scholarly journals Time to Peak Concentration of Amikacin in the Antebrachiocarpal Joint Following Cephalic Intravenous Regional Limb Perfusion in Standing Horses

2020 ◽  
Vol 33 (05) ◽  
pp. 327-332
Author(s):  
Kajsa Gustafsson ◽  
Amos J. Tatz ◽  
Roee Dahan ◽  
Malka Britzi ◽  
Stefan Soback ◽  
...  

Abstract Objective The aim of this study was to determine the time (Tmax) to the maximum concentration (Cmax) of amikacin sulphate in synovial fluid of the radiocarpal joint (RCJ) following cephalic intravenous regional limb perfusion (IVRLP) using 2 g of amikacin sulphate. Methods Cephalic IVRLP was performed with 2 g of amikacin sulphate diluted in 0.9% NaCl to a total volume of 100 mL in six healthy adult mixed breed mares. An Esmarch's rubber tourniquet was applied for 30 minutes and the antibiotic solution was infused through a 23-gauge butterfly catheter. Synovial fluid was collected from the RCJ prior to the infusion and at 5, 10, 15, 20, 25 and 30 minutes after completion of IVRLP. The tourniquet was removed after the last arthrocentesis. Synovial fluid amikacin sulphate concentrations were determined by liquid chromatography/tandem mass spectrometry. Results The calculated mean Tmax occurred at 15 minutes (range: 10–20 minutes) post-perfusion. The highest synovial fluid amikacin sulphate concentration was noted at 10 minutes in 2 horses, 15 minutes in 2 horses and 20 minutes in 2 horses. The highest mean concentration was 1023 µg/mL and was noted at 20 minutes. Synovial mean concentrations were significantly different between 15 and 30 minutes. Clinical Significance In this study no Tmax occurred after 20 minutes; thus, 30 minutes of tourniquet application time appear to be excessive. The 20 minutes duration of tourniquet application appears sufficient for the treatment of the RCJ in cephalic IVRLP using 2 g amikacin sulphate in a total volume of 100 mL.

Author(s):  
Kajsa Gustafsson ◽  
Amos J. Tatz ◽  
Roee Dahan ◽  
Malka Britzi ◽  
Stefan Soback ◽  
...  

Abstract Objective The aim of this study was to determine the concentration of metronidazole in the distal interphalangeal joint (DIPJ) of the thoracic limb after administering metronidazole to standing horses by intravenous regional limb perfusion (IVRLP). Methods Eleven healthy horses had a wide rubber tourniquet applied to the proximal aspect of the antebrachium for 0.5 hours and 500 mg of metronidazole diluted in physiologic saline solution to a total volume of 108 mL was administered by cephalic IVRLP. Synovial fluid samples were collected from the DIPJ before perfusion and at 0.25, 0.5, 2, 12 and 24 hours. Blood samples were obtained at the same time points for serum analysis. Concentrations of metronidazole were determined by liquid chromatography/tandem mass spectrometry. Results Four horses were excluded due to low synovial fluid concentrations and not completing the full tourniquet application time. The C max in the synovial fluid was 327 ± 208 µg/mL, and the t max was 26 ± 7 minutes. Only the concentrations of metronidazole at time points 0.25 and 0.5 hours were significantly different (p < 0.001) from synovial concentration before perfusion. The serum C max was 1.78 ± 0.93 µg/mL, and the t max was 76 ± 52min. Conclusion Metronidazole administered by IVRLP reached high concentrations in the synovial fluid at 0.5 hours. However, the concentrations rapidly decreased below the minimum inhibitory concentration of potential target pathogens. Effectiveness of metronidazole administered by IVRLP as a sole therapy against anaerobic infections of synovial structures of the distal limb cannot be determined by a pharmacokinetic study. However, the present study serves as the basis for future carefully planned clinical trials.


Animals ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 2085
Author(s):  
Kajsa Gustafsson ◽  
Amos J. Tatz ◽  
Roee Dahan ◽  
Wiessam Abu Ahmad ◽  
Malka Britzi ◽  
...  

