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J L Steimer

Publications and source records attributed to J L Steimer.

16 recordsLinked to original sources
PubMed1991

Simultaneous pharmacokinetic modeling of a drug and two metabolites: application to albendazole in sheep.

Albendazole pharmacokinetic parameters were determined in lambs after iv, oral, and intraruminal single administrations. The parent drug and two metabolites, albendazole sulfoxide and albendazole sulfone, were simultaneously determined in whole blood, plasma, and urine using an HPLC method. The parent drug was only recovered in plasma when injected intravenously. For other routes, only the two metabolites were detectable; they were present in red blood cells and plasma at equal concentrations. The pharmacokinetic parameters were determined by using compartmental models which simultaneously described the two oxidative steps and the urinary excretion of the sulfoxide derivative. Dose-dependent pharmacokinetics was studied in the dose range 0.95-3.8 mg/kg. The results showed that clearance remained constant within the tested dose range since the area under the curve normalized to the dose was similar in the cases of sulfoxide and sulfone metabolites, whatever the route of administration. The drug appeared to be extensively metabolized in the body regardless of the route of administration. Sulfoxidation probably took place in liver, but other tissues seemed to be responsible for the formation of the sulfoxide which has been described as the major anthelmintic derivative of albendazole.

Administration, Oral↗
PubMed1991

A mathematical model of the kinetics of 5-fluorouracil and its metabolites in cancer patients.

A compartmental model of the kinetics of 5-fluorouracil (5-FU) and its catabolites in humans is proposed. This model was developed using data from a previous study in which plasma levels and urinary amounts of unchanged drug and metabolites were quantitated after i.v. bolus injection of 500 mg/m2 5-FU in ten patients. Biliary excretion was also quantified in two subjects. The different processes, biochemical transformations, and urinary and biliary excretion were adequately described by first-order kinetics. The technique of multiresponse modelling was used for global fitting of all data for each patient. Satisfactory agreement was achieved between measured and predicted values. This model enabled accurate evaluation of pharmacokinetic parameters that could not be adequately calculated using a model-free analysis. The total clearance and elimination half-life of 5-FU and its catabolites are reported for all subjects. The estimated mean half-life was 6.9 +/- 3.9 min for unchanged 5-FU and 225 +/- 352, 7.6 +/- 4, and 9.6 +/- 7.7 min, respectively, for the three measured catabolites dihydrofluorouracil (FUH2), alpha-fluoro-beta-ureidopropionic acid (FUPA), and alpha-fluoro-beta-alanine (FBAL). The percentage of anabolic, catabolic, urinary, and biliary elimination in total clearance was also quantitated. Anabolic clearance accounted for 39% +/- 14% of total 5-FU clearance, with substantial variation occurring among patients. Urinary clearance represented 6.5% +/- 3.2%, 0.8% +/- 0.9%, 13.2% +/- 4.7%, and 98.2% +/- 2.5% of total clearance for 5-FU, FUH2, FUPA, and FBAL, respectively. The model was also satisfactorily fitted to the data of a patient deficient in dihydropyrimidine dehydrogenase, an enzyme previously thought to be the rate-limiting step for 5-FU catabolism. In this case, catabolism was highly reduced and urinary excretion of 5-FU increased up to 64% of total drug clearance. This first global model of the kinetics of 5-FU and all of its catabolites in patients given an i.v. bolus infusion of 500 mg/m2 5-FU represents a further step toward detailed comprehensive modeling of the kinetics of this drug.

Fluorouracil↗
PubMed1991

Mathematical model for in vivo pharmacodynamics integrating fluctuation of the response: application to the prolactin suppressant effect of the dopaminomimetic drug DCN 203-922.

We propose a general pharmacokinetic-pharmacodynamic model that integrates the rhythmic fluctuation of hormone secretion for the description of the hormone-lowering effect of a drug. The mathematical model takes into account the variation in response observed after administration of a placebo and the drug. It is assumed that the change with time in the physiological response during the placebo period results from fluctuations in the concentration of hypothetical endogenous molecules. The mathematical formulation for predicting the response after drug intake is derived assuming competitive interaction of these "molecules" with the active species for binding to receptors. The suggested "fluctuation model" was implemented in order to describe the time course of the prolactin (PRL) plasma level after administration of two oral doses (2.5 and 5.0 mg) of the dopaminomimetic compound DCN 203-922 (DCN) to 9 healthy male subjects. Its performance was compared with that of conventional modeling approaches, in which the circadian changes after placebo are neglected and the hormone baseline is assumed to be constant. The new model provided a better description of the time course of PRL in most subjects. It was used for prediction of the amplitude and duration of the PRL suppressant effect after single and chronic administration of DCN at various dosage regimens as well as after changes in drug absorption.

