Low‐volume LC–MS/MS method for the pharmacokinetic investigation of carvedilol, enalapril and their metabolites in whole blood and plasma: Application to a paediatric clinical trial
Abstract:Evidence‐based pharmacotherapy with carvedilol and enalapril in children suffering from heart failure is insufficient owing to limited pharmacokinetic data. Although a few data sets regarding enalapril, its metabolite enalaprilat and carvedilol in children have been published, pharmacokinetic data on carvedilol metabolites are missing. However, for both drug substances, their active metabolites contribute substantially to drug efficacy. As data can hardly be derived from adults owing to the unknown impacts of … Show more
“…Metabolomic studies, including those in adult HF (2,80), are a way of highlighting biochemical pathways and signatures correlated to the underlying pathophysiology that may aid in the diagnosis or management of pediatric HF and CHD (81,82). A wide range of metabolites in a variety of CHDs have been reported (83)(84)(85), notably acylcarnitines, triacylglycerides, amino-acid related compounds, lipids, and free fatty acids.…”
Section: Omics Studies For Biomarker Discovery In Chdmentioning
Background and Objective: Heart failure (HF) in the pediatric population is a multi-factorial process with a wide spectrum of etiologies and clinical manifestations, that are distinct from the adult HF population, with congenital heart disease (CHD) as the most common cause. CHD has high morbidity/mortality with nearly 60% developing HF during the first 12 months of life. Hence, early discovery and diagnosis of CHD in neonates is pivotal. Plasma B-type natriuretic peptide (BNP) is an increasingly popular clinical marker in pediatric HF, however, in contrast to adult HF, it is not yet included in pediatric HF guidelines and there is no standardized reference cut-off value. We explore the current trends and prospects of biomarkers in pediatric HF, including CHD that can aid in diagnosis and management.Methods: As a narrative review, we will analyze biomarkers with respect to diagnosis and monitoring in specific anatomical types of CHD in the pediatric population considering all English PubMed publications till June 2022.
“…Metabolomic studies, including those in adult HF (2,80), are a way of highlighting biochemical pathways and signatures correlated to the underlying pathophysiology that may aid in the diagnosis or management of pediatric HF and CHD (81,82). A wide range of metabolites in a variety of CHDs have been reported (83)(84)(85), notably acylcarnitines, triacylglycerides, amino-acid related compounds, lipids, and free fatty acids.…”
Section: Omics Studies For Biomarker Discovery In Chdmentioning
Background and Objective: Heart failure (HF) in the pediatric population is a multi-factorial process with a wide spectrum of etiologies and clinical manifestations, that are distinct from the adult HF population, with congenital heart disease (CHD) as the most common cause. CHD has high morbidity/mortality with nearly 60% developing HF during the first 12 months of life. Hence, early discovery and diagnosis of CHD in neonates is pivotal. Plasma B-type natriuretic peptide (BNP) is an increasingly popular clinical marker in pediatric HF, however, in contrast to adult HF, it is not yet included in pediatric HF guidelines and there is no standardized reference cut-off value. We explore the current trends and prospects of biomarkers in pediatric HF, including CHD that can aid in diagnosis and management.Methods: As a narrative review, we will analyze biomarkers with respect to diagnosis and monitoring in specific anatomical types of CHD in the pediatric population considering all English PubMed publications till June 2022.
“…Various methods were applied for the estimation of CARVL. The most accurate methods include high performance liquid chromatography [3-8], HPLC/MS [9],UHPLC [10],LC/MS/MS [11] nanosensor probe [12], electrochemical sensor [13], voltammetric determination [14], spectrofluorimetry in presence of atenolol [15] and SPE-spectrofluorimetric [16].…”
A simple, sensitive, precise, and accurate spectrophotometric method was suggested for the estimation of carvedilol (CARVL) as pure, and in its pharmaceutical formulation (tablet): the method is based on Schiff ̕ s base reaction included condensation of CARVL with 4-hydroxybenzaldehyde(4-HBED) in the presence of concentrated sulphuric acid. All parameters that affected the formation of the product have been studied and the Optimal condition were selected. The colored Schiff base product gave maximum absorption at 533 nm. The linearity of the proposed method was obeyed Beer's law in the concentrations range of 0.5 to 5 µg/ ml, with a molar absorptivity of 8.463 ×104 l. mol-1 cm-1. The suggested method was applied to the determination of CARVL in Tablet formulations with accepted results of recovery of CARVL without any interfering with the common excipients.
Hepatic carboxylesterase 1 (CES1) metabolizes numerous prodrugs into active ingredients or direct-acting drugs into inactive metabolites. We aimed to develop a semi-physiologically based pharmacokinetic (semi-PBPK) model to simultaneously predict the pharmacokinetics of CES1 substrates and their active metabolites in liver cirrhosis (LC) patients. Six prodrugs (enalapril, benazepril, cilazapril, temocapril, perindopril and oseltamivir) and three direct-acting drugs (flumazenil, pethidine and remimazolam) were selected. Parameters such as organ blood flows, plasma-binding protein concentrations, functional liver volume, hepatic enzymatic activity, glomerular filtration rate (GFR) and gastrointestinal transit rate were integrated into the simulation. The pharmacokinetic profiles of these drugs and their active metabolites were simulated for 1000 virtual individuals. The developed semi-PBPK model, after validation in healthy individuals, was extrapolated to LC patients. Most of the observations fell within the 5th and 95th percentiles of simulations from 1000 virtual patients. The estimated AUC and Cmax were within 0.5–2-fold of the observed values. The sensitivity analysis showed that the decreased plasma exposure of active metabolites due to the decreased CES1 was partly attenuated by the decreased GFR. Conclusion: The developed PBPK model successfully predicted the pharmacokinetics of CES1 substrates and their metabolites in healthy individuals and LC patients, facilitating tailored dosing of CES1 substrates in LC patients.
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