothiazide was demonstrated.

Mechanical stability, uniformity of size, complete encapsulation of cells and optimal microenvironment are major challenges in the design and development of microcapsules for cell immobilisation purposes. In this work, a novel microcapsule chemistry based on polyelectrolyte complexation between alginate and poly(methylene-co-guanidine) (PMCG) is presented. We have characterised the effect of PMCG concentration and time of exposure on microcapsule diameter and membrane thickness, selecting a PMCG concentration of 0.5% (v/v) and an exposure time of 1 min as optimal parameters for a correct coating. Afterwards, the mechanically most resistant alginate-PMCG-alginate (A-PMCG-A) microcapsule type was chosen according to two different stability studies. Beads with a solid core and an inhomogeneous internal configuration resulted in stronger microcapsules. Further, the selected A-PMCG-A beads presented both an increased stability compared to classical Ca(2+)/alginate and alginate-poly-L-lysine-alginate (APA) microcapsules, and had an adequate microenvironment for cell viability. This new chemistry allows the controlled adjustment of microcapsule size and wall thickness, offering new alternatives for cell transplantation.

The levels of metronidazole and pefloxacin in plasma and tissue penetration of both drugs were studied after prophylactic administration to 7 patients undergoing colorectal surgery. Metronidazole (1,500 mg) and pefloxacin (800 mg) were administered as an intravenous infusion 1 hour before surgery. Mean plasma levels of pefloxacin decreased from 12.92 +/- 4.10 microg/ml at the end of the infusion to 2.18 +/- 1.03 microg/ml at 36 h. These values were above the MIC90 for E. coli (0.125 microg/ml) and E. faecalis (0.5 microg/ml), microorganisms responsible for abdominal infections. Tissue pefloxacin levels were also measured with a range from 0.72 - 7.78 microg/g in subcutaneous cell tissue, from 1.94 - 17.55 microg/g in peritoneum and from 2.76 - 21.99 microg/g in colon wall. Mean plasma concentrations of metronidazole decreased from 39.89 +/- 17.08 microg/ml at the end of the infusion to 2.63 +/- 1.11 microg/ml at 36 h. During this period, concentrations were higher than 2 microg/ml, the MIC90 value for B. fragilis, the anaerobic pathogen more frequently involved in postoperative infections after rectal and colonic surgery. Tissue metronidazole levels ranged from 3.64 - 13.37 microg/g in subcutaneous cell tissue, from 3.26 - 41.66 microg/g in peritoneum and from 6.72 - 43.12 microg/g in colon wall. The AUC/MIC values (efficacy parameter for concentration-dependent killing antibiotics such as pefloxacin and metronidazole) obtained were the following: metronidazole AUC/MIC value for B. fragilis was 173; pefloxacin AUC/MIC values for E. coli and E. faecalis were 941 and 235, respectively. The values of these parameters are higher than the recommended values to ensure efficacy, which means good exposure of the antimicrobials to the microorganisms. In conclusion, the combination of pefloxacin and metronidazole as prophylactic agents to prevent infections in patients undergoing colorectal surgery produce plasma and tissue levels above the MIC values of the main pathogens responsible for this kind of infections.

The aim of cell microencapsulation technology is to treat multiple diseases in the absence of immunosuppression. Using this technique, cells are immobilized within carefully designed capsules that allow the long-term function of the graft. Although the potential impact of this field is likely to be wide-ranging, the past few years have seen several 'firsts' that have brought the whole technology much closer to a realistic clinical application.

Cell microencapsulation has emerged as a promising therapeutic strategy to treat a wide range of diseases. The optimisation of this technology depends on several critical issues such as the careful selection of the cell line, the controlled manufacture of microcapsules and the suitable adaptation of the construct design to the selected cell line. In this work, we studied the behavior of hybridoma cells once enclosed in solid and liquefied core alginate-agarose beads. Results show that hybridoma cells presented a better growing pattern and improved their viability and antibody production within liquefied beads. However, when these beads were evaluated with a compression resistance study, they were found to be mechanically more fragile than solid ones. To address this problem, we entrapped non-autologous cells (BHK fibroblast and C2C12 myoblast) in solid alginate-agarose beads and observed that they showed an improved growing profile and prolonged their viability up to 70 days in comparison to the 15 days seen for the hybridoma cells.