The aim of this study was to investigate the safety and pharmacokinetics of trimethoprim-sulphadiazine administered via intravenous regional limb perfusion (IVRLP) into the cephalic vein. According to the hypothesis, the drug could be administered without adverse effects and the synovial concentrations would remain above the minimum inhibitory concentration (MIC) for trimethoprim-sulphadiazine (0.5 and 9.5 µg/mL) for 24 h. Ten (n = 10) horses underwent cephalic vein IVRLP with an Esmarch tourniquet applied for 30 min. Four grams (4 g) of trimethoprim-sulphadiazine (TMP-SDZ) were diluted at 0.9% NaCl for a total volume of 100 mL. Synovial fluid and blood samples were obtained immediately before IVRLP and at 0.25, 0.5, 2, 6, 12 and 24 h after the initiation of IVRLP. Trimethoprim and sulphadiazine concentrations were determined using a method based on liquid chromatography/tandem mass spectrometry. The Cmax (peak drug concentration) values were 36 ± 31.1 and 275.3 ± 214.4 µg/mL (TMP and SDZ). The respective tmax (time to reach Cmax) values were 20 ± 7.8 and 26.4 ± 7.2 min. The initial synovial fluid concentrations were high but decreased quickly. No horse had synovial concentrations of trimethoprim-sulphadiazine above the MIC at 12 h. Severe vasculitis and pain shortly after IVRLP, lasting up to one week post-injection, occurred in five out of 10 horses. In conclusion, IVRLP with trimethoprim-sulphadiazine cannot be recommended due to the low concentrations of synovial fluid over time and the frequent severe adverse effects causing pain and discomfort in treated horses. Thus, in cases of septic synovitis with bacteria sensitive to trimethoprim-sulphadiazine, other routes of administration should be considered.


Talanta ◽  
2018 ◽  
Vol 186 ◽  
pp. 124-132 ◽  
Author(s):  
Araceli Garcia-Ac ◽  
Sung Vo Duy ◽  
Sébastien Sauvé ◽  
Florina Moldovan ◽  
V. Gaëlle Roullin ◽  
...  

1982 ◽  
Vol 10 (5) ◽  
pp. 379-382 ◽  
Author(s):  
Kari Soininen ◽  
Hannu Allonen ◽  
Juhani Posti

The bioavailability of the calcium and potassium salts of Phenoxymethylpenicillin (dose 38,000 I.U./kg) was investigated in eight healthy adult volunteers. Administration of the calcium salt as an aqueous oral mixture resulted in a mean peak plasma concentration of 8·52 mg/l (SD 1·96) and that of the potassium salt mixture in a concentration of 8·40 mg/ml (SD 2·61), p > 0·1. The median time-to-peak levels were 0·75 h and 1·0 h, respectively (p > 0·1). The mean AUC for the calcium salt mixture was 16·94 mg·h/l (SD 3·31) and for the potassium salt 15·84 mg·h/l (SD 4·76), p > 0·09. These findings confirm that an aqueous mixture of calcium phenoxymethylpenicillin is equivalent to a mixture of potassium Phenoxymethylpenicillin.


2019 ◽  
Vol 39 (6) ◽  
pp. 388-392
Author(s):  
Paula A. Di Filippo ◽  
Saulo T. Lannes ◽  
Marcos A.D. Meireles ◽  
Andressa F.S. Nogueira ◽  
Célia R. Quirino

ABSTRACT: The aim of the study was to determine the concentration pattern of intra-articular acute phase proteins (APPs) and immunoglobulins in healthy crossbred cattle. Synovial fluid (SF) samples were collected from the radiocarpal joint of 25 heifers and 25 steers. Concentrations of APPs were measured by SDS-PAGE. The results were submitted to analysis of variance using the SAS statistical program, and means were compared by the Student-Newman-Keuls test (P<0.05). Thirty-seven proteins with molecular weights ranging from 7 to 37kDa were identified in SF of all animals. Eight were nominally identified with immunoglobulin A (IgA) and G (IgG), ceruloplasmin (Cp), transferrin (Tf), albumin (Ab), α1-antitripsin (AAT), α1-acid glycoprotein (AGP), and haptoglobin (Hp). The α1-antitripsin was only identified in the Sf of the heifers. The SF values of Cp, Hp, AGP and IgA were significantly higher in heifers than in steers. In sera, 34 proteins with molecular weights between 7 and 244kDa were identified in heifers and steers. Similar proteins were nominally identified in the sera, however the α1-antitrypsin was identified only in SF. The serum values Tf, AGP and IgG were significantly higher in heifers compared with steers. In conclusion, the physiological acute-phase proteins concentrations in synovial fluid of healthy ruminants can be useful in the interpretation of samples from animals with joint diseases. The SF electrophoretic profile of healthy ruminants differs depending on gender. Similar proteins were nominally identified in the sera, but only the SF of α1-antitrypsin.


