◉ Summary of Use during Lactation:Primaquine is poorly excreted into breastmilk of nursing mothers and undetectable in the serum of their breastfed infants. Breastfed infants beyond the neonatal period have shown no evidence of hemolysis. Neonates and infants with glucose-6-phosphate dehydrogenase (G6PD) deficiency have not been studied, however, G6PD-deficient infants over 28 days of age appear to have a low risk of hemolysis from exposure in breastmilk. If primaquine is required, testing the mother and infant for G6PD deficiency is advisable before the drug is given to a nursing mother.
United Kingdom malaria treatment guidelines recommend that primaquine be avoided in nursing mothers with malaria and that weekly chloroquine 500 mg be given until breastfeeding is completed. However, these guidelines were developed before information on the excretion of primaquine into breastmilk and safety in breastfed infants was published. More recent information indicates that all mothers nursing infant over 28 days of age could safely receive primaquine. The Centers for Disease Control and Prevention guidelines state that primaquine may be used in breastfeeding mothers and infants with normal G6PD levels. Because the small amounts of primaquine transferred in breast milk are insufficient to provide adequate protection or treatment of malaria, infants who require chemoprophylaxis or therapy must receive the recommended dosages of primaquine.
◉ Effects in Breastfed Infants:Twenty-one mothers with vivax malaria were give a dosage of primaquine 0.5 mg/kg daily for 14 days while breastfeeding their infants who were at least 28 days old. No alterations in hematocrit, Heinz body counts, serum bilirubin, oxygen saturation, or methemoglobinemia were seen in any of the infants.
A woman with vivax malaria who was 5 months postpartum was given a dose of primaquine of 0.52 mg/kg daily for 7 days, then 0.46 mg/kg daily for 7 days after rechecking the patient’s weight. Shwas found to be heterozygous for glucose-6-phosphate dehydrogenase (G6PD) deficiency and experienced some hemolysis and anemia. Her female infant was being breastfed (extent not stated) during treatment and was found to be heterozygous for the G6PD Mahidol variant, but had no apparent hemolysis. The child’s vaccination schedule was completed, and the 6-month motor milestones were normal.
◉ Effects on Lactation and Breastmilk:Relevant published information was not found as of the revision date.
Scalable Preparation and Differential Pharmacologic and Toxicologic Profiles of Primaquine Enantiomers
摘要:
摘要
葡萄糖-6-磷酸脱氢酶(G6PD)活性基因缺陷者的血液毒性是伯氨喹(PQ)的主要局限性。
间日疟原虫
疟疾的唯一抗疟药物。目前临床上使用的是外消旋体形式的 PQ。我们开发了一种可扩展的程序来解析外消旋 PQ,从而首次提供了纯对映体,用于详细的临床前评估,并有可能用于临床。利用几种小鼠模型对这些对映体的抗寄生虫活性进行了比较,同时还对小鼠和狗的一般毒性和血液学毒性进行了比较。
S
)-PQ比(-)-( R)-PQ显示出更好的抑制和因果预防活性。
R
)-PQ对感染了
疟原虫
.同样,(+)-(
S
)-PQ比(-)-(
R
)-PQ更有效。
卡氏肺囊虫
肺炎的小鼠模型中,(+)-( R )-PQ然而,在较高剂量下,(+)-(
S
)-PQ对小鼠也显示出更大的全身毒性。在小猎犬中,(+)-(
S
)-PQ会导致更多高铁血红蛋白血症,按每公斤体重每天5毫克的剂量口服3天会产生毒性,而(-)-( R )-PQ会导致更多高铁血红蛋白血症。
R
