A comprehensive DNA barcoding reference database for Plecoptera of Switzerland

DNA barcoding is an essential tool in modern biodiversity sciences. Despite considerable work to barcode the tree of life, many groups, including insects, remain partially or totally unreferenced, preventing barcoding from reaching its full potential. Aquatic insects, especially the three orders Ephemeroptera, Plecoptera, and Trichoptera (EPT), are key freshwater quality indicators worldwide. Among them, Plecoptera (stoneflies), which are among the most sensitive aquatic insects to habitat modification, play a central role in river monitoring surveys. Here, we present an update of the Plecoptera reference database for (meta)barcoding in Switzerland, now covering all 118 species known from this country. Fresh specimens, mostly from rare or localized species, were collected, and 151 new CO1 barcodes were generated. These were merged with the 422 previously published sequences, resulting in a dataset of 573 barcoded specimens. Our CO1 dataset was delimited in 115 CO1 clusters based on a priori morphological identifications, of which 17% are newly reported for Switzerland, and 4% are newly reported globally. Among the 115 CO1 clusters, 85% showed complete congruence with morphology. Distance-based analysis indicated local barcoding gaps in 97% of the CO1 clusters. This study significantly improves the Swiss reference database for stoneflies, enhancing future species identification accuracy and biodiversity monitoring. Additionally, this work reveals cryptic diversity and incongruence between morphology and barcodes, both presenting valuable opportunities for future integrative taxonomic studies. Voucher specimens, DNA extractions and reference barcodes are available for future developments, including metabarcoding and environmental DNA surveys.

Notes on Leuctra signifera Kempny, 1899 and Leuctra austriaca Aubert, 1954 (Plecoptera: Leuctridae), with the description of a new species

Leuctra signifera Kempny, 1899 and Leuctra austriaca Aubert, 1954 are re-described and their taxonomical status is discussed. New country records are reported for L. austriaca from Hungary and L. signifera from Italy, Slovenia, and Hungary. A new species, Leuctra papukensis sp. n., from Croatia, is described and illustrated. The subspecies Leuctra signifera jahorinensis Kaćanski, 1972 is raised to species level.

On the Trichoptera of Western Europe, with surveys of Platyphylax, Simaphylax genera, Drusus chapmani, Chaetopteryx gessneri, and C. gonospina species complexes

In the present paper on the Western European Trichoptera we revise or overview the Platyphylax and Simaphylax limnephiline genera, as well as establish and/or overview the Drusus chapmani, Chaetopteryx gessneri and C. gonospina species complexes based on the principles and procedures of our fine phenomics. Having collected a new Drusus chrysotus (Rambur, 1842) specimen we have reconfirmed its delineation from its eastern sibling species Drusus lapos Oláh, 2017. By the paraproct, the Drusus spelaeus siblings in the Drusus mixtus species group are related to the Drusus siveci species complex in the Drusus discolor species group. Our discovery of a population of Drusus spelaeus with paramere structure similar to that of the Drusus discolor species group indicates further the importance of chimeric processes in species integrative organisation. Due to contradictory drawings published we have re-examined and redescribed the female of Drusus spelaeus. After surveying the recent taxonomic history of the Allogamus auricollis species subgroup we have raised the subspecies status to species rank of Allogamus auricollis bauerii (Kolenati, 1859); A. brauerii stat. nov. Chaetopteryx gessneri tomaszewski Moretti, 1991 was elevated to species rank: Ch. tomaszewski stat. nov. and Chaetopteryx kimera Oláh & Vinçon, 2021, a rather unique chimeric species having several character states of different origin was transferred to Consorophylax genus: C. kimera (Oláh & Vinçon, 2021) comb. nov. Furthermore, 17 new species were described: Wormaldia ariega, W. ligurica, W. maritima, Drusus alethes, D. italiano, Chaetopteryx tompula, C. cantabrica, C. decampsi, C. pyrenaica, Consorophylax cairos, C. lagoverde, C. livek, C. seolan, Platyphylax vinconi, Simaphylax coppai, S. andorricus and S. ariegeus spp. nov. Among them, ten were collected in France, five in Italy, one in Slovenia and one in Spain. Moreover, we report for the first time Potamophylax spinulifer Moretti, 1994 and Beraeamyia gudrunae Malicky, 2002 from France and Simaphylax altuspyrenaicus from Spain.

Una nueva especie de Zwicknia Murányi, 2014 de España (Plecoptera: Capniidae)

Se describe e ilustra una nueva especie, Zwicknia avilensis sp. n., de España a partir de machos y hembras adultos y de larvas del último estadio. También se discuten las afinidades morfológicas de esta nueva especie y se propone una clave para los adultos de Zwicknia de Europa occidental y meridional. Desde el punto de vista morfológico, Zwicknia avilensis sp. n. difiere claramente de todas las demás especies o subespecies conocidas del género Zwicknia.

Two new species of Protonemura Kempny, 1898 (Plecoptera: Nemouridae) from the Italian Alps

Two new species of Protonemura Kempny, 1898, P. bispina sp. n. and P. pennina sp. n., from the Eastern and Western Italian Alps, respectively, are described and illustrated. Further information on distribution and ecological preferences of these new species is provided. The species Protonemura auberti Illies, 1954 is re-described from topotypical material.

