High-pressure liquid chromatographic analysis of drugs in biological fluids. V. Analysis of acebutolol and its major metabolite

Ethylcellulose assisted exfoliation of graphite by the ultrasound emulsification: An application in electrochemical acebutolol sensor

This work reports the sonochemical exfoliation of graphite (bath sonication with the frequency of 37/80 kHz and power of 60 W) and its electrocatalytic properties to the β-blocker drug. The pencil graphite (PG) was exfoliated by the ultrasound emulsification with the support of ethyl cellulose (EC). Herein, EC act as an emulsifier which aids to the exfoliation and also stabilizing the exfoliated graphite. This EC assisted PG (ECPG) was characterized by various analytical techniques which showed that ECPG has high crystalline graphene sheets. In some places, EC submerged to the graphene sheets which improve the dispersibility of graphene in water. The performance of ECPG was evaluated to the electrocatalysis of acebutolol (ACE) which exhibited good electrochemical signal. Therefore, the ECPG was utilized to the detection of ACE as the electrochemical sensor electrode. It showed notable sensitivity (2.87 µA μM^-1 cm^-2) appreciable linear range (0.01-200 µM) and satisfactory detection limit (4 nM). Furthermore, it displays acceptable anti-interference properties with other interfering ions.

Effect of cavitation erosion in the sonochemical exfoliation of activated graphite for electrocatalysis of acebutolol

This study mainly covered the cavitation erosion in probe sonication and its electrochemical behavior. The activated graphite was exfoliated by the probe sonication wherein the titanium alloy (TA) is used as a probe (micro-tip). The sonication performed in the aqueous solution contains a mixture of sulfuric acid and nitric acid (1:1). The exfoliated graphite (EG) was examined by field emission scanning electron microscope, Raman and X-ray diffraction pattern analysis. The results showed that some TA particles dissolute from the TA micro-tip accompanied with graphite exfoliation. This dissolution experienced from the cavitation erosion, because the acoustic cavitation makes severe deformation on probe tips due to the bubble collapse. The dissolution rate increased when increasing sonication time; the resultant TA particles are randomly distributed over the EG. These EGTAs applied to the electrochemical oxidation of acebutolol which revealed an appreciable electrochemical performance and also exhibited better analytical performances to the electrochemical determinations. The obtained analytical parameters viz., sensitivity (0.234 µA µM^-1 cm^-2), linear range (0.01-15.1 µM), and limit of detection (0.003 µM) are highly comparable with the previous reports. Moreover, it has an acceptable tolerance with the interfering substances.

Pharmacokinetics of acebutolol enantiomers in humans

The chiral beta-blocker acebutolol (AC) is marketed as a racemic mixture. Both AC and its major metabolite, diacetotol (DC), are chiral, the S-enantiomer possessing beta-blocking activity. The pharmacokinetics of AC and DC enantiomers was determined in 12 healthy subjects following oral administration of 200 mg of AC. Plasma and urine were collected over a 24-hr period and both AC and DC enantiomers were measured utilizing a stereospecific HPLC assay. Concentrations of S-AC were predominant in both plasma and urine [AUC S:R, 1.20 +/- 0.1; cumulative urinary excretion (sigma Xu) S:R, 1.17 +/- 0.05), which corresponded to a significantly greater oral clearance of R-AC (106 +/- 30 L/h) than S-AC (87 +/- 22 L/h). The Cmax of R-DC was significantly greater than for S-DC (S/R 0.7 +/- 0.1). The half-life (t1/2) of R-DC (6.4 +/- 1.6 h) was significantly shorter than that of S-DC (8.8 +/- 2.4 h). The observed AUC values for R- and S-DC were not significantly different. Renal clearance of R-DC (70 +/- 34 mL/min) was significantly greater than that of S-DC (53 +/- 29 mL/min). The data suggest that the first-pass metabolism of R-AC to R-DC is stereoselective. This metabolism, coupled with the stereoselective renal excretion of R-DC is likely a major contributor to the observed stereoselective disposition of AC and its major metabolite in humans.

Acebutolol and diacetolol plasma levels in patients undergoing myocardial revascularization with hypothermic cardiopulmonary bypass

Cardiopulmonary bypass (CPB) has been reported to alter the disposition of numerous drugs and consequently to modify their plasma levels. The present study was designed to delineate the time course of acebutolol (a cardioselective beta-blocker) and diacetolol (its main metabolite) plasma levels in seven patients undergoing myocardial revascularization with hypothermic CPB. All patients were given oral acebutolol twice daily until 3 hours before surgery. Initiation of CPB produced an immediate and significant, but transient, decrease in acebutolol and diacetolol plasma concentrations. Cessation of CPB was not associated with an increase in plasma beta-blocker levels. It is concluded that CPB does not induce major alterations in the time course of acebutolol and diacetolol plasma concentrations.

