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  • 1
    ISSN: 1432-1041
    Keywords: Congestive heart failure ; Captopril ; sublingual ; pharmacokinetic ; pharmacodynamic
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Objective: The pharmacokinetics and pharmacodynamics of buffered sublingual captopril were assessed in patients with congestive heart failure (CHF). Methods: The study was carried out in a randomised single-blind cross-over fashion (n=6, 4 males and 2 females) and involved two study days, at least 7 days apart. Baseline measurements were carried out for plasma renin activity (PRA), blood pressure (B.P.) and heart rate (H.R.). Captopril (12.5 mg) was administered sublingually with dibasic potassium phosphate which maintained salivary pH at 7, or perorally with 100 ml of water. Further B.P., H.R. measurements and venous blood samples were taken over a 3 hour period post-drug administration. Blood samples were analysed for captopril and PRA levels. Results: tmax after buffered sublingual administration of captopril, which ranged from 40–60 min (median=40 min), was significantly shorter than after peroral administration (range 60–120 min, median=90 min). Cmax was slightly greater after buffered sublingual than after peroral administration with mean values of 108.2 vs. 94.0 ng·ml−1. AUC values were similar after both routes of administration. Systolic and diastolic B.P. vs. time profiles for each administration method were significantly different i.e. sublingual administration produced an earlier reduction in B.P., however, HR did not differ significantly between the two routes. Conclusion: The data indicate that this novel administration method of captopril leads to an increased rate, but an unchanged extent of captopril absorption, suggesting a modest therapeutic advantage with the use of buffered sublingual captopril if a rapid reduction in blood pressure is required.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 54 (1998), S. 609-614 
    ISSN: 1432-1041
    Keywords: Key words Enalapril ; Lisinopril ; Buccal absorption
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Objective: The buccal absorption of captopril does not exhibit the classical pH/partition hypothesis, suggesting that mechanisms other than passive diffusion are involved in its absorption; animal studies have suggested that a peptide carrier-mediated transport system may be responsible for its absorption. The present study evaluated the effects of pH on octanol partitioning, and on the buccal absorption of enalapril and lisinopril, using in vitro techniques and buccal partitioning in human volunteer subjects. Methods: The partitioning of enalapril and lisinopril into n-octanol was examined over the pH range of 3–9 at room temperature. Results: Enalapril exhibited maximal partitioning into the organic phase at pH 4–5; minimal partitioning was recorded at pH values 8 and 9. The partitioning of lisinopril into n-octanol was found to be maximal at pH 9 and minimal at pH 3. Using the buccal absorption technique, the partitioning of enalapril and lisinopril (0.5 mg), was examined in six healthy male volunteers from buffered solutions (pH 3, 4, 5, 6, 7, 8 and 9). In the case of enalapril, lowest buccal partitioning occurred at pH 3, 8 and 9, while maximal partitioning occurred at pH 5; absorption of lisinopril was not extensive at any pH, but was greatest at pH 6. These results, in addition to the n-octanol partition coefficients, indicated that enalapril obeyed the normal lipid partition hypothesis with respect to buccal absorption. The buccal absorption of lisinopril also obeyed the lipid partition hypothesis over the pH range 3–7. These findings are in direct contrast to those for captopril. The buccal partitioning experiments were repeated at the maximal pH for absorption for each angiotensin converting enzyme (ACE) inhibitor, but with the addition of cephradine (0.05 mmol · l−1). Conclusion: The data indicated that the presence of this peptide transport inhibitor had no effect on the buccal absorption of enalapril (0.06 mmol · l−1) and lisinopril (0.057 mmol · l−1), which suggests that both drugs do not share a common buccal absorption pathway with cephradine.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 31 (1987), S. 617-619 
    ISSN: 1432-1041
    Keywords: chronopharmacology ; indomethacin ; suppository ; pharmacokinetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The pharmacokinetics of a single 100 mg indomethacin suppository were studied in 12 healthy volunteers on two occasions at least 7 days apart. Suppositories were administered in randomised order at 9.00 and 21.00 hours to see if there was evidence of a diurnal variation in kinetic parameters. The study failed to show a significant change in single dose kinetics with the time of suppository administration. This is in contrast to previous work [1] demonstrating a circadian rhythm in the kinetics of a single oral dose of indomethacin. This suggests that the chronopharmacokinetics of indomethacin is dependent on the function of the upper gastrointestinal tract.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 40 (1991), S. 393-398 
    ISSN: 1432-1041