Review and contribution to the stonefly (Insecta: Plecoptera) fauna of Azerbaijan

Known Plecoptera data published from Azerbaijan are critically reviewed. New records of 28 species are enumerated on the basis of specimens collected between 2017 and 2019, among them 16 are new for the fauna of Azerbaijan. Nemoura irani Aubert, 1964 is new for the whole Caucasian region, Leuctra sanainica Zhiltzova, 1960 and Plesioperla sakartvella (Zhiltzova, 1956) are new for the Greater Caucasus. The female and larva of an unknown Protonemura Kempny, 1898 species, collected in the Talysh Mts, are illustrated and described under temporary name Protonemura sp. AZE-1. A new species of Protonemura, collected both in the Azerbaijan and Georgian areas of the Greater Caucasus, will be formally described in a further paper. A male Protonemura specimen was found to be infected by mermithid worms, morphological lesions are illustrated and commented; this is the second documented case of mermithid infection in stoneflies. Subspecies level identity of Azerbaijani populations of Leuctra fusca (Linnaeus, 1758) proved to be problematic, morphological characters of the specimens are illustrated. Synonymy of Isoperla caucasica Balinsky, 1950 and I. pulchra Balinsky, 1950 under I. bithynica (Kempny, 1908) is disputed, the two names are combined under I. grammatica (Poda, 1761) sensu lato.

On the Trichoptera of the Caucasus with western and eastern relatives

This caddisfly study is based mostly on the material collected in the framework of the International Visegrad Fundreseach project on the aquatic insects of Georgia and Azerbaijan. Applying the principles and procedures of fine phenomics we have delineated and characterised several Trichoptera species complexes; reinstated the species status of Hydropsyche derek Oláh & Kiss, 2015 stat. rest., Badukiella subnigra Oláh, 1985 stat. rest., Rhyacophila aliena Martynov, 1916 stat. rest., Stenophylax caspicus (Schmid, 1959) stat. rest., Stenophylax lasarea(Oláh, 1985) stat rest.; raised the subspecies status to species rank of Halesus caucasicus Oláh, 1985 stat. nov. andPotamophylax armeniacus Mey, 1979 stat. nov.; described the Sakalagen. nov in the Limnephilini tribe; and furthermore 70 species new to science: Wormaldia davidi Oláh & Vinçon sp. nov., W. elvesta Oláh sp. nov., W. harma Oláh & Vinçon sp. nov., W. holaga Oláh & Manko sp. nov., W. hoska Oláh sp. nov., W. kimera Oláh & Vinçon sp. nov., W. kitera Oláh sp. nov., W. obola Oláh sp. nov., W. sakaorum Oláh sp. nov., W. tomora Oláh & Vinçon sp. nov., Diplectrona albanica Oláh sp. nov., D. georgica Oláh & Vinçon sp. nov., D. serbica Oláh sp. nov., Hydronema turkestanica Oláh sp. nov., Hydropsyche harmada Oláh sp. nov., H. rovnaka Oláh sp. nov., H. togana Oláh & Kerimova sp. nov., H. pupka Oláh sp. nov., H. sukula Oláh sp. nov., H. ejsaka Oláh sp. nov., Agapetus gouriensis Oláh & Vinçon sp. nov., Rhyacophila kveda Oláh & Vinçon sp. nov., R. nakra Oláh & Vinçon, R. zekara Oláh & Vinçon sp. nov., R. gouria Oláh & Vinçon sp. nov., R. mtirala Oláh & Vinçon sp. nov., R. ordua Oláh sp. nov., R. rizea Oláh sp. nov., R. sacokia Oláh & Vinçon sp. nov., R. trabzona Oláh sp. nov., R. iranica Oláh sp. nov., R. kora Oláh sp. nov., R. pakistanica Oláh sp. nov., R. kimara Oláh & Vinçon sp. nov., Apataniana bacurianica Oláh & Vinçon sp. nov., A. goderdza Oláh & Kovács sp. nov., A. kintrisha Oláh & Vinçon sp. nov., Drusus erdes Oláh & Vinçon sp. nov., D. sukul Oláh & Vinçon sp. nov., D. teslenkoae Oláh & Vinçon sp. nov., D. alapos Oláh sp. nov., D. chechensis Oláh sp. nov., D. csupasz Oláh sp. nov., D. johansoni Oláh sp. nov., D. megnot Oláh & Vinçon sp. nov., D. mankoi Oláh sp. nov., D. janjulae Oláh sp. nov., Sakala adjarica Oláh & Vinçon sp. nov., Badukiella kinula Oláh & Vinçon sp. nov., B. kurta Oláh & Vinçon sp. nov., Chaetopteryx vinconi Oláh & Kovács sp. nov., Kelgena adjarica Oláh & Kovács sp. nov., K. bakurianica Oláh & Vinçon sp. nov., K. bunka Oláh & Vinçon sp. nov., K. imeretica Oláh & Vinçon sp. nov., K. meyiOláh sp. nov., K. parhuza Oláh & Vinçon sp. nov., K. svanetica Oláh & Vinçon sp. nov., K. tolaka Oláh & Kovács sp. nov., K. topora Oláh & Vinçon sp. nov., Rizeiella bayae Vinçon & Oláh sp. nov., R. ereda Oláh & Vinçon sp. nov., R. odva Oláh & Vinçon sp. nov., R. oldala Oláh & Kovács sp. nov., R. tavola Oláh & Vinçon sp. nov., Halesus kampos Oláh sp. nov., H. karmos Oláh sp. nov., Stenophylax vallas Oláh & Kovács sp. nov., S. ujjas Oláh & Kovács sp. nov., Ernodes ordubadensis Oláh & Kerimova sp. nov.

