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J L Steimer

Publications and source records attributed to J L Steimer.

At least 37 records · Page 2Linked to original sources
PubMed1991

Exploratory analysis of population pharmacokinetic data from clinical trials with application to isradipine.

Drug level monitoring during routine clinical visits in the course of phase III trials provides a means to document pharmacokinetic variability in a patient population. Such a pharmacokinetic screen was performed for the new calcium antagonist isradipine. A total of 697 blood samples were collected at any time after the morning dose from 252 patients who had received oral doses of isradipine. Three approaches of data analysis based on exploratory (graphical and statistical) techniques were used to relate plasma level to patient demographic data and laboratory parameters. The pharamacokinetics of isradipine seemed to be influenced by the demographic variables of age (already detected in conventional studies) and weight, as well as by the blood serum levels of inorganic phosphorous, uric acid, alkaline phosphatase, and bilirubin, but only to a small, clinically irrelevant extent. The findings from the three approaches were complementary. They suggest that a pharmacokinetic screening in clinical trials is feasible at reasonable experimental cost and effort and provides useful data on interindividual and intraindividual pharmacokinetic variability in patients.

Adult↗
PubMed1989

Zero-order absorption and linear disposition of oral colchicine in healthy volunteers.

The pharmacokinetics of colchicine has been studied in nine healthy male volunteers after oral doses of 0.5, 1, and 1.5 mg as tablets. Plasma and urine samples were collected over 48 h and analysed for colchicine by radioimmunoassay. Individual colchicine concentration profiles in plasma and urine were well described by a two-compartment open model with zero-order input. Considering the absorption variables as specific to each experiment, the lag time (0-0.35 h) and duration (0.39-2.38 h) of absorption were found to be independent of dose, while the zero-order rate constant of absorption (k0) increased linearly with dose. Disposition variables were taken as common to the three experiments, except in six subjects in whom renal excretion varied significantly across experiments in a dose-independent manner. For seven subjects the terminal half-life was 19.4 h, the oral apparent volume of distribution at steady-state (Vss/f) was 691 l, and the oral systemic clearance (CL/f) was 33.1 l.h-1. In the two other subjects, the values were unreliable, but the estimated terminal half-life was greater than 48 h, Vss/f ranged from 1690 to 3480 l, and CL/f was in the range of the other subjects in 1 subject, and it was about 15 l.h-1 in the other. In the latter subject, these estimates, together with the observation that plasma concentration reached a plateau at 2 to 5 h after ingestion, suggest enterohepatic cycling of colchicine. Overall, the disposition of colchicine was linear in the dose range 0.5-1.5 mg, with a long terminal half-life, and absorption obeyed zero-order kinetics, with k0 proportional to dose.

Administration, Oral↗
PubMed1988

Nonparametric maximum likelihood estimation for population pharmacokinetics, with application to cyclosporine.

A new method, nonparametric maximum likelihood (NPML), for statistical analysis of population kinetic data is proposed. NPML provides a discrete estimate of the whole probability density function of the pharmacokinetic parameters. This permits a straightforward derivation of usual population characteristics. To illustrate the application of the NPML method, a population analysis of cyclosporine RIA measured plasma levels in 188 bone marrow transplant patients after intravenous infusion, is presented. The capability of NPML to extract population information from sparse individual data is also outlined.

Biometry↗
PubMed1988

On the dose dependency of cyclosporin A absorption and disposition in healthy volunteers.

