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Biomedical subjects

B Corrigan

Publications and source records attributed to B Corrigan.

10 recordsLinked to original sources

The problem of racemization in the stereospecific assay and pharmacokinetic evaluation of ketorolac in human and rats.

PURPOSE: A comparison of a previously reported indirect (precolumn derivatization) assay for ketorolac (KT) and a new direct method described here was made to establish the conditions under which KT may undergo racemization and to explain the observed discrepancies in the pharmacokinetics of KT reported in the literature. METHODS: A previously reported pre-column derivatization method and a new direct method were employed to determine the effect of pH and ionic strength on racemization. Using the conditions where no racemization occurred, the pharmacokinetics in humans and rats, and protein binding of KT enantiomers were determined. RESULTS: Under the chromatographic conditions employed for the direct assay, no racemization was observed. Under high pH and ionic strength, however, both methods resulted in KT racemization. The indirect method resulted in rapid and complete racemization due to the strong basic conditions required for derivatization. In both humans and rats, the pharmacokinetics of racemic KT were stereoselective with the R enantiomer being predominant (AUC S/R: humans, 0.26; Rats: 0.45). This is likely due to more extensive plasma protein binding of S than its antipode (unbound S/R: 1.35). CONCLUSIONS: The discrepancies in the literature may be explained by rapid racemization of KT that occurs during sample preparation for the pre-column derivatization method. Considerations should be given to the possibility of racemization during the assay development and validation.

Animals

Cervical headache.

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Atlanto-Axial Joint

The painful shoulder.

Although a common symptom, shoulder pain is not always due to intrinsic disorders of the joint; it can be referred from lesions of the cervical spine or from visceral disease.

Adult

Rheumatic disease: exercise or immobilization?

Though it may be true that, in the absence of a dependable cause, there is no single cure for inflammatory diseases of the locomotor system, nevertheless there is no reason for therapeutic nihilism. Much can be done to induce a remission in the disease while at the same time suppressing inflammation, relieving pain, preventing or correcting deformities, easing stiffness and increasing muscular control of the joints. However, no drug regime can be expected to achieve this, and reliance on drugs alone invariably leads to disappointing results, both for the doctor and patient. Hence every patient also should have a properly organized and supervised regime of physical methods of treatment. The relative value of rest or exercise remains controversial, and different considerations play a role in some of the disease processes. Thus in patients with active rheumatoid synovitis there seems no doubt that at first, extra rest to the inflamed joints is essential, but as the disease process is brought under control, the patient can be mobilized and made more active. In patients with ankylosing spondylitis, the emphasis should be placed on activity and exercise.

Arthritis, Rheumatoid

Sports medicine.

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Humans