Evaluation and analytical applicability of a novel volumetric absorptive microsampling strategy for adherence monitoring of antihypertensive drugs by means of LC-HRMS/MS

2021 ◽  
pp. 339137
Author(s):  
Cathy M. Jacobs ◽  
Michael Kunz ◽  
Felix Mahfoud ◽  
Lea Wagmann ◽  
Markus R. Meyer
Author(s):  
Cathy M. Jacobs ◽  
Lea Wagmann ◽  
Markus R. Meyer

AbstractVolumetric absorptive microsampling (VAMS), an emerging microsampling technique, is expected to overcome some disadvantages of dried blood spots such as volume inaccuracy and influence of hematocrit (HT). This study aimed to develop and evaluate a VAMS-based strategy for quantification of 13 frequently prescribed antipsychotics in finger prick blood within the scope of adherence monitoring to complement already-established qualitative urine analysis. The final workflow consisted of VAMS tip hydration and subsequent precipitation. Samples were analyzed by using reversed-phase ultra-high-performance liquid chromatography and Orbitrap mass spectrometry operated in parallel reaction monitoring mode. The analytical procedure was successfully validated based on international recommendations at three different HT values (20%, 40%, 60%) for most of the analytes. Selectivity and within/between-run accuracy and precision were in accordance with the recommendations in most cases. Internal standard–normalized matrix factor met recommended criteria for all analytes at HT 40%. For the HT values of 20% and 60%, only four substances did not meet the criteria. Dilution integrity was given for all substances, except for olanzapine, allowing a quantification over the whole therapeutic range of selected antipsychotics. Long-term stability in VAMS tips was tested and revealed degradation of five antipsychotic drugs after 1 week of storage at 24 °C. A proof of concept of the applicability of the method was obtained by quantification of a selection of the 13 antipsychotic drugs in VAMS tips and matched plasma samples. Results were coherent between matrices. Thus, VAMS was shown to be a promising alternative for adherence monitoring of at least the investigated antipsychotics.


2020 ◽  
pp. 19-28
Author(s):  
E. Yu. Ebzeeva ◽  
O. D. Ostroumova ◽  
N. M. Doldo ◽  
E. E. Pavleeva

Arterial hypertension (AH) remains one of the most significant medical and social problems in the world, its prevalence among the adult population is 30–45%. Along with this, the modern population is characterized by a high incidence of chronic kidney disease (CKD), including due to their secondary damage in the framework of hypertension. In turn, CKD is an important independent risk factor for the development and progression of cardiovascular diseases, including fatal ones. The use of existing approaches to nephroprotection in the treatment of patients with hypertension will significantly improve the prognosis both in patients with risk factors for developing renal dysfunction and in patients with pre-existing kidney disease. According to current recommendations for hypertension in such clinical situations, therapy should begin with fixed combinations of antihypertensive drugs. The combination of an angiotensin converting enzyme inhibitor (ACE) and a dihydropyridine calcium channel blocker (CCВ) demonstrated the greatest effectiveness according to evidence-based medicine in patients with high-risk hypertension, including from the standpoint of nephroprotection. In the presented clinical case, the successful use of a fixed combination of ACE and CCВ in a patient with hypertension and microalbuminuria is described.


2020 ◽  
pp. 30-40
Author(s):  
M. G. Melnik

Purpose. To study the dynamics of blood pressure (BP) indicators under the influence of exogenously administered melatonin (Melatonin-SZ, Severnaya Zvezda, Russia) with various manifestations of desynchronosis of circadian BP rhythms (arterial hypertension – AH, high normal blood pressure) to determine the scheme of their effective compensation. Material and methods. The study included 101 patients with desynchronosis of circadian rhythms of blood pressure – 52 patients with hypertension, constituting the first and second groups, and 49 individuals with high normal blood pressure, representing the third and fourth groups. Patients of the second and fourth groups received conservative therapy, patients of the first and third groups combined it with melatonin. All patients underwent measurements of office blood pressure, home monitoring of blood pressure (ABPM), electrocardiography, 24-hour blood pressure monitoring (ABPM). Results and discussion. In patients of the first and third groups, compared with the traditional treatment groups, by the end of the observation period, a significantly (p < 0.05) decrease in office systolic blood pressure (SBP) / diastolic blood pressure (DBP) was established: in the first group compared with the second – 1.11 / 1.13 times, in the third group compared to the fourth – 1.43 / 1.58 times; significantly more (p < 0.05) pronounced decrease in SBP / DBP during DMAD – by 1.08 / 1.17 and 1.58 / 1.62 times, respectively, Significantly (p < 0.05) more pronounced decrease in average daily, average daily and average nighttime SBP / DBP during ABPM – by 1.13 / 1.20, 1.11 / 1.20, 1.23 / 1.25 and 1.47 / 1.31, 1.42 / 1.19, 1.54 / 1.41 times, respectively; reliably (p < 0.05) more frequent registration of the dipper rhythm type SBP / DBP – 1.6 / 1.4 and 1.6 / 1.4 times, respectively. In addition, the dynamics of patients in the first and third groups showed a significant (p < 0.05) decrease in the mean daily and mean nighttime SBP / DBP variability (SBP in the first group by 27.3 and 41.3 %, respectively; DBP in the first group by 20.1 and 26.3 %, respectively; SBP in the third group by 13.5 and 25.2 %, respectively; DBP in the third group by 12.2 and 28.2 %, respectively). Conclusions. With various manifestations of desynchronosis of circadian rhythms of blood pressure (AH, high normal blood pressure), the prescription of melatonin (Melatonin-SZ, Severnaya Zvezda, Russia) at a dose of 3 mg per day 30–40 minutes before bedtime for a month against the background of non-drug therapy and antihypertensive drugs led to a significantly more effective decrease in blood pressure at its office measurement, DMAD, ABPM with an improvement in the circadian rhythm of blood pressure and normalization of blood pressure variability.


