scholarly journals Improved Oral Bioavailability of Lopinavir in Melt-Extruded Tablet Formulation Reduces Impact of Third Trimester on Lopinavir Plasma Concentrations

2011 ◽  
Vol 56 (2) ◽  
pp. 816-824 ◽  
Author(s):  
L. J. Else ◽  
M. Douglas ◽  
L. Dickinson ◽  
D. J. Back ◽  
S. H. Khoo ◽  
...  
Keyword(s):  
Oral Bioavailability ◽  
Plasma Concentrations ◽  
Undetectable Viral Load ◽  
Pharmacokinetic Data ◽  
Third Trimester ◽  
Time Curve ◽  
The Third ◽  
Concentration Time ◽  
Liquid Chromatography Tandem Mass ◽  
In Pregnancy

ABSTRACTLopinavir exposure was reduced during the third trimester in pregnant women receiving standard dosing of the soft-gel capsule (SGC; 400/100 mg twice daily [b.i.d.]). Pharmacokinetic data on the lopinavir tablet in pregnancy are limited. On the basis of the tablet's improved bioavailability, standard dosing (400/100 mg b.i.d.) may provide adequate lopinavir exposure in pregnancy without a need for dose adjustment. Here we compared the total and unbound lopinavir pharmacokinetics throughout pregnancy in the second and third trimesters in HIV-infected women receiving standard dosing of the lopinavir SGC or tablet. Postpartum sampling was also performed in patients continuing therapy postdelivery. Blood samples were collected at 0 to 12 h postdosing, and lopinavir concentrations were determined by high-pressure liquid chromatography-tandem mass spectrometry. Nineteen patients were included: 8 received the SGC (cohort 1) and 11 received the tablet (cohort 2). Total lopinavir exposures in the third trimester were lower than those in the second trimester (35 and 28% for cohorts 1 and 2, respectively) and postpartum (35% for cohort 2). In the third trimester, the area under the concentration-time curve (AUC) from 0 to 12 h (AUC0–12) and maximum concentration were ∼15% and 25% higher, respectively, for the lopinavir tablet than the SGC. One SGC patient had lopinavir concentrations of <1,000 ng/ml; all patients on the tablet had concentrations of >1,000 ng/ml. In cohort 2, the percentage of the AUC that was unbound was higher (nonsignificantly) in the second (1.28%) and third (1.18%) trimesters than postpartum (1.01%). Seventeen of 19 patients had an undetectable viral load at delivery. There were no HIV transmissions. Although lopinavir (tablet) exposures were reduced during the third trimester, the higher total and unbound concentrations achieved in women receiving the tablet than in women receiving the SGC suggest that the tablet's improved oral bioavailability may partly compensate for the reduction in lopinavir exposure during the later stages of pregnancy.

scholarly journals Dose-Dependent Increase in Unconjugated Cinnamic Acid Concentration in Plasma Following Acute Consumption of Polyphenol Rich Curry in the Polyspice Study

Nutrients ◽  
2018 ◽  
Vol 10 (7) ◽  
pp. 934 ◽  
Author(s):  
Sumanto Haldar ◽  
Sze Lee ◽  
Jun Tan ◽  
Siok Chia ◽  
Christiani Henry ◽  
...  
Keyword(s):  
Cinnamic Acid ◽  
Plasma Concentrations ◽  
High Dose ◽  
Aromatic Acids ◽  
Time Curve ◽  
Concentration Time ◽  
Liquid Chromatography Tandem Mass ◽  
Dose Dependent Increase ◽  
Dose Dependent ◽  
Randomized Crossover Study

Spices that are rich in polyphenols are metabolized to a convergent group of phenolic/aromatic acids. We conducted a dose-exposure nutrikinetic study to investigate associations between mixed spices intake and plasma concentrations of selected, unconjugated phenolic/aromatic acids. In a randomized crossover study, 17 Chinese males consumed a curry meal containing 0 g, 6 g, and 12 g of mixed spices. Postprandial blood was drawn up to 7 h at regular intervals and plasma phenolic/aromatic acids were quantified via liquid chromatography tandem mass spectrometry (LC-MS/MS). Cinnamic acid (CNA, p < 0.0001) and phenylacetic acid (PAA, p < 0.0005) concentrations were significantly increased with mixed spices consumption, although none of the other measured phenolic/aromatic acids differ significantly between treatments. CNA displayed a high dose-exposure association (R2 > 0.8, p < 0.0001). The adjusted mean area under the plasma concentration-time curve until 7 h (AUC0–7 h) for CNA during the 3 increasing doses were 8.4 ± 3.4, 376.1 ± 104.7 and 875.7 ± 291.9 nM.h respectively. Plasma CNA concentration may be used as a biomarker of spice intake.

