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Tang T, Luo X, Li N, Li Q, Zhang M, Zeng J, Song H, Li L, Chen W. A developed and validated centrifugal ultrafiltration coupled with high performance liquid chromatography-tandem mass spectrometry method for rapid quantification of unbound lenvatinib in human plasma. J Chromatogr B Analyt Technol Biomed Life Sci 2024; 1240:124157. [PMID: 38761468 DOI: 10.1016/j.jchromb.2024.124157] [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] [Received: 12/04/2023] [Revised: 04/20/2024] [Accepted: 05/13/2024] [Indexed: 05/20/2024]
Abstract
In clinical practice, the determination of unbound drug concentration is very important for dose adjustment and toxicity prediction because only the unbound fraction can achieve a pharmacological effect. A fast, sensitive and accurate analytical method of centrifugal ultrafiltration coupled with high performance liquid chromatography-tandem mass spectrometry method was developed and applied to allow the quantification of unbound lenvatinib concentration. The application of linear regression analysis was used to examine the effects of centrifugal force, centrifugal time, and protein content on ultrafiltrate volume (Vu). The results indicated that the centrifugal force and centrifugal time have an influence on Vu that is significantly positive (P < 0.05). This developed method with good linearity (r2 = 0.9996), good accuracy (bias % ≤ 2.24 %), good precision (CV % ≤ 7.10 %), and good recovery (95.46 %-106.46 %) was suitable for routine clinical practice and studies. Particularly, the ultrafiltration membrane had no non-specific binding to lenvatinib. The unbound fractions can be separated in just 15 min. This method was applied to quantify clinical samples and to determine the plasma protein binding and unbound fraction of lenvatinib. This study provides a more effective and promising method for determination of unbound lenvatinib. It could be beneficial to measure the unbound concentration of lenvatinib in personalized medicine and therapeutic drug monitoring in routine clinical practice.
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Affiliation(s)
- Tiantian Tang
- Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing 400030, China
| | - Xianzhang Luo
- Hepatic Biliary & Pancreatic Cancer Center, Chongqing University Cancer Hospital, Chongqing 400030, China
| | - Na Li
- Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing 400030, China
| | - Qiaoqiao Li
- Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing 400030, China
| | - Min Zhang
- Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing 400030, China
| | - Jin Zeng
- Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing 400030, China
| | - Haichi Song
- Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing 400030, China
| | - Lixian Li
- Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing 400030, China.
| | - Wanyi Chen
- Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing 400030, China.
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Karungamye P, Rugaika A, Mtei K, Machunda R. A Review of Methods for Removal of Ceftriaxone from Wastewater. J Xenobiot 2022; 12:223-235. [PMID: 35997364 PMCID: PMC9397013 DOI: 10.3390/jox12030017] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/09/2022] [Accepted: 07/27/2022] [Indexed: 11/16/2022] Open
Abstract
The presence of pharmaceuticals in surface water and wastewater poses a threat to public health and has significant effects on the ecosystem. Since most wastewater treatment plants are ineffective at removing molecules efficiently, some pharmaceuticals enter aquatic ecosystems, thus creating issues such as antibiotic resistance and toxicity. This review summarizes the methods used for the removal of ceftriaxone antibiotics from aquatic environments. Ceftriaxone is one of the most commonly prescribed antibiotics in many countries, including Tanzania. Ceftriaxone has been reported to be less or not degraded in traditional wastewater treatment of domestic sewage. This has piqued the interest of researchers in the monitoring and removal of ceftriaxone from wastewater. Its removal from aqueous systems has been studied using a variety of methods which include physical, biological, and chemical processes. As a result, information about ceftriaxone has been gathered from many sources with the searched themes being ceftriaxone in wastewater, ceftriaxone analysis, and ceftriaxone removal or degradation. The methods studied have been highlighted and the opportunities for future research have been described.
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Affiliation(s)
- Petro Karungamye
- Department of Chemistry, The University of Dodoma (UDOM), Dodoma P.O. Box 338, Tanzania
- School of Materials Energy Water and Environmental Sciences, The Nelson Mandela African Institution of Science and Technology, Arusha P.O. Box 447, Tanzania; (A.R.); (K.M.); (R.M.)