BSA was entrapped in particles of different sizes (200, 500 and 1000 nm) prepared from poly(D,L-lactic-co-glycolic) acid by a double emulsion method. The particles were given, either intranasally, orally or subcutaneously, to Balb/c mice and the serum IgG, IgG1 and IgG2a response elicited was compared to that obtained by the subcutaneous administration of either free antigen, free antigen emulsified 1:1 with Freund's Complete Adjuvant (FCA), or free antigen administered with Al(OH)(3). The administration of 1000 nm particles generally elicited a higher serum IgG response than that obtained with the administration of 500 or 200 nm sized nanospheres, the immune response for 500 nm particles being similar than that obtained with 200 nm by the subcutaneous and the oral route, and higher by the intranasal route. PLGA nanoparticles can elicit serum IgG2a responses by the three routes studied. No significant differences on the serum IgG2a/IgG1 ratios were found after the subcutaneous, the oral and the intranasal administration of the different spheres but those were in general higher compared to the administration of either free antigen or free antigen adsorbed to alum. The route of administration influences the serum IgG2a/IgG1 ratio after the administration of free antigen, but not after the administration of the particles. Therefore, differences on the total serum IgG response induced by particles of different sizes do not result in differences on the IgG1 or IgG2a-type immune responses, suggesting that the antigen processing and presentation is similar in all cases tested for PLGA particles.

The plasma levels and tissue penetration of pefloxacin were studied after prophylactic administration to patients undergoing elective biliary surgery. Pefloxacin was administered as a single dose of 800 mg given intravenously as an infusion 1 h before surgery. Over a period of two years, cultures of bile and stone were performed after cholecystectomy in order to find the main pathogens present in the geographical area of the hospital of Txagorritxu (Vitoria, Spain), as well as to test the antimicrobial susceptibility of these bacteria to pefloxacin. Thirty seven per cent of the bile and stone cultures were positive, and 75 different species were isolated. E. coli was the predominant microorganism (25%). Other frequent microorganisms were E. faecium (9.3%), S. epidermidis (6.6%) and Cl. perfringens (6.6%). Most species isolated were susceptible to pefloxacin, with MIC(90) values of 0.125 microg/ml for E. coli, 0.5 microg/ml for S. epidermidis and 1 microg/ml for Cl. perfringens. E. faecium was resistant, with a MIC(90) value of 8 microg/ml but a MIC(50) of 4 microg/ml (intermediate). After pefloxacin infusion, adequate drug plasma levels (>MIC(90)) for the most frequent pathogens were found throughout the procedure. Elimination half-life was estimated as 22.03+/-6.91 h; the area under the concentration-time curve from zero to infinite had a value of 275.07+/-130.02 mg h/l and the values for volume of distribution at steady-state and plasma clearance were 96.48+/-28.65 L and 3.60+/-1.83 l/h, respectively. Bile pefloxacin concentrations generally exceeded the minimum inhibitory concentrations for most relevant pathogens. Drug levels in gallbladder and subcutaneous tissues were also above the MIC(90) for extended periods. Patients were observed daily throughout their hospital stay. This included examination of the surgical wound and recording of body temperature. No cases of anaerobic infection were noted in the study patients. Other constants such as hospitalization stay and time of recuperation were normal for this type of surgery. According to these results, pefloxacin presents many features that make it suitable for use as a therapeutic prophylactic agent, such as its broad spectrum of antimicrobial activity and favorable pharmacokinetic properties., (Copyright 2002 John Wiley & Sons, Ltd.)

The biocompatibility of alginate-PLL-alginate (APA) microcapsules has been evaluated with respect to impurity levels. The impurity content of three different alginates (a raw high M-alginate, a raw high G-alginate and a purified high G-alginate) has been determined and the in vivo antigenic response of APA beads made with each alginate assessed. Results show that purification of the alginate not only reduces the total amount of impurities (63% less in polyphenols, 91.45% less in endotoxins and 68.5% less in protein in relation to raw high M-alginate), but also avoids an antibody response when microcapsules of this material are implanted in mice. In contrast, raw alginates produced a detectable antibody response though the differences in their impurity content. Consequently, this work revealed that purity of the alginate rather than their chemical composition, is probably of greater importance in determining microcapsule biocompatibility.

