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Biomedical subjects

F Belpaire

Publications and source records attributed to F Belpaire.

At least 19 recordsLinked to original sources
PubMed1998

Variability of morphine disposition during long-term subcutaneous infusion in terminally ill cancer patients.

OBJECTIVE: To study the plasma concentrations of morphine and its glucuronides to assess the intra- and interindividual variability of the disposition of morphine administered by subcutaneous infusion in cancer patients. METHODS: Blood samples were taken repeatedly in eight patients with severe cancer pain who were being treated with morphine (60-3000 mg per day) via chronic (8-160 days) subcutaneous infusion. Venous blood samples were collected at least weekly and, when possible, on 3 consecutive days after dose adaptation or any other major change in the patients' treatment. Concentrations of morphine and its glucuronides in plasma were measured after solid-phase extraction using a validated high-performance liquid chromatography assay. The stability of the morphine solutions was determined by repeated measurement of the concentrations of morphine and its degradation products in the solutions. RESULTS: The morphine concentration in the infusion solutions remained unchanged during storage and infusion. The plasma concentrations of morphine and its glucuronides were within the ranges reported in the literature. There was, as expected, a large interindividual variability: from patient to patient, the mean of the normalised plasma concentrations ranged from 0.3 ng.ml(-1).mg(-1) to 0.8 ng.ml(-1).mg(-1) for morphine, from 1.0 ng.ml(-1).mg(-1) to 3.1 ng.ml(-1).mg(-1) for morphine-6-glucuronide and from 6.8 ng.ml(-1).mg(-1) to 24.3 ng.ml(-1).mg(-1) for morphine-3-glucuronide. Intraindividual variability was also important. The residual standard deviation of the mean normalised plasma concentrations calculated for each patient ranged from 26% to 56% for morphine, from 20% to 51% for morphine-6-glucuronide and from 20% to 49% for morphine-3-glucuronide. The normalised plasma concentrations of morphine and its glucuronides did not increase with dose or time, and no explanation for the pronounced pharmacokinetic intraindividual variability was found. CONCLUSION: During subcutaneous infusion of morphine, there is a large intra- and interindividual variability of the morphine disposition which could be of clinical relevance.

Aged↗
PubMed1998

ECG changes and plasma concentrations of propafenone and its metabolites in a case of severe poisoning.

CASE REPORT: Propafenone is a class IC antiarrhythmic agent metabolized into two major metabolites, 5-hydroxypropafenone and N-depropylpropafenone. The potency of 5-hydroxypropafenone to block fast sodium channels is comparable to that of its parent. We report the positive correlation between plasma concentrations and electrocardiographic changes in a patient with severe oral self-poisoning. Serial ECG changes were measured and plasma concentrations were determined by high-performance liquid chromatography. The initial plasma concentrations of propafenone were in the toxic range and correlated with the widening of the QRS-complex. The slow decline in concentration during this first phase might relate to saturation of the isoenzyme CYP2D6. The half-life of propafenone, calculated from the second phase, was approximately 3 hours, defining the patient as a fast metabolizer. The initial concentrations of the metabolite N-depropylpropafenone were surprisingly higher than those of 5-hydroxypropafenone which may also be due to saturation of CYP2D6.

Anti-Arrhythmia Agents↗
PubMed1996

Hepatotoxicity of N, N-dimethylformamide (DMF) in acute poisoning with the veterinary euthanasia drug T-61.

1. We report on a patient who was resuscitated after a suicide attempt with the veterinary euthanasia product T-61 and treated with N-acetylcysteine (NAC) to prevent hepatotoxicity from N,N-dimethylformamide (DMF), the solvent of T-61. 2. Serum concentrations of DMF were high as compared with values published on occupational exposure. 3. The patient showed only a transient increase in liver enzymes with eventually a full recovery. 4. The hepatoprotective effect of NAC was studied in a rat model using the rise in serum sorbitol dehydrogenase (SDH) as a marker for DMF-induced hepatotoxicity. 5. Four series of randomized, controlled and double-blind experiments were carried out and consistently showed a lower increase in SDH in NAC-treated animals in each series. The difference was statistically significant only when the data of the 4 series were pooled. This is probably due to the large interindividual variations in the effect of DMF. 6. We hypothesize that in the rat NAC may have a protective effect. Whether NAC is also protective in patients, in which it is administered after exposure to DMF, cannot be concluded from the present experiments.

