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Biomedical subjects

R L Kunka

Publications and source records attributed to R L Kunka.

6 recordsLinked to original sources

Steady-state fluctuation and variability of betaxolol and atenolol plasma levels.

Twenty-four nonsmoking male volunteers took 50 mg atenolol or 10 mg betaxolol orally once a day for 9 days in a two-period, four-sequence, randomized, crossover study. Plasma concentrations reached steady state after day 5. Percent fluctuation in plasma concentration defined as (Cmax-Cmin)/Cavg (% fluctuation 1) was 97% on day 9 for betaxolol and 343% for atenolol; thus atenolol fluctuation was more than threefold that of betaxolol. A 10-fold difference in plasma level fluctuation was observed when fluctuation was defined as (Cmax-Cmin)/Cmin (% fluctuation 2). The intersubject variances for % fluctuation 1 and % fluctuation 2 were 4.1 and 85.5 times greater for atenolol than for betaxolol; these differences were marginally statistically significant for % fluctuation 1 and significant for % fluctuation 2. The intrasubject variabilities for area under the curve and plasma level fluctuations were statistically greater for atenolol than for betaxolol. Atenolol intrasubject variances were 25 and 271 times greater than for betaxolol for % fluctuation 1 and % fluctuation 2, respectively. Thus, betaxolol exhibited less fluctuation in plasma levels with substantially less intersubject and intrasubject variability. These factors would be expected to provide a more consistent therapeutic response and more dependable dosage adjustment.

Adrenergic beta-Antagonists

Pharmacokinetics and tolerance of lomefloxacin after sequentially increasing oral doses.

The pharmacokinetics of five dose levels of lomefloxacin (100, 200, 400, 600, and 800 mg) were examined in a single-dose, double-blind, placebo-controlled study involving 40 subjects. There were eight subjects in each group: five received active drug and three received placebo; each subject was given only one dose. All subjects completed the study, and lomefloxacin was well tolerated at all doses. No drug crystals were noted in the urine at 3 and 6 h after the dose. The mean maximum concentration in serum (Cmax) ranged from 1.11 to 7.46 micrograms/ml for the 100- to 800-mg doses, respectively, and the AUC increased proportionally with the dose. The mean time to Cmax (Tmax) values averaged 64.8 +/- 28.8 min. The elimination half-life and plasma clearance averaged 7.7 +/- 0.52 h and 259 +/- 37 ml/min, respectively. Mean concentrations in urine were highest during the first 4 h after the dose and ranged from 104 to 713 micrograms/ml following the 100- and 800-mg doses, respectively. Concentrations above 20 micrograms/ml in urine were observed in most subjects over 24 h at the three lower doses and averaged over 120 micrograms/ml during the 12- to 24-h interval at the 400-mg dose, thus supporting once-per-day dosing. Excretion rates from urine and the cumulative amount excreted increased in a dose-related fashion. Renal clearance decreased moderately at the higher doses. Thus, lomefloxacin was well tolerated, and dose proportionality was demonstrated by most pharmacokinetic parameters. The 400-mg dose produced concentrations in plasma and urine above the MIC for susceptible pathogens.

4-Quinolones

Umbilical versus peripheral tobramycin administration.

This study evaluated the disposition of tobramycin (T) after umbilical artery catheter (UAC), intravenous (i.v.), and intramuscular administration to a group of 12 premature neonates. Patients varied in gestational age (31-42 weeks) and weight (1.76-3.98 kg). Each neonate received a 2 mg/kg dose of T at 12-h intervals for 2-15 days. Multiple blood samples after the first and last doses of T, as well as daily measurements, were made during the course of therapy. Analysis of drug concentration data revealed a biphasic distribution of T, which required a two-compartment model for description. Mean values for the alpha and beta elimination phases, t1/2 beta, Vc, and Vdss after the first dose of T were 7.604 h-1, 0.087 h-1, 11.18 h, 0.214 L/kg, and 0.645 L/kg, respectively. Average drug clearance (ClT) increased during therapy from 71 to 103 ml/min, associated with an increase in the renal function of patients. Serum concentrations of T were out of the therapeutic range in 50% of study patients. The variability of drug clearance in the neonate requires the measurement of T concentration in order to ensure safe and effective therapy.

Female

Liquid chromatographic determination of propoxyphene and norpropoxyphene in plasma and breast milk.

A sensitive and specific high-performance liquid chromatographic (HPLC) procedure was developed for determination of propoxyphene and norpropoxyphene in plasma and breast milk. The compounds were isolated from the biological specimen by extraction, the organic phase was evaporated to dryness, and the residue was redissolved in mobile phase [acetonitrile: 0.002 M H2SO4 (1:1)]. The resultant solution was then injected into an HPLC system utilizing a C18 reversed-phase analytical column and a variable-wavelength detector set at 205 nm. Under these conditions the method has a sensitivity of 20 ng/mL using 1 mL of plasma or milk. The within-run coefficient of variation for both compounds varied between 6.2 and 8.9% within the concentration range tested. Applicability of the method was demonstrated in a nursing mother who received multiple oral doses of propoxyphene.

Chromatography, High Pressure Liquid

Nonlinear model for acetazolamide.

Intravenous bolus injections of 14C-labeled acetazolamide were made in rabbits. Plasma, urine, and washed red blood cell concentrations were measured, the latter indicating bound drug. AUTOAN and NONLIN were used to fit the plasma data to a linear two-compartment model. However, utilization of the urine and red blood cell data suggested that a nonlinear model was more appropriate. The developed nonlinear system uses a one-compartment model with two tissue-binding parameters. The system simultaneously fits three equations describing drug in the plasma, in the body, and bound to red blood cells, Six parameters were estimated. The initial plasma concentration and the maximum amount bound to tissue protein (minus red blood cell protein) correlated with dose. The dissociation constant from this protein fraction suggested that it is composed mainly of the enzyme, carbonic anhydrase. The dissociation constant for the red blood cell fraction suggested that the drug binds to other protein in addition to carbonic anhydrase. The elimination constants were quite similar, indicating little variation from one animal to another. Utilization of the concepts of site and mechanism of action in this model should be of considerable help in relating drug concentration to pharmacological resonse.

Acetazolamide

Relationship of pharmacokinetics to pharmacological response for acetazolamide.

Acetazolamide concentration values derived from a nonlinear model system were related to two pharmacological responses in the rabbit. Kidney response was measured by monitoring urine flow and sodium elimination. Ocular response was followed using an applanation tonometer. Maximum urine flow and sodium elimination occurring immediately after injection correlated with log dose. Urine flow dropped below control values along with a rise in osmolality, suggesting the involvement of antidiuretic hormone. Sodium elimination was correlated with plasma levels. Urine pH is thought to be involved in reducing accessibility of drug to carbonic anhydrase in the kidney. Maximum ocular response also was correlated with log dose. Ocular response was related to a protein fraction, which is believed to be mainly carbonic anhydrase. However, the duration of ocular response was related to the red blood cell protein fraction. Thus, drug activity could conceivably be regulated by monitoring a tissue that is not the site of action and can be sampled readily.

Acetazolamide