Adult↗
PubMed1991

Exploratory analysis of population pharmacokinetic data from clinical trials with application to isradipine.

Drug level monitoring during routine clinical visits in the course of phase III trials provides a means to document pharmacokinetic variability in a patient population. Such a pharmacokinetic screen was performed for the new calcium antagonist isradipine. A total of 697 blood samples were collected at any time after the morning dose from 252 patients who had received oral doses of isradipine. Three approaches of data analysis based on exploratory (graphical and statistical) techniques were used to relate plasma level to patient demographic data and laboratory parameters. The pharamacokinetics of isradipine seemed to be influenced by the demographic variables of age (already detected in conventional studies) and weight, as well as by the blood serum levels of inorganic phosphorous, uric acid, alkaline phosphatase, and bilirubin, but only to a small, clinically irrelevant extent. The findings from the three approaches were complementary. They suggest that a pharmacokinetic screening in clinical trials is feasible at reasonable experimental cost and effort and provides useful data on interindividual and intraindividual pharmacokinetic variability in patients.

Adult↗
PubMed1989

Zero-order absorption and linear disposition of oral colchicine in healthy volunteers.

The pharmacokinetics of colchicine has been studied in nine healthy male volunteers after oral doses of 0.5, 1, and 1.5 mg as tablets. Plasma and urine samples were collected over 48 h and analysed for colchicine by radioimmunoassay. Individual colchicine concentration profiles in plasma and urine were well described by a two-compartment open model with zero-order input. Considering the absorption variables as specific to each experiment, the lag time (0-0.35 h) and duration (0.39-2.38 h) of absorption were found to be independent of dose, while the zero-order rate constant of absorption (k0) increased linearly with dose. Disposition variables were taken as common to the three experiments, except in six subjects in whom renal excretion varied significantly across experiments in a dose-independent manner. For seven subjects the terminal half-life was 19.4 h, the oral apparent volume of distribution at steady-state (Vss/f) was 691 l, and the oral systemic clearance (CL/f) was 33.1 l.h-1. In the two other subjects, the values were unreliable, but the estimated terminal half-life was greater than 48 h, Vss/f ranged from 1690 to 3480 l, and CL/f was in the range of the other subjects in 1 subject, and it was about 15 l.h-1 in the other. In the latter subject, these estimates, together with the observation that plasma concentration reached a plateau at 2 to 5 h after ingestion, suggest enterohepatic cycling of colchicine. Overall, the disposition of colchicine was linear in the dose range 0.5-1.5 mg, with a long terminal half-life, and absorption obeyed zero-order kinetics, with k0 proportional to dose.

Administration, Oral↗
PubMed1988

Nonparametric maximum likelihood estimation for population pharmacokinetics, with application to cyclosporine.

A new method, nonparametric maximum likelihood (NPML), for statistical analysis of population kinetic data is proposed. NPML provides a discrete estimate of the whole probability density function of the pharmacokinetic parameters. This permits a straightforward derivation of usual population characteristics. To illustrate the application of the NPML method, a population analysis of cyclosporine RIA measured plasma levels in 188 bone marrow transplant patients after intravenous infusion, is presented. The capability of NPML to extract population information from sparse individual data is also outlined.

Biometry↗
PubMed1988

On the dose dependency of cyclosporin A absorption and disposition in healthy volunteers.