Acetylcysteine↗
PubMed1995

Severe diltiazem poisoning with intestinal pseudo-obstruction: case report and toxicological data.

This case report concerns a 30-year-old man who survived a 4.2 g diltiazem overdose. He sustained vasoplegic shock with a junctional escape rhythm which required high doses of norepinephrine and epinephrine. Among other complications, ileus with paralytic intestinal pseudo-obstruction developed on day three. Cecal distention was demonstrated by abdomen computed tomodensitometry. The ileus resolved on day seven following the poisoning. Diltiazem plasma concentrations were determined during the first three days. The possible role of other medications, activated charcoal and sufentanil, is noted.

Adult↗
PubMed1994

Enantioselective inhibitory effect of nicardipine on the hepatic clearance of propranolol in man.

The influence of a single oral dose of 30 mg nicardipine on the pharmacokinetics of (R)- and (S)-propranolol, given orally as rac-propranolol 80 mg, was studied in 12 healthy volunteers. The plasma concentrations were higher for the (S)-enantiomer than for the (R)-enantiomer. The Cl(o) and the Cl'intr of (S)-propranolol were significantly lower than the Cl(o) and Cl'intr of (R)-propranolol. The unbound fraction of (R)-propranolol was significantly higher than that of (S)-propranolol. Coadministration of nicardipine significantly increased the AUC and Cmax and significantly decreased the Cl(o) and Cl'intr for unbound drug of (R)- and (S)-propranolol. These changes were more important for (R)- than for (S)-propranolol. The protein binding was not altered by nicardipine. The enantioselective effect of nicardipine on the metabolic clearance of propranolol appears to be due to an interaction at the level of the metabolizing enzymes. The effect on blood pressure of rac-propranolol was little affected when nicardipine was coadministered with rac-propranolol, and its bradycardic effect was reduced.

Adult↗
PubMed1992

Liquid chromatographic determination of oxytetracycline in bovine plasma by double-phase extraction.

A liquid chromatographic method for the determination of oxytetracycline in bovine plasma was developed. Contrary to most current tetracycline assays involving solid-phase extraction, oxytetracycline and the internal standard tetracycline were isolated from buffered plasma by double-phase extraction with ethyl acetate-isopropyl alcohol. The latter component was found to be essential to ensure reproducible partitioning of both tetracyclines into the organic layer. Chromatography was conducted on a Lichrosorb RP8 column, compounds were eluted with 0.01 M oxalic acid-methanol-acetonitrile, and detection was at 357 nm. Linearity was observed over the 0-8.5-micrograms/mL range, and the detection limit approximated 5 ng/mL. The extraction yield was 80.4 +/- 3.4% (n = 12), and the coefficients of variation for repetitive within-run and between-run analyses at two concentration levels (0.25 and 2 micrograms/mL) were 1.0-4.3 and 2.4-7.2%, respectively. The method was applied to a pharmacokinetic study of oxytetracycline in three nonlactating cows after a single intramuscular administration of a long-acting preparation.

1-Propanol↗
PubMed1991

Comparison of the bioavailability of two slow release preparations of disopyramide.

The bioavailability of two slow release preparations of disopyramide has been compared in a randomized cross-over trial of Rythmodan L.A. 250 mg b.d. and Dirytmin Durettes 300 mg b.d., given to 10 healthy volunteers. The plasma concentrations of disopyramide were measured on the 5th day of each treatment period. With both preparations, plasma concentrations were well sustained. The amount absorbed was slightly lower after Rythmodan L.A. than after Dirytmin Durettes, but the fluctuations over a dosing interval were significantly more pronounced for Dirytmin Durettes than for Rythmodan L.A.

Adult↗
PubMed1989

Delayed elimination of digoxin antidotum determined by radioimmunoassay.

