Dissertationen zum Thema „Omeprazole“

Orientadores: Nelci Fenalti Hoehr, Alessandra Gambero
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: O mecanismo pelo qual o H. pylori provoca a inflamação gástrica inclui a secreção de substâncias pró-inflamatórias pela bactéria e a estimulação da liberação de citocinas induzida pelo contato direto entre a bactéria e as células epiteliais gástricas. A resposta inicial à infecção por H. pylori é predominantemente neutrofílica e estes, liberam mediadores inflamatórios e enzimas proteolíticas que induzem o dano gástrico. Estresse oxidativo ocorre em pacientes infectados com H. pylori onde a expressão de enzimas como a óxido nítrico sintase induzida (iNOS), superóxido dismutase e catalase encontram-se aumentadas. A iNOS participa da resposta inflamatória e promove a apoptose de células na mucosa gástrica. Durante a infecção por H. pylori, observa-se níveis reduzidos da expressão de Bcl-2 e o aumento da expressão de Bax na mucosa gástrica, sugerindo que uma tendência pró-apoptótica na infecção. A erradicação pode ser alcançada pela combinação de antibióticos associada a uma droga anti-ácida. As duas maiores classes de inibidores de secreção ácida são: os inibidores de bomba protônica, como o omeprazol, e os antagonistas de receptor de histamina H2, como a ranitidina. Várias evidências experimentais têm mostrado que o omeprazol apresenta efeitos anti-ulcerogênicos adicionais. Deste modo, o objetivo deste trabalho foi avaliar o efeito do tratamento com omeprazol e ranitidina em um modelo animal de infecção por H. pylori, enfocando possíveis propriedades adicionais destes fármacos Para este estudo foram utilizados camundongos machos C57BL/6 com 4 semanas de idade. Os camundongos receberam por via oro-gástrica suspensão de H. pylori. Na 11ª semana de inóculo, os animais foram tratados (i.p.) com omeprazol (100 mg/kg), ranitidina (100 mg/kg) ou veículo (PBS) durante 7 dias sempre no mesmo horário. As duas drogas inibiram a produção de ácido gástrico no tratamento agudo, porém no tratamento por uma semana, apenas o omeprazol inibiu a secreção ácida. Os animais tratados com omeprazol apresentaram um aumento significativo nos níveis de colonização gástrica e elevado nível de MPO. Ambas as drogas diminuíram as lesões da mucosa provocada pela infecção. O tratamento com omeprazol restaurou a produção de Bcl-2 na mucosa gástrica e não alterou a produção de Bax. O omeprazol não protegeu a mucosa gástrica contra o dano ao DNA gerado pela infecção e o tratamento com ranitidina aumentou os níveis de dano oxidativo ao DNA. Não observamos a presença de propriedades anti-neutrofílicas, atribuídas ao omeprazol, após uma semana de tratamento, sugerindo que essas propriedades são restrita a ensaios in vitro. Entretanto, o omeprazol restaurou a produção de Bcl-2 na mucosa gástrica, sugerindo uma atividade anti-apoptótica dessa droga
Abstract: H. pylori induces gastric inflammation characterized by secretion of pro-inflammatory substances by bacteria and the stimulation of cytokine release by the gastric epithelial cells. The initial response to the H. pylori infection is predominantly by neutrophils and these cells liberate inflammatory mediators and enzymes that induce the gastric damage. Oxidative stress also occurs in infected patients where induced nitric oxide sintase (iNOS), superoxide dismutase and catalase expression were increased. Nitric oxide participates in the inflammatory response and promotes apoptosis of gastric mucosa cells. Eradication therapy can be achieved with antibacterial agents in association with anti-acid drugs. There are two major classes of gastric acid inhibitors: the proton pump inhibitors, such as omeprazole, and the histamine H2 receptor antagonists, such as ranitidine. Some experimental evidence demonstrates that omeprazole has additional pharmacological properties. Thus, the aim of this study was to evaluate the effect of omeprazole and ranitidine treatment on H. pylori-infected mice, focusing on possible additional pharmacological properties. For this study, male C57BL/6 mice that received H. pylori suspension were used. After the 11th week, the mice were treated intraperitoneally (i.p.) with omeprazole (100 mg/kg), ranitidine (100 mg/kg) or vehicle (PBS) for 7 days. Both drugs inhibited the gastric acid production after acute administration; however after one week of treatment just omeprazole inhibited gastric acid secretion. Omeprazole-treated mice presented an increase in H. pylori and MPO levels in gastric mucosa. Both drugs reduced the mucosa damage provoked by H. pylori infection. Omeprazole treatment restored the Bcl-2 production in the gastric mucosa and did not modify Bax production. Omeprazole did not reduce the DNA damage in the gastric mucosa while ranitidine treatment increased it. We conclude that some additional omeprazole-related properties, such as antineutrophil properties, were not observed in H. pylori-infected mice after one week of treatment. However, the antiapoptotic activity of omeprazole could be attributed to an ability to modify the protein expression of Bcl-2, decreased by H. pylori infection
Mestrado
Patologia Clinica
Mestre em Ciências Médicas

Orientadores: Cesar Costapinto Santana, Quezia Bezerra Cass
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia Quimica
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Resumo: O objetivo deste trabalho foi a síntese, em larga escala, da fase estacionária quiral tris(3,5-dimetilfenilcarbamato) de amilose e posterior investigação desta na separação preparativa dos enantiômeros do omeprazol por cromatografia líquida de alta eficiência. O carbamato de amilose, caracterizado por análise elementar e espectroscopia na região do infravermelho, apresentou valores experimentais de CHN próximos aos valores teóricos e absorções no infravermelho próximas a 1720 cm-1, referente ao grupo C=O, a 1220 cm-1, referente à ligação C-N e em 3294 cm-1, referente à ligação N-H. Experimentos de pulsos com soluções do traçador e da mistura racêmica, em diferentes temperaturas e vazões da fase móvel, foram realizados para avaliar a homogeneidade das colunas e sua influência no processo de separação, os coeficientes de dispersão axial e de tranferência de massa e o comportamento termodinâmico da adsorção. Uma análise estatística dos dados de porosidade foi realizada através dos testes t e F mostrando que, com um nível de confiança de 95%, apenas algumas colunas apresentam porosidades equivalentes embora os erros cometidos na determinação da porosidade total e no processo de empacotamento sejam os mesmos. A recuperação do enantiômero de interesse, S-(-)-omeprazol, variou de 10-100% quando a porosidade total sofreu variações da ordem de 3%. Os gráficos de van Deemter mostraram uma relação linear entre a altura equivalente a um prato e a velocidade superficial da fase móvel. O enantiômero S-(-)- apresentou maiores coeficientes de transferência de massa e o enantiômero R-(+)- maiores constantes de Henry. O fator de separação e a resolução apresentaram valores iguais a 1,30 e 1,96, respectivamente, a 40 °C e 1,0 mL/min. Observou-se um decréscimo nos valores desses parâmetros após um determinado tempo de uso da coluna. Os valores negativos de 0 S D e 0 H D indicam um aumento na ordem do sistema cromatográfico e que a adsorção dos enantiômeros da fase móvel na fase estacionária é entalpicamente favorável. O modelo de isoterma de Langmuir foi bem correlacionado aos dados experimentais de equilíbrio no intervalo de concentração analisado. Palavras-chave: fase estacionária quiral, omeprazol, cromatografia líquida de alta eficiência
Abstract: The aim of this work was the synthesis, in large scale, of the amylose tris(3,5- dimethylphenylcarbamate) chiral stationary phase and further evaluate in the omeprazole enantiomer preparative separation by high performance liquid chromatography. The amylose carbamate, characterized by elemental analysis and infrared spectroscopy, showed CHN experimental values close to theoretical values and infrared absorptions at 1720 cm-1 which is assigned to C=O group, at 1220 cm-1 which is assigned to C-N bond and at 3294 cm-1 which is assigned to N-H bond. Pulse experiments with solutions of the inert and racemic mixture at different flow rates and temperature were carried out to evaluate column homogeneity and its influence on separation process, axial dispersion and mass transfer coefficients and adsorption thermodynamic behavior. A statistical analysis of the porosity data was performed through of the t and F tests showing that with 95% confidence level only some columns presented equivalent porosities although the errors made in the total porosity determination and packing process are equal. The recovery of the interest enantiomer, S-(-)-omeprazole, varied of 10 until 100% when total porosity varied in the order of 3%. The van Deemter plots showed a linear dependence between height equivalent to a theoretical plate and mobile phase superficial velocity. S-(-)- enantiomer presented higher values of mass transfer coefficients and the enantiomer R-(+)-omeprazole presented higher values of Henry constants. The separation factor and resolution values were 1.30 and 1.96 at 40 °C and 1.0 mL/min, respectively. It was observed a decrease of these parameter values after a use time of the column. The negative values of 0 S D and 0 H D indicates an increase in the order of chromatographic system and that the enantiomer adsorption from the mobile phase to stationary phase is enthalpically favorable. The Langmuir isotherm model was well correlated to equilibrium experimental data in the range of investigated concentration. Key-words: chiral stationary phase, omeprazole, high performance liquid chromatography
Doutorado
Desenvolvimento de Processos Biotecnologicos
Doutor em Engenharia Química

O citalopram (CITA), inibidor seletivo da recaptação da serotonina, é disponível na clínica como mistura racêmica dos enantiômeros (+)-(S) e (-)-(R) ou como enantiômero puro (+)-(S)-CITA. O CITA é metabolizado pelo CYP2C19, CYP2D6 e CYP3A ao desmetilcitalopram (DCITA) e pelo CYP2D6 ao didesmetilcitalopram. O estudo investiga a influência de inibidores enzimáticos no metabolismo enantiosseletivo do CITA em ratos e em voluntários sadios. Os ratos machos Wistar (n=6 para cada grupo) foram tratados com dose única de 20 mg/Kg de CITA (grupo controle) ou pré-tratados com 80 mg/Kg de quinidina (grupo quinidina), 10 mg/Kg de fluvoxamina (grupo fluvoxamina) ou 50 mg/Kg de cetoconazol (grupo cetoconazol). As amostras de sangue foram colhidas dos ratos até 20 h após a administração do CITA. Os voluntários sadios fenotipados como metabolizadores extensivos (EM) do CYP2C19 (omeprazol como fármaco marcador), EM do CYP2D6 (debrisoquina como fármaco marcador) e com atividade normal do CYP3A (midazolam como fármaco marcador) receberam dose única p.o. de 20 mg de CITA racêmico associado ou não ao omeprazol (20 mg/dia durante 18 dias). Os enantiômeros do CITA e do DCITA foram analisados no sistema LC-MS/MS, com a coluna quiral Chiralcel OD-R e fase móvel constituída por acetonitrila:metanol:água (30:30:40 v/v/v) contendo 0,05 % de dietilamina. O método foi linear no intervalo de concentrações de 0,1 20 ng de cada enantiômero do CITA e DCITA/mL de plasma humano e de de 0,1 500 ng de cada enantiômero do CITA e DCITA/mL de plasma de rato. Os coeficientes de variação obtidos nos estudos da precisão e a inexatidão foram inferiores a 15 % para plasma humano e plasma de ratos. A disposição cinética do CITA é enantiosseletiva nos ratos dos grupos controle (razão de AUCS/R de 0,4), quinidina (razão de AUCS/R de 0,5) e cetoconazol (razão de AUCS/R de 0,8). A inibição do CYP2D pela quinidina resultou em inibição do metabolismo do CITA e do DCITA de maneira não enantiosseletiva. A inibição do CYP2C pela fluvoxamina e do CYP3A pelo cetoconazol resultou em inibição somente do metabolismo do (+)-(S)-CITA. A disposição cinética do CITA em voluntários sadios é enantiosseletiva na ausência de tratamento com o omeprazol com observação de maior proporção plasmática do enantiômero (-)-(R)-CITA. A razão de AUCS/R obtida para o CITA foi de 0,56 e para o metabólito DCITA foi de 1,06. A administração de CITA racêmico a voluntários sadios em tratamento com o omeprazol exibe perda da enantiosseletividade na farmacocinética do CITA. A razão de AUCS/R foi de 0,96 para o CITA e de 0,92 para o DCITA. A administração de omeprazol em doses múltiplas a voluntários sadios inibe de maneira enantiosseletiva o metabolismo do eutômero (+)-(S)-CITA com aumento das concentrações plasmáticas em aproximadamente 140%.
Citalopram (CITA), a selective serotonin reuptake inhibitor, is available for clinical use as a racemic mixture of the (+)-(S) and (-)-(R) enantiomers or as the pure (+)-(S)-CITA enantiomer. CITA is metabolized by CYP2C19, CYP2D6 and CYP3A to demethylcitalopram (DCITA) and by CYP2D6 to didemethylcitalopram. The present study investigated the influence of enzyme inhibitors on the enantioselective metabolism of CITA in rats and healthy volunteers. Male Wistar rats (n=6 for each group) received a single dose of 20 mg/kg CITA (control group) or were pretreated with 80 mg/kg quinidine (quinidine group), 10 mg/kg fluvoxamine (fluvoxamine group), or 50 mg/kg ketoconazole (ketoconazole group). Blood samples were collected from the animals up to 20 h after the administration of CITA. Healthy volunteers phenotyped as extensive metabolizers of CYP2C19 (omeprazole as marker drug) and of CYP2D6 (debrisoquine as marker drug) and those with normal CYP3A activity (midazolam as marker drug) received a single oral dose of 20 mg racemic CITA combined or not with omeprazole (20 mg/day for 18 days). The CITA and DCITA enantiomers were analyzed by LC-MS/MS using a Chiralcel OD-R chiral column and a mobile phase of acetonitrile:methanol:water (30:30:40, v/v/v) containing 0.05% diethylamine. The method was linear in the concentration range of 0.1-20 ng of each CITA and DCITA enantiomer/mL human plasma and of 0.1-500 ng of each CITA and DCITA enantiomer/mL rat plasma. Accuracy and precision were below the acceptance limits of 15% for human and rat plasma. The kinetic disposition of CITA was enantioselective in rats of the control (AUCS/R ratio = 0.4), quinidine (AUCS/R ratio = 0.5) and ketoconazole (AUCS/R ratio = 0.8) groups. The inhibition of CYP2D by quinidine resulted in the non-enantioselective inhibition of the metabolism of CITA and DCITA. The inhibition of CYP2C by fluvoxamine and of CYP3A by ketoconazole only inhibited the metabolism of (+)-(S)-CITA. The kinetic disposition of CITA in healthy volunteers was enantioselective in the absence of treatment with omeprazole, with the observation of a higher plasma proportion of the (-)-(R)-CITA enantiomer. The AUCS/R ratio was 0.56 for CITA and 1.06 for the DCITA metabolite. The administration of racemic CITA to healthy volunteers treated with omeprazole showed a loss of enantioselectivity in the pharmacokinetics of CITA. The AUCS/R ratio was 0.96 for CITA and 0.92 for DCITA. The administration of multiple doses of omeprazole to healthy volunteers enantioselectively inhibited the metabolism of the (+)-(S)-CITA eutomer, with an approximately 140% increase of plasma concentrations