A new species of <i>Leuctra</i> from Turkey, and notes on Anatolian <i>Rhabdiopteryx</i> (Plecoptera: Leuctridae &amp; Taeniopterygidae)

In the recent annotated catalogue of the Turkish Plecoptera, the fauna of Anatolia are considered remarkably rich with 32 micro-endemic species currently recorded (Darilmaz et al. 2016). The major hot spot is the Pontus, the eastern Black Sea region of Turkey. Nearly half of these micro-endemic stonefly species are only known from this region. The eastern subregion of the Pontus has a direct connection with the Caucasian stonefly fauna. This subregion even has an endemic species group of Leuctra Stephens, 1836, presently including four known species (Vinçon & Sivec 2001).

A new species of Zwicknia Murányi (Plecoptera, Capniidae) from the French and Swiss Jura Mountains, the French Massif Central, and the French Middle Rhône Region

A new species of Zwicknia Murányi, Z. ledoarei sp. n., from the Jura Mountains of France and Switzerland, the French Massif Central, and the French Middle Rhône Region, is described on the basis of morphology and molecular methods. Information on the distribution and the ecological preferences of this new species is also provided.

Contribution to the knowledge of Turkish stoneflies with annotated catalogue (Insecta: Plecoptera)

The stoneflies of Turkey are reviewed providing all known distributions and including new records. Additionally, ecological and biogeographical notes are given. The genus Taeniopteryx Pictet 1841 is reported from Turkey for the first time and 12 species new for the Turkish fauna: Leuctra joosti Braasch 1970, L. kopetdaghi Zhiltzova 1972, Protonemura rauschi Theischinger 1975, P. strandschaensis Braasch & Joost 1972, Nemoura asceta Murányi 2007, N. cambrica Stephens 1836, N. uncinata Despax 1934, Taeniopteryx caucasica Zhiltzova 1981, Brachyptera risi (Morton 1896), Pontoperla katherinae (Balinsky 1950), Siphonoperla neglecta (Rostock 1881), and Bulgaroperla mirabilis nigrita Zwick 1978.          Protonemura bithynica Aubert 1964 and Nemoura turcica Zwick 1972 are recognized as full species. The previously unknown female of Leuctra marilouae Vinçon & Sivec 2001 is described. The type locality is also given for each species located in Turkey.          The distributions of several rare endemic species are augmented by additional new records (Leuctra aculeata Zwick 1982, L. brachyptera Kazancı 1985, L. karcali Vinçon & Sivec 2001, L. kurui Kazancı 1983, L. marilouae Vinçon & Sivec 2001, L. sipahilerae Vinçon & Sivec 2001, L. theischingeri Vinçon & Sivec 2001, Protonemura bacurianica bacurianica Zhiltzova 1957, P. oreas Martynov 1928, P. spinulata Martynov 1928 (first confirmed records from Anatolia), P. triangulata Martynov 1928, Nemoura dromokeryx Theischinger 1976, N. martynovia Claassen 1936, and Brachyptera berkii Kazancı 2001.          Several species previously reported only from females are excluded from the Turkish fauna: Leuctra minuta minuta Zhiltzova 1960, L. svanetica Zhiltzova 1960, P. dilatata Martynov 1928. Other species are also excluded from the Turkish fauna: L. fusca fusca (Linnaeus 1758), N. carpathica Illies 1963, Siphonoperla burmeisteri (Pictet 1841), and S. libanica Alouf, 1992.          According to literature and our new faunistic data, 117 stonefly taxa representing 7 families and 24 genera are known from Turkey. Among them, 44 are endemic species from Anatolia.

Contribution to the knowledge of Moroccan and Maghrebin stoneflies (Plecoptera)

An overview of Moroccan stoneflies is presented as an annotated summary of published and unpublished records from 115 localities. These records have resulted in an updated species list reflecting taxonomic corrections and noteworthy range extensions for several species. A total of 28 species, belonging to 15 genera and seven families, is now known from Morocco with the greatest diversity found in the Rif Mountains (23 species) and the lowest in eastern Morocco with three species. The majority of Moroccan stoneflies are typical Mediterranean species (86%). The Moroccan endemics comprise nine species (32% of the Moroccan fauna). The Plecoptera fauna of Morocco is compared to that of Algeria and Tunisia. Thirty-eight stonefly species are reported from the entire Maghreb region. Protonemura khroumiriensis Béjaoui & Boumaïza, 2009 is considered a synonym of P. drahamensis Vinçon & Pardo, 2006.

