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The synergism between cetrimide and antibiotics against Pseudomonas aeruginosa.

Forty eight clinical isolates of P. aeruginosa were tested for susceptibility to seven different antimicrobial agents. When tested on Mueller-Hinton agar, the isolates were found to be resistant to ampicillin, sensitive to the antipseudomonal antibiotics, polymyxin B, gentamicin and carbenicillin. Polymyxin B inhibited all the isolates, whereas both carbenicillin and gentamicin inhibited 92.1% of the isolates. Neomycin, sulphamethoxypyridazine and chlortetracycline showed moderate activity and inhibited 50%, 28.9% and 15.8% of the isolates, respectively. However, on Mueller-Hinton agar supplemented with 0.03% cetrimide, the isolates succumbed readily to antimicrobial agents. In addition to polymyxin B, gentamicin and carbenicillin, all the strains were inhibited by neomycin and 94.7%, 92.1% and 63.6% of the isolates were inhibited by sulphamethoxypyridazine, chlortetracycline and ampicillin, respectively. Cetrimide, in concentrations ranging from 0.01 to 0.04% decreased the MIC of ampicillin against all the isolates, whereas 0.1% and 0.5% polysorbate 80 (tween 80) had no effect on the MIC. Growth inhibition studies have shown that the number of survivors was greatly reduced in presence of cetrimide and ampicillin. There was also an appreciable increase in the uptake of ampicillin by the bacterial cells in the presence of cetrimide.

Ampicillin↗

Intranasal booster vaccination against diphtheria and tetanus in man.

The booster responses of three different formulations of intranasal (i.n.) diphtheria-tetanus (D-T) vaccines were determined in military recruits and compared with a conventional subcutaneous D-T vaccine. The vaccines for mucosal delivery were sprayed into one nostril and contained D and T toxoids in an enhancer mixture of polysorbate and caprylic/capric glycerides. All of the vaccines gave rise mainly to a systemic IgG response. Among 51 persons with anti-D antibody concentrations in serum below a protective level of 0.01 international units (IU ml-1) before vaccination, all except two attained protective antibody concentrations 4 weeks after vaccination. The median increase in anti-D antibody concentration was 113-fold with the most efficient i.n. formulation. The median increase in anti-T antibody level was 2.4-fold, however, the pre-vaccination levels for this antigen were very high. Within the examined levels, the booster response depended mainly on the dose of the antigen in the vaccine rather than on the concentration of the vehicle mixture. Compared with the parenteral D-T vaccine containing aluminium hydroxide as an adjuvant, all of the tested i.n. formulations showed somewhat lower immunogenicity in man as well as in pre-clinical guinea-pig studies. Among 215 persons immunized i.n., 61% preferred this route of administration rather than a parenteral injection, although the formulations were all associated with varying local symptoms, frequently stinging and pronounced, nasal secretion.

Administration, Intranasal↗

A quantified analysis of the dielectric dispersion in a simple emulsion system.

The dielectric response of a simple, self emulsifying, system, based on a polysorbate and a medium chain length triglyceride, has been investigated as a function of the water content in the range 0 to 80% by weight. The low frequency capacitive dispersions have been characterised in terms of an electrode barrier layer dispersion, and the bulk conductance and capacitance have been quantified. It is shown that the barrier parameters are essentially insensitive to the water content, over concentrations from 2.5 to 75% by weight, and that the magnitude of the bulk emulsion conductance determines the form of the dispersions which can be observed.

Chemical Phenomena↗

The use of solution calorimetry with micellar solvent systems for the detection of polymorphism.

The presence of multiple polymorphic forms in seven batches of raw material of a model compound having poor wettability properties (cimetidine) was studied by solution calorimetry. Due to the large number of polymorphic forms described in the literature ('Gazz. Chim. Ital., 109 (1979) 535'; 'J. Pharm. Sci., 73 (1983) 1436'; 'J. Pharm. Biomed. Anal., 3 (1985) 303') and its poor wettability characteristics, cimetidine was chosen as a model compound to illustrate the possible use of solution calorimetry in the detection of polymorphism using surfactant systems as solvents for dissolution. Due to the closeness of the melting points of the different polymorphic forms of cimetidine, DSC was not the best investigational tool. As initially suspected, the measurement of enthalpy of solution values in water of the cimetidine batches was not possible. However, the use of sodium dodecyl sulfate (SDS) and polysorbate 20 (Tween 20(R)) at concentrations above their respective cmc values permitted the detection of significant differences in enthalpy of solution among several batches. The presence of different polymorphic forms was confirmed by microscopy, X-ray powder diffractometry, and Fourier transform infrared spectroscopy.