Sustained release formulations of ketoprofen elaborated with HPMC K100M were studied to test the hypothesis that chiral excipients can stereoselectively affect the release of the racemic drug. The differences observed in the percentage released between enantiomers show the existence of a chiral interaction between ketoprofen and HPMC K100M. HPMC interacts preferably with the S-enantiomer, although the enantioselectivity observed was not relevant from biopharmaceutical and clinical points of view. Diffusion studies were carried out in membrane diffusion cells to simplify the excipient-drug system and hence to analyze only the influence of diffusion process on the stereoselectivity. The results obtained show that the absence of the erosion process strengthens the enantiomeric differences observed in the drug release from tablets. Another objective of this work was to study the influence of formulation pH on the 'in vitro' release profile of ketoprofen. The amount and the release mechanism of ketoprofen from formulations elaborated are conditioned mainly by the pH of the matrix.

BSA was entrapped into PLGA 50:50 microspheres and the in vitro release study was performed. Then 1 microg of microencapsulated antigen was subcutaneously administered to Balb/c mice and the serum Ig G response was compared to that obtained after the subcutaneous administration of the same amount of only free antigen or of free antigen emulsified 1:1 with Freund's complete adjuvant (FCA). The specific serum Ig G responses obtained from the microencapsulated antigen were higher than those obtained from the free antigen and similar to those obtained from the antigen emulsified with FCA. Therefore, the immune response obtained with the subcutaneous administration of 1 microg of microencapsulated antigen was used as a positive control to compare the immune response elicited by the administration of the spheres either by the oral or the intranasal route. There is a dose/response relationship in the serum Ig G response elicited after three consecutive oral administrations of microencapsulated antigen at a dosing range from 200 to 50 microg. However, this relationship does not seem to be clear for the intranasal administration of the spheres at the same dosing range. When comparing the serum Ig G responses at each dosing level for the different routes of administration, it can be observed that the intranasal route is a more powerful inducer of the production of specific Ig G antibody than the oral, which could be due to a greater permeability of the nasal epithelium and to qualitative differences between the mechanisms of induction of the immune response by each route. The serum Ig G2a versus Ig G1 ratio is not significantly different among all the groups that received antigen in microspheres.

Single dose immunisation is a major goal in vaccine design. The purpose of this study was the development of a single dose delivery system for the SPf66 malaria vaccine, based on this antigen's microencapsulation in PLGA microspheres by double emulsion method. Results indicate that a single immunisation in mice and monkeys with the SPf66 malaria vaccine, encapsulated in a mixture of two formulations of PLGA microspheres, induced a remarkably high and long-lasting immune response as assessed by ELISA and Western Blott. This immune response was associated with a good protective capacity in Aotus monkeys, after experimental challenge, indicating that antigen integrity lasted following the microencapsulation process. PLGA biodegradable microspheres thus serve as an effective delivery system for the design of a single dose immunisation vaccine, such as the SPf66 synthetic malaria vaccine.

This paper describes the preparation of colloidal lipid particles containing magnetite from warm emulsions. A two step method was used to obtain the nanoparticles: (i) formulation of a transparent phase by heating a O/W emulsion (aqueous surfactant solution melted with a lipid phase, containing the ethyl oleate and soybean lecithin) in which modified lipophilic magnetite is incorporated, and (ii) preparation of the nanoparticles by dispersing the warm transparent phase in cold water (7 degrees C) under mechanical stirring. The latter method gives spherical nanoparticles of a mean size of 62 nm measured by Photon Correlation Spectroscopy and Transmission Electronic Microscopy. The magnetite entrapment efficiency was determined by use of a magnetophoretic sedimentation method.

SPf66 is the first chemically synthesised vaccine to elicit a partial protective immune response against malaria. The aluminium hydroxide (alum)-adsorbed SPf66 vaccine is weakly immunogenic and of poor to moderate efficacy in humans. To investigate the possibility of improving SPf66 vaccine immunogenicity, a delivery system based on poly-D,L-lactide-co-glycolide (PLGA) microspheres was developed and the immune response induced after its subcutaneous administration into mice was evaluated. Microspheres were prepared by a solvent extraction/double emulsion (w/o/w) method and characterised for morphology, size, peptide loading, release profile and peptide integrity. The in vitro and in vivo results obtained showed that there was no apparent effect of the encapsulation procedure on SPf66 integrity and immunogenicity. The subcutaneous administration of microspheres showed a significantly higher immune response (serum IgG levels) than that obtained with alum adsorbed SPf66 and it was comparable to that of SPf66 emulsified with Freund's adjuvant (FA). These observations illustrate the potential of PLGA microspheres as a delivery system for chemically synthesised antigens.