    Keywords: Captopril ; sublingual ; pharmacokinetics ; pharmacodynamics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary In this study we compared the pharmacokinetics and pharmacodynamics of captopril after sublingual and peroral administration. Single 25 mg doses of captopril were administered sublingually and perorally on two different occasions in a randomised cross-over fashion to eight healthy volunteers aged 22–35 years. The kinetics of unchanged captopril, plasma renin activity (PRA), BP and heart rate were studied over three hours after both peroral and sublingual administration of captopril. Mean pharmacokinetic parameters for unchanged captopril after sublingual administration were: Cmax, 234 ng·ml−1; tmax, 45 min; AUC (0–3 h), 15.1 μg·ml−1. min. Mean pharmacokinetic parameters for unchanged captopril after peroral administration were: Cmax, 228 ng·ml−1; tmax, 75 min; AUC (0–3 h), 17.0 μg·ml−1. min. tmax was significantly shorter when captopril was administered sublingually; all other pharmacokinetic parameters were equivalent. The plasma captopril concentrations achieved post drug administration led to increases in PRA and reductions in BP. tmax for PRA was 86 min for sublingual captopril and 113 min for perorally administered drug. Peak PRA values were, however, not significantly different. BP, as expected, was not reduced dramatically in these healthy volunteer subjects, however, in systolic BP vs time profiles, BP was significantly lower after volunteers received sublingual captopril. Heart rate increased slightly after captopril administration; there were no differences between the two routes of administration. Administration of captopril sublingually, therefore led to a more rapid attainment of plasma captopril concentrations and had a more rapid onset of pharmacological effect when compared with peroral administration.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1041
    Keywords: Indomethacin ; steady-state ; pharmacokinetics ; elderly
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The steady-state pharmacokinetic profile of indomethacin was examined in twelve healthy volunteers (4 m, 8 f; 20–34 y) and in 12 elderly subjects (7 m, 5 f; 70–88 y). Two formulations of indomethacin were examined, providing duplicate data for each subject group. The subjects received each formulation of indomethacin (25 mg tid) for 6 days in a single blind crossover fashion. On day 7, after an overnight fast, a final 25 mg dose of indomethacin was given and plasma concentrations measured over the following 12 h. Kinetic parameters Cpmin, tmx and AUC (0–12 h) were determined. There were no differences in the pharmacokinetic parameters between young and elderly subjects or between data for the two formulations of indomethacin. AUC values (μg · ml−1 · h), for example, for the two formulations in the young subjects were 5.85 and 6.85 while the values for the elderly subjects were 6.55 and 6.50 respectively. When each treatment period was considered independently there was a significant difference between young and elderly subjects with regard to compliance. The rates of non compliance (over and under compliance) using a capsule count technique were, however, low with a mean maximum value of 5.8% being recorded for the elderly subjects.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 48 (1995), S. 373-379 
    ISSN: 1432-1041
    Keywords: Captopril ; sublingual ; pharmacokinetics ; pharmacodynamics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract The effect of pH on the buccal and sublingual absorption of captopril was evaluated using in vitro techniques and human studies. Partitioning of captopril into n-octanol was lowest over the pH range 5 to 8 and highest at pH values 3, 4 and 9. Using the buccal absorption technique, the partitioning of captopril (2 mg) was examined in six healthy male volunteers from buffered solutions (pH 3, 4, 5, 6, 7, 8, and 9). Lowest buccal partitioning occurred at pH 3 while maximal buccal partitioning occurred at pH 7. These data clearly indicated that the buccal absorption of captopril did not obey the classical pH/partition hypothesis suggesting that mechanisms other than passive diffusion were involved in its absorption. Captopril pharmacokinetic and pharmacodynamic parameters were determined after administration of buffered sublingual captopril (pH 7, optimal pH for absorption as determined from the buccal partitioning data) and unbuffered sublingual captopril. The study was performed in eight healthy volunteers in a randomised single-blind cross-over fashion. The tmax for captopril was found to be approximately 11 minutes earlier after buffered versus unbuffered sublingual administration and AUC0–30 min increased by approximately 30% in the case of buffered captopril. Cpmax, AUC0–180 min and relative bioavailability did not differ between the buffered and unbuffered administration. Pharmacodynamic parameters (BP, heart rate and plasma renin activity) did not differ significantly between buffered and unbuffered sublingual administration. The increased rate of captopril absorption after buffered sublingual administration was small and is likely to offer little therapeutic advantage over conventional sublingual formulation.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-1041
    Keywords: Key words Congestive heart failure ; Captopril; sublingual ; pharmacokinetic ; pharmacodynamic
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract Objective: The pharmacokinetics and pharmacodynamics of buffered sublingual captopril were assessed in patients with congestive heart failure (CHF). Methods: The study was carried out in a randomised single-blind cross-over fashion (n = 6, 4 males and 2 females) and involved two study days , at least 7 days apart. Baseline measurements were carried out for plasma renin activity (PRA), blood pressure (B.P.) and heart rate (H.R.). Captopril (12.5 mg) was administered sublingually with dibasic potassium phosphate which maintained salivary pH at 7, or perorally with 100 ml of water. Further B.P., H.R. measurements and venous blood samples were taken over a 3 hour period post-drug administration. Blood samples were analysed for captopril and PRA levels. Results: tmax after buffered sublingual administration of captopril, which ranged from 40–60 min (median = 40  min), was significantly shorter than after peroral administration (range 60–120 min, median = 90 min). Cmax was slightly greater after buffered sublingual than after peroral administration with mean values of 108.2 vs. 94.0 ng ⋅ml−1. AUC values were similar after both routes of administration. Systolic and diastolic B.P. vs. time profiles for each administration method were significantly different i.e. sublingual administration produced an earlier reduction in B.P., however, HR did not differ significantly between the two routes. Conclusion: The data indicate that this novel administration method of captopril leads to an increased rate, but an unchanged extent of captopril absorption, suggesting a modest therapeutic advantage with the use of buffered sublingual captopril if a rapid reduction in blood pressure is required.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Oxford, UK : Carfax Publishing, part of the Taylor & Francis Group
