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The Impact of Gender and Menopausal Status on the Pharmacokinetics of Omeprazole and Rosuvastatin

Thesis Info

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Author

Nazir, Shabnam

Program

PhD

Institute

University of Peshawar

City

Peshawar

Province

KPK

Country

Pakistan

Thesis Completing Year

2013

Thesis Completion Status

Completed

Subject

Pharmacology

Language

English

Link

http://prr.hec.gov.pk/jspui/bitstream/123456789/2388/1/3068S.pdf

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676727581144

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Gender difference and genotypic polymorphism may affect the clinical outcome and therapeutic effectiveness of drugs. Current study was based on the same concept. Physiologically, males and females differ in body composition, body mass index, body fats proportion, plasma volume, blood flow and organ size. Gender differences also exist in expression of drug transporters and drug metabolizing enzymes due to hormonal disparity that may affect plasma drug levels. Hormonal fluctuations during menstrual cycle are considered to be the underlying cause for differences in pharmacokinetics of drugs. Similarly, hormonal changes in menopause affect physiology of females that may lead to the variations in the pharmacokinetics of drugs. It has been reported that females experience frequent side effects of the drugs compared with the males. Genotype is also a potential determinant of enzymatic activity. Genetic polymorphism of CYP2C19 may affect metabolism of omeprazole and individuals are classified as homozygous poor metabolizers (Homz PMs), homozygous extensive metabolizers (Homz EMs) and heterozygous poor metabolizers (Htrz PMs). The prevalence of PMs is 19-23% in Asians. Omeprazole (5-methoxy-2-[[(4-methoxy-3,5-dimethyl-2-pyridinyl)methyl] sulphinyl]-1H-benzimidazole) is a pyridinylsulfinylbenzimidazole compound and a prototype member of proton pump inhibitors. It is used for the treatmentof gastro esophageal reflux disease (GERD), Zollinger-Ellison syndrome and hyperacidity. Omeprazole is primarily metabolized by CYP2C19 and CYP3A4 to 5-hydroxy- viii omeprazole and omeprazole-sulphone, respectively. FDA warns that hip bone and spine fracture is associated with prolonged use of omeprazole that may accelerate osteoporosis in postmenopausal females. Rosuvastatin(3R,5S,6E)-7-[4-(4-fluorophenyl)-2-(Nmethylmethanesulfonamido)-6-(propan-2-yl)pyrimidin-5-yl]-3,5-dihydroxyhept-6-enoic acid) is a 3-hydroxy-3-methylglutaryl coenzyme A-reductase inhibitor that reduces blood cholesterol level. Rosuvastatin is used for the primary prevention of cardiovascular events. Rosuvastatin is only 10% metabolized by CYP2C9 and 90% is excreted unchanged through hepatobiliary secretion. Females are mostly underrepresented in most of the clinical trials arranged for Statin. Therefore, there is scarcity of data on the therapeutic effectiveness and safety of statins in females. In present study, the impact of gender, menopause and CYP2C19 genotype on pharmacokinetics of omeprazole and rosuvastatin was evaluated. Reversed phase High Performance Liquid Chromatography (RP-HPLC-UV) method was developed and validated for the quantitative analysis of omeprazole and rosuvastatin. Stock solutions (I mg/ml) of omeprazole, 5-hydroxy-omeprazole, omeprazole-sulphone and pantoprazole (internal standard) in methanol was prepared. Blood samples were collected in heparinized tubes and centrifuged at 5000 rpm at 0°C for 5 minutes in order to separate plasma that was stored at -20 °C until analysis. Plasma samples were thawed at room temperature extracted and analyzed using RP-HPLC coupled with UV detector. Genotyping of CYP2C19 was determined by Tetra primer polymerization chain reaction (PCR) assay. ix The single oral dose, open-label, clinical trial was designed to study PK parameters in all present studies. Pharmacokinetic study of omeprazole, 5-hydroxyomeprazole, omeprazole-sulphone and rosuvastatin was performed in general Pakistani population (n = 32) while comparative study was conducted between males (n = 16) and female (n = 16), premenopausal (n = 16) and postmenopausal females (n = 8) and during menstrual cycle where study was repeated for three time according to the menstrual phase. Pharmacokinetics of omeprazole and 5-hydroxy-omeprazol was also evaluated according to the CYP2C19 genotype. During the clinical trials, the volunteers fasted overnight and no juice, caffeine or food intake was allowed except water. At about 8.00 am, each volunteer received omeprazole capsule (40 mg) with a full glass of water (ca ≈ 250 ml). The blood samples (≈ 5 ml) were collected at 0.0, 0.5, 1.0, 2, 3, 4, 6 and 8 hours, centrifuged to separate the plasma and stored at -20°C till analysis. The samples were analyzed using RP-HPLC. The same protocol was adopted for rosuvastatin after one month of completion of omeprazole study. The plasma concentrations of omeprazole, 5-hydroxy-omeprazole, omeprazolesulphone and rosuvastatin were plotted on linear scale as a function of time while PK parameters were calculated using PK summit Soft-ware. Statistical analysis was performed to calculate mean ± SD values of PK parameters. Significant pharmacokinetic differences of omeprazole, 5-hydroxy-omeprazole and omeprazole sulphone were observed in male and female volunteers. The high AUC and low CL were observed in females compared with males. x During menstrual cycle, the AUC of omeprazole was high in follicular phase while metabolic ratios for 5-hydroxy-omeprazole and omeprazole-sulphone were insignificantly higher in luteal phase (high progesterone level). The finding suggests that progesterone stimulates CY2C19 and CYP3A4 activity. The AUC of omeprazole was high in postmenopausal compared with premenopausal females while CL was low in postmenopausal females. The metabolic ratios of 5-hydroxy-omeprazole and omeprazole-sulphone were higher in premenopausal females that reflect higher activities of CYP2C19 and CYP3A4 in premenopausal females, respectively. Pharmacokinetic differences based on CYP2C19 genotype were also observed. Higher AUC of omeprazole was observed in homozygous poor metabolizers (CYP2C19*3 in homozygous state) compared with homozygous extensive metabolizers whereas while higher AUC of 5-hydroxy-omeprazole was observed in homozygous extensive metabolizers. The finding showed that metabolism of omeprazole was high in homozygous extensive metabolizers carrying CYP2C19*1 allele in homozygous state while CYP2C19*3 was responsible for genetically deficient metabolism. The AUC of rosuvastatin was significantly higher in females while CL was slow compared with males however; AUC of rosuvastatin was low in postmenopausal females compared with premenopausal females. In current investigation, significant PK differences for omeprazole and rosuvastatin were observed in males and females, premenopausal and postmenopausal xi females and during menstrual cycle. The present results showed the variations in drug response (PK parameters) exist between males and females, in premenopausal and postmenopausal females and during menstrual cycle, these differences may have clinical impact particularly in multiple drug therapy where chances of drug-drug interaction increased.
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مولانا عبدالصمد رحمانی