The influence of hepatic regeneration after partial hepatectomy on theophylline pharmacokinetics has been studied on the rat. At different times after partial hepatectomy, theophylline was administered intravenously as a single dose of 6 mg/Kg. Drug plasma levels were determined by HPLC and pharmacokinetic parameters were obtained. Physiological parameters were also measured. Following hepatectomy, an increase in mass liver was observed and 15 days after surgery, liver mass was 78% of nonhepatectomized rats. Initial theophylline concentrations varied during the regeneration period, as well as the distribution volume at steady-estate (Vss). Elimination half-life (t 1/2), notably increased after hepatectomy (7.27+/-1.38 h), decreased with time (6.70+/-1.18 h, 6.47+/-0.69 and 5.17+/-0.87 h after 24 h, 3 days and 15 days post-hepatectomy, respectively) to reach a value close to that of the control group (4.30+/-1.37 h). The increase in elimination half-life led to a decrease in the mean residence time during the period of liver regeneration. However, the intrinsic clearance hardly varied during regeneration period. We could establish the following relationship between liver weight (LW) and the elimination half-life: t 1/2 (h)=-0.358*LW (g)+8.6168 (R2=0.9906). For the mean residence time (MRT) this relationship was: MRT (h) =-0.5173*LW (g)+12.433 (R2=0.991).

The aim of the present work was to evaluate the influence of aging that might condition the release of salbutamol sulfate from oral formulations (lipid matrices) using Gelucire as lipid excipients. Gelucires are essentially characterized by their melting point and their hydrophilic-lipophilic balance. The release profiles of salbutamol sulfate from the capsules elaborated were dependent on the type of Gelucires, fast release, in the case of Gelucire 35/10, a slower release for Gelucire 48/09 and a slow release for Gelucire 46/07. Differential scanning calorimetry was used to study the physical state of drugs in the matrices. Gelucires may exhibit aging effects, whereby a range of physical properties may change upon storage. In the case of Gelucire 35/10, which presents a fast release of salbutamol sulfate, storage produces a decrease in the values of dissolution constant for all capsule sizes. Gelucire 48/09 showed a slower release rate than Gelucire 35/10, and after 1 year of storage, a decrease in the salbutamol dissolution rate for capsule number 3 and 4 was observed. Gelucire 46/07 presented the slowest dissolution rate, but there were not statistically significant differences. These results show that the faster the dissolution rate, and the larger the capsule size, the higher is the influence of storage.

The aim of the present work was to study the release of a model protein, bovine serum albumin (BSA) encapsulated within biodegradable poly (D,L-lactide-co-glycolide) (PLGA) microspheres prepared by a modified solvent evaporation method using a double emulsion. These microspheres were characterized for size, morphology, surface adsorbed protein, encapsulation efficiency and release kinetics. Two types of in vitro assays were developed to evaluate the influence of shaking and the addition of surfactants on the release profile of encapsulated protein. Scanning electron microscopy (SEM) observation showed spherical and smooth surface particles, with a mean particle size of 20 microm and an encapsulation efficiency of 81%. Surface associated protein was about 25%. The in vitro release profile showed a biphasic pattern described by means of a biexponential equation. There was an initial burst effect due to the release of the protein adsorbed on the microsphere surface and a sustained release phase due to protein diffusion through the channels or pores formed in the polymer coat. The release obtained profiles in static and dynamic assays showed statistically significant differences in the amount of the released protein, whereas the release rate was not affected. The burst effect was 28.30+/-1.63% and 35.20+/-1.50% of the total encapsulated protein for the static and dynamic assays respectively. The addition of surfactants (SDS) to the release medium increased the rate and the amount of drug released. In both assays the value of the slow release rate constant, beta, was 0.029+/-0.002 days(-1) when the surfactant was added, and 0.017+/-0.0014 days(-1) in the samples without surfactant. It is believed that the surfactant leads to an increase in the microsphere surface polarity which allows channel and pore formation inside the polymer through which the protein diffuses easily.

