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Scherholz ML, Rao RT, Androulakis IP. Modeling inter-sex and inter-individual variability in response to chronopharmacological administration of synthetic glucocorticoids. Chronobiol Int 2019; 37:281-296. [PMID: 31797700 DOI: 10.1080/07420528.2019.1660357] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Endogenous glucocorticoids have diverse physiological effects and are important regulators of metabolism, immunity, cardiovascular function, musculoskeletal health and central nervous system activity. Synthetic glucocorticoids have received widespread attention for their potent anti-inflammatory activity and have become an important class of drugs used to augment endogenous glucocorticoid activity for the treatment of a host of chronic inflammatory conditions. Chronic use of synthetic glucocorticoids is associated with a number of adverse effects as a result of the persistent dysregulation of glucocorticoid sensitive pathways. A failure to consider the pronounced circadian rhythmicity of endogenous glucocorticoids can result in either supraphysiological glucocorticoid exposure or severe suppression of endogenous glucocorticoid secretion, and is thought be a causal factor in the incidence of adverse effects during chronic glucocorticoid therapy. Furthermore, given that synthetic glucocorticoids have potent feedback effects on the hypothalamic-pituitary-adrenal (HPA) axis, physiological factors which can give rise to individual variability in HPA axis activity such as sex, age, and disease state might also have substantial implications for therapy. We use a semi-mechanistic mathematical model of the rodent HPA axis to study how putative sex differences and individual variability in HPA axis regulation can influence the effects of long-term synthetic exposure on endogenous glucocorticoid circadian rhythms. Model simulations suggest that for the same drug exposure, simulated females exhibit less endogenous suppression than males considering differences in adrenal sensitivity and negative feedback to the hypothalamus and pituitary. Simulations reveal that homeostatic regulatory variability and chronic stress-induced regulatory adaptations in the HPA axis network can result in substantial differences in the effects of synthetic exposure on the circadian rhythm of endogenous glucocorticoids. In general, our results provide insight into how the dosage and exposure profile of synthetic glucocorticoids could be manipulated in a personalized manner to preserve the circadian dynamics of endogenous glucocorticoids during chronic therapy, thus potentially minimizing the incidence of adverse effects associated with long-term use of glucocorticoids.
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Affiliation(s)
- Megerle L Scherholz
- Department of Chemical and Biochemical Engineering, Rutgers, The State University of New Jersey, Piscataway, NJ
| | - Rohit T Rao
- Department of Chemical and Biochemical Engineering, Rutgers, The State University of New Jersey, Piscataway, NJ
| | - Ioannis P Androulakis
- Department of Chemical and Biochemical Engineering, Rutgers, The State University of New Jersey, Piscataway, NJ.,Department of Biomedical Engineering, Rutgers The State University of New Jersey, Piscataway, NJ.,Department of Surgery, Rutgers - Robert Wood Johnson Medical School, New Brusnwick, NJ
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2
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Cohen L, Ponchel A, Kas A, Ströer S, Del Cul A, Guérineau de Lamérie G, El Hachem R, Crépin P, Morin A. Recovery from cortical blindness with mepivacaïne. Ann Clin Transl Neurol 2019; 6:1541-1545. [PMID: 31402624 PMCID: PMC6689678 DOI: 10.1002/acn3.50832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 06/07/2019] [Accepted: 06/10/2019] [Indexed: 11/05/2022] Open
Abstract
We report the case of a patient suffering from cortical blindness following bilateral occipital stroke, who recovered normal vision in his right visual field following injection of the local anesthetic mepivacaïne. The effect was transient but reproducible, allowing the patient to lead a normal life. Effect duration increased after adjunction of paroxetine. We provide anatomical and functional brain imaging correlates of this improvement, showing particularly how functional connectivity is restored between intact perilesional cortex and distant brain regions. This serendipitous finding may potentially benefit patients suffering from visual but also nonvisual handicap following brain lesions.
