Systemic absorption and gastrointestinal adverse effects from topical ketorolac and diclofenac ophthalmic solutions in healthy dogs

OBJECTIVE

To investigate systemic absorption and gastrointestinal (GI) adverse effects of topical ketorolac 0.5% and diclofenac 0.1% ophthalmic solutions.

ANIMALS

11 healthy purpose-bred Beagles.

METHODS

Dogs were randomly assigned to receive either ketorolac (n = 6) or diclofenac (5), 1 drop in both eyes 4 times daily for 28 days. Upper GI endoscopy was performed on days 0 and 29 with mucosal lesion scores (0 to 7) assigned to each region evaluated. Plasma samples were collected on days 14, 21, and 28 for measurement of diclofenac and ketorolac using high-performance liquid chromatography-mass spectrometry.

RESULTS

GI erosions and/or ulcers developed in all ketorolac-treated dogs and 1 of 5 diclofenac-treated dogs. Post-treatment mucosal lesion score for the antrum was higher in the ketorolac group than in the diclofenac group (P = .006) but not significantly different for any other region. Post-treatment antral mucosal lesion scores were significantly related to plasma ketorolac concentrations (P < .001). Ketorolac and diclofenac were detected in the plasma at all time points (median ketorolac day 14, 191 ng/mL; day 21, 173.5 ng/mL; and day 28, 179.5 ng/mL; and median diclofenac day 14, 21.1 ng/mL; day 21, 20.6 ng/mL; day 28, 27.5 ng/mL). Vomiting and decreased appetite events were observed uncommonly and were not significantly different between treatment groups.

CLINICAL RELEVANCE

GI ulceration and erosion developed after ophthalmic administration of ketorolac and diclofenac, with higher plasma concentrations and more severe GI lesions associated with ketorolac. Clients should be alerted to this potential risk with ophthalmic use and informed to watch for systemic clinical signs that would warrant veterinary reevaluation.

Pharmacokinetics of Ertapenem in Sheep (Ovis aries) with Experimentally Induced Urinary Tract Infection

Sheep are commonly used as animal models for human biomedical research, but descriptions of their use for studying the pharmacokinetics of carbapenem antimicrobials, such as ertapenem, are unavailable. Ertapenem is a critical antimicrobial for human infections, and the description of the pharmacokinetics of this drug is of value for research using ovine as models for human diseases, such as urinary tract infections (UTI). There are currently no ovine models for comparative biomedical research of UTI. The objective of this study was to report the pharmacokinetics of ertapenem in sheep after single and multiple dosing. In addition, we explored the effects of an immunomodulatory drug (Zelnate) on the pharmacokinetics of ertapenem in sheep. Eight healthy ewes (weight, 64.4 ± 7.7 kg) were used in an ovine bacterial cystitis model of human cystitis with Pseudomonas aeruginosa. After disease confirmation, each ewe received 1 g of ertapenem intravenously once every 24 h for 5 administrations. Blood was collected intensively (14 samples) during 24 h after the first and last administration. After multiple-dose administration, the volume of distribution was 84.5 mL/kg, clearance was 116.3 mL/h/kg, T1/2₍λ_z) was 1.1 h, and the extraction ratio was 0.02. No significant differences in pharmacokinetic parameters or time points were found between groups treated with the immunostimulant and controls or after the 1st or 5th administration of ertapenem. No accumulation was noted from previous administration. Our ovine pharmacokinetic findings can be used to evaluate therapeutic strategies for ertapenem use (varying drug dosing schedules and combinations with other antimicrobials or immune modulators) in the context of UTI.