The pharmacokinetics of Cyclosporin A (CyA, Sandimmune) was studied in 12 healthy male volunteers after oral dosing of 350 mg, 700 mg, and 1400 mg as a drinking solution. Blood samples were collected over 96 hr and analyzed by high pressure liquid chromatography. Concentration data were evaluated with model-independent and model-based linear pharmacokinetic concepts. Individual CyA concentration-time profiles in whole blood were well described by a two-compartment open model with zero-order absorption for all three doses. Comparison of pharmacokinetic parameters across doses indicates that both absorption and disposition are dose-dependent. Nonlinear disposition is suggested by the significant increase of the terminal half-life from 8.9 +/- 4.9 hr to 11.9 +/- 4.9 hr (mean +/- SD) after a 350 mg and a 1400 mg dose, respectively. Changes in the metabolic activity of the liver with concentration might be responsible for this phenomenon. In addition, the modeling approach indicated that bioavailability decreases with increasing dose. Moreover, the dependence of the rate of CyA absorption (zero-order rate constant) versus dose was well described by a hyperbola. The limited solubility of the drug in the gastrointestinal tract might be responsible for this behavior. The lag time (0.2-0.8 hr) was independent of dose. This value is similar to the time of gastric emptying in fasting volunteers. The duration of absorption for 11 of 12 subjects was in the range 2.5-3.5 hr over all doses and agrees well with the small intestine transit time. Some subjects showed a marked secondary peak at one or two doses, which could be adequately fitted by a model with two successive zero-order inputs. This double-peak behavior was ascribed to the influence of the food on gastric emptying. Dose dependency of disposition and absorption counterbalance each other in the usual dose range. This leads to an almost proportional increase of area under the blood CyA concentration-time profile with increasing dose.

Administration, Oral↗
PubMed1988

Hyperparameter estimation using stochastic approximation with application to population pharmacokinetics.

A stochastic approximation algorithm is proposed for recursive estimation of the hyperparameters characterizing, in a population, the probability density function of the parameters of a statistical model. For a given population model defined by a parametric model of a biological process, an error model, and a class of densities on the set of the individual parameters, this algorithm provides a sequence of estimates from a sequence of individuals' observation vectors. Convergence conditions are verified for a class of population models including usual pharmacokinetic applications. This method is implemented for estimation of pharmacokinetic population parameters from drug multiple-dosing data. Its estimation capabilities are evaluated and compared to a classical method in population pharmacokinetics, the first-order method (NONMEM), on simulated data.

Algorithms↗
PubMed1986

Description of the time course of the prolactin suppressant effect of the dopamine agonist CQP201-403 by an integrated pharmacokinetic-pharmacodynamic model.

Six male volunteers (mean age 24 years) received a single oral dose of 0.025 mg CQP201-403 and placebo in a randomised double-blind crossover design. Fifteen plasma samples were collected over 48 h and were assayed by radioimmunoassay for drug substance and prolactin (PRL). Three of the samples were drawn during sleep on the first study day. The pharmacological effect (E%) of CQP201-403 was expressed as reduction in plasma PRL levels. The pharmacokinetic (PK)-pharmacodynamic (PD) model consisted of two kinetic compartments and an effect compartment linked to the central compartment. A sigmoid Emax model (Hill equation) described the relationship between the drug concentration in the effect compartment and E%. Curve-fitting of PK and PD data provided individual parameter estimates which served to generate computer-simulated PK and PD profiles after single and multiple doses in order to: investigate the in vivo concentration-effect relationship; evaluate the consequence of dosage reduction on the steady-state PD profile; and study the robustness of the response to changes in drug potency and bioavailability.

Adult↗
PubMed1985

Cytoplasmic and nuclear uptake of aldosterone in toad bladder: a mathematical modeling approach.

The mechanism of aldosterone uptake in the epithelial cells of toad bladder was studied using mathematical modeling. Two complementary approaches were used. The first involved analysis of cytosolic aldosterone binding at steady state according to models defined by the sum of independent noninteractive binding sites. The best model describing the experimental data corresponded to two specific binding sites with mean dissociation constant values of 0.20 and 60 nM for types 1 and 2, respectively. The second approach was based on the analysis of cytoplasmic and nuclear aldosterone uptake kinetics at 25 and 0 degrees C in intact bladder. Two models (A and B) were studied. They both implied the existence of two types of aldosterone binding sites as precursors of the corresponding chromatin bound complexes. In model A, nuclear translocation of the two types of receptors was assumed to obey first-order kinetics. In model B, the translocation process for type 1 sites involved a time lag leading to delayed binding to chromatin. Both models were found to fit the experimental data satisfactorily. The fit obtained for model B appeared to be better at low aldosterone concentrations.