O nitrito pode ser reduzido a NO de forma dependente do pH ácido do estômago ou por enzimas com atividade nitrito-redutase. O tratamento com omeprazol, previne parte dos efeitos anti-hipertensivos do nitrito administrado por via oral por aumentar o pH gástrico. Contudo, nenhum estudo até o momento avaliou se, assim como o omeprazol, a ranitidina também é capaz de atenuar os efeitos anti-hipertensivos do nitrito de sódio por aumentar o pH gástrico. Nesse estudo, examinamos se a administração oral de ranitidina poderia prejudicar os efeitos anti-hipertensivos do nitrito de sódio administrados por via oral, por interferir na formação de NO e espécies nitrosiladas a partir do nitrito. A fim de verificar a influência da ranitidina no efeito hipotensor do nitrito de sódio, utilizamos animais tratados agudamente com LNAME pré-tratados com ranitidina, omeprazol e veículo e, posteriormente, com nitrito de sódio 15mg/kg. Como esperado, o tratamento com L-NAME resultou em aumento na pressão arterial média (PAM). O pH gástrico foi diferente entre os grupos, tendo um aumento no pH dos animais tratados com ranitidina e omeprazol, quando comparado ao veículo, e os tampões tinham o mesmo pH do veículo e das drogas. O nitrito de sódio exerceu efeitos anti-hipertensivos significativos nos grupos estudados. No entanto, foram observadas menores diminuições na PAM em ratos tratados com omeprazol e ranitidina em comparação aos ratos que receberam veículo. Esses achados foram associados a diminuições nas concentrações gástricas de NO e diminuições nos níveis plasmáticos de espécies nitrosiladas. Além disso, houve aumento nas concentrações de nitrito no estômago. Não foram observadas diferenças nas concentrações de nitrito no plasma. Além disso, não foram observadas diferenças nos níveis de NOx no plasma e estômago entre os grupos do estudo. Os animais tratados com tampão apresentaram resultados similares aos tratados com as drogas. Nossos resultados sugerem que a ranitidina, ao aumentar o pH gástrico, afeta as respostas anti-hipertensivas ao nitrito de sódio oral por diminuir a formação de NO e espécies nitrosiladas. Este fato é reforçado pelo aumento do nitrito no estômago, sugerindo uma diminuição na conversão de nitrito a NO e espécies nitrosiladas no ambiente gástrico.
Nitrite can be reduced to NO depending on acidic pH of the stomach or by enzymes with nitrite reductase activity. Treatment with omeprazole attenuates the antihypertensive effects of oral nitrite by increasing of gastric pH. However, studies are still necessary to further evaluate wheter ranitidine is also able to attenuate the antihypertensive effects of sodium nitrite by increasing gastric pH. In this study, we examined whether oral administration of ranitidine could impair oral antihypertensive effects of sodium nitrite by interfering with the formation of NO and nitrosylated species from nitrite. In order to analyze the influence of ranitidine under hypotensive effect of sodium nitrite, rats were treated with L-NAME and pretreated with ranitidine, omeprazole, vehicle or buffer, subsequently all the groups were treated with sodium nitrite 15 mg/kg. The L-NAME treatment increase mean arterial pressure (MAP). The gastric pH was different among the groups, there was an increased in rats gastric pH treated with ranitidine and omeprazole compared to the vehicle. The buffer group had the same pH of vehicle and drugs treatment. Sodium nitrite exerted significant antihypertensive effects in the groups studied. However, lesser decreases in MAP were observed in rats treated with omeprazole and ranitidine compared to rats that received vehicle. These findings were associated with a lower NO gastric concentrations as well as nitrosylated species plasma levels. In addition, there was an increased in nitrite concentrations in the stomach. No differences were observed in plasma nitrite levels. Moreover, there was not any significant difference in plasma and stomach NOx levels among the studied groups. The rats treated with buffer showed similar results to those treated with the drugs. Together these data demonstrated that ranitidine, through increased gastric pH, affects antihypertensive responses to oral sodium nitrite by reducing the formation of NO and nitrosylated species. This fact is reinforced by higher levels in nitrite concentrations in the stomach, thereby it suggests a lower conversion of nitrite to NO and nitrosylated species in the gastric environment.

Purpose:Omeprazole is a proton pump inhibitor (PPI) used in the treatment of gastrointestinal conditions, such as gastrointestinal esophageal reflux disease (GERD). Omeprazole is often prepared as an oral suspension to accommodate certain patients. Historically, oral suspensions of omeprazole were prepared using pharmaceutical compounding with sodium bicarbonate, but a kit for preparation of omeprazole oral suspension is available, FIRST® - Omeprazole. The purpose of this project is to compare the stability of the active pharmaceutical ingredient (API), omeprazole, in the FIRST® kit product to a traditionally compounded omeprazole suspension, when stored in refrigerated unit-dosed syringes. Methods: Five 100-mL batches of compounded omeprazole oral suspension (2 mg/mL) and five 300-mL kits of FIRST® - Omeprazole were prepared by a licensed pharmacist, and aliquoted into 5-mL doses in clear luer-lock plastic oral syringes, and stored at refrigerated temperature (2-8oC). Omeprazole concentration was assessed in each batch/kit on the day of preparation. Triplicate syringes from each batch/kit (n = 15 per test group per day) were removed after 7 days, 14 days, 21 days, and 30 days of refrigerated storage. Samples were diluted to assay concentration (1 mg/mL) in ion-free water and filtered using a 0.22-micron microcentrifuge filter tube. Samples were analyzed for omeprazole recovery using a validated high-performance liquid chromatography with ultraviolet detection (HPLC-UV) method. Recovery was quantitatively assessed by comparing sample peak area to a freshly prepared calibration curve (1 – 0.125 mg/mL) using United States Pharmacopoeia (USP) reference standard on each day of sampling. Refrigerator temperatures were recorded daily using a digital thermometer. Results:Stability was defined as recovery of 90 - 110% of initial concentration of API. For the FIRST® - Omeprazole samples, the chemical potency remained within this window for the entire study period of 30 days. The compounded omeprazole suspension demonstrated a less than 90% average recovery at the day 21 sample. Furthermore, a statistically significant difference in the initial concentration was detected on the day of compounding (p = 0.0244), with the compounded omeprazole starting at 1.89 ± 0.10 mg/mL and the FIRST® - Omeprazole at 1.98 ± 0.04 mg/mL. After 30 days, the compounded omeprazole suspension had an 89.13% average API recovery (standard deviation; ± 5.17%) and the FIRST® - Omeprazole 97.20% API recovery (± 3.59%). Conclusion:Both traditionally compounded omeprazole suspension (2mg/mL) and FIRST® - Omeprazole suspension (2mg/mL) may be stored in clear luer-lock oral syringes under refrigeration for 14 days, and retain potency between 90 to 110% based on initial concentration. Furthermore, the FIRST® - Omeprazole suspension can be stored for the duration of the product’s beyond-use date of 30 days and retain potency between 90 to 110% of initial concentration or label claim. Finally, the data suggest that API concentration in FIRST® - Omeprazole suspension is more consistent from batch to batch than traditionally compounded omeprazole suspension.

O NO regula diversos sistemas orgânicos. No sistema cardiovascular participa ativamente na regulação do tônus vascular entre outras funções. Disfunções na produção ou disponibilidade de NO podem comprometer sua atuação fisiológica. No âmbito vascular isto pode participar da hipertensão. Além da produção de NO pelas óxido nítrico sintases, outras vias paralela de produção fisiológica de NO a partir do nitrito tem sido descritas. O nitrito é o produto inicial da oxidação do NO, sendo posteriormente oxidado a nitrato. Sabe-se que estas três moléculas formam um ciclo dentro do organismo, onde o nitrato é excretado na saliva e convertido a nitrito pelas bactérias bucais.Este nitrito é deglutido com a saliva e exerce seus efeitos, através da conversão a NO. A conversão de nitrito a NO pode ocorrer de forma enzimática ou não enzimática. Como forma não enzimática, o nitrito é convertido a NO pela reação com H+. Esta redução ocorre principalmente no estômago. Esta tese visa elucidar possíveis mecanismos responsáveis pelos efeitos anti-hipertensivos do nitrito de sódio. Avaliamos ratos 2 rins 1 clipe (2R1C) tratados com nitrito e nitrato e verificamos os efeitos anti-hipertensivo destes. De forma Interessante, o aumento do pH gástrico com omeprazol impediu o efeito anti-hipertensivo tanto do nitrito quanto do nitrato. O omeprazol não gerou qualquer diferença na concentração plasmática de nitrito e nitrato. Foi verificado que o tratamento com nitrito e nitrato resultou em aumento das espécies nitrosiladas no plasma e este aumento foi impedido pelo omeprazol. Também testamos a influência do ciclo entero-salivar no efeito do nitrito e nitrato. Verificamos que o tratamento com enxaguante bucal levou ao bloqueio do efeito anti-hipertensivo do nitrato, mas não alterou este efeito nos animais tratados com nitrito. Em todas as abordagens experimentais o efeito anti-hipertensivo do nitrito apenas ocorreu quando houve aumento da concentração plasmática de espécies nitrosiladas.
Nitric Oxide plays many functional roles in physiological systems. In the cardiovascular system it participates in a unique way in the regulation of vascular tone among other functions. Dysfunctions in the production or availability of NO may compromise their physiological activity and participate in hypertension. Besides the production of NO by the nitric oxide synthase, other physiological pathways of NO production from nitrite have been described. The nitrite and nitrate are oxidation products of NO. Further nitrite is oxidized to nitrate. These three molecules are known to forma cycle in the body. Nitrate is excreted in saliva and reduced to nitrite by oral bacteria. Nitrite then is swallowed with the saliva and exerts its effects through conversion to NO. The conversion of nitrite to NO may occur by enzymatic or non-enzymatic manner. As a non-enzymatic way nitrite is reduced to NO by reaction with H+.This reaction occurs mainly in the stomach. This thesis aims to elucidate possible mechanisms responsible for the antihypertensive effects of sodium nitrite. We studied 2K1C rats treated with nitrite and nitrate and checked anti-hypertensive effects of these molecules. The increased gastric pH by omeprazole prevented the anti-hypertensive effect of nitrite and nitrate. Omeprazole did not cause any differences in plasma nitrite and nitrate. It was found that treatment with nitrite and nitrate resulted inincreased nitrosylated species in the plasma, and this increase was blocked by omeprazole. We also tested the influence of the entero-salivarycycle effect of nitrite and nitrate. We found that treatment with mouthwash blunted the antihypertensive effect of nitrate but this effect did not change in animals treated with nitrite. Interestingly in all experimental approaches the anti-hypertensive effect of nitrite only occurred when there was an increase in the plasma concentration of nitrosylated species

