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Geers LM, Loonen AJM, Touw DJ. Microsampling Techniques Suitable for Therapeutic Drug Monitoring of Antipsychotics. J Clin Psychopharmacol 2024; 44:302-310. [PMID: 38639427 DOI: 10.1097/jcp.0000000000001855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
BACKGROUND Therapeutic drug monitoring (TDM) of antipsychotics for dose titration or detection of noncompliance is not uncommon in daily practice. Normally, TDM implies measuring a drug concentration in venous blood samples. This technique is invasive and requires trained assistants and patients normally need to go to an outpatient clinic. Over the past decades, sensitivity of analytical equipment has improved leading to a growing interest in microsampling techniques. These techniques are minimally invasive, require a small volume (<100 μL), usually result in stable samples, and can be collected by the patient or a caregiver at home. Before a microsampling technique can be used in daily routine, proper method development and a clinical validation study should be performed. METHOD For this review, the databases of PubMed and Embase were systematically searched. Currently available microsampling techniques for antipsychotics in blood, serum, or plasma are summarized. Subsequently, it has also been assessed whether these techniques are sufficiently validated for TDM monitoring in daily practice. RESULTS Several microsampling techniques are available today, for example, dried blood spot sampling, dried plasma extraction cards, and volumetric absorptive microsampling. Eighteen studies were identified in which a microsampling technique for 1 or a few antipsychotics was chemically analytically and clinically validated. However, the majority of these studies have relevant shortcomings that mean its usefulness for different antipsychotics is not yet well established. CONCLUSIONS Microsampling for TDM can be recommended for patients using clozapine. For TDM of other antipsychotics, it is a very promising development.
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Affiliation(s)
| | - Anton J M Loonen
- University of Groningen, Groningen Research Institute of Pharmacy, Pharmacotherapy, -Epidemiology & -Economics
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2
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Fang Z, Zhang H, Guo J, Guo J. Overview of therapeutic drug monitoring and clinical practice. Talanta 2024; 266:124996. [PMID: 37562225 DOI: 10.1016/j.talanta.2023.124996] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/29/2023] [Accepted: 07/25/2023] [Indexed: 08/12/2023]
Abstract
With the rapid development of clinical pharmacy in China, therapeutic drug monitoring (TDM) has become an essential tool for guiding rational clinical drug use and is widely concerned. TDM is a tool that combines pharmacokinetic and pharmacodynamic knowledge to optimize personalized drug therapy, which can improve treatment outcomes, reduce drug-drug toxicity, and avoid the risk of developing drug resistance. To effectively implement TDM, accurate and sophisticated analytical methods are required. By researching the literature published in recent years, we summarize the types of commonly monitored drugs, therapeutic windows, and clinical assays and track the trends and hot spots of therapeutic drug monitoring. The purpose is to provide guidelines for clinical blood drug concentration monitoring, to implement individualized drug delivery programs better, to ensure the rational use of drugs for patients, and to provide a reference for the group to carry out related topics in the future.
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Affiliation(s)
- Zijun Fang
- University of Southwest Petroleum University, College of Mechanical and Electrical Engineering, Chengdu, China
| | - He Zhang
- University of Southwest Petroleum University, College of Mechanical and Electrical Engineering, Chengdu, China
| | - Jiuchuan Guo
- University of Electronic Science and Technology of China, Chengdu, China.
| | - Jinhong Guo
- School of Sensing Science and Engineering, Shanghai Jiao Tong University, Shanghai, China.
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Zailani NNB, Ho PCL. Dried Blood Spots-A Platform for Therapeutic Drug Monitoring (TDM) and Drug/Disease Response Monitoring (DRM). Eur J Drug Metab Pharmacokinet 2023; 48:467-494. [PMID: 37495930 PMCID: PMC10480258 DOI: 10.1007/s13318-023-00846-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2023] [Indexed: 07/28/2023]
Abstract
This review provides an overview on the current applications of dried blood spots (DBS) as matrices for therapeutic drug (TDM) and drug or disease response monitoring (DRM). Compared with conventional methods using plasma/serum, DBS offers several advantages, including minimally invasiveness, a small blood volume requirement, reduced biohazardous risk, and improved sample stability. Numerous assays utilising DBS for TDM have been reported in the literature over the past decade, covering a wide range of therapeutic drugs. Several factors can affect the accuracy and reliability of the DBS sampling method, including haematocrit (HCT), blood volume, sampling paper and chromatographic effects. It is crucial to evaluate the correlation between DBS concentrations and conventional plasma/serum concentrations, as the latter has traditionally been used for clinical decision. The feasibility of using DBS sampling method as an option for home-based TDM is also discussed. Furthermore, DBS has also been used as a matrix for monitoring the drug or disease responses (DRM) through various approaches such as genotyping, viral load measurement, assessment of inflammatory factors, and more recently, metabolic profiling. Although this research is still in the development stage, advancements in technology are expected to lead to the identification of surrogate biomarkers for drug treatment in DBS and a better understanding of the correlation between DBS drug levels and drug responses. This will make DBS a valuable matrix for TDM and DRM, facilitating the achievement of pharmacokinetic and pharmacodynamic correlations and enabling personalised therapy.
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Affiliation(s)
- Nur Nabihah Binte Zailani
- Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Paul Chi-Lui Ho
- Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore, 117543, Singapore.
- School of Pharmacy, Monash University Malaysia, Level 5, Building 2, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia.