The plasma levels and tissue penetration of ofloxacin were studied after prophylactic administration in 17 patients undergoing elective biliary surgery. A single dose of ofloxacin 400mg given intravenously as an infusion was administered 1 hour before surgery. Adequate drug plasma levels [>/= minimum inhibitory concentration (MIC(90)) for Escherichia coli] were found throughout the procedure. Mean peak (1 hour) and last-determined (36 hours) ofloxacin serum levels were 7.97 +/- 3.79 mg/L and 0.19 +/- 0.13 mg/L, respectively. The elimination half-life (t((1/2)lambda)) was 8.86 +/- 3.07 hours, and the clearance and steady-state volume of distribution were 0.17 +/- 0.05 L/h.kg and 112.90 +/- 37.09L, respectively. The area under the plasma concentration-time curve from zero to infinity (AUC(0-infinity)) was 41.60 +/- 12.51 mg/L.h. In bile, ofloxacin levels were higher than in plasma and showed great variability. Adequate ofloxacin levels in subcutaneous cell tissue and gallbladder wall tissue were observed during the surgical procedure. Patients were observed daily throughout their hospital stay. This included examination of the surgical wound and recording of body temperature. No cases of anaerobic infection were noted in the study patients. Other constants such as hospitalisation stay and time of recuperation were normal for this type of surgery.

A biocompatible emulsification method for microencapsulation of live cells and enzymes within a calcium alginate matrix applied to Bacillus Calmette-Guérin (BCG) has been developed. Small-diameter alginate beads (microcapsules) were formed via internal gelation of an alginate solution emulsified within vegetable oil. Five different oils (sesame, sweet almond, perhydrosqualene, camomile and jojoba) were used. The rheological analysis of the oils showed a Newtonian behaviour, with viscosities = 30.0, 37.7, 51.2, 59.3 and 67.1 mPa.s for perhydrosqualene, jojoba, camomile, sesame and sweet almond oil respectively. The particle size of the microcapsules obtained ranged from 30.3 microns for the microcapsules prepared with sweet almond oil to 57.0 microns for those made with perhydrosqualene. The mean particle diameter obtained was found to be dependent on the viscosity of the oil employed, according to the equation: phi (micron) = 76.6-0.628 eta (mPa.s) (r2 = 0.943). The encapsulated BCG was identified by the Difco TB stain set K, followed by observation under optical microscopy. Freeze-drying of the microcapsules was carried out to ensure their stability during storage. Two batches of microcapsules (those prepared with sesame and jojoba oil) and four types of cryoprotectors (glucose, trehalose, mannitol and sorbitol), at three concentration levels (5, 10 and 20% w/v) were studied. The parameters evaluated were particle size, physical appearance, reconstitution of lyophilizates and microscopical evaluation. For both batches of microcapsules the best results were obtained with trehalose 5%, showing particle sizes of 42.1 microns in the case of the microcapsules prepared with sesame oil, and of 45.3 microns for those prepared with jojoba.

The present study was carried out to define the pharmacokinetics of salbutamol sulfate administered to mongrel dogs in five pharmaceutical forms via two routes of administration. One pharmaceutical form was administered intravenously (Ventolin i.v.) while the other four were administered orally (Ventolin: immediate-release formulation, Volmax: commercial osmotic pump, SG7 and SG14: sustained-release hydrophilic matrices developed in our laboratory). We obtained a first-order release kinetic of the salbutamol from Ventolin and SG7, whereas a zero-order release kinetic was observed for SG14 and Volmax formulations. Oral bioavailability was 80% and there were neither significant differences (P > 0.05) in terms of the calculation method used (relation of the areas under the plasma level curve Loo-Riegelman, deconvolution) nor in terms of the dosage form (Ventolin Volmax, SG7 and SG14). The elimination half-life value of salbutamol was 1.2 h when administered intravenously; this parameter had a value of 3.0 h for the immediate-release formulation and ranged between 5.4 and 7.2 h in the sustained-release formulations when administered orally. These changes in the half-life value of the sustained-release formulations will allow us to modify the frequency of administration in relation to immediate-release formulations.

The influence of partial hepatectomy on the activity of the hepatic microsomal enzymatic systems was determined in rats. Cytochrome P-450, cytochrome b5, four mixed functional oxidase (MFO) activities (microsomal aniline hydroxylase, p-nitroanisole O-demethylase, aminopyrine N-demethylase and NADPH cytochrome c reductase) and glutathione levels were measured in unhepatectomized rats (control group) and in hepatectomized rats 12 h, 24 h, 3 days and 6 days after 70% hepatectomy. Following surgery the remaining lobes of the liver grow rapidly in order to restore the original liver mass. Partial hepatectomy significantly reduces cytochrome P-450 and b5 content in the remaining liver as well as the four MFO activities studied. But when the enzymatic systems are expressed as nmoles/mg microsomal protein, only cytochrome P-450 shows statistical differences. The hepatic biotransformation capacity of drugs and xenobiotics decreases during the regeneration period due to the reduction of hepatic mass rather than because of a reduction of their metabolic capacity. Glutathione levels are increased after partial hepatectomy but increased glutathione-dependent protector mechanisms are not expected.

