Simultaneous quantitation of dexamethasone palmitate and dexamethasone in human plasma by liquid chromatography/tandem mass spectrometry

Clinical pharmacology of cytotoxic drugs in neonates and infants: Providing evidence-based dosing guidance

Cancer in neonates and infants is a rare but challenging entity. Treatment is complicated by marked physiological changes during the first year of life, excess rates of toxicity, mortality, and late effects. Dose optimisation of chemotherapeutics may be an important step to improving outcomes. Body size–based dosing is used for most anticancer drugs used in infants. However, dose regimens are generally not evidence based, and dosing strategies are frequently inconsistent between tumour types and treatment protocols. In this review, we collate available pharmacological evidence supporting dosing regimens in infants for a wide range of cytotoxic drugs. A systematic review was conducted, and available data ranked by a level of evidence (1–5) and a grade of recommendation (A–D) provided on a consensus basis, with recommended dosing approaches indicated as appropriate. For 9 of 29 drugs (busulfan, carboplatin, cyclophosphamide, daunorubicin, etoposide, fludarabine, isotretinoin, melphalan and vincristine), grade A was scored, indicating sufficient pharmacological evidence to recommend a dosing algorithm for infants. For busulfan and carboplatin, sufficient data were available to recommend therapeutic drug monitoring in infants. For eight drugs (actinomycin D, blinatumomab, dinutuximab, doxorubicin, mercaptopurine, pegaspargase, thioguanine and topotecan), some pharmacological evidence was available to guide dosing (graded as B). For the remaining drugs, including commonly used agents such as cisplatin, cytarabine, ifosfamide, and methotrexate, pharmacological evidence for dosing in infants was limited or non-existent: grades C and D were scored for 10 and 2 drugs, respectively. The review provides clinically relevant evidence-based dosing guidance for cytotoxic drugs in neonates and infants.

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Treating cancer in neonates and infants is challenging.

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Dose optimisation of cytotoxic drugs is an important step to improving outcomes.

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Clinical pharmacological evidence supporting dosing regimens in infants was collated.

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All available pharmacological evidence was ranked by a level of evidence.

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A grade of recommendation was derived and a recommended dose per agent provided.

Simultaneous Determination of Thalidomide and Dexamethasone in Rat Plasma by Validated HPLC and HPTLC With Pharmacokinetic Study

Two validated chromatographic methods have been developed for the simultaneous determination of thalidomide (THD) and dexamethasone (DEX) in rat plasma using paracetamol (PAR) as an internal standard (IS). Chromatographic analysis was achieved firstly by HPLC method on C18 column (150 × 4.6 mm2 i.d., 5 μm) and a mobile phase composed of ethanol:water (containing 0.1% acetic acid) (70:30, v/v) at the flow rate of 0.6 mL min-1. The second method was HPTLC method which depended on using a developing system of methylene chloride:acetone:ethyl acetate (7:4:1, by volume). In both methods, PAR was used as an IS. The developed methods have been validated as per FDA guidelines. All parameters were tested using quality control samples (LQC, MQC and HQC). All the obtained parameters were within the acceptance criteria. In the same way, the two methods were successfully used to study the pharmacokinetic parameters of both THD and DEX after their intra-peritoneal administration. Moreover, results obtained after administration of each drug alone were compared to those obtained after their administration together. The drugs showed drug-drug interactions when administered in combination, meaning that monitoring of such combination is very important.