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Müller IR, Linden G, Charão MF, Antunes MV, Linden R. Dried blood spot sampling for therapeutic drug monitoring: challenges and opportunities. Expert Rev Clin Pharmacol 2023; 16:691-701. [PMID: 37300458 DOI: 10.1080/17512433.2023.2224562] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/08/2023] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The use of dried blood spots (DBS) has gained interest in the field of therapeutic drug monitoring (TDM) due to its potential advantages, such as minimally invasive capillary blood collection, potential stabilization of drugs and metabolites at room or high temperatures, and lower biohazard, allowing for inexpensive storage and transportation. However, there are several drawbacks to the clinical use of DBS in TDM, mostly related to hematocrit (Hct) effects, differences between venous and capillary blood concentrations, among others, that must be evaluated during analytical and clinical method validation. AREA COVERED This review focuses on the most recent publications on the applications of DBS sampling for TDM (2016-2022), with a special focus on the challenges presented by this alternative sampling strategy, as well as the opportunities for clinical applications. Real-life studies presenting clinical applications were reviewed. EXPERT OPINION With the availability of method development and validation guidelines for DBS-based methods in TDM, higher levels of assay validation standardization have been achieved, expanding the clinical applications of DBS sampling in patient care. New sampling devices that overcome the limitations of classical DBS, such as the Hct effects, will further encourage the use of DBS in routine TDM.
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Affiliation(s)
| | - Gabriel Linden
- Laboratory of Analytical Toxicology, Universidade Feevale, Novo Hamburgo, Brazil
| | | | | | - Rafael Linden
- Laboratory of Analytical Toxicology, Universidade Feevale, Novo Hamburgo, Brazil
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Xiaoyong X, Xilin G, Guangfei W, Wei W, Xiaowen Z, Hong X, Huimin Z, Zhiping L. Reliability and feasibility of home-based dried blood spot in therapeutic drug monitoring: a systematic review and meta-analysis. Eur J Clin Pharmacol 2023; 79:183-193. [PMID: 36469108 DOI: 10.1007/s00228-022-03417-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/05/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE Dried blood spot (DBS) is one of promising home sampling methods for therapeutic drug monitoring (TDM). However, the associated reliability and feasibility (including yield, adherence, and preference), which are criteria for the promotion of home-based DBS, remain unknown. This systematic review and meta-analysis aimed to evaluate the reliability and feasibility of TDM using DBS sampling. METHODS In this study, a combination of MeSH and free terms for (dried blood spot*[title/abstract])AND ("Drug Monitoring"[Mesh])AND(home OR venous)was surveyed using EMBASE, PubMed, Cochrane Library, and Web of Science upon gathering published. we registered this study protocol with the International Prospective Registry of Systematic Reviews (CRD42021247559). RESULTS Approximately half (35/75) of the evaluations reported good agreement between DBS and plasma, and the results for drugs with poor agreement may be improved using a haematocrit-based physiological equation. The yield and adherence to home-based DBS exceeded 87%, and questionnaire-based preference for DBS was 77%. CONCLUSIONS DBS may be a reliable and feasible home sampling method; however, it requires intricate design and evaluation before implementation.
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Affiliation(s)
- Xu Xiaoyong
- Department of Clinical Pharmacy, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Shanghai, 201102, China
| | - Ge Xilin
- Department of Clinical Pharmacy, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Shanghai, 201102, China
| | - Wang Guangfei
- Department of Clinical Pharmacy, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Shanghai, 201102, China
| | - Wu Wei
- Department of Clinical Pharmacy, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Shanghai, 201102, China
| | - Zhai Xiaowen
- Department of Hematology and Oncology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, China
| | - Xu Hong
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, 201102, China
| | - Zhang Huimin
- Department of Pharmaceutics, China Pharmaceutical University, Nanjing, 210009, People's Republic of China
| | - Li Zhiping
- Department of Clinical Pharmacy, Children's Hospital of Fudan University, National Children's Medical Center, No. 399 Wanyuan Road, Shanghai, 201102, China.
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Abdallah NA. Application of Titanium Oxide Decorated Multi‐walled Carbon Nanotubes/Polyaniline as a Transducer Polymer for the Potentiometric Determination of Mirtazapine. ChemistrySelect 2022. [DOI: 10.1002/slct.202202985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Nehad A. Abdallah
- Pharmacognosy and Pharmaceutical Chemistry Department College of Pharmacy Taibah University Al-Madinah Al Mounawarah 30078 Saudi Arabia
- Experiments and Advanced Pharmaceutical Research Unit Faculty of Pharmacy Ain Shams University Cairo 11566 Egypt
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Ates HC, Mohsenin H, Wenzel C, Glatz RT, Wagner HJ, Bruch R, Hoefflin N, Spassov S, Streicher L, Lozano-Zahonero S, Flamm B, Trittler R, Hug MJ, Köhn M, Schmidt J, Schumann S, Urban GA, Weber W, Dincer C. Biosensor-Enabled Multiplexed On-Site Therapeutic Drug Monitoring of Antibiotics. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022; 34:e2104555. [PMID: 34545651 DOI: 10.1002/adma.202104555] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/31/2021] [Indexed: 05/20/2023]
Abstract
Personalized antibiotherapy ensures that the antibiotic concentration remains in the optimal therapeutic window to maximize efficacy, minimize side effects, and avoid the emergence of drug resistance due to insufficient dosing. However, such individualized schemes need frequent sampling to tailor the blood antibiotic concentrations. To optimally integrate therapeutic drug monitoring (TDM) into the clinical workflow, antibiotic levels can either be measured in blood using point-of-care testing (POCT), or can rely on noninvasive sampling. Here, a versatile biosensor with an antibody-free assay for on-site TDM is presented. The platform is evaluated with an animal study, where antibiotic concentrations are quantified in different matrices including whole blood, plasma, urine, saliva, and exhaled breath condensate (EBC). The clearance and the temporal evaluation of antibiotic levels in EBC and plasma are demonstrated. Influence of matrix effects on measured drug concentrations is determined by comparing the plasma levels with those in noninvasive samples. The system's potential for blood-based POCT is further illustrated by tracking ß-lactam concentrations in untreated blood samples. Finally, multiplexing capabilities are explored successfully for multianalyte/sample analysis. By enabling a rapid, low-cost, sample-independent, and multiplexed on-site TDM, this system can shift the paradigm of "one-size-fits-all" strategy.