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Affiliation(s)
- Laurent Cohen
- Institut du Cerveau et de la Moelle épinière, ICM, Sorbonne Université, Inserm U 1127, CNRS UMR 7225, F-75013, Paris, France.,Département de neurologie, Hôpital de la Pitié Salpêtrière, AP-HP, F-75013, Paris, France
| | - Amélie Ponchel
- Institut du Cerveau et de la Moelle épinière, ICM, Sorbonne Université, Inserm U 1127, CNRS UMR 7225, F-75013, Paris, France.,Département de neurologie, Hôpital de la Pitié Salpêtrière, AP-HP, F-75013, Paris, France
| | - Aurélie Kas
- Service de médecine nucléaire, Hôpital de la Pitié Salpêtrière, AP-HP, F-75013, Paris, France
| | - Sébastian Ströer
- Service de neuroradiologie, Hôpital de la Pitié Salpêtrière, AP-HP, F-75013, Paris, France
| | - Antoine Del Cul
- Service de psychiatrie, Hôpital de la Pitié Salpêtrière, AP-HP, F-75013, Paris, France
| | | | - Randa El Hachem
- Service d'anesthésie, Centre Hospitalier, 11100, Narbonne, France
| | - Piirika Crépin
- Centre Medico Psycho Pédagogique, 11100, Narbonne, France
| | - Alexandre Morin
- Département de neurologie, Hôpital de la Pitié Salpêtrière, AP-HP, F-75013, Paris, France
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3
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Bailey DM, Stacey BS, Gumbleton M. A Systematic Review and Meta-Analysis Reveals Altered Drug Pharmacokinetics in Humans During Acute Exposure to Terrestrial High Altitude-Clinical Justification for Dose Adjustment? High Alt Med Biol 2018; 19:141-148. [PMID: 29620950 DOI: 10.1089/ham.2017.0121] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Bailey, Damian Miles, Benjamin S. Stacey, and Mark Gumbleton. A systematic review and meta-analysis reveals altered drug pharmacokinetics in humans during acute exposure to terrestrial high altitude-clinical justification for dose adjustment? High Alt Med Biol. 19:141-148, 2018. OBJECTIVE While physiological responses during acute ascent to terrestrial high altitude (HA) have the potential to alter the pharmacokinetics (PKs) that define absorption and disposition of medicinal drugs, there have been no systematic reviews and meta-analyses performed to date. METHODS We conducted a systematic literature search in June 2017 using NCBI PubMed, EMBASE, Web of Science, and Ovid MEDLINE databases to identify relevant observational studies. Studies were deemed eligible based on the following criteria: (1) participants: healthy, nonacclimatized male or female lowlanders (born and bred at sea level) and (2) environment: exposure to low altitude (LA, ≤600 m), followed by terrestrial high altitude (HA, ≤24 hours to ≥2500 m), the time course specifically selected to avoid interpretive complications associated with erythrocytosis. All PK parameters were standardized to be in the same units and the weighted standardized mean difference (SMD) calculated using a combination of fixed and random effects models with heterogeneity evaluated using χ2 and I2 statistics. RESULTS Of 20,840 studies reviewed, 6 prospective cohort studies (n = 75) qualified for inclusion, with participants exposed to a mean altitude of 4025 (mean) ± 380 (SD) m. We observed increases for absorption half-life (SMD: 0.40, 95% CI: 0.01-0.80, p = 0.04], elimination half-life (SMD: 0.89, 95% CI: 0.30-1.48, p = 0.003), and erythrocyte binding (SMD: 0.52, 95% CI: 0.16-0.88, p = 0.004) and reduction in clearance (SMD: -0.56, 95% CI: -1.13 to 0.00, p = 0.05). CONCLUSIONS Collectively, these findings reveal impairments in both oral absorption and corresponding clearance of the, although limited, sample of drugs at HA that may potentially require closer patient monitoring and dose adjustments to maintain therapeutic efficacy and avoid incidental toxicity.
