Biomedical subjects

E I Ette

Publications and source records attributed to E I Ette.

28 records · Page 2Linked to original sources

PubMed1987

Chloroquine elimination in humans: effect of low-dose cimetidine.

A controlled study was carried out in ten healthy, male volunteers (randomly distributed into control and test groups of five subjects each) to determine the effect of low-dose cimetidine on chloroquine elimination. The control group subjects received two tablets of chloroquine sulfate (300-mg base) only, while the test group subjects took 400-mg cimetidine at bedtime for four days prior to chloroquine (two tablets of chloroquine sulfate) administration and throughout the duration of the study. Blood samples, 5 mL, were collected periodically after chloroquine administration. The samples were assayed for chloroquine and monodesethylchloroquine using a combination of thin-layer chromatography and spectrophotometry. Wilcoxon's test for unpaired data at P less than .05 was used to determine if there was any significant difference in the elimination of chloroquine in the test group when compared with the control group. The apparent oral clearance rate of chloroquine was reduced from 0.49 +/- 0.04 L/d/kg in the control group to 0.23 +/- 0.02 L/d/kg in the test group, and the elimination half-life was prolonged from 3.11 days in the control group to 4.62 days in the test group. There was a 47.04% reduction in the AUC0-7d of monodesethylchloroquine, the major metabolite of chloroquine, in the test group when compared with the control group. The apparent volume of distribution at steady state was increased from 0.46 +/- 0.07 L/kg in the control group to 0.72 +/- 0.10 L/kg in the test group. All these changes were statistically significant. The conclusion is that cimetidine impairs the elimination of chloroquine in healthy subjects.

Adult↗

PubMed1987

Chloroquine in human milk.

Simultaneous milk and saliva samples were collected over a seven-day period from five lactating subjects after they had ingested two tablets of chloroquine sulfate (300 mg base). The samples were analyzed for chloroquine content by use of a combination of thin-layer chromatography and spectrophotometry. Regression analysis of two variables subject to error was used to determine the milk:saliva levels relationship. The Student's t test for paired data at .05 level of significance was used to evaluate the relationship between chloroquine levels in milk and saliva. The milk:saliva chloroquine concentrations ratio obtained by regression analysis was 0.89 +/- 0.08 (r = .93; P less than .05), and this compared favorably with the value of 0.99 +/- 0.07 obtained from the ratio of the AUC. There were no significant differences in the Tmax, Cmax, AUC, clearance, and elimination half-life values of chloroquine in milk and saliva (P greater than .05). Milk and saliva appear to be part of the central compartment. The amount of chloroquine estimated to be consumed by a nursling over a 24-hour period is about 0.55% of a 300-mg dose consumed by the mother. The data suggest that milk chloroquine levels can be estimated from saliva levels.

Adult↗

PubMed1987

Effect of ranitidine on chloroquine disposition.

Ten healthy, male volunteers (aged 19-27 yr; weight 62-67 kg) were randomly distributed into control and test groups of five subjects each in a controlled study on the effect of ranitidine on chloroquine disposition. The control group subjects received two tablets of chloroquine sulfate (300-mg base) only. The test group subjects received ranitidine 250 mg hs for four days prior to the administration of chloroquine sulfate and throughout the sample collection period. Blood samples (5 ml) were collected from the time of the chloroquine administration to the seventh day after drug administration. The samples were analyzed for chloroquine content by a combination of thin-layer chromatography and ultraviolet spectrophotometry. The Wilcoxon test at 0.05 significance level was used to compare the disposition parameters between control and test groups. Ranitidine therapy was associated with no significant alterations in chloroquine oral clearance rate, elimination rate constant, and apparent volume of distribution. Unlike cimetidine, ranitidine does not interact pharmacokinetically with chloroquine. Ranitidine, therefore, may be the H2-receptor antagonist of choice for ulcer patients receiving chloroquine.

Adult↗

PubMed1987

Determination of the drug information needs of the medical staff of a Nigerian hospital following implementation of clinical pharmacy services.

The types and frequency of questions asked of clinical pharmacists introducing clinical pharmacy services in the internal medicine wards of a Nigerian university hospital and the degree of compliance with pharmacists' recommendations were studied. Three faculty pharmacists collected data in two 30-working day study periods, separated by a year. Totals of 197 questions (an average of 6.57 +/- 1.33 questions/working day) and 271 questions (an average of 9.03 +/- 1.10 questions/working day) were answered by the pharmacists in the first and second study periods, respectively. Pharmacists recommended changes in patient-specific drug therapy that were implemented 52 percent and 69 percent of the time in the first and second study periods, respectively. The most common type of drug information request concerned the presence or the likelihood of an adverse drug reaction. Continuous interaction between pharmacists and physicians in the patient-care setting results in a better appreciation of the pharmacist's role as drug information consultant, and the consequence of this is a high degree of compliance with pharmacists' recommendations.