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Affiliation(s)
- H Ceren Ates
- FIT Freiburg Center for Interactive Materials and Bioinspired Technologies, University of Freiburg, Georges-Koehler-Allee 105, 79110, Freiburg, Germany
- Department of Microsystems Engineering (IMTEK), Laboratory for Sensors, University of Freiburg, Georges-Koehler-Allee 103, 79110, Freiburg, Germany
| | - Hasti Mohsenin
- Faculty of Biology and Signalling Research Centres BIOSS and CIBSS, University of Freiburg, Schaenzlestrasse 18, 79104, Freiburg, Germany
| | - Christin Wenzel
- Department of Anesthesiology and Critical Care, Faculty of Medicine, Medical Center - University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Regina T Glatz
- FIT Freiburg Center for Interactive Materials and Bioinspired Technologies, University of Freiburg, Georges-Koehler-Allee 105, 79110, Freiburg, Germany
- Department of Microsystems Engineering (IMTEK), Laboratory for Sensors, University of Freiburg, Georges-Koehler-Allee 103, 79110, Freiburg, Germany
| | - Hanna J Wagner
- Faculty of Biology and Signalling Research Centres BIOSS and CIBSS, University of Freiburg, Schaenzlestrasse 18, 79104, Freiburg, Germany
- Department of Biosystems Science and Engineering, ETH Zurich, Mattenstrasse 26, Basel, 4058, Switzerland
| | - Richard Bruch
- FIT Freiburg Center for Interactive Materials and Bioinspired Technologies, University of Freiburg, Georges-Koehler-Allee 105, 79110, Freiburg, Germany
- Department of Microsystems Engineering (IMTEK), Laboratory for Sensors, University of Freiburg, Georges-Koehler-Allee 103, 79110, Freiburg, Germany
| | - Nico Hoefflin
- Faculty of Biology and Signalling Research Centres BIOSS and CIBSS, University of Freiburg, Schaenzlestrasse 18, 79104, Freiburg, Germany
| | - Sashko Spassov
- Department of Anesthesiology and Critical Care, Faculty of Medicine, Medical Center - University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Lea Streicher
- Department of Anesthesiology and Critical Care, Faculty of Medicine, Medical Center - University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Sara Lozano-Zahonero
- Department of Anesthesiology and Critical Care, Faculty of Medicine, Medical Center - University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Bernd Flamm
- Department of Anesthesiology and Critical Care, Faculty of Medicine, Medical Center - University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Rainer Trittler
- Department of Pharmacy, Medical Center - University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - Martin J Hug
- Department of Pharmacy, Medical Center - University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - Maja Köhn
- Faculty of Biology and Signalling Research Centres BIOSS and CIBSS, University of Freiburg, Schaenzlestrasse 18, 79104, Freiburg, Germany
| | - Johannes Schmidt
- Department of Anesthesiology and Critical Care, Faculty of Medicine, Medical Center - University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Stefan Schumann
- Department of Anesthesiology and Critical Care, Faculty of Medicine, Medical Center - University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Gerald A Urban
- Department of Microsystems Engineering (IMTEK), Laboratory for Sensors, University of Freiburg, Georges-Koehler-Allee 103, 79110, Freiburg, Germany
- Freiburg Materials Research Center (FMF), University of Freiburg, Stefan-Meier-Straße 21, 79104, Freiburg, Germany
| | - Wilfried Weber
- Faculty of Biology and Signalling Research Centres BIOSS and CIBSS, University of Freiburg, Schaenzlestrasse 18, 79104, Freiburg, Germany
| | - Can Dincer
- FIT Freiburg Center for Interactive Materials and Bioinspired Technologies, University of Freiburg, Georges-Koehler-Allee 105, 79110, Freiburg, Germany
- Department of Microsystems Engineering (IMTEK), Laboratory for Sensors, University of Freiburg, Georges-Koehler-Allee 103, 79110, Freiburg, Germany
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Rajadhyaksha M, Londhe V. Microsampling: A role to play in Covid-19 diagnosis, surveillance, treatment and clinical trials. Drug Test Anal 2021; 13:1238-1248. [PMID: 34089576 DOI: 10.1002/dta.3107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/29/2021] [Accepted: 06/01/2021] [Indexed: 12/13/2022]
Abstract
The outbreak of the new coronavirus disease changed the world upside down. Every day, millions of people were subjected to diagnostic testing for Covid-19, all over the world. Molecular tests helped in the diagnosis of current infection by detecting the presence of viral genome whereas serological tests helped in detecting the presence of antibody in blood as well as contributed to vaccine development. This testing helped in understanding the immunogenicity, community prevalence, geographical spread and conditions post-infection. However, with the contagious nature of the virus, biological specimen sampling involved the risk of transmission and spread of infection. Clinic or pathology visit was the most concerning part. Trained personnel and resources was another barrier. In this scenario, microsampling played an important role due to its most important advantage of remote, contactless, small volume and self-sampling. Minimum requirements for sample storage and ease of shipment added value in this situation. The highly sensitive instruments and validated assay formats assured the accuracy of results and stability of samples. Microsampling techniques are contributing effectively to the Covid-19 pandemic by reducing the demand for clinical staff in population-level testing. The validated and established applications supported the use of microsampling in diagnosis, therapeutic drug monitoring, development of treatment or vaccines and clinical trials for Covid-19.