Introduction: Tacrolimus (TCR) is an immunosuppressant drug widely used in post-transplant organ recipients. Its absorption occurs principally in the duodenum and jejunum, its peak serum concentration is reached between 0.5 and 4 hours after ingestion (average 2 hours), and its absorption may be facilitated by an alkaline medium. Omeprazole (OMP) is a proton pump inhibitor in the parietal cells of the stomach that reaches maximum concentration between 0.5 and 3.5 hours after ingestion (average 2 hours), and because it reduces gastric acidity, it is capable of releasing more alkaline content into the duodenum. Pharmacological interactions between TCR and OMP are always described primarily with respect, to the common metabolic pathway (CYP3A4 and P-gp) used by both medications which may result in elevations of the TCR plasma concentration. The objectives of this study are to identify if there is an increase or decrease in the concentration of tacrolimus when administered after omeprazole and determine the frequency of subjects who increased in two hours, the bioavailability of tacrolimus after using omeprazole. Subjects and Methods: To that end, a double blind, placebo-controlled pilot study was performed in 28 post-renal transplant subjects regularly using TCR (mean: 0.08 ± 0.05 mg/kg/day BID) and OMP (20 mg/day MID). OMP or a placebo was ingested every morning at 6 am after fasting, and TCR was ingested 2 hours later at the doses reported above. Blood samples were taken 2 hours after the ingestion of TCR over 4 consecutive days under both the OMP and placebo regimes, being the subject the control same its. Serum concentrations of TCR were obtained using the chemiluminescent microparticle in human whole blood immunoassay method (CMIA, Abbott Lab., Brazil) after the subjects fasted for 3.5 hours. Results: Of the subjects evaluated, 18 (64.3%) were male, and 10 (35.7%) were female. In total, 8 (28.6%) of subjects received living donor kidneys, and 20 (71.4%) of subjects received cadaveric donor kidneys. The mean age of the subjects was 43 ± 13 years, and the average time since transplant was 41 ± 32 months. The mean serum creatinine and urea levels were 1.6 ± 0.5 mg/dL and 59 ± 27 mg/dL, respectively, and the mean hemoglobin level was 13.7 ± 1.9 g/dL. Conclusion: We found no significant difference in the mean serum TCR concentrations measured under the placebo or OMP regime (15.8 ± 8.7 ng/mL versus 15.7 ± 6.8 ng/mL, respectively, P=0.92). Compared with the placebo period, there was an increase in the serum TCR concentration greater than 10% in 13 subjects and greater than 20% in 10 subjects, which corresponded respectively, to 46.4% and 35.7% of the studied subjects. These data infer that OMP may increase the serum TCR concentration if ingested 2 hours before TCR ingestion, likely through alkalization of the intestinal contents. These frequency rates should be used to calculate the sample sizes needed for future studies with larger numbers of subjects.
Introdução: Tacrolimo (TCR) é uma droga imunossupressora amplamente utilizada em receptores de órgãos pós-transplantes. Sua absorção ocorre principalmente no duodeno e jejuno, sua concentração sérica máxima é atingida entre 0,5 e 4 horas após a ingestão (média de 2 horas) e sua absorção pode ser facilitada em meio alcalino. Omeprazol (OMP) é um inibidor da bomba de protóns das células parietais do estômago e atinge sua concentração máxima entre 0,5 e 3,5 horas após a ingestão (média de 2 horas) e uma vez que reduz a acidez gástrica, é capaz de libertar o conteúdo mais alcalino para o duodeno. Interações farmacológicas entre TCR e OMP são descritas principalmente com relação à via metabólica comum (CYP3A4 e P-gp) utilizadas por ambos medicamentos, que pode resultar em elevações da concentração plasmática do TCR. Os objetivos deste trabalho são: identificar se há aumento ou diminuição da concentração de tacrolimo quando administrado após o omeprazol e determinar a frequência de sujeitos que aumentaram, em 2 horas, a biodisponibilidade de tacrolimo após o uso do omeprazol. Sujeitos e Métodos: Foi realizado um estudo piloto, duplo cego, cruzado contra placebo em 28 sujeitos pós transplante renal em uso regular de TCR (média: 0,08 ± 0,05 mg/kg de peso/dia BID) e OMP (20 mg/dia MID). Diariamente o OMP ou placebo foram ingeridos em jejum pela manhã às 6:00 horas e, após 2 horas, o TCR foi ingerido nas doses relatadas anteriormente. As coletas de sangue foram realizadas 2 horas após a ingestão do TCR ao final de 4 dias consecutivos, tanto em regime de OMP quanto placebo, sendo o sujeito o controle dele mesmo. As concentrações séricas do TCR foram obtidas pelo método de imunoensaio quimioluminescente por micropartículas em sangue total humano (CMIA, Abbott Lab. do Brasil) em jejum alimentar de 3,5 horas. Resultados: Dos sujeitos avaliados: 18 (64,3%) eram do sexo masculino e 10 (35,7%) feminino; 8 (28,6%) obtiveram rim de doador vivo e 20 (71,4%) de doador cadáver. A idade média dos sujeitos foi 43 ± 13 anos e o tempo pós transplante de 41 ± 32 meses. As dosagens médias de creatinina e ureia séricas foram de 1,6 ± 0,5 mg/dL e 59 ± 27 mg/dL, respectivamente, e hemoglobina de 13,7 ± 1,9 g%. Quanto às médias das concentrações séricas de TCR obtidas em uso de placebo ou OMP não mostraram diferenças significativas (15,8 ± 8,7 ng/mL versus 15,7 ± 6,8 ng/mL; respectivamente; P=0,92). Conclusão: Em nosso estudo foi possível observar que a ingestão do OMP, previamente ao TCR, não alterou as concentrações séricas médias do referido imunossupressor; entretanto, em relação ao período placebo houve aumento na concentração sérica do TCR acima de 10% em 13 sujeitos e acima de 20% em 10 sujeitos, o que correspondeu a 46,4% e 35,7%, respectivamente, dos sujeitos de pesquisa. Estes dados inferem que o OMP, se ingerido 2 horas antes do TCR, pode aumentar a concentração sérica deste imunossupressor por provável alcalinização do conteúdo intestinal. Estes dados serão utilizados nos cálculos de tamanho amostral, para futuros estudos com maior número de sujeitos.
Mestre em Ciências da Saúde

Orientador: José Eduardo Tanus dos Santos
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: O óxido nítrico (NO) regula diversos sistemas orgânicos. Disfunções na produção ou disponibilidade de NO podem comprometer sua atuação fisiológica. Além da produção de NO pelas óxido nítrico sintetases, outras vias de produção de NO são relatadas, entre elas a conversão de nitrito a NO. O nitrito é o produto inicial da oxidação do NO, sendo posteriormente oxidado a nitrato. Sabe-se que estas três moléculas formam um ciclo dentro do organismo. A conversão de nitrito a NO pode ocorrer de forma enzimática ou não enzimática. Como forma não enzimática, o nitrito é convertido a NO pela reação com H+. Esta reação ocorre principalmente no estômago, todavia não se sabe se este NO formado tem efeito na pressão arterial sistêmica ou atua apenas localmente. A fim de verificar a influência do pH gástrico no efeito hipotensor do nitrito de sódio, utilizamos animais tratados agudamente com LNAME e normotensos canulados acordados pré-tratados com omeprazol e, posteriormente, com nitrito de sódio 15mg/kg e 45mg/kg. Foi verificado que o nitrito de sódio reduz a pressão arterial média dos animais significativamente e de maneira dependente da dose. O pré-tratamento com omeprazol reduziu o efeito hipotensor do nitrito de sódio significativamente. Após, foram quantificados os níveis de nitrito e nitrato. Foi observado aumento em ambos após o tratamento com nitrito de sódio. A partir destes resultados podemos sugerir que o omeprazol atenua o efeito hipotensor do nitrito de sódio em ratos normotensos e hipertensos
Abstract: Many body systems are regulated by nitric oxide (NO). Dysfunctions in the production or availability of NO may impair it physiological roles. However, other routes of NO production are reported in addition to NO production by nitric oxide synthases, including the conversion of nitrite to NO. Nitrite is the initial product of oxidation of NO and is further oxidized to nitrate. It is known that these three molecules form a cycle within the body. The conversion of nitrite to NO can occur enzymatic or nonenzymatic. Non-enzymatic nitrite is converted to NO by reacting with H+. This reaction occurs mainly in the stomach, however it is unclear whether this NO affects blood pressure or simply acts locally. To study the influence of gastric pH on the hypotensive effect of sodium nitrite, we used hypertensive or normotensive cannulated animals pretreated with omeprazole and with sodium nitrite 15 mg/kg and 45 mg/kg. We found that sodium nitrite reduces mean arterial pressure of animals in a dose-dependent manner. Pretreatment with omeprazole reduced the hypotensive effect of sodium nitrite significantly. Thereafter, we quantified the levels of nitrite and nitrate. We found increase in both species after treatment with sodium nitrite. These results suggest that omeprazole attenuates the hypotensive effect of sodium nitrite in normotensive and hypertensive rats
Mestrado
Farmacologia
Mestre em Farmacologia

Úlceras abomasais acarretam diminuição do bem-estar e da produção de leite e carne, porém informações quanto a sua etiopatogenia, diagnóstico, prevenção e tratamento ainda são insuficientes, em especial quando acometem ruminantes adultos. Os protocolos utilizados para prevenção e tratamento desta enfermidade são extrapolados dos determinados para a lesão estomacal em monogástricos, havendo ainda incertezas sobre o efeito dos princípios ativos, doses e vias de administração mais adequados para ruminantes. Com o intuito de testar a capacidade da ranitidina e do omeprazol prevenirem o aparecimento de úlcera abomasal realizou-se administração dos antiácidos concomitantemente ao uso de fenilbutazona por sete dias (4,4 mg/kg, duas vezes ao dia, pela via intravenosa). Oito ovinos hígidos e canulados em abomaso foram distribuídos em dois quadrados latinos 4x4 e tratados com 2 mg de ranitidina/kg de peso vivo, pela via intravenosa, a cada doze horas; 0,4 mg/kg de omeprazol, pela via intravenosa, uma vez ao dia; 4 mg/kg de omeprazol em pasta, via oral, uma vez ao dia; ou nenhum medicamento antiácido (controle). Omeprazol administrado pela via intravenosa desencadeou flebite e maior número de animais apresentou lesões na mucosa abomasal. Omeprazol em pasta não foi eficaz na prevenção de úlcera do tipo 1a. Embora sem diferença entre os grupos, a ranitidina revelou o menor número de animais com lesões confirmadas pelo exame histológico; no entanto, este antagonista H2 ocasionou aumento da frequência cardíaca. O pH e a acidez do conteúdo abomasal, as concentrações séricas do pepsinogênio e da lisozima, bem como a pesquisa de sangue oculto fecal não se mostraram válidos para o diagnóstico da úlcera de abomaso do tipo 1a em ovinos adultos.
Abomasal ulcers reduce welfare and production of milk and meat, but information about their etiopathogenesis, diagnosis, prevention and treatment is still insufficient, especially for adult ruminants. Protocols used for prevention and treatment of this disease are extrapolated from those determined for gastric lesions in monogastric animals. However, there are still uncertainties about the preventive effect of these drugs, the used doses and best route of administration to ruminants. The preventive action of ranitidine and omeprazole on the development of abomasal ulcers was tested. The antacid drugs were administered concomitantly to phenylbutazone over seven days (4.4 mg/kg twice a day, intravenously). Eight healthy sheep, cannulated in abomasum, were distributed in two 4x4 Latin squares and treated with 2 mg/kg of ranitidine every 12 hours; 0.4 mg/kg of omeprazole, administered intravenously once a day; 4 mg/kg of omeprazole paste, administered orally once a day; or no antacid drug (control). Intravenously administered omeprazole caused phlebitis and a higher number of animals had lesions in the abomasal mucosa. Omeprazole paste was not effective in the prevention of type 1a ulcer. Although there was no difference between groups, ranitidine showed the lowest number of animals with lesions diagnosed by histological examination; however, this H2 antagonist caused an increase in heart rate. Measurements of pH and acidity of abomasal contents, serum pepsinogen and lysozyme concentrations, as well as fecal occult blood screening were concluded not to be valid biomarkers for type 1a abomasal ulcers in adult sheep.