    Addiction 96 (2001), S. 0 
    ISSN: 1360-0443
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine , Psychology
    Notes: Aims. To evaluate whether a structured community pharmacy-based smoking cessation programme (the PAS model) would give rise to a higher smoking cessation rate compared with ad hoc advice from pharmacists. Design. A randomized controlled trial comparing a structured intervention with usual care. Setting. One hundred pharmacists working in community pharmacies in N. Ireland and 24 in London took part in the study and were each asked to enroll 12 smokers; 44% of pharmacists who were trained managed to recruit one or more smokers during the recruitment period of approximately 1 year. Participants. A total of 484 smokers were enrolled by the pharmacists and individually randomized into the PAS intervention group (N = 265) or the control group (N = 219). Intervention. The PAS intervention involved a structured counselling programme, an information leaflet and a follow-up weekly for the first 4 weeks then monthly as needed. Measurements. The primary outcome measure of this study was self-reported smoking cessation for 12 months with cotinine validation at the 12-month follow-up. Findings. Of smokers in the PAS group, 14.3% (38) were abstinent up to 12 months compared with 2.7% (6) in the control group (p 〈 0.001 for the difference). Conclusion. The community pharmacy-based PAS smoking cessation service can be an effective method of helping people stop smoking when delivered by pharmacists willing to adopt this approach.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Cancer chemotherapy and pharmacology 17 (1986), S. 95-98 
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The uptake of melphalan into tumour cells has been shown previously to involve active transport, while that of chlorambucil is by passive diffusion. In view of these findings, the mechanism of their gastrointestinal absorption was investigated using the in situ rat intestinal model. Segment lengths in all cases were (mean±SD) 47.2±4.7 cm. Drug absorption was monitored from control intestinal segments and from segments pretreated with the metabolic inhibitors 2,4 dinitrophenol (DNP) or carbonylcyanide-M-chlorophenyl-hydrazone (CCCP). Aliquots of gut-perfusing solution were removed at 5-min intervals over 30 min and assayed for drug using a high-performance liquid chromatography (HPLC) method selective for the alkylating agents. Absorption of melphalan by control animals was (mean±SD) 1.22%±0.25% cm-1 gut length, as against 0.59%±0.13% cm-1 in DNP- and 0.45%±0.07% cm-1 in CCCP-treated animals. Absorption of chlorambucil was 1.47%±0.17% cm-1 (control), 1.49%±0.06 cm-1 (DNP), and 1.58%±0.23% cm-1 (CCCP). It was clear, therefore, that pretreatment of intestinal segments with metabolic inhibitors led to a reduced absorption of melphalan (P〈0.01) but did not influence that of chlorambucil. The experimental data suggest that melphalan uptake from the intestine involves and energy-dependent system whereas chlorambucil is passively absorbed.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Cancer chemotherapy and pharmacology 19 (1987), S. 343-346 
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Previous studies have demonstrated that the biovailability of melphalan and chlorambucil may be reduced under non-fasting conditions, and that the gastrointestinal and cellular absorption of melphalan is an active process, while that of chlorambucil is passive. In view of these findings, the effect of dietary amino acids on the gastrointestinal a absorption of these two drugs was investigated using the in situ rat intestine model. The segment lengths used in the study were (mean ±SD) 47.1±3.8 cm. Experimentation was carried out in a randomised fashion and involved monitoring the absorption of drug from control intestinal segments and from segments perfused with L-glycine (1 and 10 mM) and L-leucine (1 and 10 mM). For chlorambucil, absorption was carried out from segments perfused with the 10 mM concentration of amino acids only. Aliquots of gut-perfusing solution were removed at 5-min intervals over 30 min and assayed for drug content using a high-performance liquid chromatography (HPLC) method which was selective for each agent. Values recorded for the absorption of melphalan were (mean±SD percentage absorption per centimetre segment length over a 30-min period) 1.11%±0.07% cm-1 (control); 1.18%±0.20% cm-1 (1 mM L-glycine); 0.99%±0.27% cm-1 (1 mM L-leucine); 0.80%±0.25% cm-1 (10 mM L-glycine); and 0.60%±0.23% cm-1 (10 mM L-leucine). Chlorambucil absorption from control animals was 1.77%±0.11% cm-1 gut length, as against 1.77%±0.08% cm-1 in 10 mM L-glycine and 1.69%±0.16% cm-1 in 10 mM-L-leucine-perfused segments. The only statistically significant observation was a reduction in melphalan absorption from perfusate containing 10 mM leucine (P〈0.005). The experimental data suggest that competitive inhibition by amino acids may be one of the mechanisms involved in the observed reduction in melphalan bioavailability under non-fasting conditions, but that it has no effect on chlorambucil absorption.
    Type of Medium: Electronic Resource
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