Calorimetry↗

Targeted and sustained drug delivery using PEGylated galactosylated liposomes.

To achieve a sustained and targeted delivery of liposomes to liver parenchymal cells (PC), we modified distearoyl-L-phosphatidylcholine (DSPC)/cholesterol (Chol) (60:40) (DSPC/Chol) liposomes with a galactosylated cholesterol derivative (Gal-C4-Chol), and polysorbate (Tween) 20 or 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-polyethylene glycol (PEG(x)-DSPE). After intravenous injection, DSPC/Chol/Gal-C4-Chol (60:35:5) (Gal) liposomes were rapidly eliminated from the blood circulation and mostly recovered in the liver. The blood elimination of DSPC/Chol/Gal-C4-Chol/Tween 20 (55:35:5:5) (Tween 20-Gal) liposomes was slightly reduced as compared to Gal-liposomes. In contrast, a significant reduction in the blood elimination was observed with DSPC/Chol/Gal-C4-Chol/PEG(2000)-DSPE (59:35:5:1) (PEG(2000)-Gal) liposomes. Hepatic uptake of DSPC/Chol/Gal-C4-Chol/PEG(350)-DSPE (59:35:5:1) (PEG(350)-Gal) liposomes was intermediate between PEG(2000)-Gal-liposomes and Tween 20-Gal-liposomes. The uptake of PEG(350)-Gal-liposomes by liver PC was 7.7-fold higher than that by non-parenchymal cells (NPC). These results suggest that PEG(350)-DSPE can control the delivery rate of Gal-liposomes to liver PC without losing its targeting capability.

Animals↗

Long-term stabilization of recombinant human interferon alpha 2b in aqueous solution without serum albumin.

The development of parenteral solution dosage forms of interferon alpha 2 (rhIFN-alpha2) without human albumin may significantly diminish the problem of forming highly immunogenic rhIFN-alpha 2b aggregates and the potential risk of blood-transmitted diseases caused by infectious viruses and often living pathogens that may be present in the plasma. With this purpose, we evaluated the compatibility of type I borosilicate glass vials and chlorobutyl stoppers with rhIFN-alpha 2b in an aqueous solution. At the same time, we carried out a targeted formulation screen at 37 degrees C of single or combined (e.g. polysorbate 80, EDTA Na(2), PEG 400) potentially stabilizing excipients. Quantified biochemical results from 12 independent batches of rhIFN-alpha 2b in a polysorbate/benzyl alcohol-based vehicle formulated at pH 7.4 were all found within the limits established by the World Health Organization for this cytokine. Real-time storage data confirmed the excellent biochemical long-term (30 months) stability of rhIFN-alpha 2b in this aqueous solution formulation. Analyses were performed at intervals throughout the time period using reverse-phase high-performance liquid chromatography, a sandwich-type enzyme-linked immunosorbent assay, and antiviral activity as stability-indicating assays. Furthermore, both the physical stability (color, odor, appearance, pH, and absence of particulate material) and the sterility of this formulation were maintained under the proposed shelf conditions.

Antiviral Agents↗

Nanospheres of cyclosporin A: poor oral absorption in dogs.

The cyclic undecapeptide cyclosporin A (CYA) used as first-line therapy in the prevention of xenograft rejection following organ transplantation, is extremely hydrophobic. Marketed formulations employ solubilising agents to facilitate absorption in the gastrointestinal tract. In this study, cyclosporin A nanospheres were prepared by precipitation in an aqueous surfactant solution. The particle matrix consists of the drug itself. Drug was dissolved in acetone and mixed rapidly with an aqueous solution of polysorbate 80 and sodium dodecyl sulphate (SDS). The acetone was evaporated to give a colloidal precipitate of spherical particles. Particle size could be controlled by varying the quantity of starting materials to give nanospheres of Z-average diameters in the range 250-900 nm with low polydispersity. The oral absorption of CYA from these nanospheres was compared to absorption from a microemulsion formulation in the dog. The relative bioavailability of cyclosporin A from nanospheres was only 3%, based on comparison of the area under the blood concentration-time curve (AUC) values for the two formulations.