Os mastocitomas caninos são neoplasias originárias de mastócitos, sendo bastante prevalente entre os cães, por isso a importância de averiguar novas terapias para esta doença. O objetivo geral deste projeto foi investigar o efeito do DCA em mastocitomas caninos, por meio da realização de ensaios in vitro. Também foram investigados os efeitos do tratamento com DCA associado ao omeprazol ou merformina em linhagens de mastocitoma canino. As linhagens de mastocitoma canino utilizadas, grau 2 e 3, foram estabelecidas no Laboratório de Oncologia Experimental e Comparadas da FMVZ/USP e foram cultivadas em meio AIM-V. As células foram tratadas com diversas concentrações de DCA (de 0,31 a 100mM). O DCA 0,1; 0,5; 1,0; 5; 10 e 20mM foi também testado em associação com metformina (0,02; 0,2 e 2mM) ou com omeprazol (0,02; 0,1 e 0,2mM). Após os tratamentos, foi realizado ensaio para analisar a viabilidade celular utilizando o método do cristal violeta, com leituras em 3 e 5 dias. Ao contrário do que era esperado, o tratamento com dicloroacetato isolado ou com associações aumentou a população de células neoplásicas principalmente nas concentrações de 10 e 20mM. Num experimento realizado com três linhagens diferentes de mastocitomas caninos foram utilizadas concentrações de 10 a 100mM de DCA, e mostrou que a partir de 60mM há diminuição da viabilidade celular, sendo que o efeito se intensifica com o aumento das concentrações de DCA. Concluímos que o tratamento com DCA isoladamente, em concentrações de até 60mM, ou as associações com metformina e omeprazol não foram eficazes em diminuir a população de células de mastocitomas canino de graus 2 e 3 in vitro. Consideramos que a realização deste estudo foi importante para obter informações sobre os efeitos do DCA e associações em mastocitomas caninos. Os resultados deverão ser divulgados e evitarão o uso indiscriminado deste fármaco, cujas consequências poderiam ser adversas para os cães portadores de mastocitomas.
The Warburg effect or aerobic glycolysis is a phenomenon in which tumor cells convert glucose to lactic acid in the presence of oxygen, unlike normal cells in the body that perform the Krebs cycle and oxidative phosphorylation. Sodium dichloroacetate (DCA) activates pyruvate dehydrogenase (PDH), resulting in increased pyruvate within the mitochondria and in the reestablishment of normal metabolism of cellular respiration. Studies indicate that the association of DCA with metformin or omeprazole potentiate this effect. Canine mastocytomas are neoplasms originating from mast cells, being quite prevalent among dogs, so the importance of investigating new therapies for this disease. The general objective of this project was to investigate the effect of DCA on canine mast cell tumors, by performing in vitro tests. The treatment with dca DCA was then associated with omeprazole or merformin in canine mastocytoma cell lines. The canine mast cell tumor lines used, grade 2 and 3, were established in the Laboratory of Experimental and Comparative Oncology of FMVZ / USP and were cultured in AIM-V medium.. Treatment with DCA alone was performed with varying concentrations (0,31 mM to 100 mM). The associations were performed with 0,1; 0,5; 1,0; 5, 10 and 20 mM of DCA with 0,02; 0,2 and 2mM of metformin or with 0,02; 0,1 and 0,2 mM of omeprazole. After the treatments, an assay was performed to analyze cell viability using the crystal violet method, with readings at 3 and 5 days. Contrary to our expectations, treatment with dichloroacetate alone or with combinations increased the population of neoplastic cells mainly in the concentrations of 10 and 20mM. In an experiment with three different canine mastocytomas cell lines treated with DCA (10 to 100mM of DCA.), it was found that from 60mM the cell viability was decreased. This effect was intensified with increasing DCA concentrations. We conclude that treatment with DCA alone, at concentrations up to 60mM, or associated with metformin and omeprazole were not effective to decrease the population of canine mast cell tumors of grades 2 and 3 in vitro. The results should be disclosed and will avoid the indiscriminate use of this drug, the consequences of which could be adverse for dogs with mastocytomas.

A obesidade é uma doença crônica que atinge uma parcela preocupante da população mundial. É classificada pela OMS em graus l, ll e lll, de acordo com o Índice de Massa Corporal (IMC). A obesidade Grau lll, ou obesidade mórbida, é um fator agravante para inúmeras doenças crônicas como as doenças gastro-esofágicas, diabetes mellitus e câncer. A cirurgia bariátrica é uma intervenção bastante eficaz quando se fala em obesidade grau lll clinicamente severa. Porém, esta intervenção pode alterar a absorção e biodisponibilidade de fármacos como o inibidor da bomba de prótons, o omeprazol. O objetivo deste estudo foi desenvolver um método analítico sensível e rápido utilizando cromatografia líquida de alta eficiência (CLAE) acoplada a detector de ultra-violeta (UV) para quantificação de omeprazol em plasma de pacientes submetidos a cirurgia bariátrica no pré e pós-operatório. A preparação da amostra foi feita por extração em fase sólida utilizando uma coluna SPE DSC-18Lt. Com coluna cromatográfica Nucleosil standard C18 phases 250 x 4 mm, 5 µm e fase móvel tampão fosfato 50 mM pH 7,0:acetonitrila:metanol (60,5:35:4,5 (v/v/v)). As amostras foram analisadas e os resultados expressos em ng/mL. O método foi validado quanto à sensibilidade, linearidade, seletividade (especificidade), exatidão, precisão, limite de quantificação e robustez. A linearidade encontrada para o método foi de 5 a 1250 ng/mL. O limite de detecção estabelecido foi de 2 ng/mL e o de quantificação de 5 ng/mL. A metodologia apresentou valores de recuperação acima de 90%, exatidão e precisão interensaio variou de 96,5 a 98,1% e 5,4 a 7,0%, respectivamente. A precisão e exatidão intra-ensaio variou de 97,1 a 107,4%, respectivamente. A especificidade do método foi determinada para os seguintes interferentes: pantoprazol, metformina, fenformina, hidroclorotiazida, diazepam, lorazepam, oxazepam, clonazepam, ranitidina, propanolol, claritromicina e sulfametoxazol. A metodologia desenvolvida mostrou ser rápida e eficiente na correlação das concentrações plasmáticas do omeprazol administrado aos pacientes bariátricos, demonstrando uma porcentagem, estatisticamente significativa, na diminuição da absorção do fármaco no pós-operatório.
Obesity is a chronic disease that affects an alarming proportion of the population. This disease is classified by the WHO in grades l, ll and lll, according to the Body Mass Index (BMI). Grade lll obesity or morbid obesity, is an aggravating factor for innumerous chronic diseases such as gastro-esophageal diseases, diabetes mellitus and cancer. Bariatric surgery is a very effective intervention when it comes to clinically severe obesity class lll. However, this intervention can alter the absorption and bioavailability of drugs such as the proton pump inhibitor omeprazole. The objective of this study was to develop a sensitive and rapid analytical method using high performance liquid chromatography (HPLC) coupled to a ultra-violet detector (UV) for quantification of omeprazole in plasma of patients undergoing bariatric surgery before and after the procedure. Sample preparation was performed by solid phase extraction using a DSC-18Lt SPE column. Using a Nucleosil standard C18 phases 250 x 4 mm 5 µm column, mobile phase phosphate buffer 50 mM pH 7.0:acetonitrile:methanol in the proportions of 60.5:35:4.5 (v/v/v), samples were analyzed and the results expressed in ng/ml. The method was validated for sensitivity, linearity, selectivity (specificity), accuracy, precision, quantification limit and robustness. The linearity of this method ranged between 5 and 1250 ng/mL. The detection limit was set at 2 ng/mL and the quantification limit at 5 ng/mL. The methodology presented recovery values above 90%. Inter-assay accuracy and precision ranged from 96.5 to 98.1% and from 5.4 to 7.0%, respectively, while intra-assay accuracy and precision varied from 97.1 to 107.4 and from 2.8 to 4.1%, respectively. The specificity of the method was determined for the following interferers: pantoprazole, metformin, phenformin, hydrochlorothiazide, diazepam, lorazepam, oxazepam, clonazepam, ranitidine, propranolol, clarithromycin and sulfamethoxazole. The developed methodology proved to be fast and effective in correlating the plasmatic concentrations of omeprazole administered to patients undergoing surgery, demonstrating statistically significant percentage in the drug absorption decrease after surgery.

Thesis (M.S.)--University of Missouri-Columbia, 2006.
The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed Aug. 29, 2007). Includes bibliographical references.

This thesis is concerned with the synthesis and properties of racemic and enantiopure sulfoxides, compounds which have application as biologically active agents and are useful tools for chemical synthesis. Particular focus is placed on the sulfoxide Omeprazole, which is one of the world’s best selling pharmaceutical products, and the single isomer form of the drug (S)-Esomeprazole. Chapter one covers the fundamental aspects of sulfoxide chemistry, the synthesis of racemic sulfoxides, and describes various approaches to the production of chiral sulfoxides in optically pure form such as resolution, nucleophilic substitutions methodologies, and non-metal based oxidative processes which use either chiral catalysts or chiral oxidants. Chapter two continues this review discussing stereoselective sulfide oxidations using metal catalysts. The discovery, mechanism of action, and large scale synthesis of Omeprazole, a biologically active sulfoxide used to treat ailments associated with excess stomach acid, is discussed in chapter three. In addition, this chapter examines the developments of the single enantiomer drug (S)-Esomeprazole and the various synthetic strategies employed in the production of this chiral sulfoxide. The ensuing chapters describe my own work: chapter four contains work on the synthesis of a range of sulfides, racemic sulfoxides, and sulfones. Following on from this the asymmetric synthesis of chiral sulfoxides, including (S)-Esomeprazole, using a modified Kagan type titanium tartrate catalyst system was investigated with the achievement of sulfoxidation enantioselectivities of up to > 99.5% ee. In chapter five the development of a new method for the determination of enantiomeric excess of (S)-Esomeprazole by 1H NMR is examined. Chiral tartrates were employed as chiral shift agents (CSA) and were found to provide efficient and accurate measurement of sulfoxide ee. The choice of NMR solvent, the host:guest ratio, and the efficacy of the tartrates to act as CSA for a range of structurally diverse sulfoxides was also investigated. Chapter six covers three studies on the structures and reactivities of Omeprazole and related sulfoxides. X-ray crystallographic diffraction (XRD) was employed to investigate the solid state structures and packing a range of sulfoxides. The effect of annular tautomerism was explored by 1H and 13C NMR for a series of benzimidazole based sulfoxide species, including Omeprazole. Finally, 1H NMR was employed to investigate the selective deuteration of sulfoxides such as Omeprazole, including the examination of H/D-exchange observed by NMR in DMSO-d6.

Orientador: Cesar Costapinto Santana
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Quimica
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Resumo: O fármaco racêmico omeprazol tem sido utilizado no tratamento de doenças relacionadas à acidez gástrica e apresenta atividades diferentes entre os enantiômeros. O enantiômero S, conhecido como esomeprazol, tem maior atividade quanto à inibição da secreção gástrica e tem sido obtido a partir de uma síntese assimétrica. Entretanto, a síntese assimétrica é um processo de alto custo, que exige muitas etapas de desenvolvimento em que apenas um dos enantiômeros pode ser obtido. A separação cromatográfica com fase estacionária quiral (FEQ) tem sido utilizada como uma opção para obtenção de ambos os enantiômeros com elevada pureza ótica. Algumas FEQ têm sido utilizadas na separação do ?mais ou menos?tomeprazol, entretanto a FEQ Kromasil CID-TBB ainda não foi utilizada para essa separação. Neste trabalho, foi realizado o desenvolvimento da separação do omeprazol racêmico utilizando a FEQ Kromasil CID-TBB, e foram determinados parâmetros fundamentais para a separação em escala preparativa. A coluna foi caracterizada através da determinação das porosidades do sistema e avaliação da queda de pressão, apresentado porosidades indicativas de um processo uniforme de enchimento da coluna e baixa queda de pressão. Os parâmetros de separação cromatográfica, determinados a diferentes temperaturas e vazões apresentaram número de pratos, fator de separação e resolução superiores a 1200, 1,24 e 1,74 para a condição extrema de vazão 4,0 rnL/min e temperatura de 40°C. Em condições de concentrações elevadas foi obtido fator de separação superior a 1,27. O coeficiente de dispersão axial apresentou pouca variação entre os enantiômeros, entretanto a transferência de massa global foi considerada relativamente rápida com valores de 21,03 e 17,83 ?min POT. ?l? para S e R-omeprazol, respectivamente. A isoterma de adsorção competitiva apresentou comportamento linear e elevada quantidade de enantiômero adsorvido na FEQ. A entalpia de adsorção determinada mostrou a fenômenos entálpicos regem a separação dos enantiômeros na FEQ avaliada.O estudo de sobrecarga da coluna realizado em concentrações elevadas mostrou a possibilidade da separação do omeprazol racêmico. Os resultados obtidos mostram que a FEQ Kromasil CID-TBB é capaz de separar os enantiômeros do omeprazol em condições de escala preparativa sendo uma alternativa para a produção do S-omprazol
Abstract: The racemic mixture of the omeprazole has been used in the treatment of illnesses related to the gastric acidity and presents different activities between the enantiomers. Enantiomer S, known as esomeprazole, has greater activity how much to the inhibition of the gastric secretion and has been gotten from an asymmetric synthesis. However, the asymmetric synthesis is a process of high cost, that demands many stages of development where only one of the enantiomers can be gotten. The chromatographic separation with quiral stationary phase (CSP) has been used as an option for attainment of both the enantiomers with raised pureness optics. Some CSP have been used in the separation of omeprazole, however the FEQ Kromasil CHI-TBB was still not used for this separation. In this work, the development of the separation of omeprazole was carried through racemic mixture using the CSPKromasil CHI-TBB, and had been determined basic parameters for the separation in preparative scale. The column was characterized through the determination of the porosities of the system and evaluation of the fall of pressure, presented indicative porosities of a process wadding uniform of the column and low pressure fall. The parameters of chromatographic separation, determined the different temperatures and outflows had presented plate number, factor of separation and resolution values larger tham 1200, 1,24 and 1,74 for the extreme condition of 4,0 outflow mL/min and temperature 40°C. In conditions of high concentrations has obtained the separation factor value larger tham of 1,27. The coefficient ofaxial dispersion presented little variation between the enantiômeros, however the transference of global mass was considered relatively fast with 17,83 values of 21,03 and min-l for S and R-omeprazole, respectively. The isotherm of competitive adsortion presented linear behavior and high amount of enantiomer adsorved in the CSP. The enthalpy of the adsortion determinated showed the entalpics phenomena conducts the separation of the enantiômeros in the FEQ studied. The study of overload of the column carried through in high concentrations showed the possibility of the separation of omeprazole racemic. The gotten results show that the FEQ Kromasil CHI-TBB is capable to separate the enantiomers of omeprazol in conditions of preparative scale being an alternative for the production of the S-omprazole
Mestrado
Desenvolvimento de Processos Biotecnologicos
Mestre em Engenharia Química