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Affiliation(s)
- Madhura Rajadhyaksha
- SPPSPTM, SVKM's Narsee Monjee Institute of Management Studies, Mumbai, India.,Sitec Labs. Ltd., Navi Mumbai, India
| | - Vaishali Londhe
- SPPSPTM, SVKM's Narsee Monjee Institute of Management Studies, Mumbai, India
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Möller I, Held K, Klimpel D, Nadulski T, Dufaux B. Development and validation of an LC-MS/MS method for relevant drugs in epilepsy patients using dried blood spots. Biomed Chromatogr 2021; 35:e5130. [PMID: 33780026 DOI: 10.1002/bmc.5130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/23/2021] [Accepted: 03/05/2021] [Indexed: 11/07/2022]
Abstract
Epilepsy is one of the most common diseases of the central nervous system globally. To ensure the correct dosage of antiepileptic treatment, it is helpful to check the blood levels of the administered substances regularly. The analysis of the capillary dried blood samples provides a promising and less-invasive alternative to venous blood collection. Therefore, the aim of the present study was to develop an LC-MS method for the quantification of 22 commonly used drugs in patients with an epileptic syndrome and 5 drug metabolites in one dried blood spot (DBS). The calibration ranges were selected in such a way that the therapeutic reference ranges in serum for the respective substances were completely covered. The analytical validation was successfully performed according to relevant guidelines with a consideration of requirements for DBS analysis. Proof of concept of the developed method was obtained by the analysis of DBSs from 282 authentic leftover ethylenediaminetetraacetic acid blood samples, which were compared with the corresponding serum concentrations. Altogether, the results show a dependency on the blood/plasma (b/p) ratios of the respective analytes so that for drugs with b/p ratios close to one, for example, lacosamide, levetiracetam, brivaracetam, and sertraline, a good accordance was observed.
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Affiliation(s)
- Ines Möller
- Division of Forensic and Clinical Chemistry, MVZ Labor Krone GbR, Bad Salzuflen, Germany
| | - Kathrin Held
- Division of Forensic and Clinical Chemistry, MVZ Labor Krone GbR, Bad Salzuflen, Germany
| | - Dennis Klimpel
- Division of Forensic and Clinical Chemistry, MVZ Labor Krone GbR, Bad Salzuflen, Germany
| | - Thomas Nadulski
- Division of Forensic and Clinical Chemistry, MVZ Labor Krone GbR, Bad Salzuflen, Germany
| | - Bertin Dufaux
- Division of Forensic and Clinical Chemistry, MVZ Labor Krone GbR, Bad Salzuflen, Germany
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A review of recent advances in microsampling techniques of biological fluids for therapeutic drug monitoring. J Chromatogr A 2020; 1635:461731. [PMID: 33285415 DOI: 10.1016/j.chroma.2020.461731] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/09/2020] [Accepted: 11/12/2020] [Indexed: 12/12/2022]
Abstract
Conventional sampling of biological fluids often involves a bulk quantity of samples that are tedious to collect, deliver and process. Miniaturized sampling approaches have emerged as promising tools for sample collection due to numerous advantages such as minute sample size, patient friendliness and ease of shipment. This article reviews the applications and advances of microsampling techniques in therapeutic drug monitoring (TDM), covering the period January 2015 - August 2020. As whole blood is the gold standard sampling matrix for TDM, this article comprehensively highlights the most historical microsampling technique, the dried blood spot (DBS), and its development. Advanced developments of DBS, ranging from various automation DBS, paper spray mass spectrometry (PS-MS), 3D dried blood spheroids and volumetric absorptive paper disc (VAPD) and mini-disc (VAPDmini) are discussed. The volumetric absorptive microsampling (VAMS) approach, which overcomes the hematocrit effect associated with the DBS sample, has been employed in recent TDM. The sample collection and sample preparation details in DBS and VAMS are outlined and summarized. This review also delineates the involvement of other biological fluids (plasma, urine, breast milk and saliva) and their miniaturized dried matrix forms in TDM. Specific features and challenges of each microsampling technique are identified and comparison studies are reviewed.
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Technological advancement in dry blood matrix microsampling and its clinical relevance in quantitative drug analysis. Bioanalysis 2020; 12:1483-1501. [DOI: 10.4155/bio-2020-0211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
In the past few decades, dried blood matrix biosampling has witnessed a marvelous interest among the researcher due to its user-friendly operation during blood sampling in preclinical and clinical applications. It also complies with the basic 3Rs (reduce, reuse and recycle) philosophy. Because of comparative simplicity, a huge number of researchers are paying attention to its technological advancements for widespread application in the bioanalysis and diagnosis arena. In this review, we have explained different approaches to be considered during dried blood matrix based microsampling including their clinical relevance in therapeutic drug monitoring. We have also discussed various strategies for avoiding and minimizing major unwanted analytical interferences associated with this technique during drug quantification. Further, various recent technological advancement in microsampling devices has been discussed correlating their clinical applications.
