|
1
|
James LE, Gottschlich MM, Nelson JK, Cone LC, McCall JE. Pediatric perioperative measures of sleep, pain, anxiety and anesthesia emergence: A healing touch proof of concept randomized clinical trial. Complement Ther Med 2019; 42:264-269. [DOI: 10.1016/j.ctim.2018.11.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/28/2018] [Accepted: 11/29/2018] [Indexed: 11/24/2022] Open
|
|
2
|
Peer CJ, Strope JD, Beedie S, Ley AM, Holly A, Calis K, Farkas R, Parepally J, Men A, Fadiran EO, Scott P, Jenkins M, Theodore WH, Sissung TM. Alcohol and Aldehyde Dehydrogenases Contribute to Sex-Related Differences in Clearance of Zolpidem in Rats. Front Pharmacol 2016; 7:260. [PMID: 27574509 PMCID: PMC4983555 DOI: 10.3389/fphar.2016.00260] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 08/02/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The recommended zolpidem starting dose was lowered in females (5 mg vs. 10 mg) since side effects were more frequent and severe than those of males; the mechanism underlying sex differences in pharmacokinetics (PK) is unknown. We hypothesized that such differences were caused by known sex-related variability in alcohol dehydrogenase (ADH) expression. METHODS Male, female, and castrated male rats were administered 2.6 mg/kg zolpidem, ± disulfiram (ADH/ALDH pathway inhibitor) to compare PK changes induced by sex and gonadal hormones. PK analyses were conducted in rat plasma and rat brain. KEY FINDINGS Sex differences in PK were evident: females had a higher C MAX (112.4 vs. 68.1 ug/L) and AUC (537.8 vs. 231.8 h(∗)ug/L) than uncastrated males. Castration induced an earlier T MAX (0.25 vs. 1 h), greater C MAX (109.1 vs. 68.1 ug/L), and a corresponding AUC increase (339.7 vs. 231.8 h(∗)ug/L). Administration of disulfiram caused more drastic C MAX and T MAX changes in male vs. female rats that mirrored the effects of castration on first-pass metabolism, suggesting that the observed PK differences may be caused by ADH/ALDH expression. Brain concentrations paralleled plasma concentrations. CONCLUSION These findings indicate that sex differences in zolpidem PK are influenced by variation in the expression of ADH/ALDH due to gonadal androgens.
Collapse
Affiliation(s)
- Cody J Peer
- Clinical Pharmacology Program, National Cancer Institute, National Institutes of Health, Bethesda MD, USA
| | - Jonathan D Strope
- Molecular Pharmacology Program, National Cancer Institute, National Institutes of Health, Bethesda MD, USA
| | - Shaunna Beedie
- Molecular Pharmacology Program, National Cancer Institute, National Institutes of Health, Bethesda MD, USA
| | - Ariel M Ley
- Molecular Pharmacology Program, National Cancer Institute, National Institutes of Health, Bethesda MD, USA
| | - Alesia Holly
- Molecular Pharmacology Program, National Cancer Institute, National Institutes of Health, Bethesda MD, USA
| | - Karim Calis
- Office of Medical Policy, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring MD, USA
| | - Ronald Farkas
- Office of New Drugs, Division of Neurology Products, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring MD, USA
| | - Jagan Parepally
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring MD, USA
| | - Angela Men
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring MD, USA
| | - Emmanuel O Fadiran
- Office of Women's Health, Office of the Commissioner, Food and Drug Administration, Silver Spring MD, USA
| | - Pamela Scott
- Office of Women's Health, Office of the Commissioner, Food and Drug Administration, Silver Spring MD, USA
| | - Marjorie Jenkins
- Office of Women's Health, Office of the Commissioner, Food and Drug Administration, Silver Spring MD, USA
| | - William H Theodore
- Clinical Epilepsy Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda MD, USA
| | - Tristan M Sissung
- Clinical Pharmacology Program, National Cancer Institute, National Institutes of Health, Bethesda MD, USA
| |
Collapse
|
|
3
|
