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Ota M, Shimizu M, Kamiya Y, Emoto C, Fukuda T, Yamazaki H. Adult and infant pharmacokinetic profiling of dihydrocodeine using physiologically based pharmacokinetic modeling. Biopharm Drug Dispos 2019; 40:350-357. [PMID: 31691978 DOI: 10.1002/bdd.2209] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/16/2019] [Accepted: 10/25/2019] [Indexed: 01/11/2023]
Abstract
We previously analysed the serum concentrations of dihydrocodeine in a 1-month-old infant with respiratory depression after being prescribed dihydrocodeine phosphate 2.0 mg/day divided t.i.d. for 2 days. The purpose was to develop a full physiologically based pharmacokinetic (PBPK) model that could account for these and other drug monitoring results. Based on experiments in Caco-2 cell monolayers, the effective permeability of dihydrocodeine in human jejunum was established as 1.28 × 10-4 cm/s. The in vitro Vmax /Km values for dihydrocodeine demethylation mediated by recombinant cytochrome P450 2D6 and 3A4 were 0.19 and 0.066 μl/min/pmol, respectively, and for dihydrocodeine 6-O-glucuronidation mediated by recombinant UGT2B4 and 2B7, the Vmax /Km values were 0.14 and 0.22 μl/min/mg protein, respectively. Renal clearance was calculated as 5.37 L/h on the total clearance value multiplied by the fraction recovered in urine. The reported plasma concentration-time profiles of dihydrocodeine after intravenous administration in healthy volunteers were used to adjust the tissue partitioning ratios. The developed model simulated the pharmacokinetic profiles of dihydrocodeine after single and multiple oral administrations reasonably well in the same population. Subsequently, the validated model was used to simulate pharmacokinetic profiles for five pediatric cases, including the 1-month-old Japanese boy and a 14-year-old Japanese girl who took an overdose of dihydrocodeine phosphate (37 mg). The simulated pharmacokinetic profiles for five virtual pediatric subjects matching the age, gender, and P450 2D6 phenotype of each case approximately reflected the observed values. These results suggested that our dihydrocodeine PBPK model reproduced the results of clinical cases reasonably well for subjects.
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Affiliation(s)
- Miki Ota
- Showa Pharmaceutical University, Machida, Tokyo, 194-8543, Japan
| | - Makiko Shimizu
- Showa Pharmaceutical University, Machida, Tokyo, 194-8543, Japan
| | - Yusuke Kamiya
- Showa Pharmaceutical University, Machida, Tokyo, 194-8543, Japan
| | - Chie Emoto
- Showa Pharmaceutical University, Machida, Tokyo, 194-8543, Japan
| | - Tsuyoshi Fukuda
- Showa Pharmaceutical University, Machida, Tokyo, 194-8543, Japan
| | - Hiroshi Yamazaki
- Showa Pharmaceutical University, Machida, Tokyo, 194-8543, Japan
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George R, Haywood A, Good P, Hennig S, Khan S, Norris R, Hardy J. Can Saliva and Plasma Methadone Concentrations Be Used for Enantioselective Pharmacokinetic and Pharmacodynamic Studies in Patients With Advanced Cancer? Clin Ther 2017; 39:1840-1848. [DOI: 10.1016/j.clinthera.2017.07.044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/15/2017] [Accepted: 07/31/2017] [Indexed: 10/19/2022]
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George R, Lobb M, Haywood A, Khan S, Hardy J, Good P, Hennig S, Norris R. Quantitative determination of the enantiomers of methadone in human plasma and saliva by chiral column chromatography coupled with mass spectrometric detection. Talanta 2016; 149:142-148. [DOI: 10.1016/j.talanta.2015.11.044] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 11/17/2015] [Accepted: 11/17/2015] [Indexed: 10/22/2022]
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Bista SR, Haywood A, Norris R, Good P, Tapuni A, Lobb M, Hardy J. Saliva versus Plasma for Pharmacokinetic and Pharmacodynamic Studies of Fentanyl in Patients with Cancer. Clin Ther 2015; 37:2468-75. [PMID: 26404396 DOI: 10.1016/j.clinthera.2015.09.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 08/25/2015] [Accepted: 09/01/2015] [Indexed: 01/09/2023]
Abstract