In horses, dietary and pharmacological manipulation of gastric fluid pH is commonly recommended for the prevention and treatment of equine squamous gastric ulcer syndrome (ESGUS). The research in this thesis consisted of two principal studies to further investigate these factors and test a newly developed alkalising medication for horses. The first study was used to develop a model for testing the efficacy of alkalising medications used for the treatment of gastric ulcers in horses. It set out to compare the gastric fluid pH of horses fed a concentrate based diet with those fed a lucerne hay diet, and assessed the effects of food withholding on the gastric fluid pH measurements of horses on these two diets. The second study compared the effects of two different alkalising medications on gastric pH in horses. The aim of this research was to compare the efficacy of a newly developed, compounded, esomeprazole paste to a commercially available omeprazole paste at maintaining a gastric fluid pH of > 4 in horses. The results of the first study showed that using the food withholding model there was no difference in the mean gastric fluid pH between horses fed a concentrate based diet when compared to horses fed lucerne hay. Furthermore, there were large variations in gastric fluid pH in horses fed either diet. The results of the second study show that using this model esomeprazole paste was equally as effective as a commercially available omeprazole paste at increasing gastric pH in horses. Esomeprazole oral paste therefore has the potential to be a useful option for the prevention of gastric ulcers in horses. The developed model allowed for a successful pilot trial investing esomeprazole oral paste as a useful treatment for ESGUS. However, future studies on oral esomeprazole paste should be directed at performing clinical trials in horses to evaluate the efficacy of esomeprazole in the treatment and prevention of ESGUS in horses.

Master of Philosophy
Clozapine is a drug of choice for treatment of refractory schizophrenia, which is primarily metabolized by Cytochrome P450 1A2 (CYP1A2). Norclozapine is its main metabolite. There are reports of wide ranging gastrointestinal side effects associated with clozapine therapy, that result in concomitant administration of proton pump inhibitors to treat acid-related disorders. Omeprazole is an established CYP1A2 inducer, while an in vitro study has shown that rabeprazole is much less potent in this regard. There is no available information about the impact of rabeprazole on CYP1A2 activity in patients. Firstly, this information is essential when prescriptions are changed from omeprazole to rabeprazole to reduce medication costs. Therefore, the aim of this study was to compare the effects of rabeprazole and omeprazole on CYP1A2-mediated clearance (CL/F) of clozapine. Secondly, the effective dosage of clozapine varies widely among patients, making it necessary to individualize drug therapy with clozapine. The reason for dosage variation could be due to the influence of patient-related variables on clozapine plasma concentrations. Therefore, another aim of this study was to investigate the relationship between patient variables, such as age, gender, cigarette smoke, weight and body mass index and clozapine clearance (CL/F). A cross-over study design was used for this study. Twenty patients from Macquarie hospital who were receiving clozapine and rabeprazole (with no other interacting medications) were recruited in this study. Blood samples were taken at 30 min, 1 hr, 2 hr and 12 hr after a dose of clozapine. Rabeprazole was then replaced with omeprazole. After at least 1 month blood samples were again collected at the above corresponding intervals after clozapine. The plasma concentrations of clozapine and norclozapine were determined by high performance liquid chromatography. Abbottbase Pharmacokinetic Systems Software, which utilizes Bayesian forecasting, was used to estimate pharmacokinetic parameters of clozapine. The ratio of plasma norclozapine/clozapine concentrations at trough level was used to reflect CYP1A2 activity. No difference was observed in clozapine clearance (CL/F) and CYP1A2 activity during concurrent therapy with either rabeprazole or omeprazole. According to some studies CYP1A2 induction by omeprazole is dose dependent. Furthermore, since rabeprazole is a weak CYP1A2 inducer in vitro, we conclude that omeprazole and rabeprazole may not induce CYP1A2 activity when used at conventional therapeutic dosage (<40 mg/day). Hence, replacement of omeprazole with rabeprazole at conventional therapeutic dosages (20 or 40 mg daily) offers no advantages in the management of patients with schizophrenia on clozapine and no dose adjustment is required. Consistent with previous studies, clozapine concentrations were found to be significantly lower in cigarette smokers due to CYP1A2 induction. No relationship was found between age, gender, or weight and clozapine clearance (CL/F). However, body mass index showed a significant negative correlation with clozapine clearance (CL/F). Since weight gain and lipid accumulation are common side effects of clozapine they may be associated with a reduction of CYP1A2 activity and clozapine clearance (CL/F). Moreover, high lipoprotein levels may decrease the unbound fraction of clozapine and decrease the availability of clozapine for oxidation by cytochrome P450 enzymes. Therefore, it is concluded that omeprazole and rabeprazole may not induce CYP1A2 activity when used at conventional therapeutic dosage (<40mg/day). Hence, replacement of omeprazole with rabeprazole does not require the dose of clozapine to be adjusted. Moreover, the negative correlation between clozapine clearance (CL/F) and BMI is informative. Further studies are now required to clarify the relationship between BMI, lipoprotein levels and clozapine clearance in patients with schizophrenia.

Clozapine is a drug of choice for treatment of refractory schizophrenia, which is primarily metabolized by Cytochrome P450 1A2 (CYP1A2). Norclozapine is its main metabolite. There are reports of wide ranging gastrointestinal side effects associated with clozapine therapy, that result in concomitant administration of proton pump inhibitors to treat acid-related disorders. Omeprazole is an established CYP1A2 inducer, while an in vitro study has shown that rabeprazole is much less potent in this regard. There is no available information about the impact of rabeprazole on CYP1A2 activity in patients. Firstly, this information is essential when prescriptions are changed from omeprazole to rabeprazole to reduce medication costs. Therefore, the aim of this study was to compare the effects of rabeprazole and omeprazole on CYP1A2-mediated clearance (CL/F) of clozapine. Secondly, the effective dosage of clozapine varies widely among patients, making it necessary to individualize drug therapy with clozapine. The reason for dosage variation could be due to the influence of patient-related variables on clozapine plasma concentrations. Therefore, another aim of this study was to investigate the relationship between patient variables, such as age, gender, cigarette smoke, weight and body mass index and clozapine clearance (CL/F). A cross-over study design was used for this study. Twenty patients from Macquarie hospital who were receiving clozapine and rabeprazole (with no other interacting medications) were recruited in this study. Blood samples were taken at 30 min, 1 hr, 2 hr and 12 hr after a dose of clozapine. Rabeprazole was then replaced with omeprazole. After at least 1 month blood samples were again collected at the above corresponding intervals after clozapine. The plasma concentrations of clozapine and norclozapine were determined by high performance liquid chromatography. Abbottbase Pharmacokinetic Systems Software, which utilizes Bayesian forecasting, was used to estimate pharmacokinetic parameters of clozapine. The ratio of plasma norclozapine/clozapine concentrations at trough level was used to reflect CYP1A2 activity. No difference was observed in clozapine clearance (CL/F) and CYP1A2 activity during concurrent therapy with either rabeprazole or omeprazole. According to some studies CYP1A2 induction by omeprazole is dose dependent. Furthermore, since rabeprazole is a weak CYP1A2 inducer in vitro, we conclude that omeprazole and rabeprazole may not induce CYP1A2 activity when used at conventional therapeutic dosage (<40 mg/day). Hence, replacement of omeprazole with rabeprazole at conventional therapeutic dosages (20 or 40 mg daily) offers no advantages in the management of patients with schizophrenia on clozapine and no dose adjustment is required. Consistent with previous studies, clozapine concentrations were found to be significantly lower in cigarette smokers due to CYP1A2 induction. No relationship was found between age, gender, or weight and clozapine clearance (CL/F). However, body mass index showed a significant negative correlation with clozapine clearance (CL/F). Since weight gain and lipid accumulation are common side effects of clozapine they may be associated with a reduction of CYP1A2 activity and clozapine clearance (CL/F). Moreover, high lipoprotein levels may decrease the unbound fraction of clozapine and decrease the availability of clozapine for oxidation by cytochrome P450 enzymes. Therefore, it is concluded that omeprazole and rabeprazole may not induce CYP1A2 activity when used at conventional therapeutic dosage (<40mg/day). Hence, replacement of omeprazole with rabeprazole does not require the dose of clozapine to be adjusted. Moreover, the negative correlation between clozapine clearance (CL/F) and BMI is informative. Further studies are now required to clarify the relationship between BMI, lipoprotein levels and clozapine clearance in patients with schizophrenia.

INTRODUÇÃO: Os Inibidores de Bombas de Prótons (IBP´s) são comumente prescritos a pacientes em uso de dupla antiagregação plaquetária (DAP) com ácido acetilsalicílico (AAS) e clopidogrel. Entretanto, esta classe de medicamentos, especialmente o omeprazol, tem sido associada à redução da potência antiplaquetária do clopidogrel, levando em muitos casos ao uso de ranitidina como alternativa. MÉTODOS: Foram analisados pacientes com doença arterial coronária (DAC) estável em uso de AAS 100 mg uma vez ao dia. A agregabilidade plaquetária foi medida no momento basal e após uma semana de terapia com clopidogrel na dose de 75 mg uma vez ao dia. Após essa fase inicial, os participantes foram randomizados de modo duplo-cego e duplo-mascarado para omeprazol 20 mg duas vezes dia ou ranitidina 150 mg duas vezes ao dia, sendo os testes de agregação plaquetária novamente repetidos após uma semana. A agregabilidade foi avaliada com a utilização dos seguintes métodos: VerifyNow P2Y12® (Accumetrics - San Diego, CA, EUA, meta principal do estudo), utilizando-se Unidades de Reatividade ao P2Y12 (\"P2Y12 Reactivity Units\" - PRU) e Inibição Percentual da Agregabilidade (IPA) na descrição da agregabilidade; agregometria de sangue total (AST) por bioimpedância utilizando os reagentes ADP e colágeno, sendo a agregabilidade medida em Ohms; \"Platelet Function Analyser\" 100® (Siemens Healthcare Diagnostics®, Newark, Delaware, EUA) utilizando o cartucho de colágeno/ADP, com a agregabilidade avaliada pelo tempo de fechamento do orifício em segundos. Além disso, foi feita dosagem de tromboxano B2 (TXB2) sérico na última visita a fim de se avaliar o efeito do AAS. RESULTADOS: Oitenta e cinco pacientes foram incluídos na análise final, sendo 41 no grupo omeprazol e 44 no grupo ranitidina. Houve redução significativa da IPA após o acréscimo de omeprazol (de 26,3 ± 32,9% para 17,4 ± 33,1%; P = 0,025), enquanto o grupo ranitidina não demonstrou modificação significativa (de 32,6 ± 28,9% para 30,1 ± 31,3%; P = 0,310). Levando-se em conta o valor em PRU, houve um aumento numérico porém não significativo estatisticamente no grupo omeprazol (de 159,73 ± 83,06 para 173,54 ± 72,29; P = 0,116) enquanto no grupo ranitidina houve uma diferença muito pequena (de 153,61 ± 70,12 to 158,77 ± 76,37; P = 0,440). Em relação aos demais testes de agregabilidade e à dosagem de TXB2 sérico, não houve alterações significativas em qualquer um dos grupos. CONCLUSÃO: A ranitidina não influenciou o efeito antiplaquetário do clopidogrel, ao contrário do omeprazol, que reduziu a atividade antiplaquetária do medicamento. Esses achados podem ter um importante impacto na tomada de decisão quanto ao protetor gástrico a ser utilizado em pacientes submetidos a DAP com AAS e clopidogrel.
BACKGROUND: Proton-pump inhibitors (PPIs) are often prescribed to patients taking dual antiplatelet therapy (DAPT) with acetylsalicylic acid (ASA) and clopidogrel. However, this class of medication, especially omeprazole, has been associated with a reduction of clopidogrel efficacy, leading many to substitute omeprazole with ranitidine. METHODS: The present study analyzed patients with stable coronary artery disease (CAD) in use of ASA 100 mg daily. Platelet aggregability was measured at baseline and after one week of clopidogrel 75 mg daily. Then, the subjects were randomized, in a double-blinded, doubledummy fashion, to omeprazole 20 mg twice a day or ranitidine 150 mg twice a day. After one more week, aggregability tests were repeated. Platelet aggregability was evaluated by the following methods: VerifyNow P2Y12TM (Accumetrics - San Diego, California, USA, main endpoint of the study), with aggregability depicted as percent Inhibition of Platelet Aggregation (IPA) and as P2Y12 Reactivity Units (PRU); whole blood aggregometry by bioimpendance using ADP and collagen with aggregability measured in Ohms; and Platelet Function Analyser 100TM (Siemens Healthcare Diagnostics, Newark, Delaware, USA) using collagen/ADP cartridge with aggregability measured in time to closure in seconds. Besides that, serum thromboxane B2 dosage was done on the last visit to evaluate ASA effect. RESULTS: Eighty-five patients were included in final analysis (41 in the omeprazole group and 44 in the ranitidine group). IPA was significantly decreased after addition of omeprazole (from 26.3% ± 32.9 to 17.4% ± 33,1; P = 0.025), with no significant changes being observed in the ranitidine group (from 32.6% ± 28.9 to 30.1% ± 31.3; P = 0.310). When taking into account PRU values, there was a numerical, but statistically non-significant increase in the omeprazole group (from 159.73 ± 83.06 to 173.54 ± 72.29; P = 0.116), with a very slight difference in the ranitidine group (from 153.61 ± 70.12 to 158.77 ± 76.37; P = 0.44). There were no significant changes taking into account other aggregability tests and serum thromboxane B2 dosage. CONCLUSION: In patients with stable CAD, ranitidine did not influence clopidogrel antiplatelet activity, in contrast to omeprazole, which reduced antiplatelet drug effect. These findings may have a great impact in clinical decision making regarding gastrointestinal prophylaxis choice in patients taking DAPT with ASA and clopidogrel