High-performance liquid chromatographic determination of beta-adrenoceptor blocking agents in body fluids

Several reports have been published reviewing high-performance liquid chromatographic (HPLC) methods for the determination of beta-adrenoceptor blocking agents (beta-blockers) in biological materials (Flouvat et al., 1981; Mehta, 1983; Marko and Soltés, 1984; Ahnoff et al., 1985; Tkaczyková and Safarík, 1987). Of these, the paper by Mehta (1983) briefly summarizes the interrelationship between physiocochemical properties of beta-blockers with prechromatographic treatment of biological samples, as well as with the HPLC methods used for the determination of 12 beta-adrenoceptor blocking drugs. The work by Ahnoff et al. (1985) concerning the monitoring of cardiovascular drugs also deals with HPLC assays of 18 beta-blockers in plasma. The Appendix to this report presents the great majority of HPLC methods for determining 30 beta-blockers in various body fluids. HPLC methods providing resolution and determination of individual beta-blocker enantiomers have not been included since this topic is being covered by Walle and Walle (1989). The Appendix is just a guide to the methods reviewed for the HPLC determination of parent beta-blockers as well as some of their metabolites co-assayed in various body fluids. It does not include details such as the internal standard, recovery, setting of the detector, limit of determination, etc., given in the individual methods listed. The isolation technique of the drug(s) from the given body fluid represents the main step in the sample work-up procedure. Along with this information, only the type of the HPLC column packing and the detection principle used by each method's developers are given.

Acebutolol: a review of its pharmacology, pharmacokinetics, clinical uses, and adverse effects

Acebutolol is a new hydrophilic, cardioselective beta-adrenergic-blocking agent that possesses partial agonist and membrane-stabilizing activities. In the treatment of mild to moderate essential hypertension, once-daily acebutolol as monotherapy provides effective control in a large majority of patients and produces a further reduction in blood pressure when used concomitantly with diuretics. Acebutolol is as effective as other beta-blocking agents, and in a large, double-blind, parallel study against propranolol was found to cause less reduction in heart rate, and fewer neurologic side effects and patient withdrawals due to adverse effects. Oral acebutolol is also effective in suppressing premature ventricular contractions, and in small numbers of patients generally beneficial results were obtained in supraventricular and ventricular arrhythmias with intravenous administration. These salutary effects are attributable to beta blockade. Controlled clinical trials documented the antianginal actions of oral acebutolol in chronic stable angina pectoris; its efficacy in this regard is comparable to that of other beta-blocking agents. The drug produces smaller decreases in heart rate and cardiac output and alterations in peripheral vascular hemodynamics than beta-blocking drugs without partial agonist activity, and because of its cardioselectivity, it may be used cautiously in patients with bronchospastic disease. Acebutolol has minimal metabolic effects and does not elevate levels of blood lipids during long-term therapy; high-density-lipoprotein cholesterol increased with acebutolol in a small number of patients.

Acebutolol for premature ventricular contractions: short- and long-term effects

The safety and efficacy of oral acebutolol therapy for the suppression of premature ventricular contractions (PVCs) were assessed in two clinical trials pooled for analysis. Thirty-two patients suffering from organic heart disease, who had experienced an average of greater than or equal to 10 PVCs/h (range 14 to 996 three times a day) on Holter monitoring during a 24-hour baseline study period, were given acebutolol (100 mg three times a day to 400 mg four times a day) over 4 weeks. Three patients were withdrawn from the study for administrative reasons, and four patients were excluded from the efficacy analysis. Of the 25 remaining patients (24 men, 1 woman; mean age 56 years, range 37 to 69), 18 (72%) experienced some reduction in PVCs from the second through the fourth week of therapy. Eleven patients (44%) experienced clinically significant reductions (greater than or equal to 75%) in PVCs. The onset of the antiarrhythmic effect of acebutolol was within 7 days of administration. Transient mild to moderate side effects were noted in eight patients. Significant correlations (p less than 0.001) were observed between the mean daily dose of acebutolol and (1) mean blood levels, (2) reduction in PVCs, and (3) reduction in resting heart rate. The average daily dose of acebutolol ranged from 304 to 1060 mg. In nine patients receiving acebutolol in a 12-month open-label extension, both efficacy and safety were maintained. This study confirms that oral acebutolol therapy in both safe and efficacious for suppressing PVCs in patients with organic heart disease.