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Affiliation(s)
- Damian Miles Bailey
- 1 Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales , Mid-Glamorgan, United Kingdom
| | - Benjamin S Stacey
- 1 Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales , Mid-Glamorgan, United Kingdom
| | - Mark Gumbleton
- 2 School of Pharmacy and Pharmaceutical Sciences, Cardiff University , Cardiff, United Kingdom
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4
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Hansen AB, Hoiland RL, Lewis NCS, Tymko MM, Tremblay JC, Stembridge M, Nowak-Flück D, Carter HH, Bailey DM, Ainslie PN. UBC-Nepal expedition: The use of oral antioxidants does not alter cerebrovascular function at sea level or high altitude. Exp Physiol 2018; 103:523-534. [DOI: 10.1113/ep086887] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 02/05/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Alexander B. Hansen
- Centre for Heart, Lung & Vascular Health, School of Health and Exercise Sciences; University of British Columbia, Okanagan Campus; Kelowna BC Canada
| | - Ryan L. Hoiland
- Centre for Heart, Lung & Vascular Health, School of Health and Exercise Sciences; University of British Columbia, Okanagan Campus; Kelowna BC Canada
| | - Nia C. S. Lewis
- Centre for Heart, Lung & Vascular Health, School of Health and Exercise Sciences; University of British Columbia, Okanagan Campus; Kelowna BC Canada
| | - Michael M. Tymko
- Centre for Heart, Lung & Vascular Health, School of Health and Exercise Sciences; University of British Columbia, Okanagan Campus; Kelowna BC Canada
| | - Joshua C. Tremblay
- Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies; Queen's University; Kingston ON Canada
| | - Michael Stembridge
- Cardiff Centre for Exercise and Health; Cardiff Metropolitan University; Cardiff UK
| | - Daniela Nowak-Flück
- Centre for Heart, Lung & Vascular Health, School of Health and Exercise Sciences; University of British Columbia, Okanagan Campus; Kelowna BC Canada
| | - Howard H. Carter
- Department of Nutrition, Exercise and Sports; University of Copenhagen; Copenhagen Denmark
| | - Damian M. Bailey
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education; University of South Wales; Newport UK
| | - Philip N. Ainslie
- Centre for Heart, Lung & Vascular Health, School of Health and Exercise Sciences; University of British Columbia, Okanagan Campus; Kelowna BC Canada
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5
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Yang B, Liu Z, Wang Q, Chai Y, Xia P. Pharmacokinetic comparison of seven major bioactive components in normal and depression model rats after oral administration of Baihe Zhimu decoction by liquid chromatography–tandem mass spectrometry. J Pharm Biomed Anal 2018; 148:119-127. [DOI: 10.1016/j.jpba.2017.09.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 09/25/2017] [Accepted: 09/26/2017] [Indexed: 12/20/2022]
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6
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Linakis MW, Job KM, Liu X, Collingwood SC, Pangburn HA, Ott DK, Sherwin CMT. Riding (High) into the danger zone: a review of potential differences in chemical exposures in fighter pilots resulting from high altitude and G-forces. Expert Opin Drug Metab Toxicol 2017; 13:925-934. [PMID: 28772091 DOI: 10.1080/17425255.2017.1360867] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION When in flight, pilots of high performance aircraft experience conditions unique to their profession. Training flights, performed as often as several times a week, can expose these pilots to altitudes in excess of 15 km (~50,000 ft, with a cabin pressurized to an altitude of ~20,000 ft), and the maneuvers performed in flight can exacerbate the G-forces felt by the pilot. While the pilots specifically train to withstand these extreme conditions, the physiologic stress could very likely lead to differences in the disposition of chemicals in the body, and consequently, dangerously high exposures. Unfortunately, very little is known about how the conditions experienced by fighter pilots affects chemical disposition. Areas covered: The purpose of this review is to present information about the effects of high altitude, G-forces, and other conditions experienced by fighter pilots on chemical disposition. Using this information, the expected changes in chemical exposure will be discussed, using isopropyl alcohol as an example. Expert opinion: There is a severe lack of information concerning the effects of the fighter pilot environment on the pharmacokinetics and pharmacodynamics of chemicals. Given the possibility of exposure prior to or during flight, it is important that these potential effects be investigated further.