Dissertação de Mestrado Integrado em Medicina Veterinária
Despite the existence of effective treatment (Omeprazole) for EGUS, given the high cost and recurrence rate, it is essential to take preventive management and dietetic measures. The purpose of this retrospective study was to evaluate the treatment response with omeprazole using gastroscopy, identify risk factors associated with the appearance of gastric lesions and evaluate the effect of management changes in the prevention of recurrence, between the years of 2010 and 2015. 69 horses with suspected EGUS were evaluated by physical examination, gastroscopic examination and measurement of gastric fluid pH values. The final sample group were the 22 horses with confirmed lesion grade≥1 in the first gastroscopy, then treated with omeprazole 4mg/kg bwt, PO, SID, for 28 days, followed by 2mg/kg bwt, SID, PO, for another 28 days, and recommended management and nutritional measures. After this period, all horses were re-evaluated. Information was gathered from the horse’s owners using two questionnaires regarding clinical complaints at both examinations and regarding treatment follow-up. The occurrence of EGUS was confirmed in 100% (n=69). Clinically relevant symptomatology was identified, were signs of colic in the last year was the most frequent clinical complaint (59,10%) and was significantly associated with higher numeric scores (p=0,029) whereas the coat condition was significantly associated with severity score (p=0,038). After treatment, there was a general improvement of the lesions and clinical signs, with total remission of the lesions in 4,5% (n=2/22). Owner’s responses on signs of colic (p=0,031) and body weight (p=0,008) and body weight registered at physical examination (p=0,011) were statistically different, along with an increase in mean pH values show evidence of a certain level of efficacy of treatment with omeprazole. None of the presumable risk factors were found significantly associated with the presence or degree of gastric ulceration (p>0,05). Still, exercise and administration of NSAIDs may have determined a lower treatment response. No significant changes in ulcer scores were identified for any levels of implementation of management measures. Nevertheless, decreased ulcer scores were identified in 45,5% (n=10/22) in those who implemented the management changes in some way.
RESUMO - Utilização de gastroscopia na avaliação da evolução do tratamento de Síndrome de Úlcera Gástrica Equina (SUGE) - Apesar da existência de tratamento eficaz (Omeprazol) para SUGE, dado o elevado custo e taxa de recorrência, é essencial tomar medidas preventivas de maneio ambiental e dietética. O objetivo deste estudo retrospectivo foi avaliar a resposta ao tratamento com Omeprazol utilizando gastroscopia, identificar fatores de risco associados ao aparecimento de lesões gástricas e avaliar o efeito das alterações de maneio na prevenção de recorrência, entre os anos de 2010 e 2015. Foram avaliados 69 equinos com suspeita de SUGE por exame físico, exame gastroscópico e medição dos valores de pH gástrico. A amostra final foi de 22 equinos com lesões grau≥1 confirmados na primeira gastroscopia, tratados com Omeprazol 4 mg/kg PV, PO, SID, por 28 dias, seguido de 2mg/kg BWT, SID, PO, por mais 28 dias, e recomendado alterações de maneio ambiental e dietético. Após esse período, todos os equinos foram reavaliados. Informação a respeito das queixas clínicas em ambos os exames e do seguimento do tratamento foi recolhida dos proprietários dos cavalos usando dois questionários. A ocorrência de EGUS foi confirmada em 100% (n=69). Foi identificado sintomatologia clinicamente relevante, tendo sido a queixa clínica mais frequente sinais de cólica no último ano (59,10%, n=13/22) estando associada significativamente com o grau numérico (p=0029), enquanto a condição de pelagem foi significativamente associada ao grau de gravidade (p=0038). Após o tratamento, verificou-se uma melhoria geral das lesões e dos sinais clínicos, com remissão total das lesões em 4,5% (n=2/22). As respostas dos proprietários sobre sinais de cólica (p=0,031) e peso corporal (p=0,008) e peso corporal registados no exame físico (p=0,011) foram estatisticamente diferentes, juntamente com um aumento nos valores médios de pH mostram evidências de um certo nível de eficácia do tratamento com Omeprazol. Nenhum dos fatores de risco foram encontrados significativamente associados à presença ou grau de ulceração gástrica (p > 0,05). No entanto, o exercício e a administração de AINEs podem ter determinado uma resposta de tratamento mais baixa. Não foram identificadas alterações significativas nos graus de úlcera tendo em conta níveis de implementação das medidas de maneio diferentes. No entanto, foi identificada a diminuição do grau de ulceração em 45,5% (n=10/22) naqueles que implementaram as mudanças de maneio de alguma forma.
N/A

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The experiment took eight adult bitches, clinically healthy, mixed breed, weighing between 9 and 28 Kg. These animals formed two study groups at different times. At first the dogs comprised the control group and a moment later the same dogs formed the omeprazole group, with the aim of evaluating by endoscopy the period of healing of experimental gastric ulcer and effect of omeprazole in the treatment of this condition. The experiment was conducted at the Department of Veterinary, Federal University of Viçosa. The ulcerative gastropathy was induced by instilling 0.1 ml of sodium hydroxide at 40% through endoscopic visualization in the gastric mucosa in the pyloric antrum region. Dogs omeprazole group received 1 mg/kg of the drug orally for 24 in 24 hours during four weeks and the control group received placebo at the same moments. During the experiment, animals were assessed by daily physical examination, laboratory tests (CBC) before starting the experiment and at the end of the study, endoscopic examinations before the study began, and after induction of ulcerative gastropathy occur weekly until complete healing of lesions. The results showed that animals treated with omeprazole had better clinical and laboratory demonstrated endoscopic healing faster with a total recovery of the animals after 28 days, compared with 42 days required for full recovery of the control group.
Foram utilizadas 8 cadelas adultas, clinicamente sadias, sem raça definida, pesando entre 9 e 28 Kg. Estes animais formaram 2 grupos de estudo em momentos diferentes. No primeiro momento as cadelas compuseram grupo controle e num momento posterior as mesmas cadelas formaram o grupo omeprazol, com o objetivo de avaliar por endoscopia o período de cicatrização da mucosa gástrica ulcerada experimentalmente e o efeito do omeprazol no tratamento dessa condição. O experimento foi realizado no Departamento de Veterinária da Universidade Federal de Viçosa. A gastropatia ulcerativa foi induzida instilando-se 0,1 ml do hidróxido de sódio a 40% sob visualização endoscópica na mucosa gástrica em região de antro pilórico. Os cães do grupo omeprazol receberam 1 mg/kg do medicamento, via oral, de 24 em 24 horas, durante 4 semanas e os animais do grupo controle receberam placebo nos mesmos momentos. Durante o experimento, os animais foram avaliados por meio de exames clínicos diários; exames laboratoriais (hemograma) antes de se iniciar o experimento e ao término do estudo; exames endoscópicos antes do início do estudo, e após a indução da gastropatia ulcerativa semanalmente até ocorrer a completa cicatrização das lesões. Os resultados mostraram que os animais tratados com omeprazol tiveram melhor evolução clínica e laboratorial e demonstraram endoscopicamente uma cicatrização mais acelerada com total recuperação dos animais após 28 dias, em comparação aos 42 dias requeridos para total recuperação dos animais do grupo controle.

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The antisecretory gastric acid drugs are widely used in veterinary medicine, however there are few studies on these drugs in dogs being that many of these data are taken from human medicine. Among these drugs, one of the most used is the omeprazole due to its bigger potency by blocking the hydrochloric acid production in the stomach. This study aimed to measure the gastric pH in healthy dogs after administration of two different doses of omeprazole at different times of evaluation. Six clinically healthy adult female dogs were selected weighing between 10 and 15 kg. All animals received a percutaneous gastrostomy tube (PEG) first placed with endoscopic assistance and the gastric content was collected for measurement of pH (pH meter), performed using a portable digital pH meter. Before omeprazole administration, the gastric pHs of all animals in the study were measured every two hours for seven days in order to elaborate a control pH curve. Thereupon this period, the dogs were submitted to daily administration of omeprazole orally at a dose of 1.5mg/kg SID for seven days and had their measurements taken every two hours during those days. Five days after the end of the last measurement, a new week experiment was also performed by changing the dosage of the omeprazole to 3.0mg/kg. The week control revealed that the measured pH values were variable throughout the day, although very acidic in most of the time. With the use of omeprazole at a dosage of 1,5mg/kg, gastric pH values showed lower acidity (average pH value = 3.260) compared to control weeks (average pH value = 2.487) and evidenced less variation during the day. At a dose of 3,0mg/kg the pH was even less acidic, presented more stable values than previous weeks, and got closer to the required standards of acid suppression for treatment of gastritis and gastroduodenal ulcers in humans. It follows that the omeprazole dosage of 3,0mg/kg was the most appropriate for achieving the desired acid suppression in the treatment of stomach diseases.
Fármacos antissecretores de ácido gástrico são comumente utilizados na medicina veterinária, entretanto existem poucos estudos com esses medicamentos em cães, sendo que muitos desses dados são obtidos da medicina humana. Dentre estes fármacos um dos mais utilizados é o omeprazol, devido sua maior potência na redução da produção de ácido clorídrico no estômago. O presente estudo teve por objetivo mensurar o pH gástrico de cães sadios após a administração de duas doses diferentes de omeprazol em tempos distintos de avaliação. Foram selecionados seis cães, adultos, fêmeas, com peso entre 10 e 15 Kg e clinicamente saudáveis. Todos os animais receberam uma sonda de gastrostomia percutâneo (PEG) colocado previamente com auxílio endoscópico e o conteúdo gástrico foi coletado para mensuração do pH (phmetria), realizada com o uso de um pHmetro portátil digital. Antes da administração do omeprazol, o pH gástrico de todos os animais envolvidos no estudo foi mensurado, a cada duas horas, durante sete dias, visando a confecção de uma curva controle de pH. Logo após esse período os cães foram submetidos a administração diária de omeprazol, por via oral, na dose de 1,5 mg/kg/SID, durante sete dias e tiveram suas mensurações realizadas a cada duas horas durante estes sete dias. Após cinco dias do término da última mensuração, uma nova semana experimental foi igualmente realizada alterandose a dosagem do omeprazol para 3,0 mg/Kg. Na semana controle observou-se que os valores mensurados de pH eram variáveis ao longo do dia, entretanto se mostraram muito ácidos na maior parte do tempo. Com o uso do omeprazol na dosagem de 1,5mg/kg os valores do pH gástrico apresentaram menor acidez (valor médio de pH=3,260) em relação a semana controle (valor médio de pH=2,487) e menos variações durante o dia. Na dosagem de 3,0 mg/Kg o pH mostrou-se ainda menos ácido (valor médio de pH=4,087), aproximando-se dos padrões requeridos de supressão ácida para tratamento de gastrites e úlceras gastroduodenais em seres humanos, além de apresentar valores mais estáveis do que nas semanas anteriores. Conclui-se que a dosagem de omeprazol de 3,0 mg/Kg foi a mais adequada para alcançar a supressão ácida desejada no tratamento das gastropatias.