Limethason reduces airway inflammation in a murine model of ovalbumin-induced chronic asthma without causing side effects

Airway inflammation is the major pathological feature of asthma. Thus, the current therapeutic strategy for asthma is to control inflammation. Limethason, an anti-inflammation drug, is widely used in rheumatoid arthritis treatment. The aim of the present study was to detect the anti-inflammatory effect and side effects of limethason on airways that were sensitized with ovalbumin in a murine model of chronic asthma. In the present study, BALB/c mice were sensitized with ovalbumin. Airway hyperresponsiveness was estimated, and hematoxylin and eosin staining, Periodic acid-Schiff staining and bronchoalveolar lavage were used to detect the effect on chronic asthma. Limethason effectively reduced airway hyperresponsiveness, and inhibited inflammatory cell infiltration and mucus secretion. Bronchoalveolar lavage fluid analysis revealed that limethason suppressed levels of airway eosinophils. In the period of treatment, limethason exhibited no influence on morphology of the femoral head, bone mineral content or bone mineral density, which were detected by histological studies and dual-energy X-ray absorptiometry. The index of liver, spleen, kidney, gastrocnemius and brown adipose tissue also demonstrated that limethason had no adverse effects on organs and tissues. The present study revealed that limethason could effectively reduce inflammation in an asthma mouse model without side effects. Therefore, limethason may have therapeutic potential for treating chronic asthma clinically.

Determination of dexamethasone by flow-injection chemiluminescence method using capped CdS quantum dots

L-Cysteine capped CdS quantum dots (QDs) were synthesized through a facile hydrothermal method and characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), photoluminescence (PL) and UV-Vis spectroscopy. The light emitted from KMnO4-L-cysteine capped CdS QDs reaction in acidic medium was applied as a simple and sensitive chemiluminescence (CL) system for determination of dexamethasone. The CL intensity of KMnO4-L-cysteine capped CdS QDs CL system was remarkably enhanced in the presence of dexamethasone. Under optimum experimental conditions, the enhanced CL intensity was related to dexamethasone concentration in the range of 0.004-25.0 mg L(-1), with the detection limit (3σ) of 0.0013 mg L(-1). The analytical applicability of the proposed CL system was assessed by determining dexamethasone in spiked environmental water samples and pharmaceutical formulation. The analytical performances of proposed flow-injection CL method for the determination of dexamethasone were compared with those obtained by corona discharge ionization ion mobility spectrometry (CD-IMS) method. The proposed CL system exhibits a higher sensitivity and precision than the CD-IMS method for the determination of dexamethasone.

Simultaneous Quantification of Diazepam and Dexamethasone in Plasma by High-Performance Liquid Chromatography with Tandem Mass Spectrometry and Its Application to a Pharmacokinetic Comparison between Normoxic and Hypoxic Rats

In order to investigate the pharmacokinetics of a combination of diazepam and dexamethasone under hypoxic conditions, a novel, sensitive and specific liquid chromatography with tandem mass spectrometry (LC-MS/MS) method for the simultaneous determination of diazepam and dexamethasone in rat plasma was developed and validated. The chromatographic separation of analytes was successfully achieved on an XTerra® MS C18 column using a gradient elution of methanol and water containing 0.1% formic acid at a flow rate of 0.5 mL/min. This method demonstrated good linearity and no endogenous material interferences. The linear ranges were 1.0-100 ng/mL for diazepam and 2.0-200 ng/mL for dexamethasone. The intra- and inter-day precision for the two compounds in plasma were lower than 10.0%, and the accuracy was between -7.9% and 11.5%. Our method was then successfully applied in a pharmacokinetic comparison between normoxic and hypoxic rats. The results indicated that there were significant differences in the main pharmacokinetics parameters of diazepam and dexamethasone between normoxic and hypoxic rats. The results provide the important and valuable information for discovering and developing novel anti-hypoxia drug combinations, as well as a better understanding of the safety and efficacy of these drugs.

Simultaneous determination of dexamethasone and lenalidomide in rat plasma by solid phase extraction and ultra-performance liquid chromatography-tandem mass spectrometry: application to pharmacokinetic studies

Determination of dexamethasone and lenalidomide in plasma by SPE and UPLC-MS/MS for the purpose of TDM: application to pharmacokinetic studies.