2018 ◽  
Vol 47 (6) ◽  
pp. 852-860 ◽  
Author(s):  
Robin L. Fontenot ◽  
Vernon C. Langston ◽  
Jamie A. Zimmerman ◽  
Robert W. Wills ◽  
Pearce B. Sloan ◽  
...  

2017 ◽  
Vol 30 (05) ◽  
pp. 311-317 ◽  
Author(s):  
Jillian Mills ◽  
Duncan Peters ◽  
Patty Weber ◽  
Tara Shearer ◽  
Anthony Pease ◽  
...  

Summary Objective: The purpose of this study was to determine whether there was a correlation between circulating and intra-synovial Dkk-1 and radiographic signs of equine osteoarthritis. Methods: Circulating and intra-synovial Dkk-1 levels were measured in clinical cases using a commercially available human Dkk-1 ELISA. Radiographs were performed of the joints from which fluid was collected and these were assessed and scored by a boarded radiologist for joint narrowing, subchondral bone sclerosis, subchondral bone lysis, and periarticular modelling. Comparisons were made between radiographic scores and the concentrations of Dkk-1 using a Kruskal-Wallis one-way ANOVA. Correlations were calculated using Kendall’s statistic. Results: A total of 42 synovial fluid samples from 21 horses were collected and used in the analysis. No significant correlation was identified between Dkk-1 concentrations and radiographic signs of osteoarthritis. Intrasynovial Dkk-1 concentrations were significantly greater (p <0.001) in low motion joints (mean concentration, 232.68 pg/mL; range, 109.07–317.17) when compared to high- motion joints (28.78 pg/mL; 0.05–186.44 pg/mL) (p <0.001). Clinical significance: Low motion joints have significantly higher concentrations of Dkk-1 compared to high motion joints. Further research is needed to establish the importance of this finding and whether potential diagnostic or therapeutic applications of Dkk-1 exist in the horse.Supplementary material for this article is available at https://doi.org/10.3415/VCOT-16-11-0157


2009 ◽  
Vol 53 (11) ◽  
pp. 4840-4844 ◽  
Author(s):  
C. J. L. la Porte ◽  
J. P. Sabo ◽  
L. Béïque ◽  
D. W. Cameron

ABSTRACT Previously it has been shown that tipranavir-ritonavir (TPV/r) does not affect efavirenz (EFV) plasma concentrations. This study investigates the effect of steady-state EFV on steady-state TPV/r pharmacokinetics. This was a single-center, open-label, multiple-dose study of healthy adult female and male volunteers. TPV/r 500/200 mg twice a day (BID) was given with food for 24 days. After dosing with TPV/r for 10 days, EFV 600 mg once a day was added to the regimen. Intensive pharmacokinetic (PK) sampling was done on days 10 and 24. Validated bioanalytical high-pressure liquid chromatography-tandem mass spectrometry methods were used to determine plasma tipranavir (TPV), ritonavir (RTV), and EFV concentrations. Thirty-four subjects were entered into the study, and 16 subjects completed it. The geometric mean ratios (90% confidence intervals) for TPV and RTV area under the curves, C maxs, and C mins comparing TPV/r alone and in combination with EFV were 0.97 (0.87 to 1.09), 0.92 (0.81 to 1.03), and 1.19 (0.93 to 1.54) for TPV and 1.03 (0.78 to 1.38), 0.92 (0.65 to 1.30), and 1.04 (0.72 to 1.48) for RTV. Frequently observed adverse events were diarrhea, headache, dizziness, abnormal dreams, and rash. EFV had no effect on the steady-state PK of TPV or RTV, with the exception of a 19% increase in the TPV C min, which is not clinically relevant. TPV/r can be safely coadministered with EFV and without the need for a dose adjustment.


2015 ◽  
Vol 44 (6) ◽  
pp. 679-686 ◽  
Author(s):  
Barbara G. Hunter ◽  
Jill E. Parker ◽  
Rita Wehrman ◽  
Bernadette Stang ◽  
Christopher K. Cebra

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