Pharmacokinetics of milnacipran in liver impairment

The pharmacokinetics of single 50 mg oral and intravenous doses of milnacipran, a new non tricyclic antidepressant drug, were compared in 11 chronic liver impaired (LI) subjects and in 6 control subjects. Hepatic impairments, classified according to the PUGH scale were moderate (1 grade A), intermediate (6 grade B) and severe (4 grade C). Concentrations of unchanged drug and its conjugated form (its main metabolite) were measured in plasma and urines. In control subjects, milnacipran present high absolute bioavailability (mean value of 90%). Around 50% of the dose are excreted in urines as unchanged, while around 14% are excreted as glucuroconjugate. The remaining is composed of free and conjugated phase I inactive metabolites. Administration of milnacipran in LI subjects results in non significant changes in its pharmacokinetics, although its variability is increased. Unchanged drug exposure is not modified in LI subjects, while plasma levels of the conjugate are slightly decreased compared to the control group. This could either be due to a slight reduction in the conjugation process, or to a change in the distribution of the drug as urine excretion of both unchanged and conjugated forms are not modified compared to the control group. A few LI subjects present supra-bioavailability resulting in higher drug exposure after oral administration than after intravenous infusion. These modifications are not clinically relevant as drug exposure of the parent drug is not modified. As the unchanged drug is the only compound responsible for the activity of milnacipran, no dosage adjustment is needed in patients presenting liver impairment.

Influence of food and body weight on the pharmacokinetics of penticainide

The pharmacokinetics of penticainide, a class Ic antiarrhythmic drug, was studied in 16 healthy adults (eight males and eight females) after a single 300-mg oral dose in fasting conditions and with a standard meal. Penticainide concentrations in plasma and urine were measured by hplc. The pharmacokinetic parameters of penticainide including Cmax, tmax, AUC and t1/2 were not significantly altered in the presence of food. AUC values (mean +/- sd) were 50.68 +/- 10.8 mg.h.l-1 and 49.52 +/- 9.87 mg.h.l-1 in the absence and presence of food, respectively. However, a significant difference was observed between males and females in both fasting and fed conditions with a higher value of the apparent oral clearance in the second group. The values of apparent oral clearance, expressed in weight-normalized units were 1.33 +/- 0.35 ml.mn-1.kg-1 (male) and 1.93 +/- 0.34 ml.mn-1.kg-1 (female) in fast conditions (P < 0.01) and 1.38 +/- 0.28 ml.mn-1.kg-1 (male) and 1.93 +/- 0.49 ml.mn-1.kg-1 (female) in fed conditions (P < 0.02), respectively. The pharmacokinetics of penticainide is not modified by the presence of food, but an influence of body weight may be considered.

Determination of flunitrazepam in plasma by liquid chromatography

A reversed-phase liquid chromatographic method has been used to determine flunitrazepam in plasma. Extraction was simple and there was no need to hydrolyse the drug. Separation was achieved on a 150 x 3.9 mm i.d. column packed with 4-microns Nova Pack C18 using a mobile phase of water-acetonitrile-triethylamine (700:300:4, v/v/v) (adjusted to pH 7.5 with orthophosphoric acid). The method was shown to be rapid and reliable with a lower limit of detection of 5 ng ml-1. Results are reported of simple experiments on the effects of temperature and light on the stability of flunitrazepam in plasma kept on the laboratory bench.

Column-switching high-performance liquid chromatographic determination of vancomycin in serum

Concentrations of vancomycin in serum were measured by an automatic high-performance liquid chromatographic (HPLC) micromethod. Vancomycin is a glycopeptide antibiotic with broad application in the therapy of gram-positive infections. As this drug is potentially nephro- and ototoxic, a method to maximize its therapeutic benefit while minimizing the risk of toxicity is desirable. This fully automated HPLC method did not involve a sample pretreatment step. The configuration of the apparatus permitted a solid phase extraction of the serum sample on two precolumns filled with a reversed-phase material, followed by a chromatographic separation of the sample constituents on an analytical column. The reversed phase analytical column (muBondapak C18) was flushed with a mobile phase of water-acetonitrile-triethylamine, 870: 130: 4 (vol/vol/vol); the pH was adjusted to 3.0 with orthophosphoric acid. Precision was expressed as the coefficient of variation (CV), which was always < or = 4.13% for intra- and inter-assays (n = 10) in the range 2-50 micrograms/ml. We compared this specific HPLC determination to an enzyme-multiplied immunoassay (EMIT). Fifty clinical samples obtained from patients under vancomycin therapy were assayed by each method and results compared using a linear regression analysis. There was a significant correlation between results from HPLC and EMIT: EMIT = 0.51 + 1 x HPLC (r = 0.963; p < 0.0001). The rapidity and specificity of this HPLC micromethod make it suitable for use in the monitoring of serum levels of vancomycin and for use in pharmacokinetic studies of this antibiotic.

Cefpiramide kinetics and plasma protein binding in cholestasis

Cefpiramide is a new parenteral cephalosporin mainly excreted in the bile. Eight patients with cholestasis and 11 healthy subjects received a single 1 g i.v. dose. Cefpiramide concentrations in plasma and urine were measured by h.p.l.c. and plasma binding was determined by ultrafiltration. Total clearance of cefpiramide (mean +/- s.d.) was 15.5 +/- 7.1 ml min-1 in patients and 25.6 +/- 4.6 ml min-1 in healthy subjects. As a result, the terminal elimination half-life was longer in patients (12.0 +/- 2.9 h vs 5.3 +/- 0.9 h). Owing to impaired biliary elimination of cefpiramide in cholestasis, the urinary recovery of unchanged drug in patients was about five times greater than in healthy subjects (85.1 +/- 10.3% vs 16.2 +/- 3.9%). Plasma binding was significantly lower in cholestasis (fu = 0.23 +/- 0.13 vs 0.02 +/- 0.004 in healthy subjects). Accordingly, the dosage regimen of cefpiramide should be modified in patients with cholestasis.