An observation of a treatment with digitalis antibodies (Fab-fragments) in a young child is presented. The elimination of this antidotum proved to be much slower than normally expected. In the patient's history, the disappearance of the Fab-fragments out of the blood lasted 142 days with a half-life of 15.6 days, whereas an elimination with a T1/2 of 28 hours is accepted. Probably there has been intracellular penetration of the antibodies into the liver, caused by concomitant diseases (Hepatitis A and B infections). An "in vitro" experiment is reported. It demonstrates the equimolar binding of the Fab-fragments for digoxin and shows that the elimination of the Fab-fragments can be established by a routine radioimmunoassay of digoxin, in an indirect way.

Antibodies↗
PubMed1988

Comparison of different volume markers in peritoneal dialysis.

Four peritoneal volume markers (carbon 14-labeled dextran, dextran blue, radioactive albumin, and hemoglobin) were compared. In six rabbits 14C-dextran was compared with dextran blue during a 4-hour "dwell" with a 4.25% dextrose solution. The recovery of 14C-dextran at the end of the dwell was 71% +/- 3% vs. 92% +/- 1% for dextran blue (P less than 0.001). In six other rabbits, radioactive albumin (RISA) was compared with dextran blue. The recovery of RISA was 78% +/- 4%, compared with 85% +/- 2% for dextran blue (P less than 0.05). The calculated peritoneal volumes, uncorrected for disappearance of the markers, were consistently higher than when correction was made. After correction, the calculated end volumes were similar to actually measured end volumes. In six patients with chronic ambulatory peritoneal dialysis, the intraperitoneal volume during a single dwell of 6 hours was estimated in paired observations with lactated Ringer's solution and 1.5% dextrose dialysate, using simultaneously autologous hemoglobin and RISA. In eight additional patients, a single dwell with 4.25% dextrose dialysate was studied. The recoveries of both markers were related to the osmotic strength of the dialysate. Recoveries were 66.7% +/- 2.3% and 69.6% +/- 0.9% in lactated Ringer's solution, and increased to 81% +/- 3% and 82% +/- 2% in 4.25% dextrose for hemoglobin and RISA, respectively. With each dialysate, after correction for disappearance of the marker, no differences in volume profiles or between calculated or measured end volumes could be found with either hemoglobin or RISA.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

Lack of effect of cicletanine on plasma digoxin levels.

Six patients stabilized on long-term once daily oral digoxin were entered into a study to monitor the effect of adding a single dose of oral cicletanine (50 or 100 mg) on plasma digoxin levels. The study was performed over 2 days, a control day and a second involving the addition of the test drug to the patient's medication. No significant change in plasma digoxin concentration was found and the combined treatment was well tolerated in terms of clinical and laboratory parameters.

Adult↗
PubMed1987

Toxicokinetics of methyl paraoxon in the dog.

The toxicokinetics of methyl paraoxon, the active metabolite of the organophosphorus insecticide methyl parathion, were studied in non-anaesthetized dogs after intravenous (2.5 mg/kg) and oral (15 mg/kg) administration of methyl paraoxon. After intravenous administration, distribution and elimination occurred very rapidly and using the data from 5 min post-injection, the plasma concentration versus time curves could be fitted to a one-compartment open model. The mean half-life of elimination was 9.7 min, the average volume of distribution 1.76 l/kg and the average plasma clearance 126 ml/kg/min. After oral administration, peak plasma concentrations were obtained within 3-16 min, and the bioavailability varied from 5 to 71%. The hepatic extraction of methyl paraoxon measured in anaesthetized dogs, was high (70-92%). Comparison of the urinary excretion after intravenous and oral administration in two dogs indicated a gastrointestinal absorption of more than 60%. The kinetics of methyl paraoxon were linear in the dose range tested.

Administration, Oral↗
PubMed1986

Apolipoprotein E quantified by enzyme-linked immunosorbent assay.

We developed a sensitive, specific "sandwich"-type enzyme-linked immunosorbent assay in which affinity-purified antibodies are used for coating and also for preparing an antibody-peroxidase conjugate to quantify apolipoprotein E in serum and in its lipoprotein fractions. This technique is rapid (results within 5 h), precise (mean intra- and interassay CVs 4.3 and 8.2%, respectively), accurate, and simple to perform. Sample pretreatment did not enhance apo E immunoreactivity. For 47 normolipidemic subjects, the mean apo E concentration was 38.11 (SD 11.1) mg/L. Above-normal apo E concentrations were measured in all types of hyperlipoproteinemia, especially types III and V. Apo E correlated with triglyceride (r = 0.58) and cholesterol concentrations (r = 0.60). As determined by gel filtration, hypertriglyceridemia was associated with a redistribution of apo E towards the triglyceride-rich lipoprotein fractions, which contained 77.1% (SD 16.8%) of total plasma apo E in Fredrickson type V patients, compared with 12.5% (SD 6.3%) in normal persons.