Acebutolol: ten years of experience

During 10 years of clinical use involving almost 3 million patient-years, acebutolol has become established as a remarkably safe and well-tolerated beta-blocking agent, effective in treating essential hypertension and cardiac arrhythmias. The existence of a long-lived active metabolite (diacetolol) confers a 24-hour duration of action, which permits effective use of a once-daily regimen, particularly for hypertension. Acebutolol has low lipid solubility and low protein binding; the former property reduces the risk of central side effects, and the latter means that displacement interactions with other drugs are unlikely. Because acebutolol and its metabolite normally have both renal and hepatic excretion pathways, an alternative pathway is available should either be compromised through disease. Acebutolol is cardioselective, and clinical use has borne out the low incidence of bronchospasm in patients with impaired lung function. The possession of intrinsic sympathomimetic activity (ISA) leads to only modest reductions in cardiac output, which in turn reduces the chance of excessive bradycardia and the likelihood of precipitating heart failure. A combination of selectivity and ISA may be responsible for the low incidence of tiredness and cold extremities observed with acebutolol compared with other beta blockers. The unique pharmacologic and pharmacokinetic profile of acebutolol confers several therapeutic advantages and may be responsible for the generally low level of side effects experienced in clinical use.

Lack of effect of liver disease on the pharmacokinetics of acebutolol and diacetolol: a single dose study

The pharmacokinetics of acebutolol and its major metabolite, diacetolol, following a single 400 mg oral dose, were investigated in patients with liver disease. No significant differences were found in any of the parameters measured.

Beta-adrenoceptor blocker pharmacokinetics and the oral contraceptive pill

Higher AUC and Cmax values were obtained for metoprolol, oxprenolol and propranolol in groups receiving the low-dose oestrogen-ethinyl oestradiol oral contraceptive, but statistical significance was reached only with metoprolol AUC. The oral contraceptive had the opposite effect on acebutolol AUC and Cmax but this was not significant. The oral contraceptive had no detectable effects on the tmax and t 1/2 values of any of the beta-adrenoceptor blockers.

Acebutolol pharmacokinetics in renal failure

Acebutolol was administered orally in a single dose of 200 mg to 17 individuals whose renal function varied markedly. The plasma half-life and elimination rate constant for acebutolol showed a four-fold variation but these did not correlate with the degree of renal impairment. However, there was a good correlation between the renal clearance of creatinine and that of acebutolol (P less than 0.001). The half-life and elimination rate of the acetyl metabolite, diacetolol, were subject to 10-fold inter-individual variability which correlated significantly with the creatinine clearance and serum creatinine concentration. The AUC for the acetyl metabolite showed a 40-fold individual variation which also correlated with renal function. It is concluded that renal elimination is the principal route of excretion for diacetolol but not the parent compound, acebutolol.

The effect of acebutolol and propranolol on the hypoglycaemic action of glibenclamide

1 The effect of acebutolol, a relatively selective beta-adrenoceptor blocking drug and propranolol, a non-selective one, on the hypoglycaemic action of glibenclamide after an oral glucose load has been investigated in a group of maturity-onset diabetic patients. 2 Glibenclamide significantly reduced the blood glucose levels and both acebutolol and propranolol, at therapeutic doses, were found to modify this action significantly. 3 The effect of acebutolol was slightly less than that of propranolol. The difference was not statistically significant. 4 The modes of action of sulphonylureas are reviewed and it is suggested that beta-adrenoceptor blockers may modify their effect on insulin release. This appears to be a drug interaction rather than an effect of beta-adrenoceptor blockade on glucose tolerance.

The effect of hydralazine on the pharmacokinetics of three different beta adrenoceptor antagonists: metoprolol, nadolol, and acebutolol

The effect of hydralazine on the pharmacokinetics of metoprolol, nadolol, and acebutolol has been studied by measuring drug concentrations in plasma, serum, and urine. Metoprolol is affected by hydralazine, the AUC and Cmax being significantly increased. The kinetics of acebutolol and its major metabolite, diacetolol, are unaffected. Poor absorption of the polar beta blocker, nadolol, does not allow a firm conclusion to be drawn regarding the effect of hydralazine. It is concluded that only beta blockers with a substantial first-pass loss are likely to be significantly affected by hydralazine.