The influence of partial hepatectomy on the pharmacokinetics of theophylline was determined in rats. The pharmacokinetics of intravenous theophylline was studied in unhepatectomized rats (control group: CG) and in hepatectomized rats (HG) 12 h after 70% hepatectomy. Liver function was monitored in both groups by measurements of total and direct bilirubin, transaminases GOT and GPT, and plasma protein. Seventy per cent hepatectomy caused significant liver dysfunction: transaminase levels (GOT and GPT) increased by 118 and 683%, respectively, and the total and direct bilirubin levels increased by 28.6 and 9.1%, respectively. At the same time, plasma concentrations of theophylline decreased significantly and half-life increased from 4.16 +/- 0.57 h (CG) to 7.08 +/- 0.69 h (HG), as did the distribution volumes values of central (Vc) and peripheral (Vp) compartments (Vc: CG, 0.18 +/- 0.03 L; HG, 0.24 +/- 0.03 L) (Vp: CG, 0.08 +/- 0.05 L; HG, 0.13 +/- 0.05 L). The percentage of theophylline binding to plasma proteins decreased from 44.3% in CG to 33.8% in HG. The theophylline intrinsic clearance (CLint) dropped from 1.35 +/- 0.43 mL/min (CG) to 0.93 +/- 0.10 mL/min (HG)1, which can be attributed to a significant fall in the quantity of hepatic microsomal enzymes. These modifications on the pharmacokinetics of drugs with low hepatic extraction coefficients, such as theophylline, should be considered when dosage regimens during the posthepatectomy hepatic regeneration period are planned.

The influence of adrenalin on the pharmacokinetics of lidocaine given interpleurally to 10 patients with pancreatic neoplasia was studied. Five patients received an interpleural dose of lidocaine (200 mg; control group), and 5 patients received an interpleural dose of lidocaine (200 mg) plus adrenalin (1:200,000). Plasma and cerebrospinal fluid (CSF) levels of lidocaine were measured before and at specified times (up to 8 hours) after the dose. The analytical technique was radioimmunoassay; and plasma and CSF data were assessed using noncompartmental analysis. The drug was quickly absorbed into the plasma in the control group (Cmax = 2.76 +/- 0.10 microgram/mL at 0.33 +/- 0.14 hours after administration); whereas drug access to CSF was decreased and occurred slowly (Cmax = 0.32 +/- 0.07 microgram/mL at 1.66 +/- 1.35 hours). The drug was eliminated more quickly from plasma than from CSF, with half-lives of 1.71 +/- 0.43 hours and 3.86 +/- 1.27 hours, respectively. The simultaneous administration of adrenalin delayed absorption (tmax = 0.91 +/- 0.52 hours). The drug elimination half-lives in plasma and CSF of this group increased to 3.22 +/- 1.22 hours and 8.71 +/- 3.28 hours, respectively. The duration of the analgesia, evaluated as the time until the patient needed another dose, increased from 8.2 +/- 1.5 hours in the control group to 9.7 +/- 1.3 hours in the group that received adrenalin. From these results the levels that would be reached on a multiple-dose regimen (D = 200 mg, tau = 8 hours) were predicted.(ABSTRACT TRUNCATED AT 250 WORDS)

A comprehensive examination of phenomena related to cancer is presented that is based on hydrogen ion dynamics, as viewed from the biological, biochemical, and biophysical perspective. A model is described that considers an array of cancer-associated events from oncogenesis to carcinogenesis from this perspective. The basic ideas are viewed from various aspects, ranging from the cellular level to the clinical situation. The novel types of therapeutic and prophylactic agents that result from applying these concepts are elucidated. Considerable insight into this modern approach is seen from some of the mechanisms that characterize the phenomenon of spontaneous regression of cancer.

The aim of the present study was the use of an interspecies scaling approach to predict drug interactions during preclinical drug disposition studies. Theophylline and cimetidine were selected because of their documented interaction. The literature was searched for pharmacokinetic data of intravenously administered theophylline alone and in the presence of cimetidine in humans, dogs and rats. Further, we determined the theophylline-cimetidine drug interaction in rabbits. Application of allometric equations to the pharmacokinetic parameters and the conversion of chronological time into pharmacokinetic time allowed us to obtain the complex Dedrick plot for theophylline when administered alone or in combination with cimetidine. A superimposable kinetic profile was obtained for the plasma levels of theophylline in all species studied, both with and without cimetidine. From the terminal phase of the curves it is possible to calculate the elimination half-life: 2.69 apolisychrons for theophylline when it is administered alone and 3.86 apolisychrons when it is administered in combination with cimetidine. This 43% increase in t1/2 is similar to the increase in the elimination half-life of theophylline in humans when it is administered after pretreatment with cimetidine. These results show that an interspecies scaling approach may be useful to predict the effect of interactions in humans from the results obtained in preclinical research with new drugs.