scholarly journals Early Postpartum Pharmacokinetics of Lopinavir Initiated Intrapartum in Thai Women

2009 ◽  
Vol 53 (5) ◽  
pp. 2189-2191 ◽  
Author(s):  
Tim R. Cressey ◽  
Russell Van Dyke ◽  
Gonzague Jourdain ◽  
Thanyawee Puthanakit ◽  
Anuvat Roongpisuthipong ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Third Trimester ◽  
Serious Adverse Events ◽  
Time Curve ◽  
Thai Women ◽  
The Third ◽  
Early Postpartum Period ◽  
Concentration Time ◽  
Early Postpartum ◽  
Immunodeficiency Virus

ABSTRACT Lopinavir (LPV) exposure is reduced during the third trimester of pregnancy. We report the pharmacokinetics of standard LPV-ritonavir dosing (400/100 mg twice daily) in the immediate and early postpartum period when initiated during labor. In 16 human immunodeficiency virus-infected Thai women, the median (range) LPV area under the concentration-time curve and maximum and minimum concentrations in plasma were 99.7 (66.1 to 180.5) μg·h/ml, 11.2 (8.0 to 17.5) μg/ml, and 4.6 (1.7 to 12.5) μg/ml, respectively, at 41 (12 to 74) h after delivery. All of the women attained adequate LPV levels through 30 days postpartum. No serious adverse events were reported.

scholarly journals Ibuprofen-related renal tubular acidosis in pregnancy

2011 ◽  
Vol 4 (3) ◽  
pp. 122-124 ◽  
Author(s):  
Andrew Mallett ◽  
Matthew Lynch ◽  
George T John ◽  
Helen Healy ◽  
Karin Lust
Keyword(s):  
Renal Dysfunction ◽  
Renal Tubular Acidosis ◽  
History Taking ◽  
Third Trimester ◽  
The Third ◽  
Healthy Neonate ◽  
Renal Tubular ◽  
In Pregnancy

Ibuprofen-related renal tubular acidosis (RTA) has not been previously described in pregnancy but its occurrence outside of pregnancy is being increasingly described. In this case, a 34-year-old woman presented in the third trimester of pregnancy with Type 1 or distal RTA related to ibuprofen and codeine abuse. It was complicated by acute on chronic renal dysfunction and hypokalemia. Delivery at 37 weeks gestation due to concerns of evolving preeclampsia resulted in the birth of a healthy neonate. RTA and hypokalemia were remediated and ibuprofen and codeine abuse ceased. Some renal dysfunction however continued. Thorough and repeated history taking as well as vigilance for this condition is suggested.

The renin-aldosterone system in pre-eclampsia, essential and transient hypertension during pregnancy, and normotensive pregnant and non-pregnant control subjects

1982 ◽  
Vol 101 (2) ◽  
pp. 273-280 ◽  
Author(s):  
E. B. Pedersen ◽  
A. B. Rasmussen ◽  
P. Johannesen ◽  
H. J. Kornerup ◽  
S. Kristensen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Plasma Renin ◽  
Urinary Sodium Excretion ◽  
Third Trimester ◽  
Plasma Aldosterone Concentration ◽  
The Third ◽  
Control Subjects ◽  
Hypertension In Pregnancy ◽  
Normotensive Pregnancy ◽  
In Pregnancy

Abstract. Plasma renin concentration (PRC), plasma aldosterone concentration (PAC), and blood pressure were determined in the third trimester in pregnancy, 5 days and 6 months after delivery in pre-eclampsia, essential and transient hypertension in pregnancy and in normotensive pregnant and non-pregnant control subjects. PRC and PAC were elevated several fold above non-pregnant level in all groups during pregnancy. In pre-eclampsia PRC and PAC were 220 and 160%, respectively, above the levels 6 months after delivery, and thus lower than the corresponding values, 360 and 402%, in normotensive pregnancy. In essential and transient hypertension PRC and PAC increased to the same degree as during normotensive pregnancy. Urinary sodium excretion, serum sodium and creatinine clearance were reduced in pre-eclampsia, but not in essential and transient hypertension when compared to normotensive pregnant controls. All the parameters determined were the same as in non-pregnant controls 6 months after delivery in all groups. There were no correlations between blood pressure and PRC or PAC in any of the groups neither in pregnancy nor after delivery. It is concluded that the renin-aldosterone system is stimulated in lesser degree in pre-eclampsia than in both essential hypertension, transient hypertension and normotensive pregnancy, and there was no evidence for a causal relationship between the renin-aldosterone system and blood pressure neither in normotensive nor hypertensive pregnancy.