Variability of beta-blocker pharmacokinetics in young volunteers

Plasma concentrations of metoprolol, propranolol oxprenolol, acebutolol and its metabolite diacetolol were measured after single oral doses in young health volunteers. In order to assessed the inter- and intra-subject variability the following pharmacokinetic parameters were compared: AUC0(24), Cmax, tmax and t 1/2. The smallest variation in inter-subject variability was seen with oxprenolol and acebutolol: intrasubject variability was more uniform. Female volunteers taking an oral contraceptive generally had higher AUC0(24) and Cmax values than those not. This finding reached statistical significance only for metoprolol AUC0(24).

Reversed-phase high-performance liquid chromatography with differential pulse polarographic detection for assaying drugs in feed: stability-indicating assay of diacetolol

Reversed-phase high-performance liquid chromatography with differential pulse polarographic detection at a dropping mercury electrode provides a high degree of specificity for stability-indicating assays of drugs in animal feed. The selectivity of this detection system is demonstrated in the assay of diacetolol in feed at concentrations down to 50 microgram/g.

A simple radioimmunoassay of acebutolol in plasma

Antisera against acebutolol were produced in rabbits immunized by means of this drug conjugated with bovine serum albumin. These antisera were used to develop a method of radioimmunoassay for acebutolol. The plasma radioimmunoassay, described here, requires no extraction and is very easy to perform besides being quick, specific and sensitive. As little as 2.97 X 10(-9) mol/l of acebutolol can be detected. This radioimmunoassay is suitable for assaying the large number of samples usually measured in pharmacological studies.

The long-term suppression of ventricular arrhythmia by oral acebutolol in patients with coronary artery disease

The short-term efficacy of oral acebutolol was evaluated in 20 patients with coronary artery disease and frequent premature ventricular contractions (PVCs) by serial 24-hour Holter monitoring before and while the patients were receiving an average daily dose of 1,100 mg. of acebutolol for four weeks. Fifty-five percent of the 20 patients showed a greater than 70% PVC reduction from baseline values. The only serious side effect during short-term therapy was mild, reversible cardiac decompensation in one patient. The long-term safety and continued efficacy of acebutolol was then evaluated over the next 11 months in nine of the 11 patients showing greater than 70% PVC reduction at four weeks. Two-thirds of these nine patients continued to show greater than 80% PVC reduction from baseline values at 12 months. One patient developed alopecia during long-term therapy. The majority of patients not responding well to acebutolol at four weeks had an actual increase in PVCs on acebutolol therapy. We conclude that acebutolol produces long-term, effective reduction in PVCs without serious toxicity in the majority of patients with ventricular ectopy. However, this drug appears to either produce an excellent response or no response with regard to PVC control in most instances.

Effective treatment of supraventricular arrhythmias with acebutolol

To evaluate the antiarrhythmic efficacy of the new beta adrenergic blocking agent acebutolol, 15 monitored patients with supraventricular arrhythmias received, in double-blind fashion, an intravenous infusion of either acebutolol or saline solution after a control period. Patients treated with saline solution demonstrated no change (P greater than 0.05) in heart rate or arterial blood pressure or conversion to sinus rhythm. After administration of acebutolol, significant (P less than 0.05) reductions in heart rate were noted at 5 minutes. Peak reduction occurred at 10 to 30 minutes and correlated with maximal acebutolol plasma concentrations, antiarrhythmic activity persisted for 24 hours. Mild reductions in systolic blood pressure were observed in the majority of patients. Two patients with atrial fibrillation and one with multifocal atrial tachycardia had conversion to sinus rhythm. Frequent premature atrial complexes noted in one patient were greatly suppressed after administration of the drug. In the nine patients with clinical evidence of chronic obstructive lung disease acebutolol was well tolerated. Adverse reactions were limited to transient dyspnea in one patient with prior heart failure and a decrease in systolic blood pressure to less than 90 mm Hg in three patients who remained asymptomatic. In the patients studied, acebutolol was an effective agent for the treatment of supraventricular arrhythmias and appeared to be of special value in those with chronic obstructive lung disease.

Evaluation of a modified high-performance liquid chromatography assay for acebutolol and its major metabolite

Extensive modification of an existing high-performance liquid chromatography assay for acebutolol and its major metabolite has markedly improved chromatographic stability eliminating the previous need for frequent adjustment of the eluent composition to accommodate continuous loss of column retention. The eluents now used and avoidance of the requirement for elevated column temperature may be significant factors in the ability to maintain column life over 8 months of continuous use with little decrease in retention. As a result of the improved chromatographic stability full advantage can now be taken of automatic injection devices for the unattended processing of large numbers of samples. A significant modification of the work-up of blood samples has improved precision of the assay in whole blood. Nevertheless, it is recommended that plasma samples rather than whole blood be analyzed, since the plasma assay is faster and still more precise.