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Zhu S, Gao H, Babu S, Garad S. Co-Amorphous Formation of High-Dose Zwitterionic Compounds with Amino Acids To Improve Solubility and Enable Parenteral Delivery. Mol Pharm 2017; 15:97-107. [PMID: 29164901 DOI: 10.1021/acs.molpharmaceut.7b00738] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Solubilization of parenteral drugs is a high unmet need in both preclinical and clinical drug development. Recently, co-amorphous drug formulation has emerged as a new strategy to solubilize orally dosed drugs. The aim of the present study is to explore the feasibility of using the co-amorphous strategy to enable the dosing of parenteral zwitterionic drugs at a high concentration. A new screening procedure was established with solubility as the indicator for co-amorphous co-former selection, and lyophilization was established as the method for co-amorphous formulation preparation. Various amino acids were screened, and tryptophan was found to be the most powerful in improving the solubility of ofloxacin when lyophilized with ofloxacin at a 1:1 weight ratio, with more than 10 times solubility increase. X-ray powder diffraction showed complete amorphization of both components, and an elevated Tg compared with the theoretical value was observed in differential scanning calorimetry. Fourier transform infrared spectroscopy revealed that hydrogen bonding and π-π stacking were possibly involved in the formation of a co-amorphous system in the solid state. Further solution-state characterization revealed the involvement of ionic interactions and π-π stacking in maintaining a high concentration of ofloxacin in solution. Furthermore, co-amorphous ofloxacin/tryptophan at 1:1 weight ratio was both physically and chemically stable for at least 2 months at 40 °C/75% RH. Lastly, the same screening procedure was validated with two more zwitterionic compounds, showing its promise as a routine screening methodology to solubilize and enable the parenteral delivery of zwitterionic compounds.
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Affiliation(s)
- Saijie Zhu
- Chemical and Pharmaceutical Profiling, Technical Research and Development, China Novartis Institutes for Biomedical Research Co., Ltd , Shanghai 201203, China
| | - Huisheng Gao
- Chemical and Pharmaceutical Profiling, Technical Research and Development, China Novartis Institutes for Biomedical Research Co., Ltd , Shanghai 201203, China
| | - Sreehari Babu
- Chemical and Pharmaceutical Profiling, Technical Research and Development, China Novartis Institutes for Biomedical Research Co., Ltd , Shanghai 201203, China
| | - Sudhakar Garad
- Chemical and Pharmaceutical Profiling, Technical Research and Development, Novartis Pharmaceuticals , Cambridge, Massachusetts 02139, United States
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Rabbia F, D'Avolio A, Bernini G, Fulcheri C, De Nicolò A, Berra E, Bruno RM, Mulatero P, Taddei S, Veglio F. Antihypertensive Bridge Therapy by Continuous Drug Infusion With an Elastomeric Pump in Device-Resistant Hypertension. Hypertension 2016; 67:e3-4. [PMID: 26781280 DOI: 10.1161/hypertensionaha.115.06978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Franco Rabbia
- From the Internal Medicine and Hypertension Division, AOU Città della Salute e della Scienza, Department of Medical Sciences (F.R., C.F., E.B., P.M., F.V.) and Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital (A.D.A., A.D.N.), University of Turin, Turin, Italy; and Hypertension Unit, Department of Internal Medicine, University of Pisa, Pisa, Italy (G.P.B., R.M.B., S.T.).
| | - Antonio D'Avolio
- From the Internal Medicine and Hypertension Division, AOU Città della Salute e della Scienza, Department of Medical Sciences (F.R., C.F., E.B., P.M., F.V.) and Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital (A.D.A., A.D.N.), University of Turin, Turin, Italy; and Hypertension Unit, Department of Internal Medicine, University of Pisa, Pisa, Italy (G.P.B., R.M.B., S.T.)
| | - GiamPaolo Bernini
- From the Internal Medicine and Hypertension Division, AOU Città della Salute e della Scienza, Department of Medical Sciences (F.R., C.F., E.B., P.M., F.V.) and Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital (A.D.A., A.D.N.), University of Turin, Turin, Italy; and Hypertension Unit, Department of Internal Medicine, University of Pisa, Pisa, Italy (G.P.B., R.M.B., S.T.)
| | - Chiara Fulcheri
- From the Internal Medicine and Hypertension Division, AOU Città della Salute e della Scienza, Department of Medical Sciences (F.R., C.F., E.B., P.M., F.V.) and Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital (A.D.A., A.D.N.), University of Turin, Turin, Italy; and Hypertension Unit, Department of Internal Medicine, University of Pisa, Pisa, Italy (G.P.B., R.M.B., S.T.)