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Tuzimski T, Petruczynik A. Review of Chromatographic Methods Coupled with Modern Detection Techniques Applied in the Therapeutic Drugs Monitoring (TDM). Molecules 2020; 25:E4026. [PMID: 32899296 PMCID: PMC7504794 DOI: 10.3390/molecules25174026] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 08/29/2020] [Accepted: 08/30/2020] [Indexed: 12/15/2022] Open
Abstract
Therapeutic drug monitoring (TDM) is a tool used to integrate pharmacokinetic and pharmacodynamics knowledge to optimize and personalize various drug therapies. The optimization of drug dosing may improve treatment outcomes, reduce toxicity, and reduce the risk of developing drug resistance. To adequately implement TDM, accurate and precise analytical procedures are required. In clinical practice, blood is the most commonly used matrix for TDM; however, less invasive samples, such as dried blood spots or non-invasive saliva samples, are increasingly being used. The choice of sample preparation method, type of column packing, mobile phase composition, and detection method is important to ensure accurate drug measurement and to avoid interference from matrix effects and drug metabolites. Most of the reported procedures used liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) techniques due to its high selectivity and sensitivity. High-performance chromatography with ultraviolet detection (HPLC-UV) methods are also used when a simpler and more cost-effective methodology is desired for clinical monitoring. The application of high-performance chromatography with fluorescence detection (HPLC-FLD) with and without derivatization processes and high-performance chromatography with electrochemical detection (HPLC-ED) techniques for the analysis of various drugs in biological samples for TDM have been described less often. Before chromatographic analysis, samples were pretreated by various procedures-most often by protein precipitation, liquid-liquid extraction, and solid-phase extraction, rarely by microextraction by packed sorbent, dispersive liquid-liquid microextraction. The aim of this article is to review the recent literature (2010-2020) regarding the use of liquid chromatography with various detection techniques for TDM.
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Affiliation(s)
- Tomasz Tuzimski
- Department of Physical Chemistry, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland
| | - Anna Petruczynik
- Department of Inorganic Chemistry, Medical University of Lublin, Chodźki 4a, 20-093 Lublin, Poland
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Validation and clinical application of a volumetric absorptive microsampling method for 14 psychiatric drugs. Bioanalysis 2020; 12:1129-1147. [DOI: 10.4155/bio-2020-0136] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Aim: Volumetric absorptive microsampling offers a hematocrit insensitive way for microsampling. The aim of this study was to develop a method for routine healthcare for 14 antidepressants, antipsychotics and their active metabolites on a single-quadrupole HPLC–MS. A clinical validation study to determine conversion factors from capillary blood to plasma concentration was conducted afterward. Results: The method was validated according to current guidelines except for one substance. Five substances were measured in 49 patient samples and conversion factors could be derived with Passing–Bablok and Bland–Altman analysis. Conclusion: A reliable extraction and analysis method for commonly used antidepressants and antipsychotics was developed and validated. The method with the obtained conversion factors can now be used in routine healthcare.
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Fan X, Li J, Wu S, Jiang J, Wang J, Wang S, Lou Y, Fan G. Field-amplified sample injection in capillary zone electrophoresis for the pharmacokinetic research of trace risperidone and its major metabolite 9-hydroxyrisperidone in beagle dogs. J Sep Sci 2020; 43:3555-3564. [PMID: 32573947 DOI: 10.1002/jssc.202000252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/17/2020] [Accepted: 06/17/2020] [Indexed: 11/07/2022]
Abstract
This article describes a method for the simultaneous quantitation of risperidone and its major metabolite, 9-hydroxyrisperidone, in beagle dog plasma by field-amplified sample injection in capillary zone electrophoresis. The separation was carried out at 25°C in a 48 cm × 75 µm fused-silica capillary with an applied voltage of 20 kV using 60 mM NaH2 PO4 buffer (pH 3.6). The detection wavelength was 280 nm. Clean-up and preconcentration of plasma samples were conducted by 96-well formatted liquid-liquid extraction. In this study, this stacking technique provided a sensitivity enhancement of approximately 158 to 188 fold compared with the same sample without stacking. The method was suitably validated with respect to stability, specificity, linearity, lower limit of quantitation, accuracy, precision, and extraction recovery. Calibration curves exhibited good linearity (r2 > 0.995) over a wide concentration range of 2.5 to 200 ng/mL for both risperidone and 9-hydroxyrisperidone. The intra- and interday precisions at the three quality control levels were less than 11.40%. The intra- and interday accuracies ranged from 87.90 to 107.17% for risperidone and from 88.43 to 105.92% for 9-hydroxyrisperidone. All validation data were within the required limits. In conclusion, the method developed was successfully applied to pharmacokinetic studies of risperidone and 9-hydroxyrisperidone in beagle dogs.