Development of effect compartment model theory has greatly enhanced our understanding of the relationship between pharmacokinetics and pharmacodynamics. When effect versus concentration in serum (usually total concentration) is plotted and counterclockwise hysteresis is observed, an initial disequilibrium between receptor(s) and serum is generally presumed and an effect compartment model is used; alternatively, clockwise hysteresis may infer tolerance, which may be characterized by an adaptation model. In this simulation study, the influence of time-dependent binding to serum protein on the relationship between effect and concentration in serum was investigated. In these simulations, time-dependent protein binding occurred as a result of an increase in protein concentration in serum or displacement by a metabolite. When concentration of free drug in serum was responsible for the pharmacological response, and response versus total drug concentration in serum was plotted, counterclockwise hysteresis, consistent with an effect compartment, occurred with a time-dependent decrease in binding to serum protein. Clockwise hysteresis, consistent with tolerance, occurred with a time-dependent increase in binding to serum protein. For both sets of simulations, no hysteresis was observed when response was plotted against concentration of free drug in serum. These results indicate that, when response is related to concentration of free drug, measurement of concentration of free drug may allow a clearer interpretation of the pharmacokinetic-pharmacodynamic relationship.

We have studied the pharmacokinetics and distribution of ketamine and its biotransformation products in dogs after extradural administration of ketamine at L4-5. The mean apparent uptake rate constants of ketamine for plasma and CSF were 4.17 (SD 1.84) and 5.15 (2.50) h-1, respectively. The concentrations of ketamine in CSF were greater than those found in plasma. The elimination half-life values of the parent drug for both biological fluids were similar (4.3 (2.96) h and 4.6 (3.31) h for plasma and CSF, respectively). The apparent formation rate constant of norketamine was greater than that of dehydronorketamine. However, the concentrations of the biotransformation products in CSF were smaller than those of the parent drug. These results are similar to the distribution of ketamine and its metabolites in different cerebral structures and tissues. The concentrations decreased in concert with the increase in polarity of the metabolites. A specific distribution for all compounds was observed. Ketamine showed a greater affinity for brainstem, while norketamine and dehydronorketamine were distributed mostly in cerebellum and kidney, respectively.

The metabolism of binifibrate was studied in 10,000 g supernatant fractions from rat liver. Binifibrate was found to be completely biotransformed into clofibric acid and nicotinic acid at 60 min from the start of incubation through a series of intermediate products among which glycerol dinicotinate was identified. The biotransformation constant of binifibrate into its different metabolites proved to be 0.11 +/- 0.025 min-1. The formation of clofibric acid follows a first-order kinetic process characterized by its corresponding rate constant (kc), proving to be 0.043 +/- 0.017 min-1. The amount of clofibrate was 0.78 +/- 0.16 mumol/ml, showing that it is not biotransformed later in the incubation mixture. The formation constant of nicotinic acid (kn) was 0.067 +/- 0.020 min-1 and the amount of substance contained in the incubation mixture (0.94 +/- 0.25 mumol/ml shows that it is later biotransformed in the incubation mixture through the previously described metabolic processes.

We have studied the pharmacokinetics of ketamine administered rectally in a dose of 10 mg kg-1 to five children aged 6-9 yr and mean weight 28.80 (SD 6.55) kg. An acceptable level of anaesthesia was not obtained in any patient. Despite this, the degree of analgesia obtained was good and no child required further administration of analgesics during the postoperative period. Tolerance to the suppositories was excellent. The absorption of ketamine was found to be relatively fast, with a median peak concentration of 160 ng ml-1 (range 96-250 ng ml-1) at 0.75 h (range 0.50-1.00 h) after administration. The plasma concentrations of norketamine were greater than those of the parent drug, with a maximum of 510 ng ml-1 (range 450-810 ng ml-1) at 0.81 h (range 0.50-1.00 h) after administration. The medians of the half-lives of ketamine and norketamine were 3.15 h and 2.56 h, respectively (range 1.57-4.95 h and 1.47-5.30 h, respectively).