Aldosterone↗
PubMed1984

A mathematical model of the kinetics of 5-fluorouracil and its catabolites in freshly isolated rat hepatocytes.

A mathematical model for the kinetics of 5-fluorouracil (FUra) catabolism in liver cells is proposed. It is based on published data for the metabolism of FUra by isolated rat hepatocytes. The model relies on biochemical knowledge of the catabolic pathway. The key-steps are: the cellular uptake and the conversion of the unchanged drug to dihydrofluorouracil (FUH2) and subsequently to alpha-fluoro-beta-alanine (FBAL); the cellular fluxes of the 2 catabolites, FUH2 and FBAL. Water is partitioned between the extracellular and intracellular spaces. The first step is described by Michaelis-Menten kinetics and the other processes by first-order kinetics. Satisfactory fitting of the model validates these simplifications and provides values for the parameters describing the process. The model indicates that the kinetics of FUra disappearance are non linear, the Vmax of the first step being between 3.1 and 5.0 microM/min and the Km between 12 and 37 microM; the rate limiting step is the degradation of FUH2 (the major intracellular catabolite) with a rate constant of 0.1 to 0.02 min-1; the FUH2 transmembrane exchange is active; the exchange of the final catabolite FBAL is by diffusion.

Animals↗
PubMed1984

Alternative approaches to estimation of population pharmacokinetic parameters: comparison with the nonlinear mixed-effect model.

Individual pharmacokinetic parameters can be viewed as independent realizations of a random variable. The probability density function of the variable is assumed to be specified by its first two moments (mean vector and covariance matrix), and these moments then characterize the distribution of the parameters in the population. The following methods are presented for estimation of population characteristics from a set of pharmacokinetic measurements in a sample of subjects: The Global Two-Stage Approach (GTS) uses estimates (and their covariances) of individual parameters obtained after separate fitting of each individual's data. The Iterated Two-Stage Approach (ITS) makes the GTS procedure iterative, using refined bayesian estimates of individual parameters at each step. The Nonlinear Filtering Approach (NLF) also relies on individual parameter estimates produced by using an optimal filter on each subject's data. The three methods give exact results (maximum likelihood estimates), as does NONMEM (the Nonlinear Mixed-Effect Model Approach), when the individual pharmacokinetic model is linear with respect to the parameters and when the distributions of the pharmacokinetic parameters and of the measurement noise in the individual data are both multivariate normal. When the individual pharmacokinetic model is statistically nonlinear (the usual case), the methods differ with respect to: (1) their strategy for handling nonlinearity, (2) their ability to deal with any type of data (experimental and/or routine), and (3) their sensitivity to the amplitude of random effects. With regard to computational aspects, both the computer memory storage requirements and the amount of computation required for the GTS approach are much smaller than for the three other methods. Contrasting considerations as well as results of simulations suggest that GTS, ITS, and, in future, NLF may be valuable alternatives to NONMEM or modifications of it for estimation of population characteristics of pharmacokinetic parameters.

Humans↗
PubMed1984

[Renal clearance technic for individualizing lithium dosage in routine hospital care].