Drug Information Services↗

PubMed1986

Effects of chloroquine and didesethylchloroquine on rabbit myocardium and mitochondria.

The effects of chloroquine and didesethylchloroquine on the rabbit isolated perfused heart and on calcium binding and accumulating ability of the heart mitochondria were investigated. The drugs produced negative chronotropy, negative inotropy and a decrease in coronary flow rate in the isolated perfused myocardium. Both chloroquine and didesethylchloroquine significantly decreased mitochondrial calcium binding and accumulation. These results suggest that the cardiodepressant actions of chloroquine could be due in part to alterations in the calcium accumulating abilities of the mitochondrial membranes, and that didesethylchloroquine, among other metabolites, does contribute significantly to the total observed effect of chloroquine on the cardiovascular system.

Animals↗

PubMed1981

Actions of chloroquine and its N-oxidation metabolites on the rectus abdominis muscle of the toad (Bufo regularis).

Using the isolate rectus abdominis muscle preparation of the toad (Bufo regularis) the pharmacological actions of chloroquine, chloroquine-N-oxide and chloroquine N-di-oxide were investigated. On their own at concentrations ranging from 7.5 x 10(-5) -5 x 10(-3)M, the compounds induced contractures, chloroquine being the most active. At lower concentrations (5 x 10(-7) - 5 x 10(-5) M), chloroquine and its N-oxides enhanced acetylcholine-induced contractures whereas they depressed the carbachol-evoked contractures. At higher concentrations (5 x 10(-4) - 5 x 10(-3)M), chloroquine and its N-oxides inhibited both ACh- and carbachol-induced contractures. Analysis of the results obtained showed that the antagonism between ACh (or carbachol) and chloroquine (or its N-oxides) is non-competitive. At low concentrations chloroquine and its N-oxides (5 x 10(-7) - 5 x 10(-5)M) inhibited the potentiating action of neostigimine on ACh-induced contractures. From the results obtained in the study presented here, it is suggested that the antagonism of acetylcholine (or carbachol) by chloroquine and its N-oxidation metabolites on this muscle preparation may be at the cellular level. It is also suggested that the compounds examined may be acting as anticholinesterases (with chloroquine being the most active).

Acetylcholine↗

PubMedDate not supplied

Pharmacokinetics of chloroquine: saliva and plasma levels relationship.

The use of saliva levels as an alternative to plasma levels in monitoring chloroquine therapy was studied in five healthy volunteers. Subjects took two (250 mg) tablets of chloroquine diphosphate (300 mg chloroquine base) with 200 ml of water. Saliva and blood samples were collected at intervals over 6 days. Plasma was separated from blood samples after centrifugation while saliva samples were centrifuged to remove mucoid sediments. Both the plasma and saliva samples were analysed for chloroquine by a combination of thin-layer chromatography and spectrophotometry. Regression analysis was used to determine the correlation between saliva and plasma chloroquine levels. A significant correlation (r = 0.97, p less than 0.05) was observed between saliva and plasma levels of chloroquine. The saliva: plasma concentrations ratio was found to be 0.53. From the saliva: plasma relationship, the extent of chloroquine binding to plasma proteins was estimated to be 47%. The Cmax and AUC0-6 day values obtained from saliva data was about half those from plasma, while the Tmax obtained from both fluids remained the same. The saliva clearance rate (Cls/F) of chloroquine was about twice the plasma clearance rate (Cl/F). (Cls/F: 0.46 +/- 0.051/day/kg; 0.27 +/- 0.021/day/kg). However, the predicted Cl/F (0.27 +/- 0.031/day/kg) from saliva data was in agreement with Cl/F from plasma data. This was also true of the volume of distribution. The collection of saliva for measuring chloroquine levels provides a painless, non-invasive alternative to plasma sampling, and it is useful in predicting chloroquine pharmacokinetics.

Adult↗

PubMedDate not supplied

Chloroquine disposition in hypersensitive and non-hypersensitive subjects and its significance in chloroquine-induced pruritus.

