Urine Tests to Monitor the Self-Administration of Dapsone by Leprosy Patients *

Ellard, G. A.; Gammon, Patricia T.; Helmy, H. S.; Rees, R. J. W.

doi:10.4269/ajtmh.1974.23.464

Cited by 21 publications

(5 citation statements)

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“…Urinary creatinine concentrations were determined by a modification of the alkaline picrate method (Ellard, Gammon, Helmy & Rees, 1974).…”

Section: Determination Of Creatininementioning

confidence: 99%

“…I to 3.62 mg/ml (geometric mean, 0.77 mg/ml ) and at each time point there was a highly significant correlation (P < 0.001) between INA and creatinine concentrations, so that variations in INA/creatinine ratios were much more limited than the spread in INA concentrations (Table 5). Thus estimating INA/creatinine ratios was largely able to compensate for the effects of diuresis in a way that had been utilized previously to monitor the ingestion of dapsone by measuring urinary dapsone/creatinine ratios (Ellard et al, 1974), and the most efficient method of discriminating between postand pre-treatment samples was to use a ratio of greater than 0.1 pg apparent INA/mg creatinine as a criterion of positivity (Table 5).…”

Section: Positivity Of Urine Samples Collected At Various Times Aftermentioning

confidence: 99%

See 1 more Smart Citation

An evaluation of the potential use of isoniazid, acetylisoniazid and isonicotinic acid for monitoring the self‐administration of drugs.

Ellard¹,

Jenner²,

Downs³

1980

Brit J Clinical Pharma

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1. The possibility of using minute doses of the antituberculosis drug isoniazid (INH) or of its metabolites acetylisoniazid (AcINH) or isonicotinic acid (INA) as innocuous markers for monitoring patient compliance has been investigated. 2. The ingestion of these colourless and tasteless compounds can readily be demonstrated using a sensitive and specific colorimetric method for detecting INA and its metabolite isonicotinylglycine (INAG) in the urine that is rapid and simple to perform. 3. Studies on the kinetics of the urinary elimination of INA and INAG after the ingestion of 6 mg doses of either INH, AcINH or INA by small groups of volunteers indicated the potential suitability of INH or AcINH for monitoring daily or twice-daily self-medication and the appropriateness of INA as a marker for investigating the compliance of drugs prescribed for thrice-daily ingestion. 4. More extensive studies showed that over 99% of the urine samples collected within 18h of dosage with 6 mg INH would give positive results when tested for the presence of INA and INAG, and that doses of 2-6 mg INH could readily by incorporated into capsules or tablets and used as markers for monitoring the ingestion of the antituberculosis or antileprosy drugs dapsone, thiacetazone, ethionamide or prothionamide, or the antihypertensive oxprenolol. Such doses are less than a fiftieth of the normal therapeutic INH dose used in the treatment of tuberculosis. 5. Evidence is presented that INH, AcINH and INA possess most of the characteristics that one would hope to find in a marker for monitoring compliance including very limited inter-individual variability in the rates at which they are converted to the compounds being detected in the urine.

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“…Urinary creatinine concentrations were determined by a modification of the alkaline picrate method (Ellard, Gammon, Helmy & Rees, 1974).…”

Section: Determination Of Creatininementioning

confidence: 99%

Section: Positivity Of Urine Samples Collected At Various Times Aftermentioning

confidence: 99%

An evaluation of the potential use of isoniazid, acetylisoniazid and isonicotinic acid for monitoring the self‐administration of drugs.

Ellard¹,

Jenner²,

Downs³

1980

Brit J Clinical Pharma

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“…A quantitative method by which dapsone (DDS) self-administration in leprosy patients can be monitored has been evaluated (Ellard, Gammon, Helmy and Rees, 1974a). The ratios of DDS to creatinine (D/C) concentrations in urinary samples are determined and a comparison made between the D/C concentra tion ratios of patients taking DDS under strict supervision and those who ad minister their own medication.…”

Section: Introductionmentioning

confidence: 99%

Variability of Urinary Dapsone/Creatinine Concentration Ratios in Leprosy Patients Fully Compliant with Dapsone Therapy

Hagan¹,

Smith²

1979

Leprosy Review

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A highly sensitive and reproducible assay procedure for the determination of dapsone (DDS) and hydrolizable metabolites in urine is described. DDS/creatinine (D/C) con centration ratios, which are used to monitor compliance with DDS therapy, have been determined on samples of ali urine voided throughout a 24-h period by 7 leprosy in-patients fu lly compliant with their therapy. The D/C concentration ratios varied both within and between patients over the 24 h and the time-course of variation showed no closely predictable pattern. Urinary excretion of DDS over the 24 h was found to be 74.8%±5.7% (S.E.M.) uncorrected or 90.2%±6.8% corrected for recovery. Our results indicate an unreliability in the use of single urine samples to determine D/C ratios and hence compliance by individual patients with their DDS therapy.

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“…29 The effects of diuresis can, however, be largely overcome by quan titatively determining the ratio of the concentration of dapsone plus its diazot isable metabolites to creatinine in the urine using modificat ions of the Bratton and Marshall and alkaline picrate colorimetric methods, respectively. 27 .…”

mentioning

confidence: 99%