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Biomedical subjects

C M Myers

Publications and source records attributed to C M Myers.

At least 37 records · Page 2Linked to original sources
PubMed1985

Pharmacokinetics of imipenem and cilastatin in patients with cystic fibrosis.

The pharmacokinetics of imipenem, a new carbapenem antibiotic, and cilastatin, a metabolic inhibitor, were evaluated in 17 patients with cystic fibrosis. Imipenem and cilastatin were combined in a ratio of 1:1 in the infusion solution, and patients intravenously received 30, 60, or 90 mg of imipenem per kg of body weight per day, divided into four equal doses. Pharmacokinetic evaluation after the first dose and again under steady-state conditions revealed biodisposition characteristics which were similar and independent of the daily dose administered. Cilastatin concentrations in serum paralleled those of imipenem. A linear relationship between dose and area under the serum concentration-time curve for both compounds was observed, suggesting a first-order pharmacokinetic process. A total of 50 and 78% of the doses of imipenem and cilastatin, respectively, were recovered unchanged in the urine. The renal clearances of imipenem and cilastatin averaged 54 and 88%, respectively, of the serum clearance. These data suggest that an extrarenal mechanism may be involved in the overall elimination of imipenem. No patient experienced any clinical or biochemical abnormalities during drug therapy.

Anti-Bacterial Agents↗
PubMed1985

Pharmacokinetics and cerebrospinal fluid penetration of ceftazidime in children with meningitis.

The single dose pharmacokinetics and cerebrospinal fluid (CSF) penetration of ceftazidime were determined in 10 children with bacterial meningitis. Serum ceftazidime pharmacokinetics showed a distinct age dependence in which the clearance in children less than 1 month of age was markedly reduced. Ceftazidime concentrations in CSF, which ranged from 1.4-8.5 micrograms/ml, exceeded the minimum bactericidal concentrations for infecting pathogens throughout the 8-hour sampling period. These concentrations were found to be independent of CSF cell count, protein concentration or the day of therapy on which the study was performed. The ratio of CSF to serum ceftazidime concentration increased with time, suggesting that ceftazidime was cleared more slowly from CSF than from peripheral blood. Our data support the initiation of a study comparing the efficacy of ceftazidime to conventional therapy in children with bacterial meningitis.

Age Factors↗
PubMed1984

Dosing implications of rapid elimination of trimethoprim-sulfamethoxazole in patients with cystic fibrosis.

The first-dose and steady-state pharmacokinetics of trimethoprim and sulfamethoxazole were determined in 14 patients with cystic fibrosis. When pharmacokinetic data from the first dose were compared with those at steady state, both TMP and SMZ showed expected accumulations in serum concentrations and decreases in total body clearance. The area under the SMZ serum concentration-time curve was significantly greater at steady state, suggesting drug accumulation during long-term therapy. When pharmacokinetic characteristics for TMP and SMZ obtained in patients with cystic fibrosis were compared with those reported for normal adults, the patients were found to have shorter elimination half-lives and greater plasma clearances. In addition, the apparent volume of distribution for TMP was smaller for patients with cystic fibrosis than for normal adults, consistent with their reduced mass of adipose tissue. Our data support the need for increased dosing or decreased dosing intervals when administering TMP-SMZ to patients with cystic fibrosis.

Adolescent↗
PubMed1984

Determination of cefsulodin in biological fluids by high-pressure liquid chromatography.

Cefsulodin is a third-generation cephalosporin with a unique specificity for Pseudomonas aeruginosa. To study the pharmacokinetics of this agent in children, a rapid and sensitive high-performance liquid chromatographic micromethod was developed for plasma and urine. Protein was precipitated from plasma with one volume of cold methanol, and 20 microliter of the resulting supernatant solution was injected into a Zorbax C-8 reversed-phase column. The mobile phase was composed of 4.5 parts acetonitrile and 95.5 parts of 0.035 M ammonium acetate buffer (pH 5.2). Flow rate was 1.0 ml/min and peaks were detected at 265 nm. A flow gradient from 0.3 to 2.0 ml/min over 34 min was employed for urine. The analysis had a limit of detectability of 1 microgram/ml and a between-day coefficient of variation of 4.4 and 5.0 for 100 and 10 micrograms/ml samples, respectively.

Body Fluids↗
PubMed1984

Modification of the theophylline radioimmunoassay.

The routine utilization of a commercially available radioimmunoassay (RIA) for theophylline (GammaDab), although reliable, is currently prohibited by the high cost of the reagents. In an effort to reduce these costs we have diluted the [125I]theophylline tracer and theophylline antiserum reagents by one-half, contrary to the manufacturer's recommendations. We have demonstrated that an excellent correlation exists (r = 0.968) between our modified RIA method and a conventional high-performance liquid chromatographic technique, despite reagent dilution. Accordingly, our reagent costs have been reduced by half. We conclude that the GammaDab kit reagents can be diluted twofold and still provide an accurate determination of serum theophylline. We must also emphasize that any further alteration(s) of this theophylline RIA procedure would require a thorough evaluation before its routine use could be substantiated.