- Correspondence: or ; Tel.: +255-763750792
| | - Anita Rugaika
- School of Materials Energy Water and Environmental Sciences, The Nelson Mandela African Institution of Science and Technology, Arusha P.O. Box 447, Tanzania; (A.R.); (K.M.); (R.M.)
| | - Kelvin Mtei
- School of Materials Energy Water and Environmental Sciences, The Nelson Mandela African Institution of Science and Technology, Arusha P.O. Box 447, Tanzania; (A.R.); (K.M.); (R.M.)
| | - Revocatus Machunda
- School of Materials Energy Water and Environmental Sciences, The Nelson Mandela African Institution of Science and Technology, Arusha P.O. Box 447, Tanzania; (A.R.); (K.M.); (R.M.)
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Chen Y, Yang M, Wang M, Yu H, Zhou J, Wang T. Development of a new matrix certified reference material for metronidazole in egg powder. Microchem J 2021. [DOI: 10.1016/j.microc.2021.106379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gijsen M, Dreesen E, Van Daele R, Annaert P, Debaveye Y, Wauters J, Spriet I. Pharmacokinetic/Pharmacodynamic Target Attainment Based on Measured versus Predicted Unbound Ceftriaxone Concentrations in Critically Ill Patients with Pneumonia: An Observational Cohort Study. Antibiotics (Basel) 2021; 10:557. [PMID: 34064676 PMCID: PMC8151456 DOI: 10.3390/antibiotics10050557] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 11/16/2022] Open
Abstract
The impact of ceftriaxone pharmacokinetic alterations on protein binding and PK/PD target attainment still remains unclear. We evaluated pharmacokinetic/pharmacodynamic (PK/PD) target attainment of unbound ceftriaxone in critically ill patients with severe community-acquired pneumonia (CAP). Besides, we evaluated the accuracy of predicted vs. measured unbound ceftriaxone concentrations, and its impact on PK/PD target attainment. A prospective observational cohort study was carried out in adult patients admitted to the intensive care unit with severe CAP. Ceftriaxone 2 g q24h intermittent infusion was administered to all patients. Successful PK/PD target attainment was defined as unbound trough concentrations above 1 or 4 mg/L throughout the whole dosing interval. Acceptable overall PK/PD target attainment was defined as successful target attainment in ≥90% of all dosing intervals. Measured unbound ceftriaxone concentrations (CEFu) were compared to unbound concentrations predicted from various protein binding models. Thirty-one patients were included. The 1 mg/L and 4 mg/L targets were reached in 26/32 (81%) and 15/32 (47%) trough samples, respectively. Increased renal function was associated with the failure to attain both PK/PD targets. Unbound ceftriaxone concentrations predicted by the protein binding model developed in the present study showed acceptable bias and precision and had no major impact on PK/PD target attainment. We showed suboptimal (i.e., <90%) unbound ceftriaxone PK/PD target attainment when using a standard 2 g q24h dosing regimen in critically ill patients with severe CAP. Renal function was the major driver for the failure to attain the predefined targets, in accordance with results found in general and septic ICU patients. Interestingly, CEFu was reliably predicted from CEFt without major impact on clinical decisions regarding PK/PD target attainment. This suggests that, when carefully selecting a protein binding model, CEFu does not need to be measured. As a result, the turn-around time and cost for ceftriaxone quantification can be substantially reduced.
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Affiliation(s)
- Matthias Gijsen
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium; (E.D.); (R.V.D.); (I.S.)
- Pharmacy Department, UZ Leuven, 3000 Leuven, Belgium
| | - Erwin Dreesen
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium; (E.D.); (R.V.D.); (I.S.)
- Uppsala Pharmacometrics Research Group, Department of Pharmacy, Uppsala University, 751 05 Uppsala, Sweden
| | - Ruth Van Daele
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium; (E.D.); (R.V.D.); (I.S.)
- Pharmacy Department, UZ Leuven, 3000 Leuven, Belgium
| | - Pieter Annaert
- Drug Delivery and Disposition, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium;
- BioNotus, Galileilaan 15, 2845 Niel, Belgium
| | - Yves Debaveye
- Laboratory for Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium;
| | - Joost Wauters
- Laboratory for Clinical Infectious and Inflammatory Diseases, Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium;
| | - Isabel Spriet
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium; (E.D.); (R.V.D.); (I.S.)