[Tissue and systemic diffusion of idrocilamide after cutaneous administration]

Experimental findings have demonstrated that idrocilamide exhibits antiinflammatory and muscle relaxant properties due at least in part to tissular effects. Percutaneous diffusion of a 10% glycero-alcoholic idrocilamide solution was studied in ten patients scheduled to undergo total knee replacement. Four 200-mg doses of idrocilamide were applied to the suprapatellar area at 12-hour intervals before surgery. Pain was evaluated using a visual analog scale before and after treatment. Surgery was performed 1.75 to 3.5 hours after the last idrocilamide dose. Idrocilamide was assayed using high performance liquid chromatography in tissue, plasma, and joint fluid specimens taken during the surgical procedure. Topical administration of idrocilamide on healthy skin produced significant concentrations of the drug in all the tissue specimens, including subcutaneous fat, muscle, tendon, synovium, and knee capsule. Tissue levels were consistently higher than synovial fluid and plasma levels, indicating that little systemic diffusion occurred. Idrocilamide levels in potential target tissues might influence clinical effects.

Plasma levels of piperacillin and vancomycin used as prophylaxis in liver transplant patients

The pharmacokinetics of piperacillin and vancomycin used intravenously as antibioprophylaxis were measured in the plasma and bile during orthotopic liver transplantation. Piperacillin (4 g and then 2 g every 4 h) and vancomycin (1 g and then 0.5 g every 6 h) were infused in 10 patients. During vascular clamping without venovenous bypass, clearance of both antibiotics decreased in relation to renal insufficiency. During the surgical procedure, volume of distribution of both drugs increased because of fluid redistribution. The peaks of piperacillin after first, second and third administrations were respectively 314, 265 and 210 mg.l-1, while trough levels were 46.5, 55.2 and 54.5 mg.l-1. The peaks of vancomycin were 54.4, 49.6 and 40.9 mg.l-1, while first and second trough levels were 9.5 and 12 mg.l-1. These plasma concentrations were quite similar to levels reported in healthy subjects despite large blood loss and fluid replacement. However, piperacillin trough concentrations (< 64 mg/l) were too low in relation to its concentration-dependent antibacterial activity and vancomycin peak concentrations (> or = 40 mg/l) were slightly too high in relation to its toxicity.

The determination of bromazepam in plasma by reversed-phase high-performance liquid chromatography

A reversed-phase high-performance liquid chromatographic method has been developed for the determination of bromazepam, an anxiolytic benzodiazepine, in plasma. After a single-step extraction from alkalinized plasma with diethyl-ether in the presence of an internal standard (alpha-hydroxy-triazolam), the residues were chromatographed on a reversed-phase Nova Pak 5 microns C18 column, with a mobile phase of acetonitrile-water-triethylamine (700:300:4, v/v/v) adjusted to pH 7.4 with orthophosphoric acid. The limit of detection was 50 ng ml-1, using a 20 microliters injection with UV detection at 240 nm. Between-day and within-day relative standard deviations were lower than 6%. Studies of drug stability during sample storage at -20 degrees C and at +4 degrees C showed no degradation of bromazepam. However, bromazepam seemed to be degraded at ambient temperature, without any influence of light. This method is applied to the determination of bromazepam plasma levels in analytical toxicology.

Pharmacokinetics of intravenous and intraperitoneal ceftazidime in chronic ambulatory peritoneal dialysis

The pharmacokinetics of ceftazidime have been investigated in eight patients with chronic renal failure undergoing continuous ambulatory peritoneal dialysis. Each subject was given ceftazidime 1 g intravenously and 1 g intraperitoneally at an interval of 1 week. Ceftazidime was assayed by high-pressure liquid chromatography. After intravenous administration, the pharmacokinetic parameters of ceftazidime were: elimination plasma half-life (t1/2 beta) = 24.6 +/- 4.6 hours; apparent volume of distribution (V(area)): 0.37 +/- 0.09 1/kg, total plasma clearance (CL): 11.9 +/- 3.3 mL/minute, peritoneal clearance (CLp): 1.7 +/- 0.3 mL/minute. Over 72 hours, only 15.6 +/- 4.7% of the dose was eliminated by the peritoneal route. After intraperitoneal administration, ceftazidime appeared in the plasma rapidly, and the peak plasma concentration of 24.5 +/- 5.2 mg/L was achieved at the fourth hour; the elimination half-life (t1/2ke) was 20.8 +/- 1.7 hours. The absorption of ceftazidime from the peritoneal space was 74.1 +/- 7.4%. These data suggest that ceftazidime has bidirectional exchange characteristics through the peritoneal membrane. A single 1-g intraperitoneal dose led to serum and dialysate concentrations of ceftazidime above the minimum concentrations for susceptible pathogen germs for 24 hours.

Effect of famotidine on renal transplant patients treated with ciclosporine A

The influence of a 7-day course of 40 mg famotidine administered orally on the pharmacokinetics of ciclosporine A at steady-state has been investigated in 10 renal transplant patients. Famotidine did not appear to significantly alter the pharmacokinetics of ciclosporine A. This might be ascribed to the limited potential of famotidine for inhibiting microsomal enzyme function. Moreover, plasma creatinine concentrations and creatinine clearance remained stable. Our results suggest that famotidine has no noticeable interaction with ciclosporine A.