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Affiliation(s)
- Xianyu Fan
- Department of Clinical Pharmacy, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China
| | - Ji Li
- Department of Clinical Pharmacy, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China.,School of Pharmaceutical Sciences and Yunnan Key Laboratory of Pharmacology for Natural Products, Kunming Medical University, Kunming, P. R. China
| | - Shengyuan Wu
- Laboratory of Drug Metabolism & Pharmacokinetics, School of Medicine, Tongji University, Shanghai, P. R. China
| | - Jingjing Jiang
- Department of Pharmacy, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, P. R. China
| | - Jiajing Wang
- Shanghai Center for Drug Evaluation and Inspection, Shanghai, P. R. China
| | - Shuowen Wang
- Department of Clinical Pharmacy, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China
| | - Yuefen Lou
- Department of Pharmacy, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, P. R. China
| | - Guorong Fan
- Department of Clinical Pharmacy, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China.,Laboratory of Drug Metabolism & Pharmacokinetics, School of Medicine, Tongji University, Shanghai, P. R. China.,Shanghai Key Laboratory for Pharmaceutical Metabolite Research, Shanghai, P. R. China
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15
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Ates HC, Roberts JA, Lipman J, Cass AEG, Urban GA, Dincer C. On-Site Therapeutic Drug Monitoring. Trends Biotechnol 2020; 38:1262-1277. [PMID: 33058758 DOI: 10.1016/j.tibtech.2020.03.001] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/02/2020] [Accepted: 03/03/2020] [Indexed: 12/13/2022]
Abstract
Recent technological advances have stimulated efforts to bring personalized medicine into practice. Yet, traditional application fields like therapeutic drug monitoring (TDM) have remained rather under-appreciated. Owing to clear dose-response relationships, TDM could improve patient outcomes and reduce healthcare costs. While chromatography-based routine practices are restricted due to high costs and turnaround times, biosensors overcome these limitations by offering on-site analysis. Nevertheless, sensor-based approaches have yet to break through for clinical TDM applications, due to the gap between scientific and clinical communities. We provide a critical overview of current TDM practices, followed by a TDM guideline to establish a common ground across disciplines. Finally, we discuss how the translation of sensor systems for TDM can be facilitated, by highlighting the challenges and opportunities.
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Affiliation(s)
- H Ceren Ates
- Freiburg Centre for Interactive Materials and Bioinspired Technologies - FIT, University of Freiburg, 79110 Freiburg, Germany; Department of Microsystems Engineering - IMTEK, Laboratory for Sensors, University of Freiburg, 79110 Freiburg, Germany
| | - Jason A Roberts
- Centre of Clinical Research, Faculty of Medicine, The University of Queensland, 4072, Brisbane, Queensland, Australia; Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, 4029, Brisbane, Queensland, Australia; Department of Pharmacy, Royal Brisbane and Women's Hospital, 4029, Brisbane, Queensland, Australia; Centre for Translational Anti-infective Pharmacodynamics, School of Pharmacy, The University of Queensland, 4102, Brisbane, Queensland, Australia; Division of Anaesthesiology Critical Care Emergency and Pain Medicine, University of Montpellier, Nîmes University Hospital, 34090, Nîmes, France
| | - Jeffrey Lipman
- Centre of Clinical Research, Faculty of Medicine, The University of Queensland, 4072, Brisbane, Queensland, Australia; Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, 4029, Brisbane, Queensland, Australia; Division of Anaesthesiology Critical Care Emergency and Pain Medicine, University of Montpellier, Nîmes University Hospital, 34090, Nîmes, France
| | - Anthony E G Cass
- Department of Chemistry and Institute of Biomedical Engineering, Imperial College London, SW7 2AZ, London, UK
| | - Gerald A Urban
- Freiburg Centre for Interactive Materials and Bioinspired Technologies - FIT, University of Freiburg, 79110 Freiburg, Germany; Freiburg Materials Research Centre - FMF, University of Freiburg, 79104 Freiburg, Germany
| | - Can Dincer
- Freiburg Centre for Interactive Materials and Bioinspired Technologies - FIT, University of Freiburg, 79110 Freiburg, Germany; Department of Microsystems Engineering - IMTEK, Laboratory for Sensors, University of Freiburg, 79110 Freiburg, Germany. @imtek.de
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16
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Londhe V, Rajadhyaksha M. Opportunities and obstacles for microsampling techniques in bioanalysis: Special focus on DBS and VAMS. J Pharm Biomed Anal 2020; 182:113102. [DOI: 10.1016/j.jpba.2020.113102] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 12/31/2019] [Accepted: 01/07/2020] [Indexed: 12/31/2022]
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17
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Official International Association for Therapeutic Drug Monitoring and Clinical Toxicology Guideline: Development and Validation of Dried Blood Spot-Based Methods for Therapeutic Drug Monitoring. Ther Drug Monit 2020; 41:409-430. [PMID: 31268966 DOI: 10.1097/ftd.0000000000000643] [Citation(s) in RCA: 174] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Dried blood spot (DBS) analysis has been introduced more and more into clinical practice to facilitate Therapeutic Drug Monitoring (TDM). To assure the quality of bioanalytical methods, the design, development and validation needs to fit the intended use. Current validation requirements, described in guidelines for traditional matrices (blood, plasma, serum), do not cover all necessary aspects of method development, analytical- and clinical validation of DBS assays for TDM. Therefore, this guideline provides parameters required for the validation of quantitative determination of small molecule drugs in DBS using chromatographic methods, and to provide advice on how these can be assessed. In addition, guidance is given on the application of validated methods in a routine context. First, considerations for the method development stage are described covering sample collection procedure, type of filter paper and punch size, sample volume, drying and storage, internal standard incorporation, type of blood used, sample preparation and prevalidation. Second, common parameters regarding analytical validation are described in context of DBS analysis with the addition of DBS-specific parameters, such as volume-, volcano- and hematocrit effects. Third, clinical validation studies are described, including number of clinical samples and patients, comparison of DBS with venous blood, statistical methods and interpretation, spot quality, sampling procedure, duplicates, outliers, automated analysis methods and quality control programs. Lastly, cross-validation is discussed, covering changes made to existing sampling- and analysis methods. This guideline of the International Association of Therapeutic Drug Monitoring and Clinical Toxicology on the development, validation and evaluation of DBS-based methods for the purpose of TDM aims to contribute to high-quality micro sampling methods used in clinical practice.