Antibody Formation↗
PubMed1985

Immunonephelometric quantitation of the apolipoprotein C-III in human plasma.

A quantitative assay, based on endpoint immunonephelometry, was developed for human apolipoprotein C-III (Apo C-III) in plasma and lipoprotein fractions. The standard curve was constructed either with purified Apo C-III2 as a primary standard or with plasma as a secondary standard. It was linear between 50 and 400 ng Apo C-III per sample, corresponding to 1 microliter undiluted plasma. The intra- and interassay coefficients of variation (CV values) were 2.2 and 6.3%, respectively. The Apo C-III immunoreactivity was not influenced by detergents, denaturants nor by delipidation. The use of a non-ionic detergent (Apovax, 0.1 g/l) avoided the need for organic solvent extraction for plasma containing up to 4 g of triglycerides/l by reducing the sample turbidity. As measured in 126 normolipidemic subjects, the plasma Apo C-III concentration was 0.118 +/- 0.028 g/l (mean +/- SD). Apo C-III concentrations were only slightly elevated in patients with Fredrickson type IIa hyperlipoproteinaemia. The Apo C-III levels were nearly 3 times higher in type I, IIb, III and IV patients, while subjects with type V hyperlipaemia had about a 5-fold increase in Apo C-III compared to the healthy. The plasma Apo C-III values were strongly correlated with the plasma triglyceride concentrations (r = 0.80, n = 201). The Apo C-III distribution among the various lipoprotein fractions showed a higher proportion of Apo C-III in VLDL in hypertriglyceridaemic subjects compared to normolipaemic subjects.

Apolipoprotein C-III↗
PubMed1985

Disposition of orally administered di-(2-ethylhexyl) phthalate and mono-(2-ethylhexyl) phthalate in the rat.

The disposition of di-(2-ethylhexyl) phthalate (DEHP) and mono-(2-ethylhexyl) phthalate (MEHP) was studied in the rat. Three hours after a single oral dose of DEHP (2.8 g/kg), plasma concentrations of 8.8 +/- 1.7 micrograms/ml DEHP and 63.2 +/- 8.7 micrograms/ml MEHP were reached. MEHP levels declined with a half-life of 5.2 +/- 0.5 h. The ratio of the area under the plasma concentration-time curve of MEHP to that of DEHP was 16.1 +/- 6.1. When 14C-DEHP was administered, 19.3 +/- 3.3% of the radioactivity was excreted in the urine within 72 h, the rest being excreted in the faeces. The urinary excretion rate of total radioactivity declined with a half-life of 7.9 +/- 0.5 h. Single administration of MEHP (0.4 g/kg) resulted in plasma concentrations of 84.1 +/- 14.9 micrograms/ml 3 h after dosing; the half-life of MEHP was 5.5 +/- 1.1 h. Multiple dosing with DEHP (2.8 g/kg/day) for 7 consecutive days produced no accumulation of DEHP or MEHP in plasma.

Animals↗
PubMed1984

A method for the assay of alpha 1-acid glycoprotein in dog serum and its application to the plasma binding of propranolol and oxprenolol in animals receiving rifampicin.

A method for determination of alpha 1-acid glycoprotein (alpha 1-AGP) in dog serum was developed. Dog alpha 1-AGP was purified to homogeneity from pooled serum by DEAE and CM ion exchange chromatography. A monospecific antibody was obtained by injecting the antigen in rabbits. The antibody was used in a turbidimetric method that allowed detection at 10 micrograms/ml in serum. A linear correlation was found between the optical density and alpha 1-AGP concentration up to 20 micrograms alpha 1-AGP in the sample. The method has been used to demonstrate the effect of treatment with rifampicin on the alpha 1-AGP serum concentrations and its relation to the protein binding of oxprenolol and propranolol.

Animals↗