2010 ◽  
Vol 6 (3) ◽  
pp. 33
Author(s):  
Robert J Petrella ◽  

It is widely recognised that hypertension is a major risk factor for the development of future cardiovascular (CV) events, which in turn are a major cause of morbidity and mortality. Blood pressure (BP) control with antihypertensive drugs has been shown to reduce the risk of CV events. Angiotensin-II receptor blockers (ARBs) are one such class of antihypertensive drugs and randomised controlled trials (RCTs) have shown ARB-based therapies to have effective BP-lowering properties. However, data obtained under these tightly controlled settings do not necessarily reflect actual experience in clinical practice. Real-life databases may offer alternative information that reflects an uncontrolled real-world setting and complements and expands on the findings of clinical trials. Recent analyses of practice-based real-life databases have shown ARB-based therapies to be associated with better persistence and adherence rates and with superior BP control than non-ARB-based therapies. Analyses of real-life databases also suggest that ARB-based therapies may be associated with a lower risk of CV events than other antihypertensive-drug-based therapies.


Author(s):  
K.K. Abulkasimova ◽  
◽  
M.K. Karimova ◽  
M.A. Zakirhodjayeva ◽  
◽  
...  

Актуальность. Одним из главных патогенетических звеньев, определяющих характер течения глаукомы, является нарушение гидродинамики глаза. Цель. Сравнительная оценка влияния гипотензивных препаратов на гидродинамику глаза у больных с первичной открытоугольной глаукомой с нестабилизированным уровнем внутриглазного давления (ВГД). Материал и методы. На базе РСНПМЦМГ нами обследованы 60 больных (106 глаз) с ПОУГ I, II и III стадии с нестабилизированным уровнем ВГД и были разделены на 2 группы: 1-группа – 30 больных (52 глаза), которым в качестве гипотензивного средства применялся препарат Офтан-Тимолол 0,5% («Santen») 2 раза в сутки, 30 больным (54 глаза) 2-группы был назначен новый гипотензивный препарат Прессимол («Aseptica») 0,5% 2 раза в день. Динамическое и контрольное исследование гидродинамики глаза проводили до лечения, через 10 дней и через 1 месяц в процессе лечения по методу упрощенной тонографии по А.П. Нестерову. Результаты. В обеих группах отмечалось достоверное снижение коэффициента Беккера (КБ) в среднем в 1,9 раза по сравнению с исходным (р<0,05), а P0 снизилось в среднем на 1,4–1,7 мм.рт. ст. Среднее значение коэффициента легкости оттока достигло 0,49 мм3/мин. Однако, продукция водянистой влаги менялась в значительной степени, на 16-19% от исходного уровня. Выводы. Указанные препараты в обеих исследуемых группах достоверно нормализовали показатели гидродинамики глаз больных глаукомой за счет снижения выработки водянистой влаги.


GlaucomaNews ◽  
2020 ◽  
pp. 65-69
Author(s):  
T.E. Lipatkina ◽  
◽  
Е.V. Karlova ◽  
A.V. Zolotarev ◽  
◽  
...  

Patients with primary open-angle glaucoma (POAG) and ophthalmic hypertension have an increased likelihood of developing occlusions (thrombosis) of the central retinal vein. Different groups of antihypertensive drugs differ in their mechanism of action and may affect concomitant ocular pathology, in particular, retinal edema, which occurs, for example, in occlusion of the central retinal vein. Used in most patients with glaucoma, prostaglandin analogs can contribute to the long-term preservation of macular edema due to the effect on the permeability of the vascular wall. Preparations of other pharmacological groups, reducing the production of aqueous humor, on the contrary, may contribute to its regression. Therefore, the question of choosing a drug for antihypertensive therapy in patients with primary open-angle glaucoma and concomitant macular edema is relevant and is for further study.


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