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Ahn C, Oh KH, Kim K, Lee KY, Lee JG, Oh MD, Kim Y, Han JS, Kim S, Lee JS, Jang IJ, Shin SG. Effect of Peritoneal Dialysis on Plasma and Peritoneal Fluid Concentrations of Isoniazid, Pyrazinamide, and Rifampin. ARCH ESP UROL 2003. [DOI: 10.1177/089686080302300409] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
♦ Objective This study was performed to elucidate the pharmacokinetic profiles of antimycobacterial regimens for peritoneal dialysis patients. ♦ Patients Nine patients on maintenance continuous ambulatory peritoneal dialysis (CAPD) were included in this study. ♦ Methods After administering a conventional oral dose of antituberculosis medications, we measured plasma and peritoneal fluid concentrations of isoniazid by fluorometry, and rifampin and pyrazinamide by high performance liquid chromatography. The assay data were subjected to pharmacokinetic analysis. ♦ Results Average peak plasma concentrations of isoniazid, rifampin, and pyrazinamide were 3.3 mg/L, 6.5 mg/L, and 30.9 mg/L, respectively, all of which much exceed the minimum inhibitory concentration (MIC) for Mycobacterium tuberculosis. Peritoneal fluid concentrations of isoniazid and pyrazinamide were maintained well above the MICs for M. tuberculosis; however, peritoneal fluid concentration of rifampin was below the therapeutic range most of the time. ♦ Conclusion For the treatment of systemic or pulmonary tuberculosis in CAPD patients, no dose adjustments are required for isoniazid, rifampin, or pyrazinamide. On the contrary, for the treatment of tuberculous peritonitis, oral rifampin therapy is not expected to be effective because of its low peritoneal fluid concentration.
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Affiliation(s)
- Curie Ahn
- Departments of Nephrology, College of Medicine, Seoul National University
| | - Kook-Hwan Oh
- Department of Nephrology, College of Medicine, Hallym University
| | - Kiwon Kim
- Departments of Nephrology, College of Medicine, Seoul National University
| | - Kyung Yi Lee
- Departments of Nephrology, College of Medicine, Seoul National University
| | - Jung Geon Lee
- Department of Nephrology, Eulji University School of Medicine, Seoul, Korea
| | - Myung Don Oh
- Departments of Nephrology, College of Medicine, Seoul National University
| | - Yonsu Kim
- Departments of Nephrology, College of Medicine, Seoul National University
| | - Jin Suk Han
- Departments of Nephrology, College of Medicine, Seoul National University
| | - Suhnggwon Kim
- Departments of Nephrology, College of Medicine, Seoul National University
| | - Jung Sang Lee
- Departments of Nephrology, College of Medicine, Seoul National University
| | - In-jin Jang
- Clinical Pharmacology, College of Medicine, Seoul National University
| | - Sang-Goo Shin
- Clinical Pharmacology, College of Medicine, Seoul National University
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Kraemer HJ, Feltkamp U, Breithaupt H. Quantification of pyrazinamide and its metabolites in plasma by ionic-pair high-performance liquid chromatography. Implications for the separation mechanism. JOURNAL OF CHROMATOGRAPHY. B, BIOMEDICAL SCIENCES AND APPLICATIONS 1998; 706:319-28. [PMID: 9551819 DOI: 10.1016/s0378-4347(97)00519-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Pyrazinamide, the amide of pyrazinoic acid, is one of the basic therapeutic agents currently used in combination for chemotherapy of tuberculosis. A reversed-phase high-performance liquid chromatography method based on ionic pair chromatography, was developed after solid-phase extraction of the analytes from plasma with prior addition of internal standard. The main metabolites, pyrazinoic acid, 5-hydroxypyrazinoic acid and 5-hydroxypyrazinamide, were included as well as uric acid and other purine derivatives to allow detailed study of the pharmacokinetics of the drug, especially in patients with impaired kidney function. Some interesting features of the chromatographic system giving some insight in the retention mechanism and of the solid-phase extraction are discussed in detail.