- Pharmacy Department, UZ Leuven, 3000 Leuven, Belgium
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Prediction of Unbound Ceftriaxone Concentration in Children: Simple Bioanalysis Method and Basic Mathematical Equation. Antimicrob Agents Chemother 2020; 65:AAC.00779-20. [PMID: 33020163 DOI: 10.1128/aac.00779-20] [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: 04/22/2020] [Accepted: 10/01/2020] [Indexed: 01/29/2023] Open
Abstract
The pharmacological activity of ceftriaxone depends on the unbound concentration. However, direct measurement of unbound concentrations is obstructive, and high individual variability of the unbound fraction of ceftriaxone was shown in children. We aim to evaluate and validate a method to predict unbound ceftriaxone concentrations in pediatric patients. Ninety-five pairs of concentrations (total and unbound) from 92 patients were measured by the bioanalysis method that we developed. The predictive performance of the three equations (empirical in vivo equation, disease-adapted equation, and multiple linear regression equation) was assessed by the mean absolute prediction error (MAPE), the mean prediction error (MPE), the proportions of the prediction error within ±30% (P 30) and ±50% (P 50), and linear regression of predicted versus actual unbound levels (R 2). The average total and unbound ceftriaxone concentrations were 126.18 ± 81.46 μg/ml and 18.82 ± 21.75 μg/ml, and the unbound fraction varied greatly from 4.75% to 39.97%. The MPE, MAPE, P 30, P 50, and R 2 of the empirical in vivo equation, disease equation, and multiple linear equation were 0.17 versus 0.00 versus 0.06, 0.24 versus 0.15 versus 0.27, 63.2% versus 89.5% versus 74.7%, 96.8% versus 97.9% versus 86.3%, and 0.8730 versus 0.9342 versus 0.9315, respectively. The disease-adapted equation showed the best predictive performance. We have developed and validated a bioanalysis method with one-step extraction pretreatment for the determination of total ceftriaxone concentrations, and a prediction equation of the unbound concentration is recommended. The proposed method can facilitate clinical practice and research on unbound ceftriaxone in children. (This study has been registered at ClinicalTrials.gov under identifier NCT03113344.).
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Kan M, Wu YE, Li X, Dong YN, Du B, Guo ZX, Shi HY, Huang X, Su LQ, Wang WQ, Zheng Y, Zhao W. An adapted LC-MS/MS method for the determination of free plasma concentration of cefoperazone in children: Age-dependent protein binding. J Chromatogr B Analyt Technol Biomed Life Sci 2020; 1144:122081. [DOI: 10.1016/j.jchromb.2020.122081] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 03/22/2020] [Accepted: 03/24/2020] [Indexed: 01/14/2023]
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Standing JF, Ongas MO, Ogwang C, Kagwanja N, Murunga S, Mwaringa S, Ali R, Mturi N, Timbwa M, Manyasi C, Mwalekwa L, Bandika VL, Ogutu B, Waichungo J, Kipper K, Berkley JA. Dosing of Ceftriaxone and Metronidazole for Children With Severe Acute Malnutrition. Clin Pharmacol Ther 2018; 104:1165-1174. [PMID: 29574688 PMCID: PMC6282491 DOI: 10.1002/cpt.1078] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 03/15/2018] [Accepted: 03/18/2018] [Indexed: 12/12/2022]
Abstract
Infants and young children with severe acute malnutrition (SAM) are treated with empiric broad-spectrum antimicrobials. Parenteral ceftriaxone is currently a second-line agent for invasive infection. Oral metronidazole principally targets small intestinal bacterial overgrowth. Children with SAM may have altered drug absorption, distribution, metabolism, and elimination. Population pharmacokinetics of ceftriaxone and metronidazole were studied, with the aim of recommending optimal dosing. Eighty-one patients with SAM (aged 2-45 months) provided 234 postdose pharmacokinetic samples for total ceftriaxone, metronidazole, and hydroxymetronidazole. Ceftriaxone protein binding was also measured in 190 of these samples. A three-compartment model adequately described free ceftriaxone, with a Michaelis-Menten model for concentration and albumin-dependent protein binding. A one-compartment model was used for both metronidazole and hydroxymetronidazole, with only 1% of hydroxymetronidazole predicted to be formed during first-pass. Simulations showed 80 mg/kg once daily of ceftriaxone and 12.5 mg/kg twice daily of metronidazole were sufficient to reach therapeutic targets.