| | - Amedeo De Nicolò
- From the Internal Medicine and Hypertension Division, AOU Città della Salute e della Scienza, Department of Medical Sciences (F.R., C.F., E.B., P.M., F.V.) and Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital (A.D.A., A.D.N.), University of Turin, Turin, Italy; and Hypertension Unit, Department of Internal Medicine, University of Pisa, Pisa, Italy (G.P.B., R.M.B., S.T.)
| | - Elena Berra
- From the Internal Medicine and Hypertension Division, AOU Città della Salute e della Scienza, Department of Medical Sciences (F.R., C.F., E.B., P.M., F.V.) and Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital (A.D.A., A.D.N.), University of Turin, Turin, Italy; and Hypertension Unit, Department of Internal Medicine, University of Pisa, Pisa, Italy (G.P.B., R.M.B., S.T.)
| | - Rosa Maria Bruno
- From the Internal Medicine and Hypertension Division, AOU Città della Salute e della Scienza, Department of Medical Sciences (F.R., C.F., E.B., P.M., F.V.) and Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital (A.D.A., A.D.N.), University of Turin, Turin, Italy; and Hypertension Unit, Department of Internal Medicine, University of Pisa, Pisa, Italy (G.P.B., R.M.B., S.T.)
| | - Paolo Mulatero
- From the Internal Medicine and Hypertension Division, AOU Città della Salute e della Scienza, Department of Medical Sciences (F.R., C.F., E.B., P.M., F.V.) and Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital (A.D.A., A.D.N.), University of Turin, Turin, Italy; and Hypertension Unit, Department of Internal Medicine, University of Pisa, Pisa, Italy (G.P.B., R.M.B., S.T.)
| | - Stefano Taddei
- From the Internal Medicine and Hypertension Division, AOU Città della Salute e della Scienza, Department of Medical Sciences (F.R., C.F., E.B., P.M., F.V.) and Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital (A.D.A., A.D.N.), University of Turin, Turin, Italy; and Hypertension Unit, Department of Internal Medicine, University of Pisa, Pisa, Italy (G.P.B., R.M.B., S.T.)
| | - Franco Veglio
- From the Internal Medicine and Hypertension Division, AOU Città della Salute e della Scienza, Department of Medical Sciences (F.R., C.F., E.B., P.M., F.V.) and Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital (A.D.A., A.D.N.), University of Turin, Turin, Italy; and Hypertension Unit, Department of Internal Medicine, University of Pisa, Pisa, Italy (G.P.B., R.M.B., S.T.)
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Sarafidis PA, Georgianos PI, Malindretos P, Liakopoulos V. Pharmacological management of hypertensive emergencies and urgencies: focus on newer agents. Expert Opin Investig Drugs 2012; 21:1089-106. [PMID: 22667825 DOI: 10.1517/13543784.2012.693477] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Hypertensive crises are categorized as hypertensive emergencies and urgencies depending on the presence of acute target-organ damage; the former are potentially life-threatening medical conditions, requiring urgent treatment under close monitoring. Although several short-acting intravenous antihypertensive agents are approved for this purpose, until recently little evidence from proper trials on the relative merits of different therapies was available. AREAS COVERED This article discusses in brief the pathophysiology, epidemiology and diagnostic approach of hypertensive crises and provides an extensive overview of established and emerging pharmacological agents for the treatment of patients with hypertensive emergencies and urgencies. EXPERT OPINION Agents such as sodium nitroprusside, nitroglycerin and hydralazine have been used for many years as first-line options for patients with hypertensive emergencies, although their potential adverse effects and difficulties in use were well known. With time, equally potent and less toxic alternatives, including nicardipine, fenoldopam, labetalol and esmolol are increasingly used worldwide. Recently, clevidipine, a third-generation dihydropyridine calcium-channel blocker with unique pharmacodynamic and pharmacokinetic properties was added to our therapeutic armamentarium and was shown in clinical trials to reduce mortality when compared with nitroprusside. In view of such evidence, a change in pharmacological treatment practices for hypertensive crises toward newer and safer agents is warranted.
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Affiliation(s)
- Pantelis A Sarafidis
- Aristotle University of Thessaloniki, AHEPA Hospital, 1st Department of Medicine, Section of Nephrology and Hypertension, Thessaloniki, Greece.
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