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Affiliation(s)
- H J Kraemer
- Department of Internal Medicine, Justus-Liebig-University, Giessen, Germany
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Abstract
In the present study, we investigated whether ethanol inhibits the activity of xanthine dehydrogenase. Ethanol and/or inosine were administered to normal subjects, and plasma concentration and urinary excretion of purine bases were measured together with blood concentrations of lactic acid and pyruvic acid. In addition, ethanol and pyrazinamide were administered to these subjects, and plasma concentration and urinary excretion of pyrazinamide and its major metabolites were measured. Increases in plasma concentration and urinary excretion of xanthine induced by a combination of ethanol and inosine were greater than the sums of increases induced separately by ethanol and inosine, although increases in plasma concentration and urinary excretion of uric acid induced by the combination of ethanol and inosine were not different from the sums of increases induced separately by ethanol and inosine. Ethanol increased the ratio of blood lactic acid to blood pyruvic acid and decreased plasma concentration and urinary excretion of 5-hydroxypyrazinamide and 5-hydroxypyrazinoic acid. These results suggest that ethanol inhibits xanthine dehydrogenase presumably by an ethanol-induced increase in the cytosolic concentration of NADH in the liver.
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Affiliation(s)
- T Yamamoto
- Third Department of Internal Medicine, Hyogo College of Medicine, Japan
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Nasako Y, Yamamoto T, Moriwaki Y, Takahashi S, Tsutsumi Z, Hada T, Higashino K. In vitro and in vivo study on the conversion of allopurinol and pyrazinamide. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 1995; 370:43-6. [PMID: 7660944 DOI: 10.1007/978-1-4615-2584-4_11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Y Nasako
- Third Department of Internal Medicine, Hyogo College of Medicine, Japan
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Yamamoto T, Moriwaki Y, Suda M, Nasako Y, Takahashi S, Hiroishi K, Nakano T, Hada T, Higashino K. Effect of BOF-4272 on the oxidation of allopurinol and pyrazinamide in vivo. Is xanthine dehydrogenase or aldehyde oxidase more important in oxidizing both allopurinol and pyrazinamide? Biochem Pharmacol 1993; 46:2277-84. [PMID: 8274161 DOI: 10.1016/0006-2952(93)90618-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Allopurinol or pyrazinamide was administered to rats treated with BOF-4272 (a potent xanthine oxidase inhibitor) to investigate to what degree xanthine dehydrogenase participates in the oxidation of these agents. BOF-4272 markedly decreased the plasma concentration and the urinary excretion of both oxypurinol and 5-hydroxypyrazinamide. It also decreased the sum of the urinary excretion of allopurinol and oxypurinol and that of pyrazinamide and its metabolites, although it did not affect the sum of the plasma concentrations of allopurinol and oxypurinol at 105 min after administration of allopurinol or the plasma concentration of pyrazinamide during the period after the administration of pyrazinamide. These results suggested that BOF-4272 almost completely inhibited the oxidation of allopurinol and pyrazinamide and had some effect on the excretion and/or the tissue incorporation of these two compounds. Since the in vitro study demonstrated that BOF-4272 did not inhibit the activity of aldehyde oxidase, which oxidized both allopurinol to oxypurinol and pyrazinamide to 5-hydroxypyrazinamide, the results suggested that xanthine dehydrogenase was the more important enzyme in converting allopurinol to oxypurinol and pyrazinamide to 5-hydroxypyrazinamide.
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Affiliation(s)
- T Yamamoto
- Third Department of Internal Medicine, Hyogo College of Medicine, Japan
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6
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Yamamoto T, Moriwaki Y, Takahashi S, Suda M, Higashino K. Effects of pyrazinamide, probenecid, and benzbromarone on renal excretion of oxypurinol. Ann Rheum Dis 1991; 50:631-3. [PMID: 1929586 PMCID: PMC1004507 DOI: 10.1136/ard.50.9.631] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The effects of pyrazinamide, probenecid, and benzbromarone on renal excretion of oxypurinol were investigated. Pyrazinamide decreased the mean (SEM) fractional clearance of oxypurinol from 19.2 (2.1) to 8.8 (1.5). Probenecid increased the fractional clearance of oxypurinol from 14.1 (3.5) to 24.8 (4.1). Benzbromarone increased the fractional clearance of oxypurinol from 15.6 (2.3) to 33.8 (2.8). These results suggest that oxypurinol may be secreted by 'an organic acid system' and that oxypurinol is reabsorbed at a putative postsecretory site of the renal tubules.