Effects of experimentally induced respiratory disease on the pharmacokinetics and tissue residues of tulathromycin in meat goats

Tulathromycin is a macrolide antibiotic commonly used for the treatment of respiratory disease in food animal species including goats. Recent research in pigs has suggested that the presence of disease could alter the pharmacokinetics of tulathromycin in animals with respiratory disease. The objectives of this study were (a) compare the plasma pharmacokinetics of tulathromycin in healthy goats as well as goats with an induced respiratory disease; and (b) to compare the tissue residue concentrations of tulathromycin marker in both groups. For this trial, disease was induced with Pasteurella multocida. Following disease induction, tulathromycin was administered. Samples of plasma were collected at various time points up to 312 hr posttreatment, when study animals were euthanized and tissue samples were collected. For PK parameters in plasma, V_z (control: 28.7 ± 11.9 ml/kg; experimental: 57.8 ± 26.6 ml/kg) was significantly higher (p = 0.0454) in the experimental group than the control group, and nonsignificant differences were noted in other parameters. Among time points significantly lower plasma concentrations were noted in the experimental group at 168 hr (p = 0.023), 216 hr (p = 0.036), 264 hr (p = 0.0017), 288 hr (p = 0.0433), and 312 hr (p = 0.0486). None of the goats had tissue residues above the US bovine limit of 5 µg/g at the end of the study. No differences were observed between muscle, liver, or fat concentrations. A significantly lower concentration (p = 0.0095) was noted in the kidneys of experimental goats when compared to the control group. These results suggest that the effect of respiratory disease on the pharmacokinetics and tissue residues appear minimal after experimental P. multocida infection, however as evidenced by the disparity in C_max , significant differences in plasma concentrations at terminal time points, as well as the differences in kidney concentrations, there is the potential for alterations in diseased versus clinical animals.

Rapid untargeted screening for drug residues in animal tissues with liquid microjunction surface sampling probe mass spectrometry

An untargeted screening method for the rapid identification of veterinary drug residues in incurred animal tissues using liquid microjunction surface sampling probe mass spectrometry (LMJSSP-MS) was developed. Current analytical methods for veterinary drug residue screening involve lengthy sample preparation, extraction, and instrumental analysis steps. This method identifies veterinary drug residues in several different incurred animal tissues more quickly than conventional analytical methods. This LMJSSP-MS method uses an ambient ionization technology called liquid microjunction surface sampling probe along with a data dependent scan function of a quadrupole orbitrap mass spectrometer. Collected product ion spectra are searched against the mzCloud™ online mass spectral database to identify veterinary drug residues found in incurred animal tissue samples. Examples of veterinary drugs identified with this method include flunixin, tilmicosin, pentobarbital, xylazine, and ketamine. Optimization of method parameters is described and discussed. The limit of identification (LOI) of this method is estimated to be approximately 1 μg g^-1 for xylazine and ketamine.

Production of the Neurotoxin Salsolinol by a Gut-Associated Bacterium and Its Modulation by Alcohol

Utilizing a simulated gastrointestinal medium which approximates physiological conditions within the mammalian GI tract, experiments aimed at isolating and identifying unique microbial metabolites were conducted. These efforts led to the finding that Escherichia coli, a common member of the gut microbiota, is capable of producing significant quantities of salsolinol. Salsolinol is a neuroactive compound which has been investigated as a potential contributor to the development of neurodegenerative diseases such as Parkinson’s disease (PD). However the origin of salsolinol within the body has remained highly contested. We herein report the first demonstration that salsolinol can be made in vitro in response to microbial activity. We detail the isolation and identification of salsolinol produced by E. coli, which is capable of producing salsolinol in the presence of dopamine with production enhanced in the presence of alcohol. That this discovery was found in a medium that approximates gut conditions suggests that microbial salsolinol production could exist in the gut. This discovery lays the ground work for follow up in vivo investigations to explore whether salsolinol production is a mechanism by which the microbiota may influence the host. As salsolinol has been implicated in the pathogenesis of PD, this work may be relevant, for example, to investigators who have suggested that the development of PD may have a gut origin. This report suggests, but does not establish, an alternative microbiota-based mechanism to explain how the gut may play a critical role in the development of PD as well other conditions involving altered neuronal function due to salsolinol-induced neurotoxicity.

Adverse reactions to fentanyl transdermal patches in calves: a preliminary clinical and pharmacokinetic study

OBJECTIVE

To describe adverse reactions and measure plasma fentanyl concentrations in calves following administration of a fentanyl transdermal patch (FTP).

STUDY DESIGN

Prospective, experimental clinical study.