Lithium has a narrow therapeutic index and exhibits a wide pharmacokinetic variability. Individual dosage regimen adjustment is necessary to warrant the efficacy and safety of long-term treatment. We propose the "renal clearance method" for rapid determination of the lithium carbonate daily dose for chronic therapy. After the first intake of drug by a manic-depressive patient, a four-hour trial is performed. It involves two blood samplings and two urine collections, in which lithium and creatine are assayed. Comparison of observed creatinine with a value predicted according to age, morphological characteristics, sex and serum creatinine of the patients allows the interpretation of conflicting results. The estimation of lithium and creatinine clearances of each patient is performed using a computerized or manual method which unfolds a decision procedure. The daily dosage (1.5 to 6 250 mg tablets in two or three daily intakes) is deduced from the according lithium renal clearance (0.4 to over 2 l/h) by means of a nomogram established in previous studies on about 50 patients. The clearance method has been investigated in routine hospital care on a 40 patients sample. The range of satisfactory lithium serum levels during patients monitoring was 0.6-0.9 mmol/l. Accurate dosage regimen forecasting is obtained in 92% of the patients. The percentage observed in a subset of 13 patients with the C24 method, which relies on a unique blood sample 24 hours after the first dose, was much lower (54%). The renal clearance method appears as a robust and reliable technique for individual lithium dosage regimen adjustment in routine care.

Adult↗
PubMed1984

Isoniazid plasma and lymph kinetics after intravenous injection in dogs.

Isoniazid pharmacokinetics after bolus intravenous injection in dogs has been studied using concentration measurements in plasma and in the lymph collected as the outflow of the thoracic duct. Simple graphical analysis as well as fitting of the data indicates that the plasma concentration exhibits biexponential decrease whereas three exponential components are detected in lymphatic kinetics. The discrepancy in the number of exponentials cannot be accounted for by a catenary three-compartment model. Another model, which is compatible with the anatomo-physiological characteristics of the lymphatic circulation is proposed. To account for transfer delays between the plasma-lymph exchange areas and the site of measurement, we assume that the drug concentration in the lymph collected at the extremity of the thoracic duct is the convolution of the interstitial lymphatic concentration with an exponential distribution of transit times. Assuming, furthermore, that a rapid equilibrium between plasma and interstitial lymph is established and that variations in the lymphatic flow are negligible, this model provides an adequate description of isoniazid plasma and lymph kinetics as can be judged from: 1. the satisfactory adjustment of model predicted values to the concentration measurements after global nonlinear least-squares fitting of plasmatic and lymphatic data; 2. the agreement of the estimated isoniazid pharmacokinetic parameters with values reported in literature. This agreement suggests that lymphatic concentrations at the exit of the thoracic duct give an indirect and distorted picture of interstitial fluid isoniazid levels whose kinetics, in fact, closely follows that existing in plasma.

Animals↗
PubMed1982

A time-lag model for pharmacokinetics of drugs subject to enterohepatic circulation.

A two-compartment model with time lag is proposed to describe the pharmacokinetics of drugs subject to enterohepatic circulation. The basic model, including two compartments for body and GI tract, respectively, with elimination occurring from both compartments, was previously proposed. The assumption that the reabsorption of a drug molecule is delayed after its biliary excretion is expressed by the addition of a time lag in the transfer from the first to the second compartment. Computer simulation of the model for intravenous bolus injection and oral intake of the drug was performed through first-order numerical integration. Several qualitative results concerning changes in pharmacokinetics due to modifications in biliary excretion, in reabsorption, or in elimination are identical with predictions using the basic model. However, several qualitative and quantitative results were significantly different. The pharmacokinetics, though remaining linear, are no longer biexponential. Initial decay after intravenous injection was not affected by modifications in reabsorption or elimination from intestine. Predictions based on the time-delay model agree with existing experimental evidence concerning pharmacokinetics of substances undergoing enterohepatic cycling. Delayed recirculation may lead to rebounds in plasma level profiles as well as after intravenous and oral administration. The half-life of the drug is significantly prolonged even when the kinetic processes involved in recirculation remain unchanged.

Enterohepatic Circulation↗
PubMed1981

Effect of adrenalectomy and aldosterone on the modulation of mineralocorticoid receptors in rat kidney.