PURPOSE Fentanyl is widely used to relieve cancer pain. However there is great interpatient variation in the dose required to relieve pain and little knowledge about the pharmacokinetic and pharmacodynamic (PK/PD) relationship of fentanyl and pain control. Patients with cancer are fragile and there is reluctance on the part of health professionals to take multiple plasma samples for PK/PD studies. The relationship between plasma and saliva fentanyl concentrations was investigated to determine whether saliva could be a valid substitute for plasma in PK/PD studies. METHODS One hundred sixty-three paired plasma and saliva samples were collected from 56 patients prescribed transdermal fentanyl (Durogesic, Janssen-Cilag Pty Limited, NSW, Australia) at varying doses (12-200 µg/h). Pain scores were recorded at the time of sampling. Fentanyl and norfentanyl concentrations in plasma and saliva were quantified using HPLC-MS/MS. FINDINGS Saliva concentrations of fentanyl (mean = 4.84 μg/L) were much higher than paired plasma concentrations of fentanyl (mean = 0.877 μg/L). Both plasma and saliva mean concentrations of fentanyl were well correlated with dose with considerable interpatient variation at each dose. The relationship between fentanyl and norfentanyl concentrations was poor in both plasma and saliva. No correlation was observed between fentanyl concentration in plasma and saliva (r(2) = 0.3743) or free fentanyl in plasma and total saliva concentrations (r(2) = 0.1374). Pain scores and fentanyl concentration in either of the matrices were also not correlated. IMPLICATIONS No predictive correlation was observed between plasma and saliva fentanyl concentration. However the detection of higher fentanyl concentrations in saliva than plasma, with a good correlation to dose, may allow saliva to be used as an alternative to plasma in PK/PD studies of fentanyl in patients with cancer.
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Affiliation(s)
- Sudeep R Bista
- School of Pharmacy, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.
| | - Alison Haywood
- School of Pharmacy, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Ross Norris
- School of Pharmacy, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia; Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia; SydPath, St Vincent's Hospital, Sydney, New South Wales, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Phillip Good
- Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia; Department of Palliative and Supportive Care, Mater Health Services, Brisbane, Queensland, Australia; Palliative Care, St Vincent's Private Hospital, Brisbane, Queensland, Australia
| | - Angela Tapuni
- Department of Palliative and Supportive Care, Mater Health Services, Brisbane, Queensland, Australia
| | - Michael Lobb
- Mater Pathology Services, South Brisbane, Queensland, Australia
| | - Janet Hardy
- Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia; Department of Palliative and Supportive Care, Mater Health Services, Brisbane, Queensland, Australia
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Bista SR, Lobb M, Haywood A, Hardy J, Tapuni A, Norris R. Development, validation and application of an HPLC-MS/MS method for the determination of fentanyl and nor-fentanyl in human plasma and saliva. J Chromatogr B Analyt Technol Biomed Life Sci 2014; 960:27-33. [PMID: 24780703 DOI: 10.1016/j.jchromb.2014.04.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 04/07/2014] [Accepted: 04/08/2014] [Indexed: 11/24/2022]
Abstract
Monitoring fentanyl concentration in saliva and plasma may be useful in pharmacokinetic/pharmacodynamic studies. Salivettes(®) have been used widely for collecting saliva samples. However due to its lipophilicity, fentanyl adsorbs to the cotton dental bud (CDB) used in this device. Furthermore, due to dry mouth being a common adverse effect seen in patients treated with opioids, obtaining enough saliva for analysis is often a challenge. Hence, a simple simultaneous method to quantify fentanyl and its metabolite in both human plasma and saliva was developed and validated. A novel extraction method was also developed and validated to recover fentanyl in saliva directly from the CDB. This extraction method utilises acetonitrile to recover the fentanyl directly from the CDB rather than recovery by centrifugation, which is not always possible. Reverse phase chromatographic separation was performed on a Shimadzu LC 20A HPLC system using gradient elution. The electrospray ion source (ESI) was operated in positive ion mode using an Applied Biosystems API 3200 LC/MS/MS as detector. Deuterated fentanyl (D5) and nor-fentanyl (D5) were used as internal standards (IS). The retention times for fentanyl and nor-fentanyl were 3.70 min and 3.20 min respectively. The lower limit of quantitation (LLOQ) was determined to be 0.030 μg/L in plasma and 0.045 in saliva for fentanyl and nor-fentanyl. Acceptable linearity for fentanyl and nor-fentanyl in both plasma and saliva was demonstrated from 0.02 to 10 μg/L (R(2) 0.9988-0.9994). Accuracy for fentanyl and nor-fentanyl in both plasma and saliva samples was between 96% and 108%. Total imprecision expressed as the co-efficient of variation was between 1.0 and 15.5% for both analytes in both matrices. The validated method was applied successfully in 11 paired plasma and saliva samples obtained from patients with cancer pain receiving transdermal fentanyl (Duragesic(®)) at doses from 25 μg to 100 μg.