Administration, Oral↗

[Sustained clinical response of large hepatocellular carcinoma after chemoembolization with pirarubicin, amiodarone and Lipiodol].

Although chemoembolization is known to be an effective palliative treatment in hepatocellular carcinoma, it has a limited effect in large tumors. We report the case of a patient with a large hepatocellular carcinoma of the left liver who had a significant and sustained clinical response after six sessions of chemoembolization with a pirarubicin/amiodarone/lipiodol emulsion. Pirarubicin is an anthracycline which penetrates faster than doxorubicin into cancer cells. Amiodarone is a multidrug resistance inhibitor. Polysorbate 80, an excipient of injectable amiodarone stabilizes the anthracycline/lipiodol emulsion. The clinical efficacy of this new formulation could be evaluated in a phase II clinical trial.

Amiodarone↗

Simple and rapid analysis of endocrine disruptors in liquid medicines and intravenous injection solutions by automated in-tube solid-phase microextraction/high performance liquid chromatography.

A simple and rapid method was developed for analyzing contamination of endocrine disruptors in liquid medicines and intravenous injection solutions. Endocrine disrupting compounds such as bisphenol A (BPA), alkylphenols and phthalates were quantitated by on-line in-tube solid-phase microextraction coupled with high performance liquid chromatography (in-tube SPME/HPLC) with UV detection. The liquid medicines and intravenous injection solutions could be used directly without any pretreatment, and the BPA, alkylphenols and phthalates in these solutions were automatically analyzed. The limits of quantification for these compounds were 1-10 ng/ml. Recoveries of these compounds spiked to the intravenous injection solutions was over 80%, except for some phthalates. Di-n-butyl phthalate (DBP) was detected at a concentration of 7-60 ng/ml in most intravenous injection solutions in plastic containers, but it was not detected in solutions in glass bottles. Diethyl phthalate, di-n-propyl phthalate, DBP and di-2-ethylhexyl phthalate (DEHP) were also detected in syrup, lotion and eye drops in plastic containers. On the other hand, BPA and alkylphenols were not detected at all in these solutions. DEHP contamination from an administration set increased when total vitamin formulation was added to the infusion solution. DEHP was easily leached from polyvinyl chloride tubing by polysorbate 80. The in-tube SPME/HPLC method is simple, rapid and automatic, and it provides a useful tool for the screening and determination of endocrine disruptor contamination in liquid medicines and intravenous injection solutions.

Autoanalysis↗

Diffusion of n-butyl-p-aminobenzoate (BAB), lidocaine and bupivacaine through the human dura-arachnoid mater in vitro.

INTRODUCTION: Epidural administration of a suspension of n-butyl-p-aminobenzoate (BAB) to humans resulted in a selective, ultra-long lasting sensory block without motor function impairment. The absence of motor block was attributed to 'spatial' confinement of active concentrations of dissolved BAB within the epidural space. This study was designed to investigate the diffusion of BAB through the human dura-arachnoid membrane in vitro relative to lidocaine and bupivacaine and to quantify the influence of the composition of the suspension formulation on this flux. MATERIALS AND METHODS: Human dura-arachnoid specimens were mounted between the donor and the receiver compartment of a diffusion cell. Five concentrations of BAB, lidocaine and bupivacaine in phosphate-buffered saline, pH 7.4, were added to the donor compartment and the increase of the concentration of the agent in time in the receiver compartment was measured by automated UV-spectrometry. Fluxes and permeabilities were calculated. The influence of pH, polysorbate 80 (PS 80) and polyethylene glycol 3350 (PEG 3350) on the flux of BAB in solution and in suspension formulations were analyzed. RESULTS: The flux of both lidocaine and bupivacaine at pH 4 was considerably smaller than at pH 7.4. Permeabilities decreased in the order bupivacaine>lidocaine&z.Gt;BAB and at the level T12>T1. PS 80 at concentrations exceeding 0.025 mg/ml and PEG 3350 decreased the flux of BAB from BAB-solutions. Used in the preparation of the suspension, PS 80 and PEG 3350 did significantly reduce the permeability. DISCUSSION: The results of this study are consistent with the hypothesis that the selective action of epidurally applied BAB suspension can be attributed to the spatial confinement of active BAB-concentrations within the epidural space. Additives used in the preparation of the aqueous suspension formulation may substantially influence the local pharmacokinetics and by that the pharmacodynamic effects.