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Wang H, Zhang Y, Zhang X, Li J, Lin Z, Huang Z, Chang J, Zhang Y, Wang J, Zhang C, Rao Y. An LC-MS/MS method for comparing the stability of ethanol's non-oxidative metabolites in dried blood spots during 90 days. Alcohol 2020; 83:29-35. [PMID: 31175945 DOI: 10.1016/j.alcohol.2019.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 05/18/2019] [Accepted: 05/29/2019] [Indexed: 10/26/2022]
Abstract
Problems of stability were found for biomarkers of alcohol consumption: ethyl glucuronide (EtG), ethyl sulfate (EtS), phosphatidylethanols (PEths), and fatty acid ethyl esters (FAEEs) in whole blood. The purpose of this study was to establish a method for the determination of these four kinds of ethanol's non-oxidative metabolites in dried blood spots (DBS) by liquid chromatography tandem mass spectrometry (LC-MS/MS), and to evaluate their stability. In this method, 50 μL of human blood was spotted onto a filter paper for DBS analysis. Samples were extracted by methanol, reconstituted by 2-propanol, and injected into the LC-MS/MS system. Limits of detection were among 0.5-50 ng/mL, and deviations in accuracy and precision were all lower than 15% at three quality control levels. The stability of the four kinds of ethanol non-oxidative metabolites in DBS was investigated during a 90-day range under three temperatures, -20 °C, 4 °C, and 25 °C. EtG and EtS showed a high level of stability in DBS in the 90-day range, regardless of the temperature. FAEEs were unstable after three days. PEths showed stability within 15 days in postmortem DBS and 60 days in antemortem DBS, respectively, at all temperatures.
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Kim HM, Park JH, Long NP, Kim DD, Kwon SW. Simultaneous determination of cardiovascular drugs in dried blood spot by liquid chromatography-tandem mass spectrometry. J Food Drug Anal 2019; 27:906-914. [PMID: 31590762 PMCID: PMC9306983 DOI: 10.1016/j.jfda.2019.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/29/2019] [Accepted: 06/10/2019] [Indexed: 12/23/2022] Open
Abstract
A dried blood spot (DBS) sampling method was exploited to extract cardiovascular drugs using a small volume of whole blood of human and rodent. Thereafter, an analytical method using liquid chromatography with tandem mass spectrometry (LC-MS/MS) was developed and validated for the determination of 12 cardiovascular drugs. A 6 mm internal diameter disc containing 10 μL of blood was punched from a specifically designed card and analyzed by LC-MS/MS using a gradient elution method with a total run time of 16 min. For sample separation, a universal octadecyl-silica column was used with a flow rate of 0.2 mL/ min. The developed method was validated in terms of linearity, accuracy, and precision, which showed satisfactory results. In addition, the matrix effects were closely investigated to confirm the extraction efficiency. Additionally, the stability was tested by storing DBSs at room temperature; the results showed that these drugs were stable for at least 30 days. Accordingly, the proposed LC-MS/MS method is capable to analyze several cardiovascular drugs in a single analysis. It can be applied to therapeutic drug monitoring in patients as well as in the in vivo settings.
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Affiliation(s)
- Hyung Min Kim
- College of Pharmacy, Seoul National University, Seoul 08826, South Korea
| | - Ju-Hwan Park
- College of Pharmacy, Seoul National University, Seoul 08826, South Korea
| | - Nguyen Phuoc Long
- College of Pharmacy, Seoul National University, Seoul 08826, South Korea
| | - Dae-Duk Kim
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, South Korea
| | - Sung Won Kwon
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, South Korea
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A simple poly(styrene-co-divinylbenzene)-coated glass blood spot method for monitoring of seven antidepressants using capillary liquid chromatography-mass spectrometry. Talanta 2018; 188:772-778. [PMID: 30029445 DOI: 10.1016/j.talanta.2018.06.059] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 06/13/2018] [Accepted: 06/16/2018] [Indexed: 01/18/2023]
Abstract
A simple, rapid, selective and sensitive monitoring method for the simultaneous determination of the widely-prescribed antidepressants agomelatine, bupropion, citalopram, fluoxetine, mirtazapine, paroxetine, trazodone in just a human blood drop is here developed and validated. This methodology is based on the use of lab manufactured poly(styrene-co-divinylbenzene)-coated glass (PS-DVB) blood spot for the extraction of the analytes and their subsequent separation and detection by capillary liquid chromatography-mass spectrometry (CLC-MS). Briefly, 10 mm-side squares were punched out from blood spots collected on glass substrate coated by 10 µg of the PS-DVB polymer and eluted with 1.0 mL of 2.0% acetic acid in methanol. The analytes were then separated and detected in less than 20 min by capillary CLC-MS using a Jupiter 4 µm Proteo 90 Å column and water: acetonitrile (20:80 v/v) and ammonium acetate (5 mM, pH 3.0) as mobile phase. Limit of detection (LOD) ranged from 0.018 to 0.038 µg mL-1, and remarkable precision values for the responses and retention times lower than 5.89% and 1.92% were calculated, respectively. Moreover, accuracy values ranging between 85% and 104% were obtained.