Adrenalectomized rat kidney is commonly used for the study of mineralocorticoid mechanism of action in mammals. In this model, aldosterone is known to bind to two classes of binding sites: type I (mineralocorticoid) and type II (glucocorticoid). The study of the aldosterone binding in normal rat kidney requires the elimination of endogenous hormones bound to each type of receptor. Thus, a suitable technique was developed using in situ perfusion of the kidneys. The efficacy of this method was of about 85 to 90% at the level of both cytoplasm and nucleus. Aldosterone binding capacity was checked in normal rat kidney after in situ perfusion and was found to be 300 to 500% lower than in adrenalectomized rat kidney, both in cytoplasm and nuclei. Computer analysis of aldosterone binding parameters in the cytoplasm (30,000 X g supernatant) of rat kidney suggested that adrenalectomy might induce an important rise in the number of mineralocorticoid receptors (congruent to 260%). An increase in the number of glucocorticoid receptors was also observed but appeared to be lower. Aldosterone, when perfused during 24 h in adrenalectomized rats, lowered the number of type I sites to the same level as observed in normal rat kidney. This effect was fully reversible after interruption of aldosterone perfusion. These results suggested an aldosterone-induced down regulation of mineralocorticoid receptors.

Adrenalectomy↗
PubMed1979

A priori lithium dosage regimen using population characteristics of pharmacokinetic parameters.

The important problem of initiation of long-term lithium treatment is tackled by means of the selection of an a priori dosage regimen based on the presumed efficacy of lithium and absence of toxicity. The pharmacokinetics of Li+ ion is represented by a four-compartment open model including the supposed first-order processes for the release of the active compound from the dosage form and its absorption. Experimental protocols for measurements of serum concentrations and of urinary amounts after single and multiple dosing to healthy volunteers were derived with several oral dosage forms. Estimation of the pharmacokinetic parameters for each subject made it possible to validate the model for the various dosage forms. The interindividual variability of these parameters is taken into account by estimating the characteristics of the statistical distribution for the whole population. A dosage regimen is considered optimum when serum concentration profiles at steady state range from the threshold of efficacy (0.8 mmol/liter) to the threshold of toxicity (2.0 mmol/liter). When the number of daily intakes is fixed, the search for the optimum dose for the whole population is effected by minimizing the expected value of the random variable which characterizes the risks of excursion out of the therapeutic range. By this means universal dosages are shown to be unsatisfactory. However, certain dosage regimens individualized with respect to the renal clearance value of lithium and based on two or three daily intakes can give excellent results even when conventional dosage forms are used.

Adolescent↗
PubMed1979

A non-linear mathematical model for the in vivo determination of Kupffer cells number and rate of phagocytosis of radiocolloids in rats.

In order to perform a quantification of the hepatic RES function, a mathematical model of the colloids phagocytosis was constructed and validated in normal and partially hepatectomised rats. The experimental design consisted of the collection of successive blood samples for the measurement of radiocolloids time courses after the injection of different doses of gelatin colloids (0.075--5 mg of gelatin/100 g body wt). The unknown parameters were estimated by method of maximum likelihood using a second order algorithm. A good fit between experimental and simulated data was obtained for a large range of injected doses using a single set of parameters. Comparisons of parameters values between normal and hepatectomised rats were found to be -onsistent with the hepatectomy ratio. This computerised estimation of parameters provides a determination of both the total number of Kupffer cells and the mean time of a complete phagocytosis cycle which cannot be obtained by classical approaches.

Animals↗
PubMedDate not supplied

Pharmacokinetic aspects of the sublingual administration of vincamine.

The sublingual absorption of vincamine used as tracer occurs in two successive absorption steps: true sublingual absorption and absorption in the gastrointestinal tract of the drug dissolved in the saliva and not absorbed through the buccal mucosa. This is confirmed by a pharmacokinetic study and simulation. These two successive absorptions can explain the increase in the amounts of drug absorbed.

Administration, Oral↗