Anesthetics, Local↗

Spray-dried indomethacin-loaded polyester nanocapsules and nanospheres: development, stability evaluation and nanostructure models.

The industrial development of polymeric nanoparticle suspensions, as drug delivery systems, is limited due to the problems in maintaining stability of suspensions. In this work, a spray-drying technique was applied to dry nanocapsule and nanosphere suspensions prepared by nanoprecipitation of polyesters using SiO(2) as adjuvant. Powders obtained from nanocapsules presented stable drug recoveries and morphological characteristics after 5 months. For nanocapsules, nanostructures around 200 nm were observed by scanning electron microscopy (SEM) on the surface of microparticles of SiO(2), whereas for the nanosphere formulation, nanostructures with a reduced diameter (60-90 nm) were observed, despite the particle sizes of each original suspension being similar, when measured by photon correlation spectroscopy (PCS). In order to investigate the morphological aspects of nanocapsule and nanosphere powders, several nanosphere formulations were spray-dried using different concentrations of SiO(2) and a comparative study of the different colloidal systems (nanocapsules, nanospheres, nanoemulsion or nanodispersion) was carried out by PCS. SEM analyses showed that nanostructures with reduced diameter are formed independently of the adjuvant concentration. The dynamic properties of these systems allowed to suggest that the structure of the nanosphere particle (polymer, sorbitan monostearate and polysorbate 80) was a polymeric matrix dispersing the sorbitan monostearate which, when submitted to the spray-drying process in the presence of SiO(2), gave nanostructures presenting diameters around 80 nm covering the microparticles due to the release of lipophilic surfactant from the polymeric matrix.

Capsules↗

Biodegradable polymer nanocapsules containing a sunscreen agent: preparation and photoprotection.

Biodegradable polymer nanocapsules containing the lipophilic sunscreen, Parsol MCX (OMC), as the oil core were prepared by solvent displacement. We investigated the influence of polysorbate 85 (P-85) and poloxamer 188 (P-188) as stabilizing agents, the OMC loading capacity and the photoprotective potential of the formulations. The formation of nanocapsules is probably due to an interfacial instability arising from rapid diffusion of the solvent across the interface. The effectiveness of the stabilizing agents was attributed to their ability to inhibit coalescence during solvent diffusion. P-85 was a better stabilizer of poly(epsilon-Caprolactone)-nanocapsules than P-188. The OMC loading capacity was high (99+/-1% of OMC initial concentration). The in vitro release of OMC-nanocapsules is governed by hydrophobicity and crystallinity of the polymer and by the high lipophilicity of the drug. The OMC-nanocapsules provided partial protection against UV-induced erythema, in a manner significantly better than a conventional gel.

Animals↗

Characterization of solidified reverse micellar solutions (SRMS) and production development of SRMS-based nanosuspensions.

Solidified reverse micellar solutions (SRMS), i.e. binary mixtures of 30-60% (w/w) lecithin and two different hard fats, were investigated regarding their physicochemical properties and the influence of lecithin on solid lipids. For this purpose, the systems were characterized with X-ray and thermal analysis, transmission electron microscopy (TEM) and photon correlation spectroscopy. The melting point (m.p.) of the solid lipids, which is a crucial parameter of the solid state, was not altered up to a lecithin concentration of 50% whereas reverse micelles were likely to be frozen still in the solid state. In addition, solubilities of 17beta-oestradiol-hemihydrate, pilocarpine base and hydrochloride in the SRMS melt were studied for evaluation of the drug carrier potency. Drug solubilization in the SRMS melt increased linearly with rising amount of lecithin. SRMS-based nanosuspensions were developed with a given lecithin/hard fat ratio of 1:1 (w/w). High-pressure homogenization was applied on cold to avoid lecithin loss. Optimization of the systems in terms of a variation of the homogenizing parameters such as pressure, number of cycles and temperature resulted in nanoparticulate systems with a polysorbate 80/SRMS ratio of 1:5 (w/w), and a total amount of 5 and 15% (w/w) SRMS, respectively. Production temperatures near the lipid m.p. proved best to be maintained by varying the pressure, yielding small nanoparticles with a narrow particle size distribution. The solid lipid nanoparticles were characterized with X-ray and thermal analysis as well as TEM. The crystalline particles (beta modification) are of anisometrical shape and have transition temperatures far below the bulk m.p. due to the colloidal character of the systems.