Pharmacokinetics of famotidine in patients with cirrhosis and ascites

The pharmacokinetics of famotidine has been investigated in ascitic cirrhotic patients. 10 decompensated cirrhotic patients were studied (9m, 1f), who had normal renal function, and six healthy control subjects (4m, 2f), matched for age, sex and weight. Each subject received on two occasions, at least four days apart, a single oral (40 mg) or intravenous dose (20 mg) of famotidine, at 21.00 h in a randomised manner. Serial blood samples were collected and famotidine in plasma was determined by a HPLC/UV method. Plasma data were subjected to non compartmental pharmacokinetic analysis. There were no statistically significant differences in pharmacokinetic parameters between the two groups after either the intravenous or oral administration of famotidine. The findings suggest that the dose of famotidine may not require any adjustment in ascitic patients without renal failure.

[Mode of action of non-narcotic analgesics]

According to Lim's experiments, non-narcotic analgesics are usually considered as "peripherally" acting drugs. Conversely, most of these compounds were shown to easily cross the blood-brain barrier, and hence partly produce their effects by a central mechanism. The relative contribution of each site of action may vary from one drug to another. Aspirin-like drugs may act by inhibiting arachidonate cyclooxygenase in both the damaged tissues and the central nervous system. Finally, these drugs appear to be either selective, or dose-dependent, or nonspecific inhibitors of prostaglandin-synthetases.

Pharmacokinetics and protein binding of cefpiramide in patients with alcoholic cirrhosis

The pharmacokinetics of cefpiramide, a new cephalosporin, were investigated after a single 1 gm intravenous injection in 11 patients with alcoholic cirrhosis and compared with those of 11 healthy subjects. In patients with cirrhosis the plasma elimination half-life was three times longer than that in normal subjects. The total plasma clearance was decreased significantly (p less than 0.001): 12.3 +/- 6.5 ml/min in patients and 25.6 +/- 4.6 ml/min in healthy volunteers, respectively. The urinary excretion of unchanged drug (percent of intravenous dose) for patients (69.8% +/- 29.9%) was statistically higher (p less than 0.01) than that for subjects (16.2% +/- 3.9%). The renal elimination became increasingly important with hepatic impairment. Protein binding of cefpiramide was reduced significantly in the group with cirrhosis. The average unbound fraction was 10.4% +/- 9.5% in patients with cirrhosis and 1.9% +/- 0.3% in normal subjects (p less than 0.01). Because the rate of elimination from plasma in patients is slower, the dosage regimen of cefpiramide would probably be modified in cirrhosis.

[Pharmacokinetics of propofol injected after deliberate preoperative hemodilution]

The effects of acute isovolaemic haemodilution (AIH) on propofol pharmacokinetics were studied in 16 male patients scheduled for prostatectomy. They were all ranked ASA 1, and were randomly allocated to two groups, group I (n = 8), who did not undergo any haemodilution, and group II (n = 8), in whom AIH was carried out. Anaesthesia was induced with a single 2.5 mg.kg-1 propofol bolus given in 30 s; maintenance was achieved with fentanyl 2 micrograms.kg-1, atracurium 1 mg.kg-1, and a ventilation with a mixture of nitrous oxide in oxygen 50 %, with enflurane 1 %. Those patients due to be haemodiluted had blood withdrawn before surgery (1,387.5 +/- 423.3 ml), at the same time as they were given the same volume of modified fluid gelatin (Plasmion). The volume of blood to be withdrawn was calculated according to the initial haematocrit, and that required. Haematocrit was decreased to 32.3 +/- 3.9 % (extremes 27 and 37 %). Thereafter blood samples were then collected over a 24 h period, which included surgery. Propofol was assayed in whole blood using high performance liquid chromatography. Analysis with a three-compartment model was carried out. The AIH only altered the central compartment volume (65.5 +/- 15.6 l in the control group vs 83.6 +/- 13.3 l in group II, p less than 0.01). Initial concentrations were not significantly different in the two groups (2,892 +/- 762 ng.ml-1 in controls vs 2,373 +/- 589 ng.ml-1 in the others). Clinically, anaesthesia and recovery were uneventful. It is concluded that the induction dose of propofol in patients scheduled for haemodilution does not require any alteration.

Micro-method for the determination of piperacillin in plasma by high-performance liquid chromatography

A simple and sensitive high-performance liquid chromatographic method for the determination of piperacillin in plasma is described. A C8 reversed-phase column was used with a mobile phase consisting of methanol-water-triethylamine (550:450:4, v/v/v) adjusted to pH = 3 with orthophosphoric acid and UV detection at 270 nm. Cephalothin was used as internal standard. The method involves a plasma protein precipitation with acetonitrile followed by extraction of endogenous compound with chloroform and injection of the upper aqueous phase into the chromatograph. Within-day and between-day assays give relative standard deviations less than or equal to 5.7%. The detection limit is 0.2 microgram ml-1. Stability studies show that piperacillin degradation starts at -4 degrees C. Therefore, samples have to be processed promptly and stored at -20 degrees C. The method described is convenient for clinical monitoring and for pharmacokinetic studies.