scholarly journals DESENHO DA GRAVIDEZ E SENSIBILIDADE SONORA: CONTRIBUTOS PARA O ESTUDO DA PSICOLOGIA DA GRAVIDEZ

2016 ◽  
Vol 1 (1) ◽  
pp. 25
Author(s):  
Mª Eduarda Salgado Carvalho ◽  
Joao Manuel Rosado de Miranda Justo
Keyword(s):  
Longitudinal Study ◽  
Graphical Representation ◽  
Third Trimester ◽  
Psychological Study ◽  
Portuguese Version ◽  
The Third ◽  
Projective Measures ◽  
Music Representations ◽  
Maternal Orientation ◽  
In Pregnancy

Resumo.Introdução: Esta comunicação pretende descrever um estudo longitudinal acerca da aplicação da Escala do Desenho da Gravidez e da Escala da Sensibilidade Sonora-Musical na Gravidez, ambas construídas e validadas para este estudo, numa amostra de 211 mulheres grávidas aguardando a realização das ecografias do II e do III trimestres de gestação. Objectivos: 1) avaliar a evolução das variáveis do desenho da gravidez e das variáveis sonoro-musicais na passagem do II para o III trimestre e 2) analisar a contribuição de cada uma de estas variáveis para o estudo da psicologia da gravidez. Método: 1) estudo longitudinal comparando as variáveis do desenho da gravidez e a sensibilidade sonoro-musical observadas nos dois momentos de avaliação; 2) estudo correlacional entre cada uma destas variáveis e as variáveis de vinculação materna pré-natal e de orientação materna pré-natal. Instrumentos: Escala do Desenho da Gravidez (Carvalho, 2011), Escala da Sensibilidade Sonora-Musical na Gravidez (Carvalho & Justo, 2013), Escala de Vinculação Materna Pré-natal (versão Portuguesa, Camarneiro & Justo, 2010) e Questionário do Paradigma Placentário (versão portuguesa, Carvalho, 2011). Resultados: Os resultados revelam a existência de diferenças significativas, entre o II e o III trimestres nas variáveis estudadas, apontando para: a) um aumento da sensibilidade sonoro-musical no terceiro trimestre, b) uma evolução da auto-representação da imagem materna no terceiro trimestre e c) um aumento da frequência de representação gráfica da posição de apresentação fetal cefálica da imagem do bebé na passagem para o terceiro trimestre. Observaram-se correlações significativas entre, por um lado, as variáveis da sensibilidade sonoro-musical e as variáveis do desenho da gravidez e, por outro lado, as variáveis de orientação materna pré-natal. Registaram-se correlações significativas entre sensibilidade sonoro-musical, por um lado, e vinculação materna pré-natal e a orientação maternal pré-natal, por outro. Conclusão: Será importante investigar a dialética entre a representação do bebé imaginado através de medidas projectivas maternas e a percepção do comportamento fetal recorrendo à observação ecográfica e a medidas biofísicas e hemodinâmicas.Palavras chave: Gravidez, Escala do Desenho da Gravidez, Escala das Representações Sonoro-Musicais na Gravidez, Escala de Vinculação Materna Pré-Natal, Questionário do Paradigma Placentário.Abstract.Background: This paper aims to describe a longitudinal study about the use of the Drawing Pregnancy Scale and of the Sound-Music Representations in Pregnancy Scale, both of it created and validated in a sample of 211 pregnant women while waiting for sonograms of the II and III trimesters of pregnancy. Aims: 1) to assess, the evolution of variables in drawings of pregnancy and also of sound-music variables, by the transition of the II to the III trimester of gestation and 2) to analyze the contribution of each one of these variables for the psychological study of pregnancy. Method: 1) longitudinal study comparing variables in drawings of pregnancy and sound-music variables at the two moments of assessment; 2) correlational study between each one of these variables and variables of maternal pre-natal attachment and also of maternal pre-natal orientation. Instruments: Drawing Pregnancy Scale (Carvalho, 2011), Sound-Music Representations in Pregnancy Scale (Carvalho & Justo, 2013), Maternal Pre-natal Attachment Scale (Portuguese version, Camarneiro & Justo, 2010) and Placental Paradigm Questionnaire (Portuguese version, Carvalho, 2011). Results: Results show the existence of significant diferences between the II and the III trimestres in some of the variables under analysis, suggesting: a) a increase of the sound-music sensibility by the third trimester, b) an evolution of the maternal image at the third trimester and c) an increase of the frequency of the graphical representation of the cephalic fetal presentation of the baby’s image at the third trimester. Significant correlations were observed between, on one side, the variables of soundmusic sensibility and the variables of the pregnancy drawings and, on another side, variables of prenatal maternal orientation. Significant correlations between sound-music sensibility, on one side, and prenatal maternal attachment and prenatal maternal orientation, on the other side, were found. Conclusion: It will be important to investigate about the representation of the imagined baby through maternal projective measures and the perception of fetal behaviour using sonograms as well as biophysical and hemodynamic measures.Keywords: Pregnancy, Drawing Pregnancy Scale, Sound-Music Representations in Pregnancy Scale, Maternal Pre-natal Attachment Scale, Placental Paradigm Questionnaire.

