PubMed Health⌕ Search

Biomedical subjects

C M Berlin

Publications and source records attributed to C M Berlin.

At least 55 records · Page 3Linked to original sources

Disposition of salicylazosulfapyridine (Azulfidine) and metabolites in human breast milk.

A nursing mother with ulcerative colitis was treated with salicylazosulfapyridine (SASP, Azulfidine). Multiple milk samples were collected over a 2-month period. Maternal plasma, saliva, urine and nursing infant's urine were collected. All fluids were analyzed for SASP and its metabolites. Milk did not contain SASP or its 5-amino salicylate component. Sulfapyridine (SP) and its metabolites were present in milk; the SP level was fairly constant at 3--6 micrograms/ml. The milk/saliva ratio for SP was 0.81; the milk/plasma ratio for SP was 0.60 and 0.63. Assuming an average milk concentration of 5 micrograms/ml of SP, the estimated 24-hour secretion (800 cm3 milk) would be approximately 4 mg or 0.3% of maternal dose of SP in the form of SASP. The levels of SP and metabolites determined in random urine samples from the infant were 3--4 micrograms/ml or a 24-hour excretion of 1.2--1.6 mg (30--40% of the total dose in milk). This exposure did not seem hazardous to this infant.

Adult↗

Disposition of acetaminophen in milk, saliva, and plasma of lactating women.

Acetaminophen (APAP) is a widely used analgesic and antipyretic, but its disposition in human milk has not yet been reported. Twelve nursing mothers (nursing two to 22 months) were given a single 650-mg peroral dose of APAP. Simultaneous saliva and milk samples were collected at zero, 1/4, 1/2, 3/4, 1, 2, 3, 5, 8, 12, and 24 hours after maternal dosing. In two mothers, plasma samples were also obtained at several points during the first six hours. Single voided urine samples were collected from the infants three to five hours after maternal dosing (two hours after nursing at peak maternal milk levels). All samples were assayed for APAP by high pressure liquid chromatography (HPCL) using a mobile phase of 0.05 M Na acetate pH 4.0-acetonitrile (93:10) with n-butyryl-p-aminophenol as the internal standard. APAP appeared in saliva and milk in the 1/4-hour samples; peak level (10-15 micrograms/ml) were achieved by one to two hours. Saliva/milk ratios during the elimination phase ranged from 0.7 to 1.1, with most values between 0.8 and 0.9. In two patients studied, saliva/plasma ratios were 0.9 to 1.0. Elimination phase t 1/2 (calculated from beta) ranged from 1.35 to 3.50 (x = 2.28 +/- SD 0.69) hours for milk, and from 1.72 to 3.30 (x = 2.48 +/- 0.56) hours for saliva. There was close agreement between saliva t 1/2 and milk t 1/2 for each patient. Assuming each infant ingested 90 ml milk at 3, 6, and 9 hours after maternal ingestion of APAP, the amount of APAP available for ingestion ranged from 0.28 to 1.51 mg (x = 0.88 +/- 0.31) or from 0.04% to 0.23% (x = 0.14 +/- 0.04) of maternal dose. Neither APAP nor metabolite was detected in nursing infants' urine. Maternal APAP ingestion in usual analgesic doses does not appear to present a risk to the nursing infant.

Acetaminophen↗

Guillain-Barré syndrome associated with Epstein-Barr virus in a cytomegalovirus-negative patient.

Epstein-Barr virus and cytomegalovirus have both been associated with Guillain-Barré syndrome after antibody investigations in several patients. In the teenage female patient in this present report, Guillain-Barré syndrome following infectious mononucleosis was associated with sero-conversion against Epstein-Barr virus but not cytomegalovirus. The findings are consistent with the hypothesis that Epstein-Barr virus might be an etiological agent for the Guillain-Barré syndrome and that infection with cytomegalovirus is not a requisite for the syndrome.

Adolescent↗

Quinine-induced alterations in drug disposition.

In normal volunteers, chronic quinine administration shortened plasma antipyrine half-life and significantly increased the intraindividual correlation between the disposition of quinine and antipyrine. Decreased plasma antipyrine half-life appears to be due to a quinine-induced enhancement of antipyrine metabolism. A dose-dependent prolongation of plasma quinine half-life was observed and attributed primarily to an increased apparent volume of distribution of quinine, although our data did not permit separation of an effect on quinine metabolism from an effect on quinine distribution between the peripheral and central compartments. Plasma protein binding of quinine was similar at both the low and high doses of quinine. Studies in dogs given quinine intravenously revealed a biphasic plasma decay curve compatible with a 2-compartment open model for quinine disposition. Dose dependence of plasma quinine half-life in the dog after intravenous quinine eliminated altered gastrointestinal absorption of quinine as a cause for the dose dependence of plasma quinine half-life. These studies illustrate the importance of such conditions as dose and time of administration in determining the type and magnitude of interaction observed between drugs.

Administration, Oral↗