Detection of synthetic glucocorticoids by liquid chromatography-tandem mass spectrometry in patients being investigated for Cushing's syndrome

Background

We report a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the detection of four commonly prescribed steroid drugs (prednisolone, dexamethasone, betamethasone and beclomethasone dipropionate) while simultaneously measuring 24-h urine free cortisol and cortisone in patients.

Methods

Two hundred and fifty microlitre aliquots of urine were spiked with internal standard and extracted with dichloromethane. The MS instrument was operated with positive electrospray and multiple reaction monitoring. Two transitions were monitored for each analyte of interest and the ratio of the intensities of the product ion fragments was established.

Results

The LC-MS/MS method for the measurement of urine free cortisol and cortisone was established. The assay was linear up to 788 nmol/L for cortisol and 777 nmol/L for cortisone, with a limit of quantitation of 5.0 nmol/L for both. Analysis time per sample was seven minutes. Transitions for four synthetic glucocorticoids were included, and they were identified based on the ratio of the intensities of product ion fragments. Analysis of 219 samples collected from 154 patients (55 male and 99 female) revealed the presence of prednisolone in five samples from three patients. Dexamethasone was detected in samples from four patients, and betamethasone was detected in one sample.

Conclusion

This is the first LC-MS/MS method in routine use to combine quantification of urinary cortisol and cortisone and detection of synthetic glucocorticoids in patients being investigated for Cushing's syndrome. Since the most common quoted cause of Cushing's syndrome is steroid treatment, this is a valuable diagnostic tool.

Development and validation of an HPLC–MS/MS method for the analysis of dexamethasone from pig synovial fluid using dried matrix spotting

Background: Dried matrix spot techniques were employed to validate an HPLC–MS/MS assay for the determination of dexamethasone in clear Yorkshire pig synovial fluid using 15 µl of sample. We have adopted the term dried matrix spot to indicate that the techniques used for dried blood spots can be applied to nonblood matrices. The dried matrix spot method employs a color-indicating process developed at Alturas Analytics that enhances the ability to analyze transparent fluids spotted onto collection paper by allowing the analyst to visually verify the location of the dried sample spot. Results: The method was shown to be accurate (±4.3%) and precise (14.2% at the LLOQ and ≤10.0% at all other concentrations) across the dynamic range of the assay. Conclusion: The method shows the potential application of dried matrix spot techniques for the analysis of transparent biological fluids.

Comprehensive plasma-screening for known and unknown substances in doping controls

Occasionally, doping analysis has been recognized as a competitive challenge between cheating sportsmen and the analytical capabilities of testing laboratories. Both have made immense progress during the last decades, but obviously the athletes have the questionable benefit of frequently being able to switch to new, unknown and untested compounds to enhance their performance. Thus, as analytical counteraction and for effective drug testing, a complementary approach to classical targeted methods is required in order to implement a comprehensive screening procedure for known and unknown xenobiotics. The present study provides a new analytical strategy to circumvent the targeted character of classical doping controls without losing the required sensitivity and specificity. Using 50 microL of plasma only, the method potentially identifies illicit drugs in low ng/mL concentrations. Plasma provides the biological fluid with the circulating, unmodified xenobiotics; thus the identification of unknown compounds is facilitated. After a simple protein precipitation, liquid chromatographic separation and subsequent detection by means of high resolution/high accuracy orbitrap mass spectrometry, the procedure enables the determination of numerous compounds from different classes prohibited by the World Anti-Doping Agency (WADA). A new hyphenated mass spectrometry technology was employed without precursor ion selection for higher collision energy dissociation (HCD) fragmentation experiments. Thus the mass spectra contained all the desired information to identify unknown substances retrospectively. The method was validated for 32 selected model compounds for qualitative purposes considering the parameters specificity, selectivity, limit of detection (<0.1-10 ng/mL), precision (9-28%), robustness, linearity, ion suppression and recovery (80-112%). In addition to the identification of unknown compounds, the plasma samples were simultaneously screened for known prohibited targets.