scholarly journals Effects of a High-Fat Meal on the Relative Oral Bioavailability of Piperaquine

2005 ◽  
Vol 49 (6) ◽  
pp. 2407-2411 ◽  
Author(s):  
Ing-Kye Sim ◽  
Timothy M. E. Davis ◽  
Kenneth F. Ilett
Keyword(s):  
Oral Bioavailability ◽  
Geometric Mean ◽  
Pharmacokinetic Analysis ◽  
Lipid Solubility ◽  
Fasting State ◽  
High Fat ◽  
Time Curve ◽  
Hematological Indices ◽  
Concentration Time ◽  
Fat Meal

ABSTRACT Piperaquine (PQ) is an antimalarial drug whose high lipid solubility suggests that its absorption can be increased by a high-fat meal. We examined the pharmacokinetics of PQ phosphate (500 mg given orally) in the fasting state and after a high-fat meal in eight healthy Caucasian volunteers (randomized crossover). Plasma PQ concentration-time profiles were analyzed by using noncompartmental pharmacokinetic analysis. In the fed state, the geometric mean C max increased by 213%, from 21.0 to 65.8 μg/liter (P < 0.001). The time of C max was not significantly different between the fasting and fed states. The geometric mean area under the concentration-time curve from zero onward (AUC0-∞) increased by 98%, from 3,724 to 7,362 μg h/liter (P = 0.006). The oral bioavailability of PQ relative to the fasting state was 121% greater after the high-fat meal (95% confidence interval, 26 to 216% increase; P = 0.020). The side effects, postural blood pressure changes, electrocardiographic corrected QT interval, serum glucose, and other biochemical and hematological indices were similar in the fasting and fed states over 28 days of follow-up.

Exposure to Retinoic Acids in Non-Pregnant Women Following High Vitamin A Intake with a Liver Meal

2005 ◽  
Vol 75 (3) ◽  
pp. 187-194 ◽  
Author(s):  
Hartmann ◽  
Brørs ◽  
Bock ◽  
Blomhoff ◽  
Bausch ◽  
...  
Keyword(s):  
Plasma Concentration ◽  
Vitamin A ◽  
Safety Concern ◽  
Peak Plasma ◽  
Plasma Concentrations ◽  
Pregnant Female ◽  
Time Curve ◽  
High Vitamin ◽  
Concentration Time ◽  
Plasma Concentration Time Curve

Animal liver is a rich source of vitamin A. Due to retinoic acid (RA) metabolites, vitamin A has a teratogenic potential and women are generally advised to avoid or to limit the consumption of liver during pregnancy. In a recent study in non-pregnant female volunteers following single and repeated doses of up to 30,000 IU/day of vitamin A as a supplement, the plasma concentration time curve of all-trans RA acid showed a diurnal-like profile. But, the overall exposure (AUC24h) remained essentially unaltered whereas AUC24h increased linearly with dose for 13-cis and 13-cis-4-oxo RA. The current study in non-pregnant female volunteers showed that a single high vitamin A intake with a liver meal (up to 120,000 IU) exhibited a similar diurnal-like plasma concentration time curve for all-trans RA and its overall exposure remained also unaltered, despite a temporary two-fold increase in peak plasma concentration. Concentrations of 13-cis and 13-cis-4-oxo RA increased several-fold after a liver meal, and exposure (AUC24h) increased three- to five-fold. Pooling our results with data in the literature revealed a linear relation between the mean AUC24h of 13-cis and 13-cis-4-oxo RA and vitamin A intake with liver. Metabolism to all-trans RA of vitamin A with liver seems not to be of safety concern. However, the observed increase of plasma concentrations and the dose-dependent increase in exposure to 13-cis and 13-cis-4-oxo RA support the current safety recommendations on vitamin A intake and suggest that women should be cautious regarding their consumption of liver-containing meals during pregnancy.