Calorimetry, Differential Scanning↗

Effect of cryoprotectants on the stability and aerosol performance of nebulized aviscumine, a 57-kDa protein.

Nebulization of aqueous drug solutions is a suitable delivery system for pulmonary application of proteins because it can easily produce droplets small enough to reach the alveolar region. However, proteins are sensitive to nebulization. Therefore, stabilizers need to be added which on the other hand influence the aerosol performance, such as average droplet size or mass output. This research presents the effect of various cryoprotectants such as Na-polyphosphate, CaCl(2) x 6H(2)O and MgSO(4) x 7H(2)O on the stability and aerosol performance of freeze-dried aviscumine after reconstitution and nebulization using three different nebulizers. Formulations containing Tris-buffer, polysorbate 80, Na(2)-EDTA and HES450 were lyophilized and reconstituted with a buffered isotonic solution containing 100 mmol/l Tricine-buffer pH 8, 0.03% (w/v) octanoyl-N-methylglucamide, 150 mmol/l NaCl and a cryoprotectant. The aviscumine activity was determined by a binding assay. The addition of 0.2% Na-polyphosphate to the reconstitution medium led to retention of approx. 73% of the aviscumine activity after 20 min nebulization with the Systam ultrasonic nebulizer. It has been observed that 84 and 72% of the activity were retained by the addition of 10 mmol/l CaCl(2) x 6H(2)O using PariBoy air-jet and Multisonic ultrasonic nebulizer, respectively. In addition, a decrease in the mean droplet size with increasing the cryoprotectant concentration has been observed. A relationship between the average droplet size, surface tension and viscosity depending on the used cryoprotectant type and concentration could be established.

Aerosols↗

In vitro toxicity of surfactants in U937 cells: cell membrane integrity and mitochondrial function.

Surface-active agents are components of many drugs and cosmetics. In order to examine their cytotoxic and membrane-toxic potential, various surfactants were examined in U937 cells using the tetrazolium reduction assay EZ4U, a modified XTT test, and the arachidonic acid release test (AART). EZ4U measures the ability of living cells to reduce a colorless tetrazolium salt to an orange water-soluble formazan derivative by mitochondrial dehydrogenases. [3H]arachidonic acid ([3H]AA) is rapidly incorporated into cell membrane phospholipids. Due to membrane disintegration or enzymatic catalysis, it is released into the cell culture medium and can be measured by scintillation technique. The results after 24-hour-exposure are as follow (CC50 microg/ml; RC50 microg/ml): benzalkonium chloride (0.6), Cremophor A25 (1.4; 5.9), sodium cetearyl sulfate (1.6; 19.9), Brij78 (1.6; 7.7), TEGO betaine E (3.0; 19.3), TEGO betaine CKD (4.1; 20.2), TEGO betaine L7 (7.5; 20.0), sodium dodecyl sulfate (7.5; 39.0), Triton X-100 (8.9; 110), polysorbate 80 (48.1; 491), soybean lecithin (7920; 19940).

Arachidonic Acid↗

Development and validation of a liquid chromatography-tandem mass spectrometry assay for the quantification of docetaxel and paclitaxel in human plasma and oral fluid.