)-PQ 的耐受性良好。在一个与人类 G6PD 缺乏症相关的溶血性贫血的新型小鼠模型中,也证明了 (-)-(
R
)-PQ的溶血性低于(+)-(
S
)-PQ对接种到NOD-SCID小鼠体内的G6PD缺陷人红细胞的溶血作用更小。所有这些数据都表明,虽然(+)-(
S
)-PQ在啮齿类动物中显示出更强的抗寄生虫效力,但它的血液毒性也比(-)-( S )-PQ更强。
R
)-PQ对小鼠和狗的血液毒性更大。PQ 对映异构体在不同物种中的活性和毒性差异可归因于它们不同的药代动力学和代谢特征。综上所述,这些研究表明,(-)-(
R
)-PQ在人体中可能比外消旋体具有更好的安全系数。
Scalable Preparation and Differential Pharmacologic and Toxicologic Profiles of Primaquine Enantiomers
摘要:
摘要
葡萄糖-6-磷酸脱氢酶(G6PD)活性基因缺陷者的血液毒性是伯氨喹(PQ)的主要局限性。
间日疟原虫
疟疾的唯一抗疟药物。目前临床上使用的是外消旋体形式的 PQ。我们开发了一种可扩展的程序来解析外消旋 PQ,从而首次提供了纯对映体,用于详细的临床前评估,并有可能用于临床。利用几种小鼠模型对这些对映体的抗寄生虫活性进行了比较,同时还对小鼠和狗的一般毒性和血液学毒性进行了比较。
S
)-PQ比(-)-( R)-PQ显示出更好的抑制和因果预防活性。
R
)-PQ对感染了
疟原虫
.同样,(+)-(
S
)-PQ比(-)-(
R
)-PQ更有效。
卡氏肺囊虫
肺炎的小鼠模型中,(+)-( R )-PQ然而,在较高剂量下,(+)-(
S
)-PQ对小鼠也显示出更大的全身毒性。在小猎犬中,(+)-(
S
)-PQ会导致更多高铁血红蛋白血症,按每公斤体重每天5毫克的剂量口服3天会产生毒性,而(-)-( R )-PQ会导致更多高铁血红蛋白血症。
R
)-PQ 的耐受性良好。在一个与人类 G6PD 缺乏症相关的溶血性贫血的新型小鼠模型中,也证明了 (-)-(
R
)-PQ的溶血性低于(+)-(
S
)-PQ对接种到NOD-SCID小鼠体内的G6PD缺陷人红细胞的溶血作用更小。所有这些数据都表明,虽然(+)-(
S
)-PQ在啮齿类动物中显示出更强的抗寄生虫效力,但它的血液毒性也比(-)-( S )-PQ更强。
R
)-PQ对小鼠和狗的血液毒性更大。PQ 对映异构体在不同物种中的活性和毒性差异可归因于它们不同的药代动力学和代谢特征。综上所述,这些研究表明,(-)-(
R
)-PQ在人体中可能比外消旋体具有更好的安全系数。
Chiral separation and modeling of quinolones on teicoplanin macrocyclic glycopeptide antibiotics CSP
作者:Imran Ali、Mohd Suhail、Leonid Asnin
DOI:10.1002/chir.23024
日期:2018.12
retention, resolution, and separation factors ranged from 1.5 to 6.0, 1.80 to 2.25, and 2.86 to 6.0, respectively. The limit of detection and quantification ranged from 4.0 to 12 ng and 40 to 52 ng, respectively. The modeling studies indicated strong interactions of R‐enantiomers with teicoplanin chiral selector than S‐enantiomers. The supra molecular mechanism of the chiralrecognition was established
开发并描述了用于喹诺酮对映体拆分的新手性高效液相色谱(HPLC)方法。使用的色谱柱为Chirobiotic T(150×4.6 mm,5.0μm)。使用的三个流动相是MeOH:ACN:水:TEA(70:10:20:0.1%),(60:30:10:0.1%)和(50:30:20:0.1%)。流动相的流速为1.0 mL / min,并在不同波长下进行UV检测。保留值,分离度和分离系数的范围分别为1.5到6.0、1.80到2.25和2.86到6.0。检测限和定量限分别为4.0到12 ng和40到52 ng。建模研究表明,R-对映异构体与替考拉宁手性选择剂的相互作用强于S-对映异构体。通过建模和色谱研究建立了手性识别的超分子机理。据观察,氢键和π-π相互作用是手性分离的主要力量。本手性HPLC方法可用于任何基质中喹诺酮的对映体拆分。
IDO INHIBITORS AND THERAPEUTIC USES THEREOF
申请人:Roehrig Ute
公开号:US20110112282A1
公开(公告)日:2011-05-12
Compounds of formula (I), and pharmaceutically acceptable salts thereof, in which each compound is adapted to occupy the binding site of human IDO, which comprises a large hydrophobic pocket A and a second, proximal hydrophobic pocket B, the compound comprising at least one of the following elements: (i) a large hydrophobic fragment to substantially fill pocket A in the binding site of human IDO; (ii) an atom that can coordinate to the heme iron of human IDO, (iii) a positively charged group that can form a salt-bridge with the heme 7-propionate of the human IDO; (iv) a negatively charged group that can form a salt-bridge with Arg231 of the human IDO; (v) a hydrophobic group that can form van der Waals interactions with pocket B; and (vi) one or more substituents that can hydrogen bond to Ser167 and to Gly262, and as IDO inhibitors and their therapeutic use, eg in the treatment of cancer.