scholarly journals Juvenile granulosa cell tumour in the third trimester of pregnancy

2020 ◽  
Vol 9 (2) ◽  
pp. 861
Author(s):  
Jonathan Gaughran ◽  
Argha Datta ◽  
Judith Hamilton ◽  
Tom Holland ◽  
Ahmad Sayasneh
Keyword(s):  
Case Report ◽  
Granulosa Cell ◽  
Cell Tumour ◽  
Granulosa Cell Tumour ◽  
Third Trimester ◽  
Rare Finding ◽  
Histopathological Findings ◽  
The Third ◽  
In Pregnancy

This case report describes the rare finding of a granulosa cell tumour in the third trimester of pregnancy. The presentation, investigation, management, histopathological findings and subsequent follow up are detailed. The difficulties associated with such diagnoses in pregnancy are explored.

scholarly journals Pharmacokinetics of Daptomycin in Critically Ill Pediatric Patients

2018 ◽  
Vol 62 (6) ◽  
Author(s):  
Charalampos Antachopoulos ◽  
Stavroula Ilia ◽  
Paschalis Kadiltzoglou ◽  
Eirini Baira ◽  
Aristides Dokoumetzidis ◽  
...  
Keyword(s):  
Critically Ill ◽  
Drug Exposure ◽  
Pediatric Patients ◽  
Plasma Concentrations ◽  
Therapeutic Drug ◽  
Burn Patients ◽  
Time Curve ◽  
Once Daily ◽  
Concentration Time ◽  
Optimal Drug

ABSTRACT The pharmacokinetics of daptomycin (10 mg/kg once daily) was studied in 4 critically ill pediatric patients aged 8 to 14 yrs. The area under the concentration-time curve from time zero to infinity (AUC 0–∞ ) of plasma concentrations on day 1 ranged between 123.8 to 663.9 μg · h/ml, with lower values observed in septic and burn patients; clearance ranged from 15.1 to 80.7 ml/h/kg. Higher-than-recommended doses of daptomycin may be needed in septic children to ensure optimal drug exposure. Interpatient variability may suggest a role for therapeutic drug monitoring.

scholarly journals THE DIFFERENCE IN ADDITION OF BACK MASSAGE COMBINATION IN PREGNANCY EXERCISE IN IMPROVING QUALITY OF SLEEP IN THIRD TRIMESTER PREGNANT WOMEN

2018 ◽  
Vol 6 (2) ◽  
pp. 16
Author(s):  
Mezzi Wulandari Arenza ◽  
Ni Wayan Tianing ◽  
I Putu Adiartha Griadhi
Keyword(s):  
Sleep Quality ◽  
Pregnant Women ◽  
Control Group ◽  
Quality Of Sleep ◽  
Third Trimester ◽  
The Third ◽  
The Difference ◽  
In Pregnancy ◽  
Back Massage

ABSTRACTSleep disturbance in the third trimester pregnant women is caused by discomfort, an increasingly largeabdominal condition, back pain, frequent urination, fetal movement, heartburn, cramps in the legs, tiredness, difficultygetting started, and physiological changes. Sleep disorders result in decreased quality of sleep. Pregnant women whohave poor sleep quality are at risk of longer labor, cesarean delivery, premature birth, and even infant mortality. The aimof this research is to know the difference of pregnant exercise combination and back massage in improving the sleepquality of third trimester pregnant women. This research use experiment method with quasi experiment approach andresearch design is pre and post test with control design. Sample are 18 people, divided into 2 groups, 9 people intreatment groups given pregnancy exercise and back massage and 9 people in control group is given only pregnantexercise. Intervention is given 8 times. Pittsburgh Sleep Quality Index (PSQI) questionnaire used for measured of sleepquality. The result of different test of unpaired group, in the treatment group got difference of average 4,556 and controlgroup got difference mean 2,333 with p=0,004 (p<0,05). These results showed that there was a significant differencebetween the treatment group and the control group in improving the sleep quality of the third trimester pregnant women.In conclusion, there are differences in the addition of back massage combination in pregnancy exercise intervention inimproving sleep quality of third trimester pregnant women.Keyword : Pregnancy Exercise, Back Massage, Sleep Quality, Third Trimester.

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