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Affiliation(s)
- Sudeep R Bista
- School of Pharmacy, Gold Coast Campus, Griffith Health Institute, Griffith University, Qld 4222, Australia.
| | - Michael Lobb
- Mater Research Institute & Mater Pathology Services (Australian Centre for Paediatric Pharmacokinetics), South Brisbane, Qld 4101, Australia
| | - Alison Haywood
- School of Pharmacy, Gold Coast Campus, Griffith Health Institute, Griffith University, Qld 4222, Australia
| | - Janet Hardy
- Mater Research Institute & Mater Pathology Services (Australian Centre for Paediatric Pharmacokinetics), South Brisbane, Qld 4101, Australia
| | - Angela Tapuni
- Mater Research Institute & Mater Pathology Services (Australian Centre for Paediatric Pharmacokinetics), South Brisbane, Qld 4101, Australia
| | - Ross Norris
- School of Pharmacy, Gold Coast Campus, Griffith Health Institute, Griffith University, Qld 4222, Australia; Mater Research Institute & Mater Pathology Services (Australian Centre for Paediatric Pharmacokinetics), South Brisbane, Qld 4101, Australia; School of Pharmacy, University of Queensland, St Lucia, Qld, Australia
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Hardy J, Norris R, Anderson H, O’Shea A, Charles B. Is saliva a valid substitute for plasma in pharmacokinetic studies of oxycodone and its metabolites in patients with cancer? Support Care Cancer 2011; 20:767-72. [DOI: 10.1007/s00520-011-1147-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Accepted: 03/28/2011] [Indexed: 11/29/2022]
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Samyn N, Laloup M, De Boeck G. Bioanalytical procedures for determination of drugs of abuse in oral fluid. Anal Bioanal Chem 2007; 388:1437-53. [PMID: 17404716 DOI: 10.1007/s00216-007-1245-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2007] [Revised: 03/02/2007] [Accepted: 03/06/2007] [Indexed: 10/23/2022]
Abstract
Recent advances in analytical techniques have enabled the detection of drugs and drug metabolites in oral fluid specimens. Although GC-MS is still commonly used in practice, many laboratories have developed and successfully validated methods for LC-MS(-MS) that can detect a large number of compounds in the limited sample volume available. In addition, several enzyme immunoassays have been commercialized for the detection of drugs of abuse in oral fluid samples, enabling the fast screening and selection of presumably positive samples. A number of concerns are discussed, such as the variability in the volume of sample collected and its implications in terms of quantitative measurements, and the drug recoveries of the many different specimen collection systems on the market. Additional considerations that also receive attention are the importance of providing complete validation data with respect to analyte stability, matrix effect, and the choice of collection method.
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Affiliation(s)
- Nele Samyn
- Laboratory of Toxicology, National Institute of Criminalistics and Criminology (N.I.C.C.), Federal Public Service Justice, Vilvoordsesteenweg 100, 1120 Brussels, Belgium.