Orientador: Marcos Nogueira Eberlin
Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Química
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Resumo: O presente trabalho descreve a utilização de polímeros de impressão molecular (MIP) no preparo de amostra para a extração seletiva de fármacos em matrizes biológicas com determinação por LC-MS/MS e MS/MS. Inicialmente foi sintetizado e caracterizado um MIP seletivo a omeprazol, sendo o mesmo empregado na extração com fase sólida molecularmente impressa (MISPE) de omeprazol em amostras de plasma humano, seguido de determinação por LC-MS/MS. A metodologia foi validada por meio do estudo dos parâmetros: precisão (repetibilidade e precisão intermediária), exatidão (recuperação), curva analítica, intervalo de linearidade, limite de detecção ¿ LD e limite de quantificação ¿ LQ, e seletividade. O limite de quantificação obtido foi de 5 ng mL. Posteriormente, foi sintetizado e caracterizado um MIP seletivo a cocaína, sendo este empregado na extração em fase sólida molecularmente impressa (MISPE) online de cocaína em amostras de urina de usuários de drogas, seguido da quantificação por MS/MS. O limite de quantificação obtido foi de 10 ng mL. A seletividade do método foi avaliada pelo estudo de adsorção de metabólitos (benzoilecgonina e cocaetileno) e interferente (lidocaína) pelo polímero sintetizado e posterior determinação por MS/MS.
Abstract: The present work describes the applications of molecularly imprinted polymers (MIP) in sample preparation for the selective extraction of drugs in biological matrices by LC-MS/MS and MS/MS. Initially a MIP selective for omeprazolewas synthesized and characterized. It was used in molecularly imprinted solid phase extraction (MISPE) of omeprazole from human plasma samples, followed by LC-MS/MS determination. The methodology was validated by studying the parameters: precision (repeatability and intermediate precision), accuracy (recovery), calibration curve, linear range, detection limit - LOD and quantification limit - LOQ, and selectivity. The quantification limit was 5 ng ml. Subsequentlya MIP selective for cocaine was synthesized and characterizedwhich was used in online molecularly imprinted solid phase extraction (MISPE) for cocaine in urine samples of drug users, followed by quantification by MS / MS. The quantification limit was 10 ng mL. The selectivity of the method was evaluated by studying the adsorption of metabolites (benzoylecgonine and cocaethylene) and an interferent (lidocaine) by the synthesized polymer with subsequent determination by MS / MS.
Doutorado
Quimica Analitica
Doutora em Ciências

Este trabalho teve por finalidade o desenvolvimento e validação de métodos para análise estereosseletiva de alguns fármacos e metabólitos, bem como a aplicação desses métodos na avaliação do potencial de fungos, principalmente endofíticos, em processos de biotransformação. Os seguintes fármacos foram selecionados para esse estudo: fluoxetina, propranolol, omeprazol, oxibutinina e ibuprofeno. Para determinação simultânea dos enantiômeros da fluoxetina (FLX) e norfluoxetina (NFLX) em meios de cultura de fungos endofíticos, empregou-se a cromatografia líquida de alta eficiência com detecção por absorção no ultravioleta, em um sistema com duas colunas em série, sendo uma de fase reversa (C18) e outra com fase estacionária quiral (Chirobiotic® V). A fase móvel foi composta por etanol: tampão acetato de amônio 15 mmol L-1, pH 5,90: acetonitrila (77,5: 17,5: 5, v/v/v) e a detecção foi realizada em 227 nm. A extração líquido-líquido foi empregada na preparação das amostras. As curvas analíticas foram lineares no intervalo de concentração de 12,5 a 3750 ng mL-1 (r 0,996) para todos os enantiômeros analisados. Os coeficientes de variação e erros relativos obtidos nos estudos de precisão e exatidão foram inferiores a 10%. Nas condições empregadas, os cinco fungos endofíticos estudados não foram capazes de promover a biotransformação da FLX (reação de demetilação). A eletroforese capilar foi empregada para análise enantiosseletiva do propranolol (PROP) e 4-hidroxipropranolol (4-OHPROP). A melhor condição de resolução dos enantiômeros foi encontrada com a aplicação de um planejamento experimental de Box-Behnken: solução de eletrólitos composta por tampão trietilamina / ácido fosfórico (TEA/H3PO4), 25 mmol L-1, pH 9,00, carboximetil--ciclodextrina 4% (m/v) como seletor quiral e análise realizada na voltagem de 17 kV. O método de extração líquido-líquido também foi empregado para preparação das amostras. As curvas analíticas foram lineares no intervalo de concentração de 0,25 a 10,0 g mL-1 para 4-OHPROP e de 0,10 a 10,0 g mL-1 para PROP, apresentando coeficientes de correlação (r) 0,995 para todos os enantiômeros analisados. Os coeficientes de variação e erros relativos obtidos nos estudos de precisão e exatidão foram inferiores a 15%. Os cinco fungos endofíticos em estudo se mostraram eficientes na biotransformação estereosseletiva do PROP, com maior formação do metabólito (-)-(S)-4-OHPROP. O fungo Glomerella cingulata (VA1), em especial, apresentou uma concentração de 1,745 g mL-1 do enantiômero (-)-(S)-4-OHPROP depois de 72 horas de incubação, ao passo que a formação do enantiômero (+)-(R)-4-OHPROP não foi observada. A utilização deste fungo em escalas ampliadas pode ser uma fonte promissora de obtenção do metabólito 4-OHPROP na forma enantiomericamente pura. A determinação simultânea de omeprazol (OMZ), 5-hidroxiomeprazol (5-HOMZ) e omeprazol sulfona (OMZ SUL) em meio de cultura Czapek Dox modificado ii tamponado foi realizada empregando um método rápido de análise por cromatografia líquida de ultra eficiência com detector por arranjo de diodos (UPLC / DAD), usando coluna monolítica de fase reversa e eluição por gradiente. OMZ, 5-HOMZ e OMZ SUL foram extraídos das amostras utilizando uma mistura de acetato de etila: t-butil metil éter (9: 1, v/v). A separação foi obtida empregando uma coluna RP 18 Chromolith Fast Gradient endcapped e fase móvel constituída por 0,15% (v/v) de ácido trifluoroacético (TFA) em água (solvente A) e 0,15% (v/v) de TFA em acetonitrila (solvente B). Os tempos de retenção foram de 0,70 min para 5-HOMZ, 0,74 min para OMZ, 0,77 min para OMZ SUL e 0,91 min para o padrão interno (bupropiona, BUP). O método foi linear no intervalo de 0,2 a 10,0 g mL-1 (r 0,995) para todos os analitos. O processo de biotransformação foi realizado durante apenas 24 horas de incubação, por causa de problemas de estabilidade do OMZ. Por esse mesmo motivo, a biotransformação estereosseletiva não foi avaliada. Apenas três fungos apresentaram formação do metabólito 5-HOMZ, e dentre estes, apenas o fungo Botritis cinerea (BC) produziu esse metabólito em concentração superior ao limite de quantificação do método. A formação do metabólito OMZ SUL foi observada para todos os fungos, exceto para Glomerella cingulata (VA1) e Guignardia mangiferae (VA15). Esses fungos podem ser úteis para a obtenção dos metabólitos do OMZ, mas estudos detalhados do comportamento do fármaco nas condições de cultivo são necessários, uma vez que este substrato pode sofrer degradação em meio ácido e na presença de luz. A análise simultânea dos enantiômeros da oxibutinina (OXY) e da N-desetiloxibutinina (DEOB) em meio de cultura Czapek foi obtida empregando a cromatografia líquida de alta eficiência com detector UV (HPLC/UV). Os analitos foram separados usando coluna quiral Chiralpak AD e fase móvel constituída por hexano: isopropanol: etanol: dietilamina (94: 4: 2: 0,05, v/v/v/v) e detectados em 210 nm. Um estudo piloto de biotransformação empregando os mesmos fungos e as condições de biotransformação utilizadas para os demais fármacos mostrou que não houve a formação do metabólito de interesse. Além disso, não houve uma diminuição significativa da concentração de OXY durante o período de incubação, o que poderia ser um indicativo da formação de outros metabólitos não monitorados nas condições de análise. Como a reação de desetilação da OXY para formar a DEOB não foi observada nos experimentos, não foi necessário realizar a validação do método analítico. A separação simultânea do ibuprofeno (IBP), dos enantiômeros do 2-hidroxi-ibuprofeno (2-OH-IBP) e dos estereoisômeros do carboxi-ibuprofeno (COOH-IBP) foi realizada empregando-se uma coluna Chiralpak AS-H e fase móvel constituída por hexano: isopropanol: TFA (95: 5: 0,1, v/v/v). O solvente extrator usado na extração líquido-líquido foi uma mistura de hexano: acetato de etila (1: 1, v/v). A detecção foi feita por espectrometria de massas (MS/MS), com a fonte de ionização por eletronebulização operada no modo positivo (ESI+). O método foi linear nos intervalos de 0,1 a 20,0 g mL-1 para IBP, de 0,05 a 7,5 g mL-1 para o cada enantiômero do 2-OH-IBP e de 0,025 a 5,0 g mL-1 para cada estereoisômero do COOH-IBP. Os demais parâmetros de validação obtidos para o método apresentaram-se dentro dos limites recomendados pela literatura. Os sete fungos endofíticos estudados se mostraram eficientes na biotransformação do IBP em seu principal metabólito 2-OH-IBP, mas apenas os fungos Nigrospora sphaerica (SS67) e Chaetomium globosum (VR10) iii biotransformaram o IBP de forma enantiosseletiva mais acentuada, observando-se maior formação do metabólito ativo (+)-(S)-2-OH-IBP. A não estereosseletividade observada para os demais fungos pode ser indício de uma possível conversão quiral do fármaco, similar a que ocorre em humanos. A formação dos estereoisômeros do COOH-IBP não foi observada, provavelmente, porque sua rota de formação envolve uma seqüência de reações. Os resultados apresentados nesse trabalho mostram que fungos, particularmente os endofíticos, podem ser uma fonte promissora para obtenção de metabólitos de fármacos, inclusive de forma enantiomericamente pura.
This work aimed the development and validation of suitable methods for the stereoselective analysis of some drugs and metabolites, as well as, the application of these methods to assess the potential of fungi, mainly the endophytic ones, in biotransformation processes. The following drugs were selected for this study: fluoxetine, propranolol, omeprazole, oxybutynin and ibuprofen. The simultaneous determination of fluoxetine (FLX) and norfluoxetine (NFLX) enantiomers in culture media of endophytic fungi was carried out by high-performance liquid chromatography with UV-detection, in a system of two columns coupled in series, in which one of them was a reversed phase (C18) column and the another one was a chiral stationary phase column (Chirobiotic ® V). The mobile phase consisted of ethanol: ammonium acetate buffer, 15 mol L-1, pH 5.90: acetonitrile (77.5: 17.5: 5, v/v/v) and the detection was performed at 227 nm. Liquid-liquid extraction was employed for sample preparation. The analytical curves were linear over the concentration range of 12.5 to 3750 ng mL-1 (r 0.996) for all enantiomers evaluated. The coefficients of variation and relative errors obtained in the evaluation of method precision and accuracy were lower than 10%. In the studied conditions, the five endophytic fungi used were not able to perform the biotransformation of FLX (demethylation reaction). Capillary electrophoresis was employed for the enantioselective analysis of propranolol (PROP) and 4-hydroxypropranolol (4-OHPROP). The best condition for enantiomer resolution was obtained by applying an experimental design of Box-Behnken: electrolyte solution composed of triethylamine / phosphoric acid (TEA/H3PO4) buffer, 25 mmol L-1, pH 9.00, with 4% (w/v) carboxymethyl--cyclodextrin as the chiral selector and analysis performed at 17 kV. Liquid-liquid extraction was also used for sample preparation. The analytical curves were linear over the concentration range of 0.25 to 10.0 g mL-1 for 4-OHPROP and 0.10 to 10.0 g mL-1 for PROP, presenting correlation coefficients (r) 0.995 for all enantiomers evaluated. The coefficients of variation and relative errors obtained in the evaluation of precision and accuracy were lower than 15%. All the five endophytic fungi (Phomopsis sp. (TD2), Glomerella cingulata (VA1), Penicillium crustosum (VR4), Chaetomium globosum (VR10) and Aspergillus fumigatus (VR12)) showed effectiveness in the stereoselective biotransformation of PROP, with higher formation of (-)-(S)-4-OH-PROP. The fungus Glomerella cingulata (VA1), in particular, showed a concentration of 1.745 g mL-1 for the enantiomer (-)-(S)-4-OHPROP after 72 hours of incubation, whereas there was no formation of the enantiomer (+)-(R)-4-OHPROP. Therefore, the use of this fungus in large scale may be a promising source to obtain 4-OHPROP in the enantiomerically pure form. A fast analytical method based on ultra-performance liquid chromatography / diode array detector (UPLC/DAD) using a monolithic reversed phase column and gradient elution was developed for the simultaneous determination of omeprazole (OMZ), 5-hydroxyomeprazole (5-HOMZ) and omeprazole sulfone (OMZ SUL) in modified and buffered Czapek-Dox culture medium. OMZ, 5-HOMZ and OMZ SUL were extracted using a mixture of ethyl acetate: methyl t-butyl ether (9: 1, v/v). The separation was achieved using a Chromolith Fast Gradient RP 18 endcapped column with the mobile phase consisting of 0.15% (v/v) trifluoroacetic acid (TFA) in water (solvent A) and 0.15% (v/v) TFA in acetonitrile (solvent B). Retention times were 0.70 min for 5-HOMZ, 0.74 min for OMZ, 0.77 min for OMZ SUL and 0.91 min for internal standard (bupropion, BUP). The method was linear over the concentration range of 0.2 to 10.0 g mL-1 (r 0.995) for all analytes. The biotransformation process was carried out only within 24 hours of incubation, due to OMZ instability. For the same reason, the stereoselectivity in this process was not evaluated. The formation of the metabolite 5-HOMZ was observed only for three fungi, and among them, only the fungus Botrytis cinerea (BC) produced this metabolite in concentrations higher than the limit of quantification. The formation of OMZ SUL was observed for all fungi, except for Guignardia mangiferae (VA1) and Glomerella cingulata (VA15). The fungi evaluated in this study can be useful to obtain the metabolites of OMZ, but detailed study of the drug stability in culture conditions is required, since this substrate can undergo degradation in acidic conditions and in the presence of light. The simultaneous analysis of oxybutinin (OXY) and N-desethyloxybutinin (DEOB) enantiomers in Czapek culture medium was carried out by liquid chromatography with UV detection (HPLC/UV). The analytes were separated using a Chiralpak AD column employing as mobile phase hexane: isopropanol: ethanol: diethylamine (94: 4: 2: 0.05, v/v/v/v) and detection at 210 nm. A pilot study of biotransformation using the same fungi and conditions employed for the biotransformation of the other drugs showed that the metabolite of interest was not formed. Moreover, the decrease in the concentration of OXY, which could be indicative of the formation of other metabolites not monitored under the conditions of analysis, was not observed. Since the reaction of OXY desethylation to form DEOB was not observed in the experiments, the validation of the analytical method was not required. The method for the simultaneous analysis of ibuprofen (IBP), 2-hydroxyibuprofen (2-OH-IBP) enantiomers and carboxyibuprofen (IBP-COOH) stereoisomers was developed using a Chiralpak AS-H column and a mobile phase consisting of hexane: isopropanol: TFA (95: 5: 0.1, v/v/v). A mixture of hexane: ethyl acetate (1: 1, v/v) was used as solvent extractor for sample preparation. The detection was performed by tanden mass spectrometry (MS/MS) with the electrospray interface operated in the positive mode (ESI+). The method was linear over the concentration range of 0.1 to 20.0 g mL-1 for IBP, 0.05 to 7.5 g mL-1 for each 2-OH-IBP enantiomer and 0.025 to 5.0 g mL-1 for each COOH-IBP stereoisomer. The other validation parameters studied were within the limits established in the literature. The seven studied endophytic fungi showed to be efficient in the biotransformation of IBP to its main metabolite 2-OH-IBP, however, only the fungi Nigrospora sphaerica (SS67) and Chaetomium globosum (VR10) biotransformed IBP enantioselectively, with greater formation of the active metabolite (+)-(S)-2-OH-IBP. The lack of stereoselectivity observed for the other fungi could be caused by a possible chiral inversion process occurring for IBP, in a similar way that happens in humans. The formation of COOH-IBP stereoisomers was not observed probably because the route of formation of this metabolite requires a sequence of reactions. The results presented here show that fungi, particularly the endophytic ones, may be a promising source to obtain the metabolites of drugs, including in their enantiomerically pure form.