ANIMALS

Six female Holstein calves and one male Angus calf. Four calves were healthy experimental animals and three calves were clinical patients.

METHODS

Plasma fentanyl concentrations were measured in blood collected from a jugular vein. FTP 2 μg kg^-1 hour^-1 and 1 μg kg^-1 hour^-1 was applied to four and three calves, respectively. Heart rate, respiratory rate, temperature and ataxia were recorded at the same times as blood collection (0, 2, 4, 6, 12, 24, 36, 48, 60, 72, 84 and 96 hours). Substance P concentrations were determined via radioimmunoassay for two calves.

RESULTS

After the FTP (2 μg kg^-1 hour^-1) application, two calves developed tachycardia, hyperthermia, excitement and ataxia within 6 hours; no adverse effect was observed in the other two calves. The three calves administered FTP (1 μg kg^-1 hour^-1) exhibited tachycardia and excitement, and the FTP were removed at 4 hours. Naloxone was administered to two calves before the adverse clinical signs ceased, while adverse events in the other three calves resolved within 2 hours of FTP removal. Variables returned to previous baseline values by 2-4 hours after FTP removal. Maximum plasma fentanyl concentrations were variable among calves (0.726-6.923 ng mL^-1). Substance P concentrations measured in two calves were not consistently depressed during FTP application. Fentanyl concentrations at 4 and 6 hours were significantly associated with the appearance of adverse effects.

CONCLUSIONS AND CLINICAL RELEVANCE

FTP (1-2 μg kg^-1 hour^-1) administered to calves may result in adverse behavioral and cardiovascular effects. Patch removal and treatment with an opioid antagonist may resolve these adverse effects. Additional research is needed to determine optimal FTP dosing for cattle.

Pharmacokinetics of fentanyl citrate and norfentanyl in Holstein calves and effect of analytical performances on fentanyl parameter estimation

This study describes the pharmacokinetics of intravenously administered (i.v.) fentanyl citrate, and its primary metabolite norfentanyl in Holstein calves. Eight calves (58.6 ± 2.2 kg), aged 3-4 weeks, were administered fentanyl citrate at a single dose of 5.0 μg/kg i.v. Blood samples were collected from 0 to 24 hr. Plasma (nor)fentanyl concentrations were determined using liquid chromatography with mass spectrometry and a lower limit of quantification (LLOQ) of 0.03 ng/ml. To explore the effect of analytical performance on fentanyl parameter estimation, the noncompartmental pharmacokinetic analysis was then repeated with a hypothetical LLOQ value of 0.05 ng/ml. Terminal elimination half-life was estimated at 12.7 and 3.6 hr for fentanyl and norfentanyl, respectively. For fentanyl, systemic clearance was estimated at 2.0 L hr^-1  kg^-1 , volume of distribution at steady-state was 24.8 L/kg and extraction ratio was 0.42. At a hypothetical LLOQ of 0.05 ng/ml fentanyl half-life, volume of distribution at steady-state and clearance were, respectively, of 3.0 hr, 8.8 L/kg and 3.4 L kg^-1  hr^-1 . Fentanyl citrate administered i.v. at 5.0 μg/kg can reach levels associated with analgesia in other species. Pharmacokinetic parameters should be interpreted with respect to LLOQ, as lower limits can influence estimated parameters, such as elimination half-life or systemic clearance and have significant impact on dosage regimen selection in clinical practice.

Athletic drug testing: an analyst's view of science and the law

Detection of performance-enhancing drugs in sports has received increasing visibility. Athletic drug testing uses sophisticated technology and both interindividual (population) and intraindividual reference ranges to interpret data. An effective program must incorporate educational and adjudication components in addition to testing. The difficult interface between science and the law is evident in many recent sports arbitration decisions.