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Affiliation(s)
- Matthew W Linakis
- a Division of Clinical Pharmacology, Department of Pediatrics , University of Utah , Salt Lake City , UT , USA.,b Department of Pharmaceutics and Pharmaceutical Chemistry , University of Utah , Salt Lake City , UT , USA
| | - Kathleen M Job
- a Division of Clinical Pharmacology, Department of Pediatrics , University of Utah , Salt Lake City , UT , USA
| | - Xiaoxi Liu
- a Division of Clinical Pharmacology, Department of Pediatrics , University of Utah , Salt Lake City , UT , USA
| | - Scott C Collingwood
- a Division of Clinical Pharmacology, Department of Pediatrics , University of Utah , Salt Lake City , UT , USA
| | - Heather A Pangburn
- c Department of Aeromedical Research , United States Air Force School of Aerospace Medicine , Dayton , OH , USA
| | - Darrin K Ott
- c Department of Aeromedical Research , United States Air Force School of Aerospace Medicine , Dayton , OH , USA
| | - Catherine M T Sherwin
- a Division of Clinical Pharmacology, Department of Pediatrics , University of Utah , Salt Lake City , UT , USA
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7
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Pharmacokinetic changes of norfloxacin based on expression of MRP2 after acute exposure to high altitude at 4300 m. Biomed Pharmacother 2017; 89:1078-1085. [DOI: 10.1016/j.biopha.2017.02.092] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/15/2017] [Accepted: 02/24/2017] [Indexed: 02/07/2023] Open
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8
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Bailey DM. On the Significance of Altered Drug Pharmacokinetics-Pharmacodynamics at High Altitude. High Alt Med Biol 2017; 18:88-89. [DOI: 10.1089/ham.2016.0128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Damian M. Bailey
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, United Kingdom
- Faculty of Medicine, University of British Columbia-Okanagan, Kelowna, British Columbia, Canada
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9
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Konstandi M, Johnson EO, Lang MA. Consequences of psychophysiological stress on cytochrome P450-catalyzed drug metabolism. Neurosci Biobehav Rev 2014; 45:149-67. [DOI: 10.1016/j.neubiorev.2014.05.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 04/17/2014] [Accepted: 05/18/2014] [Indexed: 12/11/2022]
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10
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Franconi F, Campesi I. Sex and gender influences on pharmacological response: an overview. Expert Rev Clin Pharmacol 2014; 7:469-85. [DOI: 10.1586/17512433.2014.922866] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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11
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Zeng Y, Xie X, Duan J, Zhou T, Zhang Y, Yang M, Xu F. Perturbation of mitiglinide metabolism by chronic unpredicted mild stress in rats. Sci Rep 2014; 4:3794. [PMID: 24445843 PMCID: PMC3896903 DOI: 10.1038/srep03794] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 01/02/2014] [Indexed: 12/19/2022] Open
Abstract
Many diabetic patients complicated with wild to severe depression. It is unclear in diabetic medication whether depression perturbs the drug metabolic process of the hypoglycemic agents or not. The present study was designed to investigate the impact of chronic unpredicted mild stress (CUMS) -induced depression on mitiglinide (MGN) pharmacokinetics in rats. Adult female Sprague-Dawley rats in CUMS group were subjected to different types of stressors and the stress procedures lasted for 8 weeks. Control group without receiving stress had free access to food and water. Open-field test and 5-HT levels were assayed to evaluate the depression. After CUMS all rats were given 2.5 mg/kg of mitiglinide per os. The blood samples were collected at different time and mitiglinide plasma concentration was measured by high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Non-compartmental statistical moment analysis was processed with DAS software. In CMUS-induced depression group, peak concentration (Cmax), peak time (Tmax), area under curve (AUC0 → ∞), mean residence time (MRT0 → ∞), and half-life (T1/2z) were reduced while total plasma clearance (CLz/F) was increased compared to control group. These preliminary results indicated that CUMS-induced depression alter the drug metabolic process of mitiglinide in rats. This finding will be significant in clinic.