Chromatography, High Pressure Liquid↗
PubMed1984

Single-dose pharmacokinetics of cefsulodin in patients with cystic fibrosis.

The single-dose pharmacokinetics of cefsulodin were evaluated in 12 patients with cystic fibrosis. Each patient received 3 g of cefsulodin intravenously over 30 min. Multiple plasma and urine samples were obtained during the 6-h study period for the determination of cefsulodin. Pharmacokinetic parameters were determined by model-independent methods. Mean values for t1/2, Vss, and CLp were 1.53 h, 0.242 liters/kg, and 117.3 ml/min per 1.73 m2, respectively. Six-hour urine recovery revealed 73.2% of the administered dose with a corresponding cefsulodin urinary clearance of 75.1 ml/min. These pharmacokinetic data in patients with cystic fibrosis appear consistent with data reported for unaffected individuals.

Adolescent↗
PubMed1984

Determination of imipenem and cilastatin in serum by high-pressure liquid chromatography.

Imipenem and cilastatin concentrations in serum were determined by using reverse-phase high-pressure liquid chromatography. Serum samples were stabilized with 0.5 M morpholineethanesulfonic acid buffer (pH 6.0) and subjected to ultrafiltration before chromatography. The elution solvent consisted of water or potassium phosphate buffered to pH 2.5 and methanol. The imipenem and cilastatin peaks were detected at 300 and 220 nm, respectively. Recovery from serum was 99% for both imipenem and cilastatin, and the limits of detectability for the two compounds were 0.3 and 0.5 microgram/ml, respectively. The assay may be readily applied to pharmacokinetic analysis of imipenem and cilastatin biodisposition in patients.

Anti-Bacterial Agents↗
PubMed1983

Determination of amiodarone and its N-deethylated metabolite in serum by high-performance liquid chromatography.

A high-performance liquid chromatographic (HPLC) method utilizing hexane extraction and a normal bonded phase column (NH2-alkylamine) was developed to measure serum concentrations of amiodarone and its N-deethylated metabolite. A single analysis requires 8 min. The one-step extraction efficiencies of amiodarone and the internal standard are greater than 90%. The method is linear between 0.05 and 20.0 micrograms/ml. The average relative standard deviation of the slope of the standard curve is 4% and the single day coefficient of variation is 3.2%. The use of hexane extraction for sample cleanup and a bonded phase column for chromatography result in a sensitive and reproducible system well suited to laboratories monitoring serum concentrations of multiple drugs by HPLC. A preliminary study has shown the assay to be useful for the investigation of the pharmacokinetics of this agent.

Adult↗
PubMed1983

Ceftazidime in cystic fibrosis: pharmacokinetics and therapeutic response.

The pharmacokinetics of ceftazidime were assessed following a single-dose in 20 patients (8 to 30 years) with cystic fibrosis. All patients received 50 mg/kg (0.9 to 3.5 g) bolus over 30 to 60 sec. Multiple timed samples were obtained over 8 h and analysed by a sensitive HPLC technique. Two-compartment pharmacokinetic analysis revealed means (+/- S.D.) T 1/2 alpha, 0.45 (0.20) h; T 1/2 beta, 1.74 (0.63) h; Vd, 270.0 (50.0) ml/kg; Vc, 190.0 (50.0) ml/kg and Cl beta, 133.7 (22.8) ml/min/1.73 m2. Probenecid pretreatment in six patients was without effect on T 1/2 beta and Cl beta. Urinary excretion was (% of dose) 0 to 2 h, 65.4 (11.1); 2 to 4 h, 14.9 (3.4) and 4 to 8 h, 9.8 (5.8). Ceftazidime was used to treat pulmonary exacerbations in 12 adult cystic fibrosis patients with multiply-resistant Pseudomonas species. Each patient received 2 g iv 8-hourly for 14 to 35 days. Ten of 12 patients showed dramatic improvement as determined by increased appetite and weight gain and arterial pCO2. No hepatic, renal or bone-marrow toxicity was noted. Ceftazidime is an effective antipseudomonal agent possessing favourable pharmacokinetic characteristics with potential use in the treatment of pulmonary exacerbations in cystic fibrosis.

Adolescent↗
PubMed1983

Determination of ceftazidime in biological fluids by using high-pressure liquid chromatography.

Ceftazidime is a new beta-lactamase-stable third-generation cephalosporin with a broad spectrum of antimicrobial activity. To evaluate the biodisposition of the drug in infants and children, a rapid and simple high-pressure liquid chromatographic technique was developed. The method is useful for both serum and urine and involves methanol precipitation followed by reverse-phase chromatography on MicroPak MCH 10. The mobile phase, consisting of 20% methanol and an 80% aqueous solution of 50 mM ammonium dihydrogen phosphate and 117 microM perchloric acid, is pumped at 1 ml/min through the column which is maintained at 50 degrees C. The drug was detected at 257 nm with a variable-wavelength UV detector. A good linear correlation was observed between the peak area and the ceftazidime concentration at 0.3 to 500 micrograms/ml (r = 0.999). Since an equal volume of cold methanol is used to precipitate proteins from serum samples and only 20 microliters of the resultant supernatant is injected into the column, samples as small as 50 microliters may be routinely analyzed. This method has been used to study ceftazidime pharmacokinetics in more than 30 patients and has proven to be rapid and reproducible.