The pharmacokinetics of Cyclosporin A (CyA, Sandimmune) was studied in 12 healthy male volunteers after oral dosing of 350 mg, 700 mg, and 1400 mg as a drinking solution. Blood samples were collected over 96 hr and analyzed by high pressure liquid chromatography. Concentration data were evaluated with model-independent and model-based linear pharmacokinetic concepts. Individual CyA concentration-time profiles in whole blood were well described by a two-compartment open model with zero-order absorption for all three doses. Comparison of pharmacokinetic parameters across doses indicates that both absorption and disposition are dose-dependent. Nonlinear disposition is suggested by the significant increase of the terminal half-life from 8.9 +/- 4.9 hr to 11.9 +/- 4.9 hr (mean +/- SD) after a 350 mg and a 1400 mg dose, respectively. Changes in the metabolic activity of the liver with concentration might be responsible for this phenomenon. In addition, the modeling approach indicated that bioavailability decreases with increasing dose. Moreover, the dependence of the rate of CyA absorption (zero-order rate constant) versus dose was well described by a hyperbola. The limited solubility of the drug in the gastrointestinal tract might be responsible for this behavior. The lag time (0.2-0.8 hr) was independent of dose. This value is similar to the time of gastric emptying in fasting volunteers. The duration of absorption for 11 of 12 subjects was in the range 2.5-3.5 hr over all doses and agrees well with the small intestine transit time. Some subjects showed a marked secondary peak at one or two doses, which could be adequately fitted by a model with two successive zero-order inputs. This double-peak behavior was ascribed to the influence of the food on gastric emptying. Dose dependency of disposition and absorption counterbalance each other in the usual dose range. This leads to an almost proportional increase of area under the blood CyA concentration-time profile with increasing dose.

Administration, Oral↗
PubMed1988

Hyperparameter estimation using stochastic approximation with application to population pharmacokinetics.

A stochastic approximation algorithm is proposed for recursive estimation of the hyperparameters characterizing, in a population, the probability density function of the parameters of a statistical model. For a given population model defined by a parametric model of a biological process, an error model, and a class of densities on the set of the individual parameters, this algorithm provides a sequence of estimates from a sequence of individuals' observation vectors. Convergence conditions are verified for a class of population models including usual pharmacokinetic applications. This method is implemented for estimation of pharmacokinetic population parameters from drug multiple-dosing data. Its estimation capabilities are evaluated and compared to a classical method in population pharmacokinetics, the first-order method (NONMEM), on simulated data.

Algorithms↗
PubMed1986

Description of the time course of the prolactin suppressant effect of the dopamine agonist CQP201-403 by an integrated pharmacokinetic-pharmacodynamic model.

Six male volunteers (mean age 24 years) received a single oral dose of 0.025 mg CQP201-403 and placebo in a randomised double-blind crossover design. Fifteen plasma samples were collected over 48 h and were assayed by radioimmunoassay for drug substance and prolactin (PRL). Three of the samples were drawn during sleep on the first study day. The pharmacological effect (E%) of CQP201-403 was expressed as reduction in plasma PRL levels. The pharmacokinetic (PK)-pharmacodynamic (PD) model consisted of two kinetic compartments and an effect compartment linked to the central compartment. A sigmoid Emax model (Hill equation) described the relationship between the drug concentration in the effect compartment and E%. Curve-fitting of PK and PD data provided individual parameter estimates which served to generate computer-simulated PK and PD profiles after single and multiple doses in order to: investigate the in vivo concentration-effect relationship; evaluate the consequence of dosage reduction on the steady-state PD profile; and study the robustness of the response to changes in drug potency and bioavailability.

Adult↗
PubMed1985

Cytoplasmic and nuclear uptake of aldosterone in toad bladder: a mathematical modeling approach.

The mechanism of aldosterone uptake in the epithelial cells of toad bladder was studied using mathematical modeling. Two complementary approaches were used. The first involved analysis of cytosolic aldosterone binding at steady state according to models defined by the sum of independent noninteractive binding sites. The best model describing the experimental data corresponded to two specific binding sites with mean dissociation constant values of 0.20 and 60 nM for types 1 and 2, respectively. The second approach was based on the analysis of cytoplasmic and nuclear aldosterone uptake kinetics at 25 and 0 degrees C in intact bladder. Two models (A and B) were studied. They both implied the existence of two types of aldosterone binding sites as precursors of the corresponding chromatin bound complexes. In model A, nuclear translocation of the two types of receptors was assumed to obey first-order kinetics. In model B, the translocation process for type 1 sites involved a time lag leading to delayed binding to chromatin. Both models were found to fit the experimental data satisfactorily. The fit obtained for model B appeared to be better at low aldosterone concentrations.

Aldosterone↗
PubMed1979

A priori lithium dosage regimen using population characteristics of pharmacokinetic parameters.