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Affiliation(s)
- Yingtong Zeng
- Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Xingqian Xie
- Sixth People's Hospital South Campus, Shanghai Jiaotong University, Shanghai, 201400, China
| | - Jingjing Duan
- Sixth People's Hospital South Campus, Shanghai Jiaotong University, Shanghai, 201400, China
| | - Ting Zhou
- Sixth People's Hospital South Campus, Shanghai Jiaotong University, Shanghai, 201400, China
| | - Ye Zhang
- Sixth People's Hospital South Campus, Shanghai Jiaotong University, Shanghai, 201400, China
| | - Min Yang
- Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Feng Xu
- Sixth People's Hospital South Campus, Shanghai Jiaotong University, Shanghai, 201400, China
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Peng HT, Bouak F, Vartanian O, Cheung B. A physiologically based pharmacokinetics model for melatonin--effects of light and routes of administration. Int J Pharm 2013; 458:156-68. [PMID: 24120727 DOI: 10.1016/j.ijpharm.2013.09.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 09/17/2013] [Accepted: 09/24/2013] [Indexed: 01/20/2023]
Abstract
Physiologically based pharmacokinetic (PBPK) models were developed using MATLAB Simulink(®) to predict diurnal variations of endogenous melatonin with light as well as pharmacokinetics of exogenous melatonin via different routes of administration. The model was structured using whole body, including pineal and saliva compartments, and parameterized based on the literature values for endogenous melatonin. It was then optimized by including various intensities of light and various dosage and formulation of melatonin. The model predictions generally have a good fit with available experimental data as evaluated by mean squared errors and ratios between model-predicted and observed values considering large variations in melatonin secretion and pharmacokinetics as reported in the literature. It also demonstrates the capability and usefulness in simulating plasma and salivary concentrations of melatonin under different light conditions and the interaction of endogenous melatonin with the pharmacokinetics of exogenous melatonin. Given the mechanistic approach and programming flexibility of MATLAB Simulink(®), the PBPK model could provide predictions of endogenous melatonin rhythms and pharmacokinetic changes in response to environmental (light) and experimental (dosage and route of administration) conditions. Furthermore, the model may be used to optimize the combined treatment using light exposure and exogenous melatonin for maximal phase advances or delays.
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Affiliation(s)
- Henry T Peng
- Defence Research and Development Canada - Toronto, 1133 Sheppard Avenue West, Toronto, Ontario, Canada M3K 2C9.
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13
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Peng HT, Edginton AN, Cheung B. Investigation of an alternative generic model for predicting pharmacokinetic changes during physiological stress. J Clin Pharmacol 2013; 53:1048-57. [DOI: 10.1002/jcph.131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 06/05/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Henry T. Peng
- Defence Research and Development Canada-Toronto; Toronto; Ontario; Canada
| | | | - Bob Cheung
- Defence Research and Development Canada-Toronto; Toronto; Ontario; Canada
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14
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Konstandi M. Psychophysiological stress: a significant parameter in drug pharmacokinetics. Expert Opin Drug Metab Toxicol 2013; 9:1317-34. [DOI: 10.1517/17425255.2013.816283] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Duan J, Zeng Y, Zhou T, Zhang Y, Xu F. Study on the Pharmacokinetics of Tacrolimus in Depression Model Rats. INT J PHARMACOL 2013. [DOI: 10.3923/ijp.2013.265.270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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