Ceftazidime↗
PubMed1983

Developmental pharmacokinetics of moxalactam.

A pharmacokinetic evaluation of moxalactam was performed with 30 infants and children with documented or suspected bacterial infections arising outside the central nervous system. Each child received 50 mg of moxalactam per kg infused intravenously over a period of 15 min every 8 h. A total of 26 children were studied after receiving the first dose; 20 of these, along with 4 additional patients, were evaluated after receiving continuous therapy for at least 3 days. After the first dose, the elimination half-life, apparent volume of distribution, and plasma clearance averaged 1.59 h, 0.331 liter/kg, and 100.9 ml/min per 1.73 m2, respectively. The biodisposition of the moxalactam epimers was also evaluated, with similar overall results. No differences in pharmacokinetic parameters were observed when the first-dose values were compared with those obtained at the steady state. Age-dependent changes in moxalactam elimination were observed for children of less than or equal to 1 year of age, suggesting that a dosage reduction may be necessary for children of less than or equal to 2 months of age.

Adolescent↗
PubMed1982

The dexamethasone suppression test in mania.

The results of the overnight 2 mg Dexamethasone Suppression Test administered to 50 manic patients are reported. Twenty-three (46%) cases showed an absence of normal suppression, results which are similar to those seen in endogenous depression and which differ to those of others who have all reported normal suppression in mania. Suppressors and non-suppressors were not shown to differ in the factors of age, weight, polarity or the rated severity of mood.

Adult↗
PubMed1982

Alterations in gentamicin pharmacokinetics during neonatal exchange transfusion.

The effect of double volume exchange transfusion on the pharmacokinetics of gentamicin was studied in 7 neonates undergoing eight transfusions. The procedures were performed an average of 9.6 h following the previous dose of drug and required an average of 0.91 h to complete. Exchange transfusion decreased serum gentamicin concentrations by 18.5 +/- 4.2% and increased the elimination rate for gentamicin by 31.8%. Serum concentrations obtained an average of 3.3 h following the procedure showed a rebound increase in concentration compared to that obtained just at the end of the transfusion (2 cases), no change (1 case) or a decrease compared with the immediate posttransfusion period (5 cases). The results observed in the late posttransfusion period were found to be inversely related (r = -0.78) to the number of doses received by the patient prior to the procedure. A one-compartment pharmacokinetic model was found to be adequate in predicting the amount of drug removed by the procedure while a two-compartment model best described the posttransfusion alteration in elimination kinetics.

Exchange Transfusion, Whole Blood↗
PubMed1965

The inheritance of yellow-larva and ruby-eye in Culex pipiens.

It has been suggested that mosquito vectors of filariasis and other diseases might be controlled by genetic methods. This is not yet possible because of the lack of genetic information concerning the vector species. The present study describes the development of a marker strain which is being used to study genetic control.Two spontaneous mutants of Culex pipiens are described, one for the first time. Ruby-eye (ru) is an autosomal recessive in linkage group 2. It is completely penetrant and completely expressed. It is evident in later instar larvae, pupae, and adults. Yellow-larva (y) is an autosomal recessive, sometimes behaving as a partial dominant, and is also in linkage group 2. It is evident in late fourth-instar larvae and pupae and is generally associated with lengthened larval development. Ruby-eye and yellow-larva are occasionally seen in collections from the field. The frequency of crossing over between ru and y differs significantly among progenies and also between the sexes, the median values being 17% in males and 24% in females.

Culex↗
PubMedDate not supplied

Single-dose pharmacokinetics of aztreonam in children with cystic fibrosis.

The single-dose pharmacokinetics of aztreonam was evaluated in 10 clinically stable subjects with cystic fibrosis. Each child received 30 mg aztreonam/kg intravenously over 2 to 3 minutes. Multiple timed blood samples were obtained over 8 hours for determination of aztreonam elimination kinetics; all urine excreted for 24 hours was collected in timed aliquots for the determination of aztreonam and its microbiologically inactive metabolite, SQ 26,992. Aztreonam pharmacokinetic parameters were determined by model-independent methods. Mean t1/2, steady-state volume distribution, and body clearance were 1.3 hr, 0.25 L/kg, and 127.2 ml/min/1.73m2, respectively. In 9 of the 10 subjects, two-compartment pharmacokinetic analysis was possible and compared favorably with model-independent parameter estimates. Twenty-four-hour urinary recovery of aztreonam was 76.3% of the administered dose; 2.6% was recovered as the metabolite SQ 26,992. The renal clearance of aztreonam averaged 92.5 ml/min/1.73m2. When these data are combined with in vitro susceptibility data for aztreonam against Pseudomonas aeruginosa isolated from the sputum of patients with cystic fibrosis, a dose of 200 mg aztreonam/kg/day divided six hourly would be predicted to maintain serum concentrations above the minimum inhibitory concentration (MIC) for these organisms for the majority of the dosing interval.

Adolescent↗