RESUMO
Blood flow enables the delivery of oxygen and nutrients to the different tissues of the human body. Drugs follow the same route as oxygen and nutrients; thus, drug concentrations in tissues are highly dependent on the blood flow fraction delivered. Although the free drug concentration in blood correlates with pharmacodynamics, the pharmacodynamics of a drug is primarily commanded by the drug concentrations in the aqueous spaces of bodily tissues. However, the concentrations of the drug are not homogeneous throughout the tissues, and they rarely reflect the free drug concentration in the blood. This heterogeneity is due to differences in the blood flow fraction delivered to the tissues and membrane transporters, efflux pumps, and metabolic enzymes. The rate of drug elimination from the body (systemic elimination) depends more on the driving force of drug elimination than on the free concentration of the drug at the site from which the drug is being eliminated. In fact, the actual free drug concentration in the tissues results from the balance between the input and output rates. In the present paper, we develop a theoretical concept regarding solute partition between intravascular and extravascular spaces; discuss experimental research on aqueous/non-aqueous solute partitioning and clinical research on microdialysis; present hypotheses to predict in-vivo elimination using parameters of in-vitro metabolism.
Assuntos
Proteínas de Membrana Transportadoras , Oxigênio , Transporte Biológico , Humanos , Soluções , Distribuição TecidualRESUMO
OBJECTIVE: To evaluate the factors associated with plasma concentrations of atazanavir (ATV) in a cohort of well-controlled HIV infected subjects (undetectable viremia). Design: Cross-sectional study where 69 subjects were consecutively enrolled between April and November, 2011. METHODS: Patients had to be on atazanavir for at least six months, undetectable viral load for a period equal to or longer than 12 months, T CD4+ lymphocyte count higher than 200 cells/mm³, and aged between 18 years and 70 years old. Exclusion criteria were pregnancy, any neurologic disease, active opportunistic disease, hepatitis or cancer. Atazanavir plasma levels were measured by ultra-performance liquid chromatography. RESULTS AND DISCUSSION: Overall, 54 patients (mean age of 47 years and 50% women) were included in the analysis. Those without ritonavir (unboosted atazanavir) had statistically lower plasma concentrations than those with ritonavir boosted atazanavir (p = 0.001) and total and indirect bilirubin were statistically associated with plasma concentration of atazanavir (r = 0.32 and r = 0.33 respectively; p < 0.05 in both cases). no statistical association was found among gender, ethnicity, age, weight, body mass index (BMI), lipid profile, and the plasma concentration of atazanavir. CONCLUSION: in summary, as expected, concomitant ritonavir use was the only factor associated with atazanavir plasma levels. prospective studies with a larger sample size might help to observe an association of atazanavir concentrations to other characteristics such as body weight, since the p-value showed to be close to significance (p = 0.068).
Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Fármacos Anti-HIV/sangue , Infecções por HIV/sangue , Oligopeptídeos/sangue , Piridinas/sangue , Fármacos Anti-HIV/farmacocinética , Fármacos Anti-HIV/uso terapêutico , Cromatografia Líquida , Estudos de Coortes , Estudos Transversais , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , Oligopeptídeos/farmacocinética , Oligopeptídeos/uso terapêutico , Estudos Prospectivos , Piridinas/farmacocinética , Piridinas/uso terapêutico , Carga ViralRESUMO
OBJECTIVE: To evaluate the factors associated with plasma concentrations of atazanavir (ATV) in a cohort of well-controlled HIV infected subjects (undetectable viremia). DESIGN: Cross-sectional study where 69 subjects were consecutively enrolled between April and November, 2011. METHODS: Patients had to be on atazanavir for at least six months, undetectable viral load for a period equal to or longer than 12 months, T CD4+ lymphocyte count higher than 200 cells/mm(3), and aged between 18 years and 70 years old. Exclusion criteria were pregnancy, any neurologic disease, active opportunistic disease, hepatitis or cancer. Atazanavir plasma levels were measured by ultra-performance liquid chromatography. RESULTS AND DISCUSSION: Overall, 54 patients (mean age of 47 years and 50% women) were included in the analysis. Those without ritonavir (unboosted atazanavir) had statistically lower plasma concentrations than those with ritonavir boosted atazanavir (p=0.001) and total and indirect bilirubin were statistically associated with plasma concentration of atazanavir (r=0.32 and r=0.33 respectively; p<0.05 in both cases). No statistical association was found among gender, ethnicity, age, weight, body mass index (BMI), lipid profile, and the plasma concentration of atazanavir. CONCLUSION: In summary, as expected, concomitant ritonavir use was the only factor associated with atazanavir plasma levels. Prospective studies with a larger sample size might help to observe an association of atazanavir concentrations to other characteristics such as body weight, since the p-value showed to be close to significance (p=0.068).
Assuntos
Fármacos Anti-HIV/sangue , Infecções por HIV/sangue , Oligopeptídeos/sangue , Piridinas/sangue , Adolescente , Adulto , Idoso , Fármacos Anti-HIV/farmacocinética , Fármacos Anti-HIV/uso terapêutico , Sulfato de Atazanavir , Contagem de Linfócito CD4 , Cromatografia Líquida , Estudos de Coortes , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Oligopeptídeos/farmacocinética , Oligopeptídeos/uso terapêutico , Estudos Prospectivos , Piridinas/farmacocinética , Piridinas/uso terapêutico , Carga Viral , Adulto JovemRESUMO
Since cyclooxygenase (COX) inhibitors have been pointed out as potent ial treatments to increase pregnancy rates after embryo transfer, the present experiment aimed to evaluate the effects of flunixin meglumine (FM) and parecoxib (P), a COX-1 and 2 or COX-2 specific inhibitor, respectively, on the development of bovine embryos until the hatched blastocyst stage. In vitro produced bovine embryos were cultured in media with different concentrations of FM (0.14; 1.4; 14; 140 or 1400 μg/ml) or P (0.09; 0.9; 9; 90 or 900 μg/ml) and the production rates were evaluated. Concentrations of FM ≤ 14 μg/ml and P ≤ 90 μg/ml did not impair embryo development, although compiled data from non-lethal FM concentrations ( ≤ 14 μg/ml) indicated a toxic effect enough to decrease the hatching rate of blastocysts. Concentrations of FM at 140 and 1400 μg/ml and P at 900 μg/ml were lethal as no cleavage was detected on presumptive zygotes.(AU)
Assuntos
Animais , Gravidez , Embrião de Mamíferos , Zigoto/citologia , Bovinos/classificaçãoRESUMO
Since cyclooxygenase (COX) inhibitors have been pointed out as potent ial treatments to increase pregnancy rates after embryo transfer, the present experiment aimed to evaluate the effects of flunixin meglumine (FM) and parecoxib (P), a COX-1 and 2 or COX-2 specific inhibitor, respectively, on the development of bovine embryos until the hatched blastocyst stage. In vitro produced bovine embryos were cultured in media with different concentrations of FM (0.14; 1.4; 14; 140 or 1400 μg/ml) or P (0.09; 0.9; 9; 90 or 900 μg/ml) and the production rates were evaluated. Concentrations of FM ≤ 14 μg/ml and P ≤ 90 μg/ml did not impair embryo development, although compiled data from non-lethal FM concentrations ( ≤ 14 μg/ml) indicated a toxic effect enough to decrease the hatching rate of blastocysts. Concentrations of FM at 140 and 1400 μg/ml and P at 900 μg/ml were lethal as no cleavage was detected on presumptive zygotes.