The important problem of initiation of long-term lithium treatment is tackled by means of the selection of an a priori dosage regimen based on the presumed efficacy of lithium and absence of toxicity. The pharmacokinetics of Li+ ion is represented by a four-compartment open model including the supposed first-order processes for the release of the active compound from the dosage form and its absorption. Experimental protocols for measurements of serum concentrations and of urinary amounts after single and multiple dosing to healthy volunteers were derived with several oral dosage forms. Estimation of the pharmacokinetic parameters for each subject made it possible to validate the model for the various dosage forms. The interindividual variability of these parameters is taken into account by estimating the characteristics of the statistical distribution for the whole population. A dosage regimen is considered optimum when serum concentration profiles at steady state range from the threshold of efficacy (0.8 mmol/liter) to the threshold of toxicity (2.0 mmol/liter). When the number of daily intakes is fixed, the search for the optimum dose for the whole population is effected by minimizing the expected value of the random variable which characterizes the risks of excursion out of the therapeutic range. By this means universal dosages are shown to be unsatisfactory. However, certain dosage regimens individualized with respect to the renal clearance value of lithium and based on two or three daily intakes can give excellent results even when conventional dosage forms are used.

Adolescent↗
PubMed1979

A non-linear mathematical model for the in vivo determination of Kupffer cells number and rate of phagocytosis of radiocolloids in rats.

In order to perform a quantification of the hepatic RES function, a mathematical model of the colloids phagocytosis was constructed and validated in normal and partially hepatectomised rats. The experimental design consisted of the collection of successive blood samples for the measurement of radiocolloids time courses after the injection of different doses of gelatin colloids (0.075--5 mg of gelatin/100 g body wt). The unknown parameters were estimated by method of maximum likelihood using a second order algorithm. A good fit between experimental and simulated data was obtained for a large range of injected doses using a single set of parameters. Comparisons of parameters values between normal and hepatectomised rats were found to be -onsistent with the hepatectomy ratio. This computerised estimation of parameters provides a determination of both the total number of Kupffer cells and the mean time of a complete phagocytosis cycle which cannot be obtained by classical approaches.

Animals↗
PubMedDate not supplied

Pharmacokinetic aspects of the sublingual administration of vincamine.

The sublingual absorption of vincamine used as tracer occurs in two successive absorption steps: true sublingual absorption and absorption in the gastrointestinal tract of the drug dissolved in the saliva and not absorbed through the buccal mucosa. This is confirmed by a pharmacokinetic study and simulation. These two successive absorptions can explain the increase in the amounts of drug absorbed.

Administration, Oral↗
PubMedDate not supplied

Feedback control methods for drug dosage optimisation. Concepts, classification and clinical application.

The concept of feedback control methods for drug dosage optimisation is described from the viewpoint of control theory. The control system consists of 5 parts: (a) patient (the controlled process); (b) response (the measured feedback); (c) model (the mathematical description of the process); (d) adaptor (to update the parameters); and (e) controller (to determine optimum dosing strategy). In addition to the conventional distinction between open-loop and closed-loop control systems, a classification is proposed for dosage optimisation techniques which distinguishes between tight-loop and loose-loop methods depending on whether physician's interaction is absent or included as part of the control step. Unlike engineering problems where the process can usually be controlled by fully automated devices, therapeutic situations often require that the physician be included in the decision-making process to determine the 'optimal' dosing strategy. Tight-loop and loose-loop methods can be further divided into adaptive and non-adaptive, depending on the presence of the adaptor. The main application areas of tight-loop feedback control methods are general anaesthesia, control of blood pressure, and insulin delivery devices. Loose-loop feedback methods have been used for oral anticoagulation and in therapeutic drug monitoring. The methodology, advantages and limitations of the different approaches are reviewed. A general feature common to all application areas could be observed: to perform well under routine clinical conditions, which are characterised by large interpatient variability and sometimes also intrapatient changes, control systems should be adaptive. Apart from application in routine drug treatment, feedback control methods represent an important research tool. They can be applied for the investigation of pathophysiological and pharmacodynamic processes. A most promising application is the evaluation of the relationship between an intermediate response (e.g. drug level), which is often used as feedback for dosage adjustment, and the final therapeutic goal.

Anesthetics↗