[Pharmacokinetics of chlormezanone in healthy volunteers]

The kinetics of chlormezanone were determined after oral administration of single (400 mg) and multiple doses (400 mg/day during 8 days) in eight young healthy male subjects. Plasma levels determination had been carried out by HPLC. After single dose administration, Cmax concentrations 4.62 +/- 0.75 mg/l were obtained (Tmax) 2.18 +/- 1.49 h after drug intake. Area under plasma concentrations time curve was 224.93 +/- 27.79 mg.h/l and terminal half-life 40.50 +/- 4.19 h. On chronic regimen, chlormezanone accumulates in the body: trough plasma concentrations are significantly increased from Day 7 (2.97 +/- 0.45 mg/l) to Day 9 (5.41 +/- 0.90 mg/l) and reach the steady state faster than it can be expected from half-life (40 hours) and dosing interval (24 hours). Elimination is faster (T1/2 beta = 37.14 +/- 3.18 h) after chronic regimen. Area under curve during dosing interval at steady state (164.19 +/- 21.70 mg.h/l) is significantly lower than the area under curve between zero and infinity in the single dose sequence (224.93 +/- 27.79 mg.h/l). These results agree with probable induction effect of chlormezanone on its own metabolism.

The influence of the route of administration of imipramine on imipramine and desipramine blood levels

Imipramine was used to treat 18 depressed inpatients for 22 days. Imipramine 2 mg/kg/day was administered from day 0 to day 14 intramuscularly, and 4 mg/kg/day was administered orally from days 15-21. Two pharmacokinetic studies were performed, the first at the end of the intramuscular phase (day 14) and the second at the end of the oral phase (day 21). Imipramine and desipramine blood levels were measured every hour from 8 a.m. to 4 p.m. Between these two pharmacokinetic evaluations, blood levels of imipramine and desipramine were measured every morning at 8 a.m. During intramuscular administration, the parent drug imipramine predominated in the plasma and, conversely, the desmethylated metabolite predominated during oral administration. With the changeover in route of administration, the doubling of the dose kept the blood levels of imipramine equal, while desipramine increased; the sum of imipramine and desipramine also increased, and the ratio of imipramine and desipramine decreased sharply, the median ratio changing over 3 days from 1.50 (day 15) to 0.62 (day 18).

Arterial and ventricular CSF pharmacokinetics after intrathecal meperidine in humans

In order to investigate the mechanisms leading to respiratory depression after lumbar administration of opioids, plasma and ventricular CSF pharmacokinetics of intrathecal meperidine (1 mg.kg-1) were studied in five head-injured patients undergoing surgery for lower limb fracture. Meperidine was detected both in the plasma (arterial catheter) and in the ventricular CSF (intracranial catheter) soon after intrathecal administration: 45 +/- 17 min and 100 +/- 14 min, respectively. The maximal plasma concentration was 341 +/- 133 ng.ml-1, whereas, in ventricular CSF, it was 64.5 +/- 14.9 ng.ml-1. The ventricular CSF-plasma ratio increased with time (r = 0.82) from 0.18 +/- 0.04 at the first hour to 0.38 +/- 0.1 at 16th hour. It is concluded that the putative risk of respiratory depression appears to be mainly related to the absorption into the systemic circulation and to redistribution back into CSF.

Pharmacokinetics of intravenous and intraperitoneal fosfomycin in continuous ambulatory peritoneal dialysis

Kinetics of fosfomycin were investigated in six patients undergoing continuous ambulatory peritoneal dialysis. Each subject received both an i.v. and an i.p. 1 g dose of fosfomycin with a one week washout between doses. Fosfomycin was assayed by a microbiological diffusion technique. After intravenous injection the fosfomycin serum kinetic parameters were as followed: elimination half-life (t1/2 beta) 38.4 +/- 8.7 h; volume of distribution 0.32 +/- 0.02 l/kg; total plasma clearance 7.0 +/- 1.4 ml/min and peritoneal clearance 3.2 +/- 0.2 ml/min. Dialyzate fosfomycin concentrations reached a maximum mean value of 32.2 +/- 2.8 micrograms/ml at 4 h post-injection and fosfomycin was detectable in dialyzate samples for up to 72 hours post-dosing. After intraperitoneal instillation, fosfomycin appeared in the serum rapidly and the mean peak plasma concentration was 36.2 +/- 2.8 micrograms/ml at the 4th h. The absorption rate (ka) was 0.580 +/- 0.039 h-1 and the absorption of fosfomycin from peritoneal space was 68.4 +/- 6.0%. These data suggest a bidirectional exchange through the peritoneal membrane. Intraperitoneal administration of 1 g either 48 h apart for anephric patients or 36 h apart for patients with residual renal function may achieve therapeutic serum concentrations.

Effects of josamycin on carbamazepine kinetics

The steady state pharmacokinetics of oral carbamazepine in epileptic patients (n = 8) was compared before and after one week of treatment with josamycin (2 g/day). There was a small but statistically significant decrease in oral clearance of total (17%) and unbound (21.5%) drug. In spite of an unchanged AUC of 10,11-epoxide carbamazepine the ratio of metabolite to parent drug AUC was significantly decreased (20.2%). The plasma protein binding of carbamazepine and its 10,11-epoxide metabolite did not vary. The results demonstrate impairment by josamycin of the apparent clearance of carbamazepine. Care should be taken in patient receiving both carbamazepine and josamycin.