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Dams R, Choo RE, Lambert WE, Jones H, Huestis MA. Oral fluid as an alternative matrix to monitor opiate and cocaine use in substance-abuse treatment patients. Drug Alcohol Depend 2007; 87:258-67. [PMID: 17008030 PMCID: PMC1892788 DOI: 10.1016/j.drugalcdep.2006.08.020] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2006] [Revised: 08/24/2006] [Accepted: 08/24/2006] [Indexed: 10/24/2022]
Abstract
Interest in oral fluid as an alternative matrix for monitoring drug use is due to its ease-of-collection and non-invasiveness; however, limited data are available on the disposition of drugs into oral fluid. The objective of this research was to provide data on the presence and concentrations of heroin, cocaine and multiple metabolites in oral fluid after illicit opioid and cocaine use. Thrice weekly oral fluid specimens (N=403) from 16 pregnant opiate-dependent women were obtained with the Salivette oral fluid collection device. Evidence of heroin (N=62) and cocaine (N=130) use was detected in oral fluid by LC-APCI-MS/MS. 6-Acetylmorphine (6-AM), heroin and morphine were the major opiates detected, with median concentrations of 5.2, 2.3, and 7.5 microg/L, respectively. Cocaine and benzoylecgonine (BE) had median concentrations of 6.4 and 3.4 microg/L. Application of the Substance Abuse Mental Health Services Administration (SAMHSA) recommended cutoffs for morphine and codeine (40 microg/L), 6-AM (4 microg/L) and cocaine and BE (8 microg/L), yielded 28 opiate- and 50 cocaine-positive specimens. Oral fluid is a promising alternative matrix to monitor opiate and cocaine use in drug testing programs. These data guide interpretation of oral fluid test results and evaluate currently proposed SAMHSA oral fluid testing cutoffs.
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Affiliation(s)
- Riet Dams
- Chemistry and Drug Metabolism, National Institute on Drug Abuse, 5500 Nathan Shock Drive, Baltimore, MD 21224, USA
- Laboratory of Toxicology, Ghent University, Harelbekestraat 72, B-9000 Gent, Belgium
| | - Robin E. Choo
- Chemistry and Drug Metabolism, National Institute on Drug Abuse, 5500 Nathan Shock Drive, Baltimore, MD 21224, USA
| | - Willy E. Lambert
- Laboratory of Toxicology, Ghent University, Harelbekestraat 72, B-9000 Gent, Belgium
| | - Hendree Jones
- Center for Addiction and Pregnancy, Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Baltimore, MD 21224, USA
| | - Marilyn A. Huestis
- Chemistry and Drug Metabolism, National Institute on Drug Abuse, 5500 Nathan Shock Drive, Baltimore, MD 21224, USA
- * Corresponding author: Dr. Marilyn A. Huestis, Chemistry and Drug Metabolism Section, National Institute on Drug Abuse, 5500 Nathan Shock Drive, Baltimore, MD, 21224, U.S.A. Tel: +1 410 550 2711, Fax: +1 410 550 2971, E-mail:
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Abstract
This article reviews studies that have measured drug concentrations in oral fluid following controlled dosing regimens. A total of 23 studies have been identified over the last 15 years. These show that the amphetamines including designer amphetamines, cocaine, cannabis and cocaine are quickly found in oral fluid following dosing and usually have similar time-courses to that in plasma. Following common doses peak oral fluid concentrations exceed 0.1 microg/mL and often even 1 microg/mL. The drug concentration will depend on whether a dilution step occurs with buffer as part of the sampling procedure. The uses of collectors that stimulate oral fluid usually reduce the drug concentration compared to a non-stimulated manner. This reduction will not disadvantage the recipient since it will potentially reduce the detectability of drug in oral fluid compared to non-stimulated collections. Only one recent study has been reported for a benzodiazepine. This showed nanogram per milliliter concentrations for flunitrazepam. More studies are required for benzodiazepines and indeed for other drugs, particularly in multiple drug situations and where disease may affect the pharmacokinetics of drugs.
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Affiliation(s)
- Olaf H Drummer
- Victorian Institute of Forensic Medicine and Department of Forensic Medicine, Monash University, 57-83 Kavanagh Street, Southbank, Melbourne 3006, Australia.
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