Increased dissolution rates of water-insoluble cardiac glycosides and steroids via solid dispersions in polyethylene glycol 6000.
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In 1996, a National Pharmacoepidemiology Network was set up in Cuba in order to disseminate problem-oriented information and develop continuing education activities on drug therapy, to perform research on drug utilisation and to promote interventions to improve drug use. It is coordinated by the Centre for the Development of Pharmacoepidemiology, which is also in charge of regulatory and administrative duties and collaborates with the National Pharmaceutical Industry. By 2001, a number of educational and information initiatives had been undertaken, particularly in primary health care, which resulted in improvement of indicators of drug use. Cuba keeps good health standards in spite of a short health budget.
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The addition of activators like flavone and hexobarbital to hepatic microsomes markedly stimulates H2O2 formation. The similar increase observed with flavone of microsomal hydroxylation of benzo(a)pyrene and its inhibition by catalase and methanol suggests but does not prove a necessary interaction of microsomal H2O2 production with benzo(a)pyrene hydroxylation. Hexobarbital and flavone-stimulated H2O2 formation is optimal at a stoichiometric relationship of these activators and NADPH. This implies either their direct participation as electron donors or their indirect involvement in electron transport by facilitation of stoichiometric substrate cytochrome P-450/NADPH flavoprotein interactions. Steady state kinetics data are consistent with a scheme in which the formation in microsomes of a complex of 1 mole of NADPH with NADPH-cytochrome P-450 reductase and 1 mole hexobarbital with cytochrome P-450 regulates H2O2 formation.
Under conditions of experimental cardiac overload and hypertrophy in rats, a digoxinlike immunoreactivity appears in their serum which is correlated with cardiac growth. It is hypothesized that this is caused by the presence of an endogenous cardiotropic factor displaying cross immunoreactivity with digoxin. Additional evidence of the existence of the putative cardiotropic factor is provided by the finding that the sera of rats with cardiac overload displaying digoxinlike immunoreactivity stimulate the multiplication of rat cardiac myocytes in the tissue culture. This factor may be an adrenal steroid different from corticosterone and aldosterone. The name endocardin or endocardiotonin for this substance is suggested.
In order to compare and clarify the effects of various antiarrhythmic drugs when given as monotherapy, we reevaluated our previous data on antiarrhythmic drugs and recalculated antiarrhythmic plasma concentrations of drugs for several canine arrhythmia models. We used three spontaneously occurring arrhythmias: a) digitalis-, b) two-stage coronary ligation-, and c) adrenaline-induced arrhythmias. All antiarrhythmic drugs of class I suppressed digitalis arrhythmia, and, except for lidocaine, also suppressed coronary ligation arrhythmia. Class II antiarrhythmic drugs, beta blockers, and class IV antiarrhythmic drugs, Ca antagonists, had common features of effectiveness and suppressed adrenaline arrhythmia in relatively low concentrations. Class III drugs were not effective on these three arrhythmias. Differences among the antiarrhythmic effects of class I drugs could not be explained by their subclassification based either on action potential duration or kinetic properties of dissociation or association with Na channels. New triggered arrhythmia models in vivo and in vitro canine hearts were developed, and drug effects were not the same as those on the three spontaneously occurring arrhythmia models.
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An economical hemoperfusion system for clearance studies in vitro was developped. It was ascertained, that hemoperfusion using columns which contain 13 g of adsorbent and perfused at a blood flow rate of 1.25 ml/min results in the same relative clearances as when using clinical sized columns containing 300--355 g of the absorbent and run at 100ml/min. The adsorption kinetics of toxicologically important drugs and pesticides are given as examples. To date 27 substances were tested systematically. The investigation has shown, that no adsorbent is without exception the best one, but the efficacy can vary from substance to substance.
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The influence of potassium ions on the equilibrium state of the binding of cardiac glycosides and their derivatives to partially purified dog heart and rat brain enzyme preparations was studied in vitro. The addition of potassium to the incubation mixture containing enzyme preparation, 3H-ouabain, Na+, Mg2+ and ATP, at the time when the binding reaction is close to equilibrium, caused an immediate reduction of the bound drug concentration; the concentration apparently shifting toward a lower equilibrium state. The degree of the potassium-induced reduction in bound drug concentration was dependent on the potassium concentration and on the chemical structure of the compound. The binding of aglycones, pentacetyl-gitoxin and cassaine was affected to a greater extent than that of the glycosides. These data suggest that one of the mechanisms by which potassium antagonizes the toxic actions of digitalis on the heart is to reduce the drug binding to cardiac Na+,K+-ATPase.
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