Effect of aluminum phosphate on the bioavailability of ranitidine

The effect of aluminum phosphate on the bioavailability of ranitidine has been investigated in 10 young, healthy volunteers. Following a random cross over design, each subject took at a 1 week interval 150 mg ranitidine alone or with 11 g aluminum phosphate. Plasma and urine ranitidine levels were measured by HPLC. The antacid reduced both the maximum plasma ranitidine concentration by 40% and the area under the curve by 30%. Elimination of ranitidine was not changed. The results indicate that aluminum phosphate significantly diminished the bioavailability of ranitidine.

Pharmacokinetics of intravenous and intraperitoneal ceftriaxone in chronic ambulatory peritoneal dialysis

The kinetics of ceftriaxone was investigated in 8 patients without infection, who were receiving continuous ambulatory peritoneal dialysis (CAPD). Ceftriaxone 1 g was injected i.v. and 1 g was given intraperitoneally in the CAPD fluid during a 4-h dwell time. Ceftriaxone was assayed by HPLC. After intravenous administration, the kinetic parameters of ceftriaxone were: plasma t1/2, 12.3 h, total plasma clearance, 14.0 ml/min, volume of distribution at steady state 0.18 l/kg, and peritoneal clearance 0.59 ml/min. Over 72 hours only 5.5% of the dose was eliminated by the peritoneal route. After intraperitoneal administration, ceftriaxone rapidly appeared in serum; the absorption t1/2 was 1.1 h and the mean peak concentration was 38.8 micrograms/ml. The absorption of ceftriaxone from the peritoneal space was 39%. A single 1.0 g IP dose led to serum and dialysate concentrations of ceftriaxone above the minimum inhibitory concentration for susceptible pathogens for 24 hours.

Pharmacokinetics of fosfomycin in hemodialyzed patients

The pharmacokinetics of fosfomycin, an original antimicrobial agent, were investigated in 11 voluntary hemodialyzed patients. Fosfomycin, 2 g, was administered intravenously, 15 minutes before hemodialysis began in group 1 (6 patients), and just after hemodialysis in group 2 (6 patients). Blood samples were collected during 8 hours (group 1) and during 44 hours (group 2). Antibiotic concentrations were determined microbiologically. In group 1, half-life was 4.2 +/- 0.27 hours, total clearance 65.1 +/- 7.1 ml/mn and clearance by hemodialyzer 103 +/- 10 ml/mn. In group 2 plasma levels were 60 mg/l at the 44th hour and half-life was 48.8 +/- 17.5 hours. These results suggest that fosfomycin is actively eliminated by the hemodialyzer in group 1, and largely retained between two dialysis sessions in group 2. As for therapy, intravenous administration of 2 g after dialysis and further administration after each succeeding session are proposed.

Effect of two antacids on the bioavailability of paracetamol

The effect of two antacids on the bioavailability of paracetamol has been investigated in 12 young healthy volunteers. Following a random cross over design, each subject swallowed, on three separate occasions, one weak apart, 500 mg paracetamol alone, or together with two different aluminium hydroxide, magnesium hydroxide preparations (Dimalan and Maalox). Plasma paracetamol levels were measured by HPLC. The bioavailability of paracetamol was not altered by either antacid, but they both delayed the time to peak plasma concentration (0.85 h; 1.43 h; 1.25 h, without antacid, with Dimalan and with Maalox respectively). The peak plasma concentration was not affected by concurrent antacid administration.

[Pharmacokinetics of alcohol after 3-hour intravenous infusion with and without cimetidine in 10 healthy non-alcoholic subjects]

Ethanol metabolism was studied in ten male non-alcoholic subjects following the constant intravenous infusion of ethanol (1.2 g/kg) administered during three hours with and without cimetidine. Pharmacokinetic analysis was performed on the pseudolinear portion of the elimination curve. The mean peak ethanol concentrations were not significantly different with and without cimetidine. There was no acceleration of ethanol metabolism at high concentrations: the ethanol elimination rate was similar above and under 17 mM, with and without cimetidine. Cimetidine administration had no effect on pharmacokinetic parameters of ethanol (area under the curve, Km and Vm). The fact that the ethanol elimination rate is similar whatever be its concentration and the absence of modifications of the pharmacokinetic parameters by cimetidine are not in favor of an important role of the microsomal ethanol oxidizing system (MEOS) in the ethanol metabolism of nonalcoholic subjects. The data do not allow to examine the role of MEOS in ethanol metabolism after chronic alcohol consumption.

[Pharmacokinetics of cimetidine in ascitic cirrhotics]

Eleven patients with ascitic cirrhosis and eleven patients without liver disease received 200 mg of cimetidine orally and intravenously. Plasma concentrations of cimetidine were analysed by high pressure liquid chromatography. No differences were observed in cimetidine half-life (2.53 +/- 0.63 and 2.33 +/- 0.40 h) between the two groups. Cimetidine clearance was diminished by about 30 p 100 in cirrhotic patients (0.426 +/- 0.138 vs. 0.649 +/- 0.163 l/h/kg). The apparent volume of distribution was also significantly diminished (1.50 +/- 0.44 vs. 2.14 +/- 0.55 l/kg) in patients with cirrhosis and ascites.