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Scala C, Oesterwind M, Lanot T. Suspected Mefloquine Toxicity in a Colony of Humboldt Penguins ( Spheniscus humboldti). J Avian Med Surg 2023; 36:400-405. [PMID: 36935212 DOI: 10.1647/21-00054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Avian malaria is an important cause of mortality in captive penguins housed in outdoor exhibits. Mefloquine was used as a prophylaxis to treat a colony of 19 Humboldt penguins (Spheniscus humboldti) for avian malaria. A target dose of 30 mg/kg was obtained from anecdotal literature for sphenisciforms that was not based on pharmacokinetic or toxicity studies. For this reason, preliminary plasma concentrations of mefloquine were acquired after the first dose in some penguins to ensure that plasma concentrations reached human malaria prophylactic concentrations. Afterward, each penguin in the entire colony received mefloquine (26-31 mg/kg [125 mg in toto] PO q7d). Regurgitation was frequently observed starting after the fourth weekly administration. Plasma concentrations of mefloquine after the seventh dose showed elevated concentrations, and the treatment was immediately terminated. Eight penguins died during and after the treatment period. The first fatality occurred after the fifth weekly administration, and 7 birds died within 7-52 days after the seventh weekly administration. Three penguins were found dead without previous symptoms. The other five presented with marked lethargy, dyspnea, poor appetite, and vomiting, and all died despite medical care. The remaining 11 penguins of the colony survived without any supportive care; 5 did not exhibit any clinical disease signs, while the other 6 showed a mild apathy and decreased appetite. Mefloquine toxicity was highly suspected on the basis of clinical signs, the elevated mefloquine plasma concentrations, and no other underlying pathologic disease conditions identified through postmortem examinations. Nonspecific lesions, including pulmonary congestion and edema and hepatic perivascular hematopoiesis, were noted in the birds that died. Additionally, 1 case presented with myocarditis, and mycobacteria were observed within granulomas in the respiratory tract of 2 penguins. Caution is advised, and further studies are encouraged before administering mefloquine to penguins.
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Affiliation(s)
| | | | - Thomas Lanot
- Laboratoire de Pharmacocinétique et Toxicologie, Institut Fédératif de Biologie, Centre Hospitalier Universitaire Purpan, 31400 Toulouse, France
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Silva D, Lopes MVC, Petrovski Ž, Santos MM, Santos JP, Yamada-Ogatta SF, Bispo MLF, de Souza MVN, Duarte ARC, Lourenço MCS, Gonçalves RSB, Branco LC. Novel Organic Salts Based on Mefloquine: Synthesis, Solubility, Permeability, and In Vitro Activity against Mycobacterium tuberculosis. Molecules 2022; 27:molecules27165167. [PMID: 36014405 PMCID: PMC9412322 DOI: 10.3390/molecules27165167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 11/21/2022] Open
Abstract
The development of novel pharmaceutical tools to efficiently tackle tuberculosis is the order of the day due to the rapid development of resistant strains of Mycobacterium tuberculosis. Herein, we report novel potential formulations of a repurposed drug, the antimalarial mefloquine (MFL), which was combined with organic anions as chemical adjuvants. Eight mefloquine organic salts were obtained by ion metathesis reaction between mefloquine hydrochloride ([MFLH][Cl]) and several organic acid sodium salts in high yields. One of the salts, mefloquine mesylate ([MFLH][MsO]), presented increased water solubility in comparison with [MFLH][Cl]. Moreover, all salts with the exception of mefloquine docusate ([MFLH][AOT]) showed improved permeability and diffusion through synthetic membranes. Finally, in vitro activity studies against Mycobacterium tuberculosis revealed that these ionic formulations exhibited up to 1.5-times lower MIC values when compared with [MFLH][Cl], particularly mefloquine camphorsulfonates ([MFLH][(1R)-CSA], [MFLH][(1S)-CSA]) and mefloquine HEPES ([MFLH][HEPES]).
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Affiliation(s)
- Dário Silva
- LAQV-REQUIMTE, Department of Chemistry, NOVA School of Science and Technology, 2829-516 Caparica, Portugal
| | - Márcio V. C. Lopes
- Instituto de Química, Universidade Federal do Rio de Janeiro, Av. Athos da Silveira Ramos 149, Cidade Universitaria, Rio de Janeiro 21941-909, Brazil
| | - Željko Petrovski
- LAQV-REQUIMTE, Department of Chemistry, NOVA School of Science and Technology, 2829-516 Caparica, Portugal
| | - Miguel M. Santos
- LAQV-REQUIMTE, Department of Chemistry, NOVA School of Science and Technology, 2829-516 Caparica, Portugal
| | - Jussevania P. Santos
- Departamento de Microbiologia, Universidade Estadual de Londrina, Rodovia Celso Garcia Cid (PR 445), Km 380, Campus Universitário, Londrina 86057-970, Brazil
| | - Sueli F. Yamada-Ogatta
- Departamento de Microbiologia, Universidade Estadual de Londrina, Rodovia Celso Garcia Cid (PR 445), Km 380, Campus Universitário, Londrina 86057-970, Brazil
| | - Marcelle L. F. Bispo
- Departamento de Microbiologia, Universidade Estadual de Londrina, Rodovia Celso Garcia Cid (PR 445), Km 380, Campus Universitário, Londrina 86057-970, Brazil
| | - Marcus V. N. de Souza
- FioCruz-Fundação Oswaldo Cruz, Instituto de Tecnologia em Fármacos-Far-Manguinhos, Rua Sizenando Nabuco, 100, Manguinhos, Rio de Janeiro 21041-250, Brazil
| | - Ana Rita C. Duarte
- LAQV-REQUIMTE, Department of Chemistry, NOVA School of Science and Technology, 2829-516 Caparica, Portugal
| | - Maria C. S. Lourenço
- Instituto de Pesquisas Clínica Evandro Chagas—IPEC, Av. Brasil, 4365, Manguinhos, Rio de Janeiro 21040-900, Brazil
| | - Raoni Schroeder B. Gonçalves
- Instituto de Química, Universidade Federal do Rio de Janeiro, Av. Athos da Silveira Ramos 149, Cidade Universitaria, Rio de Janeiro 21941-909, Brazil
- Correspondence: (R.S.B.G.); (L.C.B.)
| | - Luis C. Branco
- LAQV-REQUIMTE, Department of Chemistry, NOVA School of Science and Technology, 2829-516 Caparica, Portugal
- Correspondence: (R.S.B.G.); (L.C.B.)
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