مولانا عبدالصمد رحمانی
تین مہینہ کے سفر کے بعد جب ۳/جون کوبحمداﷲ بہمہ وجوہ خیریت و عافیت واپسی ہوئی توجن احباب اوربزرگوں کے انتقال پرملال کی خبر سے سخت افسوس اوررنج ہوا ان میں مولانا عبدالصمد صاحب رحمانی بھی تھے۔مولانا ان اکابر علم وفضل اوراصحاب ورع وتقوی میں سے تھے جن کے دم سے اسلام کی روحانی اوردینی واخلاقی عظمت کی آبرو قائم ہے۔ ان کی استعداد بڑی پختہ تھی، مطالعہ وسیع، نظر دقیق اورفہم ثاقب رکھتے تھے۔ یوں تو سب ہی علوم دینیہ و مروجۂ مدارس عربیہ سے ان کو قلبی لگاؤ تھا لیکن فقہ اورحدیث سے ان کوزیادہ دلچسپی اور مناسبت تھی۔ جب گفتگو کرتے تھے توان کی باتوں سے رسوخ فی العلم کے ساتھ سنجیدگی ٔرائے،ذہانت اورتوازن فکر کے بھبکے آتے تھے۔عملاً بڑے قناعت پسند اور درویش صفت بزرگ تھے، ہرچیز میں سادگی اور بے تکلفی ملحوظ رکھتے تھے۔ صاحب درس اورصاحب تصنیف وتالیف بھی تھے۔ ملک کی تحریک آزادی کے ہراوّل دستے میں تھے لیکن آزادی کے بعد ملک میں جوحالات پیش آئے اورجن کا سلسلہ اب بھی جاری ہے، انھوں نے بعض دوسرے مجاہدین وطن کی طرح ان کو اس درجہ دل شکستہ اور مایوس کردیا تھا کہ وہ سب کچھ چھوڑ چھاڑ گوشہ نشین ہوگئے تھے۔ چند برس سے مجموعۂ امراض واسقام تھے اوربہت کمزور ہوگئے تھے، آخر وقت موعود بھی آپہنچا۔اﷲ تعالیٰ مغفرت وبخشش اور رفع درجات کی نعمتوں سے سرفراز فرمائے۔آمین [جون۱۹۷۳ء]

 