Scalable Preparation and Differential Pharmacologic and Toxicologic Profiles of Primaquine Enantiomers
作者:N. P. Dhammika Nanayakkara、Babu L. Tekwani、H. M. T. Bandara Herath、Rajnish Sahu、Montip Gettayacamin、Anchalee Tungtaeng、Yvonne van Gessel、Paul Baresel、Kristina S. Wickham、Marilyn S. Bartlett、Frank R. Fronczek、Victor Melendez、Colin Ohrt、Gregory A. Reichard、James D. McChesney、Rosemary Rochford、Larry A. Walker
DOI:10.1128/aac.02674-13
日期:2014.8
ABSTRACT
Hematotoxicity in individuals genetically deficient in glucose-6-phosphate dehydrogenase (G6PD) activity is the major limitation of primaquine (PQ), the only antimalarial drug in clinical use for treatment of relapsing
Plasmodium vivax
malaria. PQ is currently clinically used in its racemic form. A scalable procedure was developed to resolve racemic PQ, thus providing pure enantiomers for the first time for detailed preclinical evaluation and potentially for clinical use. These enantiomers were compared for antiparasitic activity using several mouse models and also for general and hematological toxicities in mice and dogs. (+)-(
S
)-PQ showed better suppressive and causal prophylactic activity than (−)-(
R
)-PQ in mice infected with
Plasmodium berghei
. Similarly, (+)-(
S
)-PQ was a more potent suppressive agent than (−)-(
R
)-PQ in a mouse model of
Pneumocystis carinii
pneumonia. However, at higher doses, (+)-(
S
)-PQ also showed more systemic toxicity for mice. In beagle dogs, (+)-(
S
)-PQ caused more methemoglobinemia and was toxic at 5 mg/kg of body weight/day given orally for 3 days, while (−)-(
R
)-PQ was well tolerated. In a novel mouse model of hemolytic anemia associated with human G6PD deficiency, it was also demonstrated that (−)-(
R
)-PQ was less hemolytic than (+)-(
S
)-PQ for the G6PD-deficient human red cells engrafted in the NOD-SCID mice. All these data suggest that while (+)-(
S
)-PQ shows greater potency in terms of antiparasitic efficacy in rodents, it is also more hematotoxic than (−)-(
R
)-PQ in mice and dogs. Activity and toxicity differences of PQ enantiomers in different species can be attributed to their different pharmacokinetic and metabolic profiles. Taken together, these studies suggest that (−)-(
R
)-PQ may have a better safety margin than the racemate in human.
摘要
葡萄糖-6-磷酸脱氢酶(G6PD)活性基因缺陷者的血液毒性是伯氨喹(PQ)的主要局限性。
间日疟原虫
疟疾的唯一抗疟药物。目前临床上使用的是外消旋体形式的 PQ。我们开发了一种可扩展的程序来解析外消旋 PQ,从而首次提供了纯对映体,用于详细的临床前评估,并有可能用于临床。利用几种小鼠模型对这些对映体的抗寄生虫活性进行了比较,同时还对小鼠和狗的一般毒性和血液学毒性进行了比较。
S
)-PQ比(-)-( R)-PQ显示出更好的抑制和因果预防活性。
R
)-PQ对感染了
疟原虫
.同样,(+)-(
S
)-PQ比(-)-(
R
)-PQ更有效。
卡氏肺囊虫
肺炎的小鼠模型中,(+)-( R )-PQ然而,在较高剂量下,(+)-(
S
)-PQ对小鼠也显示出更大的全身毒性。在小猎犬中,(+)-(
S
)-PQ会导致更多高铁血红蛋白血症,按每公斤体重每天5毫克的剂量口服3天会产生毒性,而(-)-( R )-PQ会导致更多高铁血红蛋白血症。
R
)-PQ 的耐受性良好。在一个与人类 G6PD 缺乏症相关的溶血性贫血的新型小鼠模型中,也证明了 (-)-(
R
)-PQ的溶血性低于(+)-(
S
)-PQ对接种到NOD-SCID小鼠体内的G6PD缺陷人红细胞的溶血作用更小。所有这些数据都表明,虽然(+)-(
S
)-PQ在啮齿类动物中显示出更强的抗寄生虫效力,但它的血液毒性也比(-)-( S )-PQ更强。
R
)-PQ对小鼠和狗的血液毒性更大。PQ 对映异构体在不同物种中的活性和毒性差异可归因于它们不同的药代动力学和代谢特征。综上所述,这些研究表明,(-)-(
R
)-PQ在人体中可能比外消旋体具有更好的安全系数。