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Affiliation(s)
- Joseph F. Standing
- Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
- Paediatric Infectious Diseases Research GroupInstitute for Infection and Immunity, St. George's, University of LondonLondonUK
| | - Martin O. Ongas
- Center for Research in Therapeutic SciencesStrathmore UniversityNairobiKenya
- KEMRI‐Centre for Clinical ResearchNairobiKenya
| | | | | | | | | | - Rehema Ali
- KEMRI‐Wellcome Trust Research ProgrammeKilifiKenya
| | - Neema Mturi
- KEMRI‐Wellcome Trust Research ProgrammeKilifiKenya
| | - Moline Timbwa
- KEMRI‐Wellcome Trust Research ProgrammeKilifiKenya
- Mbagathi County HospitalNairobiKenya
| | - Christine Manyasi
- KEMRI‐Wellcome Trust Research ProgrammeKilifiKenya
- Mbagathi County HospitalNairobiKenya
| | - Laura Mwalekwa
- KEMRI‐Wellcome Trust Research ProgrammeKilifiKenya
- Coast General HospitalMombasaKenya
| | | | - Bernhards Ogutu
- Center for Research in Therapeutic SciencesStrathmore UniversityNairobiKenya
- KEMRI‐Centre for Clinical ResearchNairobiKenya
| | | | - Karin Kipper
- Analytical Services International, St George's University of LondonLondonUK
- Institute of ChemistryUniversity of TartuTartuEstonia
| | - James A. Berkley
- KEMRI‐Wellcome Trust Research ProgrammeKilifiKenya
- The Childhood Acute Illness & Nutrition (CHAIN) NetworkNairobiKenya
- Centre for Tropical Medicine & Global Health, Nuffield Department of MedicineUniversity of OxfordOxfordUK
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Mohamed D, Kamal M. Enhanced HPLC-MS/MS method for the quantitative determination of the co-administered drugs ceftriaxone sodium and lidocaine hydrochloride in human plasma following an intramuscular injection and application to a pharmacokinetic study. Biomed Chromatogr 2018; 32:e4322. [PMID: 29934999 DOI: 10.1002/bmc.4322] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 05/24/2018] [Accepted: 06/06/2018] [Indexed: 11/07/2022]
Abstract
A sensitive HPLC-MS/MS method was established for the quantification of ceftriaxone sodium (CFT) and lidocaine HCl (LDC) in human plasma utilizing cefixime (CFX) and tadalafil (TDA) as internal standards. The analytes were extracted from human plasma by protein precipitation using acetonitrile. Chromatographic separation was performed on Kinetex C18 (50.0 × 4.6 mm, 5 μm particle size) column with methanol-0.01 M ammonium acetate pH 6.4 (70: 30, v/v) as mobile phase. Multiple reaction monitoring involving the transitions 555.10 → 396.20, 235.20 → 86.00, 454.20 → 284.80 and 390.20 → 268.20 was utilized to quantify CFT, LDC, CFX and TDA, respectively, using a triple quadrupole mass spectrometer which was operated in positive ion mode. The method revealed linearity in the concentration range of 3.0-300.0 μg/mL for CFT and 3.0-300.0 ng/mL for LDC. The validation of the method was achieved in accordance to the US Food and Drug Administration guidelines. A pharmacokinetic study was performed on healthy Egyptian volunteers after intramuscular injection of sterile ceftriaxone sodium (1 g CFT dissolved in 3.5 mL of 1% LDC) after approval from the ethics committee. The pharmacokinetic parameters were: Cmax 141.15 ± 39.84 (μg/mL) and 55.02 ± 9.36 (ng/mL); tmax (h) 2.50 ± 0.50 and 1.5 ± 0.50; t½ (h) 7.30 ± 2.98 and 4.23 ± 1.96; and Kel (h-1 ) 0.10 ± 0.04 and 0.20 ± 0.13 for CFT and LDC, respectively.
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Affiliation(s)
- Dalia Mohamed
- Analytical Chemistry Department, Faculty of Pharmacy, Helwan University, Cairo, Egypt.,Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, October University for Modern Sciences and Arts, 6 October City, Egypt
| | - Maha Kamal
- Analytical Chemistry Department, Faculty of Pharmacy, Al-Ahram Canadian University, 6 October City, Egypt
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