Stockmann C, Spigarelli MG, Healy DP, Gottschlich MM, Kagan R, Balch AH, Sherwin C. Application of a method used to deconstruct a single dose pharmacokinetic profile from multiple dose data. Biopharm Drug Dispos 2015; 36:405-409. [PMID: 25766031 DOI: 10.1002/bdd.1949] [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: 07/01/2014] [Revised: 12/17/2014] [Accepted: 02/22/2015] [Indexed: 11/07/2022]
Abstract
With traditional non-compartmental methods, it is challenging to deconstruct plasma concentration versus time curves to assess the influence of individual doses. This study describes the application of a mathematical approach used to deconstruct a single dose curve using data derived from the second, third, fourth or nth dosing interval. Using data from a prospective clinical trial it is demonstrated that this approach reliably estimates pharmacokinetic parameters measured following two doses of zolpidem tartrate. Additionally, the study demonstrates the application of this approach using previously published data from a single- and multiple-dose pharmacokinetic study of the antibiotic gatifloxacin. Copyright © 2015 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Chris Stockmann
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Department of Pharmacology and Toxicology, University of Utah College of Pharmacy, Salt Lake City, Utah, USA
| | - Michael G Spigarelli
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Department of Pharmacology and Toxicology, University of Utah College of Pharmacy, Salt Lake City, Utah, USA
| | - Daniel P Healy
- James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, Ohio, USA; Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Shriners Hospitals for Children, Cincinnati, Ohio, USA
| | | | - Richard Kagan
- Shriners Hospitals for Children, Cincinnati, Ohio, USA
- Department of Surgery, University of Cincinnati, Cincinnati, Ohio, USA
| | - Alfred H Balch
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Department of Pharmacology and Toxicology, University of Utah College of Pharmacy, Salt Lake City, Utah, USA
| | - Catherine Sherwin
- Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Department of Pharmacology and Toxicology, University of Utah College of Pharmacy, Salt Lake City, Utah, USA
| |
Collapse
|
|
4
|
Relationship between zolpidem concentrations and sleep parameters in pediatric burn patients. J Burn Care Res 2014; 36:137-44. [PMID: 25185933 DOI: 10.1097/bcr.0000000000000164] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Zolpidem is a short-acting non-benzodiazepine hypnotic that is used to improve sleep architecture in patients with burn injuries. This study evaluated the relationship between zolpidem administration and sleep parameters in a cohort of children with severe burn injuries. Standard age-based zolpidem dosing practices were employed. Polysomnography data were recorded at 30-second intervals throughout the night. Serum concentrations of zolpidem were measured at 0, 1, 2, 4, 5, 6, and 8 hours after administration of the first dose. The relationship between zolpidem concentrations and sleep parameters was evaluated using Markov mixed-effects pharmacodynamic models. Ten children received two doses of zolpidem at 22:00 and 02:00 hours. The median total amount of sleep was 361.0 (interquartile range [IQR]: 299.0-418.5) minutes; approximately 65% of the normal reference value for an 8-hour period. Slow-wave and rapid eye movement (REM) sleep were also dramatically reduced (18-37% of normal). With two doses of zolpidem, stage 2 sleep was 99% of normal levels. Higher peak zolpidem concentrations were associated with increased stage 2 sleep (r = .54; P = .04). Despite this, a median of 120.0 (IQR: 99.5-143.5) transitions between nocturnal sleep stages were recorded, with a median of 55.5 (IQR: 36-75) night-time awakenings per patient. In pediatric burn patients, higher zolpidem serum concentrations were associated with restoration of stage 2 sleep to normal levels. Nonetheless, slow-wave and REM sleep were profoundly depressed with frequent transitions between sleep stages, suggesting that alternative hypnotic agents may be required to restore normal sleep architecture in severely burned children.
Collapse
|