Twenty-one healthy Nigerian volunteers distributed into four groups participated in a study to determine the significance of chloroquine disposition in chloroquine-induced pruritus. It involved the administration of chloroquine with or without promethazine pre-administration to the subjects. Group I consisted of 8 chloroquine non-hypersensitive subjects receiving 2 tablets of chloroquine sulphate (300 mg base); Group II consisted of 5 chloroquine non-hypersensitive subjects receiving 2 tablets of chloroquine sulphate 30 minutes after 25 mg promethazine tablet pre-administration; Group III consisted of 5 chloroquine hypersensitive subjects treated as in Group II; Group IV consisted of 3 hypersensitive subjects treated as in Group I. Blood (5 ml) and urine samples were collected periodically for up to 6 days post-dose. The samples were analysed for chloroquine and some of its oxidation metabolites by a specific HPLC method. Probit plots of cumulative drug/metabolite ratios were done to determine if there is polymorphism in chloroquine metabolism. There was bimodality only in the distribution of chloroquine/monodesethylchloroquine ratios, suggesting polymorphism in the metabolic oxidation of chloroquine in these subjects. Higher levels of monodesethylchloroquine were obtained in Group IV subjects when compared with any of the other groups. The oral clearance rate, elimination half-life, and volume distribution at steady state of chloroquine in the study groups were not significantly different (P greater than 0.05). In the absence of promethazine there appears to be an extensive metabolism of chloroquine in hypersensitive individuals to produce monodesethylchloroquine which probably determines the degree of pruritus experienced by an individual.

Adult↗

PubMedDate not supplied

Designing population pharmacokinetic studies: performance of mixed designs.

The interplay of the following factors: population design (PDN), the cost function in terms of maximum cost (Max. C) (i.e., maximum number of samples/sample size), sample size, and intersubject variability [restricted (30%) to moderate (60%)] on the estimation of pharmacokinetic parameters from population pharmacokinetic data sets obtained using mixed designs was investigated in a simulation study. A two compartment model with multiple bolus intravenous inputs was assumed, and the residual variability was set at 15%. The sample size (N) investigated ranged from 30 to 200 with the associated cost function varying accordingly with the five individual and sixteen population designs studied. Accurate and precise estimates of structural model parameters were obtained for N > or = 50 (Max. C > or = 150) irrespective of the intersubject variability (ITV) and PDN investigated. When ITV was 30%, all structural model parameters were well estimated irrespective of the PDN. Robust estimates of clearance and its variability were obtained for all N at all levels of ITV with Max. C > or = 90 (PDN > or = 4). Imprecise estimates of ITV in V1, V2, and Q were obtained at 60% ITV irrespective of N, PDN, or Max. C. Positive bias was associated with the estimation of variability in V1, V2, and Q with PDN < or = 4 (Max. C < or = 150). This was due in part to a greater proportion of subjects sampled only once. Correspondingly, residual variability was underestimated. It is of utmost importance to avoid this artifact by ensuring that at least a moderate subset of subjects contributing data to a population pharmacokinetic study contribute data more than once. Given a sample size and ITV, the cost function must be considered in designing a population pharmacokinetic study using mixed designs.

Humans↗

PubMedDate not supplied

Statistical graphics in pharmacokinetics and pharmacodynamics: a tutorial.

OBJECTIVE: To discuss the use of statistical graphics in the analysis of pharmacokinetics and pharmacodynamics data. METHODS: Information on graphic techniques and their application was retrieved from a MEDLINE search (January 1980-March 1997) of the English-language literature and bibliographic reviews of review articles and books. Data used to generate plots were extracted from some new drug applications submitted to the Food and Drug Administration and by simulation. DATA SYNTHESIS: In carrying out data analysis, we should look at data in several ways, construct a number of plots, and do several analyses, letting the results of each step suggest the next. The information from a plot should be relevant to the goals of the analysis. Thus, in choosing a graphic method, it is necessary to match the capabilities of the method to the need in the context of the application. For example, if linear relationships among variables in a set of multidimensional data are relevant, scatter plots such as the pairs plot with smoothing is likely to be more informative than other graphic methods. It is necessary to recognize what kinds of perceived structure are attributable to the data, and what kinds are artifacts of the display technique itself when using graphs for data analysis. CONCLUSIONS: Graphic techniques enable the data analyst to explore data thoroughly, look for patterns and relationships, confirm or disprove the expected, and discover new phenomena. An important element of statistical graphic techniques is flexibility, both in tailoring the analysis to the structure of the data and in responding to patterns that successive steps of analysis uncover. Statistical graphics can and should be used to enhance numeric statistical analyses.

Computer Graphics↗