Magister Scientiae - MSc (Pharmacy Administration and Policy Regulation)
The aim of this study is to provide more information in terms of the cost-effectiveness of selecting an enantiopure formulation over a racemic mixture in the context of promoting rational use of medicines. This was done by comparing costs and efficacy of escitalopram versus citalopram and esomeprazole versus omeprazole since they are the most commonly used medicines with both racemate and enantiopure products registered.

Šio darbo tikslas buvo pritaikyti instrumentinės analizės metodus (plonasluoksnės chromatografijos, UV - spektroskopijos ir efektyviosios skysčių chromatografijos) apsinuodijimą sukeliančio mišinio - diazepamo, metamizolo natrio druskos ir omeprazolo tyrimui. UV spektroskopijos metodas tinkamas atskirų mišinį sudarančių komponentų omeprazolo, diazepamo, metamizolo natrio identifikavimui. Plonasluoksnės chromatografijos metodas buvo pritaikytas metodikos kūrime tirtų medžiagų mišinio identifikavimui ir atskyrimui suradus ir modifikavus dvi tirpiklių sistemas: etilacetatas : etanolis: 25% NH4OH santykiu 17:2:1; etilacetatas : etanolis : 25% NH4OH : benzenas santykiu 16:3:1:4. Sukurta metodika tinkanti omeprazolo, metamizolo natrio ir diazepamo atskyrimui ir identifikavimui efektyviosios skysčių chromatografijos metodu.
This work was undertaken to instrumental analytical methods (thin-layer chromatography, UV - spectroscopy and high performance liquid chromatography) poisoning causes mix - diazepam, metamizol sodium and omeprazole test. UV – spectroscopy method is suitable individual components fixing of the latter.The thin-layer chromatographic method has been applied to investigate the creation of methods for identification and mixture separation and finding a modification of the two solvent systems: ethyl acetate: ethanol: 25% NH4OH 17:2:1 ratio; ethyl acetate: ethanol: 25% NH4OH: benzene ratio of 16: 3:1:4. Also was created solvent system suitable for omeprazole, metamizol sodium and diazepam separation and identification using high-performance liquid chromatography.

Tese (doutorado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde. Programa de Pós-Graduação em Farmácia.
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O omeprazol é o fármaco de primeira escolha para o tratamento de desordens ácido-pépticas. A terapia a base de omeprazol é disponibilizada geralmente na forma de cápsulas contendo microgrânulos (pellets) gastro-resistentes e, em casos de crise aguda, na forma de pó extemporâneo para injetáveis. O fármaco é altamente instável em soluções ácidas, portanto, para garantir sua eficácia terapêutica o omeprazol necessariamente deve ser liberado na região proximal do intestino delgado. A partir do omeprazol sódico (matéria-prima) foi proposta uma alternativa farmacotécnica para o desenvolvimento de uma formulação inovadora na forma de comprimidos gastro-resistentes. Primeiramente, foi realizado um estudo de caracterização das propriedades físico-químicas da matéria-prima no estado sólido através de diversas metodologias analíticas. Foi observado que o omeprazol sódico não apresenta ponto de fusão e quando sofre processo de desidratação se transforma em uma forma instável amorfa. Através de ressonância nuclear magnética foi permitido elucidar as interações intermoleculares e as ligações do fármaco com a molécula de água. Um estudo de pré-formulação foi realizado para avaliar a compatibilidade entre o omeprazol sódico e excipientes farmacêuticos. De acordo com os resultados obtidos, foi possível evidenciar incompatibilidade com os seguintes excipientes: ácido cítrico, acryl-eze® e ácido esteárico. Assim, foram obtidos núcleos por compressão direta contendo 20 mg de omeprazol, que subsequentemente foram revestidos. As formulações denominadas R1 e R2 foram revestidas com diferentes concentrações de pré-revestimento (Opadry® YS) e polímero entérico (Acryl-eze®). Os comprimidos gastro-resistentes foram obtidos com sucesso e através dos parâmetros de controle de qualidade observou-se que a forma farmacêutica preservou as características físico-químicas do fármaco. Um método analítico por CLAE foi desenvolvido e validado para o doseamento das formulações. Através do estudo de estabilidade foi possível verificar que a formulação mais adequada, e que preservou melhor as características do fármaco foi a R2, com ganho de peso teórico de pré-revestimento de 8 % (Opadry® YS) e revestimento gastro-resistente de 12 % (Acryl-eze®).

OBJECTIVE The purpose of this study was to examine the stability of a generic lansoprazole product in a 3 mg/mL sodium bicarbonate suspension under room temperature and refrigerated conditions. METHODS Lansoprazole suspensions (3 mg/mL) were prepared in triplicate using an 8.4% sodium bicarbonate vehicle for each storage condition (room temperature and refrigerated). During 1 month, samples from each replicate were periodically removed and analyzed for lansoprazole concentration by liquid chromatography–tandem mass spectrometry (LC-MS/MS). Each sample was spiked with 10 mg/L omeprazole to serve as the internal standard. A positive electrospray LC-MS/MS method was validated over the calibration range of 5 to 25 mg/L using Food and Drug Administration Guidance. The identities of the analyte and internal standard in the samples were verified by monitoring the MS/MS transitions of m/z 370 to m/z 252 and m/z 346 to m/z 198 for lansoprazole and omeprazole, respectively. Additionally, the pH of the suspensions was monitored throughout the study. RESULTS The stability of lansoprazole in the oral sodium bicarbonate suspension under refrigeration is compromised prior to what has been previously reported in the literature. Samples kept at room temperature lost >10% of the lansoprazole after 48 hours compared with the refrigerated samples, which maintained integrity up to 7 days. No statistically significant difference was found between the pH of the room temperature and refrigerated suspension samples, indicating that this factor is not the cause for the differences in stability at these two conditions. CONCLUSIONS This study suggests that the extemporaneously compounded lansoprazole oral suspension prepared in 8.4% sodium bicarbonate should not be stored in plastic oral syringes longer than 48 hours at room temperature and no longer than 7 days when refrigerated. These data indicate an expiration time earlier than that previously reported for the refrigerated product (14 days).

Modified-release oral drug delivery dosage forms are widely used in the pharmaceutical field to overcome all the potential issues imposed by the physiological variabilities of the gastrointestinal tract as well as to maintain drug concentrations within the therapeutic window. In the market, they are available only as solid dosage forms such as capsules or tablets. The development of a liquid oral dosage form with modified-release properties has been keenly awaited. This form could increase the compliance of patients with a swallowing impairment (i.e. paediatric, older or critically ill patients) and, consequently, the efficacy of the therapeutic treatment. In this study, a new technology has been developed that consists of multi-layered particles suspended extemporaneously in a syrup. Omeprazole and budesonide have been employed as model drugs. The coating procedure was optimized to obtain a yield of minimum 90% w/w and a median diameter below 500 µm. Once the final suspension is prepared extemporaneously, it presents sufficient stability to guarantee the administration of multiple doses filled into a syrup bottle and kept for a limited storage time at room temperature (e.g. up to 10 doses to be administered within 10 days).
Doctorat en Sciences biomédicales et pharmaceutiques (Pharmacie)
info:eu-repo/semantics/nonPublished

The purpose of this study was to evaluate the chemical stability of six medications in two types of unit-dose packaging, one was Webster-Package and another was a plastic seal unit-dose package. Stability was observed in terms of the drugs’ active ingredients and appearance of tablets and/or capsules. The study was commenced under condition of 35 ºC and 90% RH that related to temperature and humidity of tropical climate areas. A period of sixty days was chosen as the time period since unit-dose packages have to be delivered to patients and patients have to use the medications for up to one month. Six medications tested in this study were aspirin tablets 100mg (DBL Aspirin®), atorvastatin 40mg (Lipitor®), gliclazide 30mg MR (Diamicron MR®, and Oziclide®), metformin (GenRx Metformin® 500mg, and Formet® 1000mg), omeprazole 20mg (Omeprazole Winthrop®, and Omepral®), and ramipril 10mg (Ramipril Winthrop®, Ramipril Sandoz®).Each medication was transferred from an original package into eighteen different wells of small size Webster-Package. All six medications were also packed together into an other eighteen different wells of large size Webster-Package. To test the stability of the medicines in the Webster-Package, all of the packs were stored at 35 °C and 90% humidity for 60 days. Ramipril and omeprazole were also examined in another test condition (30°C and 90% RH) for 28 days. In addition, unit-dose packages from the Northern Territory of South Australia were tested. Medications were packed into clear sealed plastic bags by Stuart Park Pharmacy and tested using the same control condition. Time points for analysis were undertaken at day 0, 7, 14, 21, 28, and 60. Three samples were collected and triplicate tests were done for each sample. Shape and colour of the tablets were evaluated. Quantitative results were gained by using High Performance Liquid Chromatography (HPLC). Results of the stability testing at each time point were compared with their standard curves. Visual stability alterations were found in aspirin tablets (DBL Aspirin®), omeprazole tablets (Omeprazole Winthrop®, and Omepral®), and ramipril capsules (Ramipril Winthrop®, Ramipril Sandoz®) in both groups of Webster-Packages and unit-dose packages. Fading of ramipril capsules’ colour and sealing of cap and body of the capsules were found in both test conditions. Film-coatings of omeprazole tablets were cracked in both test conditions. Chemical stability alterations were found in omeprazole tablets used in unit-dose package. The results showed that in both experimental conditions omeprazole active ingredient was detected at levels of less than 90% of the active ingredient in the control tablets at Day 14 of the experiment.It may be concluded that not all of these medications can be repackaged into Webster-Packaging and unit-dose packaging. Pharmacists should be concerned about chemical properties of drugs, especially hydrolysis, photosensitivity, and heat resistance properties, before deciding to repackage them.