A quantitative method for the simultaneous determination of docetaxel (Taxotere), paclitaxel (Taxol), 6alpha-hydroxypaclitaxel, and p-3'-hydroxypaclitaxel in human plasma and oral fluid is developed and validated. Oral fluid (this term is now preferred to saliva) was sampled with a Salivette collection device. The procedure used a simple liquid/liquid extraction with methyl tert-butyl ether followed by LC-ESI-MS/MS. Gradient elution was applied and provided increased robustness to ion suppression by the drug formulation vehicle (polysorbate 80 and Cremophor EL). Adduct ion formation with sodium and potassium was noticed and controlled by mobile-phase optimization. The protonated analytes generated in the positive ion mode were monitored through multiple reaction monitoring. Calibration was performed by internal standardization with cephalomannine, and regression curves were constructed ranging between 2 and 1000 ng/mL in plasma and 0.125 and 62.5 ng/mL in oral fluid, using a weighing factor of 1/x2. The regression curves were quadratic for paclitaxel and docetaxel and linear for the paclitaxel metabolites. Accuracy varied from 91.3 to 103.6%, and imprecision did not exceed 12.7% for all analytes in plasma and oral fluid. In conclusion, a sensitive and robust method was obtained, which fulfilled all validation criteria.

Antineoplastic Agents↗

Rapid expansion from supercritical to aqueous solution to produce submicron suspensions of water-insoluble drugs.

Stable suspensions of submicron particles of cyclosporine, a water-insoluble drug, have been produced by rapid expansion from supercritical to aqueous solution (RESAS). To minimize growth of the cyclosporine particles, which would otherwise occur in the free jet expansion, the solution was sprayed into an aqueous Tween-80 (Polysorbate-80) solution. Steric stabilization by the surfactant impedes particle growth and agglomeration. The particles were an order of magnitude smaller than those produced by RESS into air without the surfactant solution. Concentrations as high as 38 mg/mL for 400-700 nm particles were achieved in a 5.0% (w/w) Tween-80 solution.

Cyclosporine↗

Effects of buffer composition and processing conditions on aggregation of bovine IgG during freeze-drying.

The objective of this study was to identify critical formulation and processing variables affecting aggregation of bovine IgG during freeze-drying when no lyoprotective solute is used. Parameters examined were phosphate buffer concentration and counterion (Na versus K phosphate), added salts, cooling rate, IgG concentration, residual moisture level, and presence of a surfactant. No soluble aggregates were detected in any formulation after either freezing/thawing or freeze-drying. No insoluble aggregates were detected in any formulation after freezing, but insoluble aggregate levels were always detectable after freeze-drying. The data are consistent with a mechanism of aggregate formation involving denaturation of IgG at the ice/freeze-concentrate interface which is reversible upon freeze-thawing, but becomes irreversible after freeze-drying and reconstitution. Rapid cooling (by quenching in liquid nitrogen) results in more and larger aggregates than slow cooling on the shelf of the freeze-dryer. This observation is consistent with surface area measurements and environmental electron microscopic data showing a higher surface area of freeze-dried solids after fast cooling. Annealing of rapidly cooled solutions results in significantly less aggregation in reconstituted freeze-dried solids than in nonannealed controls, with a corresponding decrease in specific surface area of the freeze-dried, annealed system. Increasing the concentration of IgG significantly improves the stability of IgG against freeze-drying-induced aggregation, which may be explained by a smaller percentage of the protein residing at the ice/freeze-concentrate interface as IgG concentration is increased. A sodium phosphate buffer system consistently results in more turbid reconstituted solids than a potassium phosphate buffer system at the same concentration, but this effect is not attributable to a pH shift during freezing. Added salts such as NaCl or KCl contribute markedly to insoluble aggregate formation. Both sodium and potassium chloride contribute more to turbidity of the reconstituted solid than either sodium or potassium phosphate buffers at similar ionic strength, with sodium chloride resulting in a substantially higher level of aggregates than potassium chloride. At a given cooling rate, the specific surface area of dried solids is approximately a factor of 2 higher for the formulation containing sodium chloride than the formulation containing potassium chloride. Turbidity is also influenced by the extent of secondary drying, which underscores the importance of minimizing secondary drying of this system. Including a surfactant such as polysorbate 80, either in the formulation or in the water used for reconstitution, decreased, but did not eliminate, insoluble aggregates. There was no correlation between pharmaceutically acceptability of the freeze-dried cake and insoluble aggregate levels in the reconstituted product.

Animals↗