The pharmaceutical preparations of paracetamol Duorol and Termalgin, both containing 500 mg of active compound, were studied to test their bioequivalence. The results obtained showed that absorption of the drug follows two sequential kinetic processes by their corresponding first order rate constants (K1 and K2) with values of 0.31, 5.69 and 0.30, 5.71 h-1 for Duorol and Termalgin, respectively. Analysis of variance showed that there were no statistically significant differences (p greater than 0.5) in the absorption, biotransformation and excretion processes between the two preparations assayed. Finally, the use of symmetric confidence intervals by the Westlake test, showed that both preparations are bioequivalent.

The plasma levels of ketamine, an anaesthetic, and its metabolites were studied in 10 rabbits with normal renal function and in 9 rabbits with varying degrees of experimentally induced renal impairment. All the animals received a single bolus type i.v. dose of 10 mg/kg of the drug. The results obtained reveal an apparent inhibition of the biotransformation of ketamine in rabbits with renal impairment in which the drug is accumulated. The plasma half-life of ketamine ranged from 0.74 h in rabbits with normal renal function to 2.6 h in the animals with severe renal impairment. The plasma levels of norketamine (metabolite I) did not alter significantly in states of renal impairment. However, the kinetics of the other metabolite (II), dehydronorketamine, did change significantly in renal impairment, due to its high renal excretion capacity.

The biotransformation kinetics of Ketamine in 10,000 g supernatant fractions of liver and lung homogenates was studied. The products found in the incubation mixtures by gas chromatography and mass spectrometry were identified. In the two homogenates studied it was only possible to detect and identify metabolite I of ketamine. This study enabled us to characterize the kinetic parameters in order to define the biotransformation of ketamine (Km and Vmax) in the two organs studied. The lung enzyme systems were found to be more easily saturable than those of the liver. Furthermore, the fact that all of the ketamine is biotransformed and only 60% of metabolite norketamine appears suggests the existence of parallel biotransformation pathways for this anaesthetic.

The evolution of the plasma levels of ketamine and its two biotransformation products, norketamine (metabolite I) and dehydronorketamine (metabolite II) was studied after i.v. and epidural administration at doses of 2 and 5 mg/kg, respectively. The results show a good access capacity of ketamine from the epidural space to the systemic circulation as reflected in the high value of its apparent incorporation constant (ka = 5.54 +/- 2.33 h-1) and its good bioavailability (F = 0.77 +/- 0.22). The evaluation of clinical parameters points to a more attenuated cardiovascular and respiratory response after administration of the anesthetic by the epidural route.

The plasma concentrations of amoxapine and its active metabolites, 8-hydroxyamoxapine and 7-hydroxyamoxapine were determined in 8 healthy volunteers receiving a single oral dose of 100 mg of the drug. Considerable interindividual variation was seen in the plasma levels of the three substances. Amoxapine reached maximum levels of 67.4 +/- 35.8 ng/ml between 1 and 2 h after administration. The decline of amoxapine levels in plasma was biphasic. The mean elimination half-life was 9.8 +/- 2.6 h and the estimated first-pass loss ranged between 0.18 and 0.54. The peak levels of the metabolites were reached between 1 and 3 h after administration, with 8-hydroxyamoxapine levels significantly higher than those of 7-hydroxyamoxapine. The mean elimination half-lives were 30.8 and 5.1 h for 8-hydroxyamoxapine and 7-hydroxyamoxapine respectively. The margins of the plasma concentrations reached at steady-state were calculated according to pharmacokinetics parameters for a dosage interval of 8 h.

The urinary excretion kinetics of amikacin was studied in 28 healthy volunteers who received doses of 125, 250 and 500 mg of the antibiotic. The average percentages of the dose excreted were 67.67, 79.4 and 68.65% for each dose, respectively. The elimination constant (Ke), the urinary excretion constant (Ku) and the extra-renal excretion constant (Knr) had similar values for the three groups studied. The average value obtained for Knr showed the existence of a moderate extra-renal excretion of amikacin. A linear relationship was observed between the maximum excretion rate (Vmax) and the dose administered (D), according to the equation: Vmax (mg/h) = 3.714 + 0.207 X D (mg); r = 1.000 This relationship reveals the linear kinetics of renal excretion in the dose range studied. In view of the high urinary concentrations obtained, it is concluded that amikacin doses of 4 mg/kg/day should ensure therapeutic urinary concentrations sufficient to combat most amikacin-susceptible organisms.