Determinants of Factors That Influence Income Smoothing

The aim of this research is to find out the partial and simultaneous influence of firm size, leverage, cash holding, winner/loser and profitability on smoothing in technology sector companies listed on the Indonesia Stock Exchange in 2019-2021. The method in this research uses quantitative methods. The hypothesis in this research was tested using logistic regression analysis using EViews 12 software. The sampling technique used in this research was the Purposive Sampling Technique which produced 11 samples of selected companies over a period of 3 years so that 33 sample units of companies in the technology sector were listed. on the Indonesian Stock Exchange. The results of this research show that the variables firm size, leverage and profitability have a significant effect on income smoothing. Meanwhile, cash holding and winner/loser stock do not have a significant effect on income smoothing. For the results of simultaneous hypothesis testing, firm size, leverage, cash holding, winner/loser stock and profitability have a significant effect on income smoothing. The implication of this research is that companies can first consider the impact before carrying out income smoothing.

Approaches to Assess the Optimum Dissolved Oxygen Released by Macrophytes in the Substratum of Constructed Wetlands

Approaches to Assess the Optimum Dissolved Oxygen Released by Macrophytes in the Substratum of Constructed Wetlands Constructed wetlands (CWs) have been successfully employed to treat wastewater in developing countries as they are economical and based on ecologically friendly principles. Wastewater treatment by CW involves chemical, biological and physical processes like precipitation, sedimentation, absorption, adsorption and biodegradation. However, the degradation of organic matter is dependent on oxygen availability in wastewater. The hydrologic environment of CW with water saturated substrate is prevailed by poor oxygen conditions. Therefore, the oxygen added by the macrophytes through their roots to the substrate of CW plays a key role in wastewater treatment. A part of the oxygen produced during the process of photosynthesis is transported through the inter-connected air spaces comprising aerenchyma of these plants to the roots and rhizosphere. The active oxygen transfer capability is one of the main parameters that controls the performance of a CW and is thus considerably dependent on the oxygen availability in the rhizosphere, which may be controlled by the finest combination of macrophytes, climatic factors and microorganisms. In the current study, a specially designed Wireless Sensor Network (WSN) was used for monitoring temperature, light intensity and humidity supplemented with a mix of digital controlling and measuring devices. A precise, continuous and frequent data about humidity, temperature and light intensity combinations was recorded with insignificant fluctuations of 1 - 2 ºC in temperature and 7 to 20 µmol m-2 s-1 in light intensity. The study discovered the significant increase in dissolved oxygen (DO) in the rhizosphere of Typha latifolia and Phragmites australis affected by the optimum combination of temperature and light intensity, i.e., 30 - 35 ºC with 210 µmol.m-2 s-1 and 35 ºC with 140 - 210 µmol m-2 s-1, respectively. The highest DO recorded from the rhizosphere of Typha when exposed to these combinations was 1.67 mg/L whereas in the rhizosphere of Phragmites it was 2.16 mg/L. The exposure to the optimum temperature and light intensity combinations, increased the fresh plant biomass in Typha by 27% and Phragmites 32% whereas the chlorophyll content was enhanced by 13% and 14%, respectively. The Plant Growth Promoting Rhizobacteria (PGPR) enhanced the plant growth and chlorophyll content. The PGPR also had positive influence on the process of photosynthesis and consequently on the release of oxygen from the roots of plants. The PGPR (GRP-C3) inoculated plants were able to add maximum oxygen to their rhizosphere. The highest amount of oxygen recorded from the rhizosphere of Typha and Phragmites was 4.54 mg/L and 2.57 mg/L, respectively. It was observed that the PGPR, GRP-C3 showed the highest phosphate solubilization index (17 mm) and higher ability to produce Indole Acetic Acid (IAA), i.e., 12.5 mg/L. The higher concentration of DO in the substratum of CW significantly reduced the retention time for treating maximum chemical and biological oxygen demand from the wastewater, i.e., 8 days for the Typha vegetated microcosms and 9 days for the Phragmites vegetated microcosms. The non-vegetated microcosms required 17-18 days, however, all vegetated microcosms exposed to unfavorable temperature and light intensity combinations required 10-15 days for achieving maximum COD/BOD removal efficiency. A major feature of variable rate of photosynthesis also revealed a rhythmic and regular pattern of diurnal fluctuation of DO concentration in the rhizosphere of macrophytes during the light and dark period. The highest photosynthetic rates observed in Saururus cernuus and Pistia stratiotes were 5.76 μmol CO2 m-2 s-1 and 3.52 μmol CO2 m-2 s-1 at light intensity level of 140 µmol m-2 s-1 and 210 µmol m-2 s-1, respectively. The Pistia exhibited a significantly higher release of oxygen (5.83 mg/L) from the roots than the Saururus (3.87 mg/L). The stomatal conductance in both plants was observed to be significantly affected by the variable temperatures where a regression between the stomatal conductance and DO in the rhizosphere of Pistia and Saururus was determined.