Direct measurement of urinary testosterone and epitestosterone conjugates using high-performance liquid chromatography/tandem mass spectrometry

Measurement of the ratio of testosterone (T) and epitestosterone (E) in urine has been used as an indication of 'natural' steroid supplementation for a decade. The direct measurement of the glucuronide and sulfate conjugates of testosterone and epitestosterone by high-performance liquid chromatography/tandem mass spectrometry (HPLC/MS/MS) should resolve a number of issues regarding unusual metabolism due to either genetic disposition or attempts to avoid detection of abuse. Determination of nanomoles per liter (0.1 ppb) concentrations of analytes in a complex biological matrix by HPLC/MS/MS is complicated by sample matrix-specific ion suppression during ESI. Deuterated internal standards of all compounds were used to overcome the effects of suppression. Comparison of the HPLC/MS/MS method with a two-part gas chromatographic/mass spectrometric method showed statistical equivalence in urine samples. Analysis of urine samples with elevated T-glucuronide to E-glucuronide ratios did not show that a significant number could be explained by an elevated excretion of epitestosterone sulfate. The HPLC/MS/MS method was also used further to characterize genetic and metabolic factors that give rise to unusual T/E ratios.

Evaluation of selected-ion storage ion-trap mass spectrometry for detecting urinary anabolic agents

Limits of detection are important issues for GC/MS screening for anabolic agents and for confirmation of various drugs of abuse. We compared a quadrupole ion trap (QIT) operated in two different selected-ion storage modes and a quadrupole mass filter (QMF) operated in the selected-ion monitoring mode. Results with the model compound tetrachlorobenzene indicate that, for simultaneous monitoring of more than four ions, the QIT operated in a frequency-modulated selected-ion storage mode has better limits of detection than the QMF. Use of a single-ion storage technique gave results similar to those of the QMF. We also evaluated both QIT selected-ion storage approaches for the limits of detection of the trimethylsilyl derivatives of four anabolic steroid metabolites and the beta-agonist clenbuterol. We found no improvement in detection limits over that of a similar method with selected-ion monitoring and a QMF when four anabolic steroid metabolites and clenbuterol were extracted from a urine matrix. The lack of improvement in the limit of detection resulted from matrix background signals at masses similar to those of the steroids.

Evaluation of selected-ion storage ion-trap mass spectrometry for detecting urinary anabolic agents

Limits of detection are important issues for GC/MS screening for anabolic agents and for confirmation of various drugs of abuse. We compared a quadrupole ion trap (QIT) operated in two different selected-ion storage modes and a quadrupole mass filter (QMF) operated in the selected-ion monitoring mode. Results with the model compound tetrachlorobenzene indicate that, for simultaneous monitoring of more than four ions, the QIT operated in a frequency-modulated selected-ion storage mode has better limits of detection than the QMF. Use of a single-ion storage technique gave results similar to those of the QMF. We also evaluated both QIT selected-ion storage approaches for the limits of detection of the trimethylsilyl derivatives of four anabolic steroid metabolites and the β-agonist clenbuterol. We found no improvement in detection limits over that of a similar method with selected-ion monitoring and a QMF when four anabolic steroid metabolites and clenbuterol were extracted from a urine matrix. The lack of improvement in the limit of detection resulted from matrix background signals at masses similar to those of the steroids.

Separation and confirmation of anabolic steroids with quadrupole ion trap tandem mass spectrometry

Gas chromatography-mass spectrometry (GC-MS) is the method of choice for separation and detection of anabolic steroids in urine. Recently, there have been advances in the areas of gas chromatography columns, tandem mass spectrometry using ion traps, and large volume sample injection that have promise for lowering detection limits and extending the utility of GC-MS for steroid analysis. In this work, a Varian Saturn III GC-MS system has been used in its tandem mass spectrometry mode to detect low picogram levels of model steroids in standard solution and the urine matrix. Application of MS-MS-MS provided structurally informative spectra for 3'-hydroxystanozolol at concentrations of 1 ng/ml. In addition, four polysilphenylene-polydimethylsiloxane capillary columns were examined for background and selectivity. The columns had bleed several-fold lower than conventional polysiloxane columns. The columns also exhibited significant differences in selectivity for structurally similar steroids. Finally, a new temperature-programmed split-splitless injector was used to inject as much as 25 microliters on column. The resulting limits of detection were 5 pg/ml for norandrosterone.