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Biomedical subjects

O Chosidow

Publications and source records attributed to O Chosidow.

At least 181 records · Page 10Linked to original sources

Pharmacokinetics of prednisone and prednisolone in bullous pemphigoid patients.

The purpose of this prospective study was to attempt to evaluate a possible relationship between corticosteroids pharmacokinetics parameters and clinical efficacy in bullous pemphigoid (BP) patients. Sixteen BP patients took part in the study. Prednisone (Cortancyl, Laboratoire Roussel) was given orally (1 mg/kg/day) in a single morning dose. Eleven blood samples were collected over 24 h for the pharmacokinetic studies on day 1 (first day of treatment) and on day Y (after the clinical evaluation). Efficacy was evaluated as the number of new skin blisters on day 1 and on day X which was either the day of cure, i.e. no blisters (responders), or the day of treatment failure, i.e. persistence of blisters (non-responders). Prednisolone (PO) was assayed using high-performance liquid chromatography (HPLC). Areas under the plasma concentration time curves (AUC) and plasma half-lives were estimated using a model independent approach. In responder patients, PO AUC values were 6,225.5 +/- 575.5 ngh/ml, range 3,933-9,080.5 on day 1 and 5,687 +/- 535 ngh/ml, range 4,513.5-9,828.5 on day Y. There was a significant correlation (0.87) between the number of skin blisters on day 1 and the time required for their resolution. The pharmacokinetics and clinical data suggest that a "therapeutic" AUC value was necessary to achieve clinical efficacy and that the duration of treatment depended on the number of blisters on day 1.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗

Toxic epidermal necrolysis (Lyell syndrome).

Toxic epidermal necrolysis is perhaps the most formidable disease encountered by dermatologists. Uncommon but not rare, toxic epidermal necrolysis occurs in 60 to 70 persons per year in France. It remains as puzzling a disorder as it was 34 years ago, when described by Lyell. Whether or not toxic epidermal necrolysis is the most severe form of erythema multiforme is still the subject of discussion. The physiopathologic events that lead to this rapidly extensive necrosis of the epidermis are not understood. Indirect evidence suggests a hypersensitivity reaction, but the search for potential immunologic mechanisms has resulted in little data to support this hypothesis. Accumulated clinical evidence points to drugs as the most important, if not the only, cause of toxic epidermal necrolysis. Sulfonamides, especially long-acting forms, anticonvulsants, nonsteroidal anti-inflammatory agents, and certain antibiotics are associated with most cases of toxic epidermal necrolysis. Many other drugs have been implicated in isolated case reports. All organs may be involved either by the same process of destruction of the epithelium as observed in the epidermis or by the same systemic consequences of "acute skin failure" as seen in patients with widespread burns. Sepsis is the most important complication and cause of death. Approximately 20% to 30% of all patients with toxic epidermal necrolysis die. Elderly patients and patients with extensive lesions have a higher mortality rate. Surviving patients completely heal in 3 to 4 weeks, but up to 50% will have residual, potentially disabling ocular lesions. The prognosis is improved by adequate therapy, as provided in burn units, that is, aggressive fluid replacement, nutritional support, and a coherent antibacterial policy. Corticosteroids, advocated by some in high doses to halt the "hypersensitivity" process, have been shown in several studies to be detrimental and should be avoided.

Humans↗

[Pharmacokinetic parameters of prednisone and prednisolone in healthy volunteers].

A cross-over, double-blind, randomized trial with 8 healthy volunteers was undertaken to compare prednisolone and prednisone pharmacokinetics after a single oral dose (1 mg/kg) of prednisone (Cortancyl) and prednisolone sodium metasulfobenzoate (Solupred). Maximum prednisolone concentrations measured after ingestion of prednisone are higher (535 +/- 32 ng/ml) and occur earlier than after taking prednisolone sodium metasulfobenzoate (198 +/- 114 ng/ml) (p less than 0.001). The areas under the curve are significantly larger after prednisone than after prednisolone sodium metasulfobenzoate (p less than 0.02). These findings suggest a decreased systemic availability of prednisolone after prednisolone sodium metasulfobenzoate (Solupred) administration and show, from a strictly pharmacokinetic point of view, that equimolar doses of prednisone and prednisolone sodium metasulfobenzoate are not equivalent therapies.

Adult↗