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21
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Ji WH, Guo YS, Wang X, Guo DS. A water-compatible magnetic molecularly imprinted polymer for the selective extraction of risperidone and 9-hydroxyrisperidone from human urine. Talanta 2018; 181:392-400. [DOI: 10.1016/j.talanta.2018.01.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 01/06/2018] [Accepted: 01/10/2018] [Indexed: 01/23/2023]
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Supandi S, Harahap Y, Harmita H, Andalusia R. Quantification of 6-Mercaptopurine and Its Metabolites in Patients with Acute Lympoblastic Leukemia Using Dried Blood Spots and UPLC-MS/MS. Sci Pharm 2018; 86:scipharm86020018. [PMID: 29693618 PMCID: PMC6027686 DOI: 10.3390/scipharm86020018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 04/19/2018] [Accepted: 04/19/2018] [Indexed: 11/25/2022] Open
Abstract
This research aimed to quantitatively bioanalyze 6-mercaptopurine (6-MP), 6-methylmercaptopurine (6-MMP), and 6-thioguanosine-5′-monophosphate (6-TGMP) in dried blood spots (DBS) prepared from a small volume of acute lymphoblastic leukemia (ALL) patients. Analytes on the DBS card were extracted using 90% methanol with 5-fluorouracil (5-FU) as an internal standard. Analytical separation was performed on a Waters Acquity® UPLC BEH AMIDA column of 1.7 μm (2.1 × 100 mm) with a mobile phase mixture of 0.2% formic acid in water and 0.1% formic acid in acetonitrile-methanol, with gradient elution and a flow rate of 0.2 mL/min. Mass detection of 6-MP, 6-MMP, 6-TGMP, and 5-FU showed m/z values of 153.09 > 119.09, 167.17 > 126.03, 380.16 > 168.00, and 129.09 > 42.05, respectively. This DBS method had a run time of 5 min and yielded a linear calibration curve over a range of 25.5–1020 ng/mL for 6-MP, 6-MMP, and 6-TGMP. Analyte analysis in 22 of 24 ALL patients showed that the measured value of 6-TGMP as an active metabolite was in the range of 29–429 pmol/8 × 108 erythrocytes. Five of 22 patients had concentrations in a therapeutic range, which indicates that the treatment is effective, while 17 of 24 patients had concentrations below the therapeutic range, which indicates that a treatment dose adjustment is needed. The measured value of 6-MMP, an inactive metabolite, was in the range of 28–499 pmol/8 × 108 erythrocytes, which includes concentrations below the hepatotoxic range. The method employed here can thus be effectively utilized to support therapeutic drug monitoring.
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Affiliation(s)
- Supandi Supandi
- Department of Pharmacy, Faculty of Pharmacy and Science, Universitas Muhammadiyah Prof. Dr. HAMKA, Jakarta 13460, Indonesia.
| | - Yahdiana Harahap
- Faculty of Pharmacy, Universitas Indonesia, Kampus UI Depok, West Java 16424, Indonesia.
| | - Harmita Harmita
- Faculty of Pharmacy, Universitas Indonesia, Kampus UI Depok, West Java 16424, Indonesia.
| | - Rizka Andalusia
- Department of Research and Development of Dharmais Cancer Hospital, Jakarta 11420, Indonesia.
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Al-Majed A, Bakheit AH, Alharbi RM, Abdel Aziz HA. Mirtazapine. PROFILES OF DRUG SUBSTANCES, EXCIPIENTS, AND RELATED METHODOLOGY 2018; 43:209-254. [PMID: 29678261 DOI: 10.1016/bs.podrm.2018.01.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Mirtazapine is one of antidepression which is used mainly in the treatment of depression, moreover, it is sometimes used in the treatment of anxiety disorders, insomnia, nausea, and vomiting, and to produce weight gain when desirable. The action of mirtazapine is an antagonist of certain adrenergic and serotonin receptors, and, furthermore, the drug is used strong as antihistamine, and it is occasionally defined as a noradrenergic and specific serotonergic antidepressant (NaSSA). The comprehensive profile of mirtazapine gives more detailed information about nomenclature, formulae, elemental analysis, and appearance. In addition, the numerous methods of drug synthesis are summarized. Also the profile covers the physicochemical properties as: the value of pKa, drug solubility, melting point, X-ray powder diffraction, and analysis methods for example: (compendial, electrochemical, spectroscopic, and method of chromatographic). Besides that, the profile covered pharmacological profile and clinical pharmacokinetics in subtitle's (absorption, distribution, metabolism, and elimination). About 100 references were given as a proof of the above-mentioned studies.
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Affiliation(s)
| | - Ahmed H Bakheit
- College of Pharmacy, King Saud University, Riyadh, Kingdom of Saudi Arabia; Faculty of Sciences & Technology, Al-Neelain University, Khartoum, Sudan
| | - Raed M Alharbi
- College of Pharmacy, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Hatem A Abdel Aziz
- Centre of Excellence for Advanced Sciences, National Research Centre, Dokki, Cairo, Egypt
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