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Affiliation(s)
- T Yamamoto
- Third Department of Internal Medicine, Hyogo College of Medicine, Japan
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Lacroix C, Hoang TP, Nouveau J, Guyonnaud C, Laine G, Duwoos H, Lafont O. Pharmacokinetics of pyrazinamide and its metabolites in healthy subjects. Eur J Clin Pharmacol 1989; 36:395-400. [PMID: 2737233 DOI: 10.1007/bf00558302] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The plasma and urine pharmacokinetic parameters of pyrazinamide and of its metabolites (pyrazinoic acid, 5-hydroxy-pyrazinamide, 5-hydroxy-pyrazinoic acid and pyrazinuric acid) have been studied after a single oral dose of pyrazinamide 27 mg.kg-1 in 9 healthy subjects. Pyrazinamide was rapidly absorbed (tmax less than or equal to 1 h) and showed a short distribution phase followed by an elimination phase of t1/2 beta = 9.6 h. The close similarity of the apparent elimination rates of the metabolites led to a second trial of a single oral dose of pyrazinoic acid to evaluate the formation and elimination stages. The limiting factor was found to be the activity of a microsomal deamidase (pyrazinoic acid formation from pyrazinamide and 5-hydroxy-pyrazinoic acid formation from 5-hydroxy-pyrazinamide). In contrast, oxidation by xanthine oxidase occurred very rapidly (5-hydroxy-pyrazinamide formation and pyrazinoic acid catabolism to 5-hydroxy-pyrazinoic acid).
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Affiliation(s)
- C Lacroix
- Department of Pharmacokinetics, Centre Hospitalier Général, Le Havre, France
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Lacroix C, Hermelin A, Guiberteau R, Guyonnaud C, Nouveau J, Duwoos H, Lafont O. Haemodialysis of pyrazinamide in uraemic patients. Eur J Clin Pharmacol 1989; 37:309-11. [PMID: 2612545 DOI: 10.1007/bf00679791] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The pharmacokinetics of PZA during haemodialysis were determined in 6 patients with chronic renal impairment after a single oral dose of 25.7 (1.9) mg.kg-1. The dialysis clearance of PZA and of its metabolites were: pyrazinamide 132 ml.min-1; pyrazinoic acid 121 ml.min-1; 5-hydroxy-pyrazinamide 107 ml.min-1; 5-hydroxy-pyrazinoic acid 118 ml.min-1. The average amount extracted during a dialysis session of 4.1 h was 926 mg after an oral dose of 1700 mg. The high dialysability shows that PZA can properly be administered at the end of each dialysis session in the usual dose of 25 to 30 mg.kg-1.
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Affiliation(s)
- C Lacroix
- Unités de Pharmacocinétique, Centre Hospitalier Général, Le Havre, France
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Yamamoto T, Moriwaki Y, Takahashi S, Hada T, Higashino K. In vitro conversion of pyrazinamide into 5-hydroxypyrazinamide and that of pyrazinoic acid into 5-hydroxypyrazinoic acid by xanthine oxidase from human liver. Biochem Pharmacol 1987; 36:3317-8. [PMID: 3663245 DOI: 10.1016/0006-2952(87)90654-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- T Yamamoto
- Third Department of Internal Medicine, Hyogo College of Medicine, Japan
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Microdétermination du pyrazinamide et de ses métabolites (acide pyrazinoïque, acide hydroxy-5-pyrazinoïque, hydroxy-5-pyrazinamide, acide pyrazinurique) plasmatiques et urinaires par chromatographie en phase liquide. ACTA ACUST UNITED AC 1987. [DOI: 10.1016/0378-4347(87)80454-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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