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      In vitro/in vivo performance of different complexes of itraconazole used in the treatment of vaginal candidiasis

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          Abstract

          A large majority of new chemical entities and many existing drug molecules exhibit poor aqueous solubility, which may limit their potential use in developing drug formulations, with optimum bioavailability. One of the approaches to improve the solubility of a poorly water soluble drug and eventually its bioavailability is complexation with agents like humic acid (HA), fulvic acid (FA), β-cyclodextrin (β-CD), 2-hydroxypropyl-β-cyclodextrin (HP-β-CD) and caffeine (Caff). The current work emphasized at employing these agents to prepare different complexes and their in vitro/in vivo assessment. All the complexes evaluated for their complexation efficiency and authenticated by molecular modeling; conformational analysis, differential scanning calorimetry (DSC), X-ray diffraction (XRD), nuclear magnetic resonance (NMR) and mass spectroscopy. Furthermore, the complexes were assessed in an in vivo, rat vaginal model for their efficacy in treatment of vaginal candidiasis. Amongst the five tested complexes, fulvic acid-itraconazole complex yielded better solubility as well as in vivo efficacy and therefore may further be explored for developing a commercial formulation for treating vaginal candidiasis.

          Translated abstract

          A maioria das novas entidades químicas e muitas moléculas de fármacos existentes apresenta fraca solubilidade em água, o que pode limitar seu uso potencial no desenvolvimento de formulações com biodisponibilidade ideal. Uma das abordagens para melhorar a solubilidade de um fármaco pouco solúvel em água e, eventualmente, a sua biodisponibilidade é a complexação com agentes como o ácido húmico (HA), ácido fúlvico (FA), β-ciclodextrina (β-CD), 2-hidroxipropil-β-ciclodextrina (HP-β-CD) e cafeína (Caff). O presente trabalho baseia-se no uso desses agentes para preparar diferentes complexos e suas avaliações in vitro/in vivo. Todos os complexos foram avaliados quanto à eficiência de complexação por modelação molecular, análise conformacional, calorimetria de varredura diferencial (DSC), difração de raios-X (XRD), ressonância magnética nuclear (RMN) e espectroscopia de massas. Além disso, os complexos foram avaliados in vivo, em ratas, no tocante à sua eficácia no tratamento de candidíase vaginal. Entre os cinco complexos testados, o complexo de ácido fúlvico-itraconazol foi o que apresentou melhor solubilidade, bem como melhor eficácia in vivo e, portanto, pode ser explorado para o desenvolvimento de uma formulação comercial para o tratamento de candidíase vaginal.

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          Most cited references23

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          Rapid colorimetric assay for cellular growth and survival: Application to proliferation and cytotoxicity assays

          A tetrazolium salt has been used to develop a quantitative colorimetric assay for mammalian cell survival and proliferation. The assay detects living, but not dead cells and the signal generated is dependent on the degree of activation of the cells. This method can therefore be used to measure cytotoxicity, proliferation or activation. The results can be read on a multiwell scanning spectrophotometer (ELISA reader) and show a high degree of precision. No washing steps are used in the assay. The main advantages of the colorimetric assay are its rapidity and precision, and the lack of any radioisotope. We have used the assay to measure proliferative lymphokines, mitogen stimulations and complement-mediated lysis.
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            History of the development of azole derivatives.

            J Maertens (2004)
            Until the 1940s, relatively few agents were available for the treatment of systemic fungal infections. The development of the polyene antifungals represented a major advance in medical mycology. Although amphotericin B quickly became the mainstay of therapy for serious infections, its use was associated with infusion-related side-effects and dose-limiting nephrotoxicity. The continued search for new and less toxic antifungals led to the discovery of the azoles several decades later. Ketoconazole, the first available compound for the oral treatment of systemic fungal infections, was released in the early 1980s. For almost a decade, ketoconazole was regarded as the drug of choice in nonlife-threatening endemic mycoses. The introduction of the first-generation triazoles represented a second major advance in the treatment of fungal infections. Both fluconazole and itraconazole displayed a broader spectrum of antifungal activity than the imidazoles and had a markedly improved safety profile compared with amphotericin B and ketoconazole. Despite widespread use, however, these agents became subject to a number of clinically important limitations related to their suboptimal spectrum of activity, the development of resistance, the induction of hazardous drug-drug interactions, their less than optimal pharmacokinetic profile (itraconazole capsules), and toxicity. In order to overcome these limitations, several analogues have been developed. These so-called 'second-generation' triazoles, including voriconazole, posaconazole and ravuconazole, have greater potency and possess increased activity against resistant and emerging pathogens, in particular against Aspergillus spp. If the toxicity profile of these agents is comparable to or better than that of the first-generation triazoles and drug interactions remain manageable, then these compounds represent a true expansion of our antifungal arsenal.
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              The role of solid nanoparticle technology in the parenteral delivery of poorly water-soluble drugs.

              J Kipp (2004)
              Water insolubility has always been a key obstacle in pharmaceutical formulation, affecting formulation stability and drug bioavailability. Approaches for achieving complete dissolution often have disadvantages associated with the large quantities of required excipients. Small-particle suspensions (200 nm-2 microm), consisting essentially of pure drug, require only a minimum amount of surface-active agent for stabilization. Such suspensions may be formulated for rapid dissolution, thus achieving pharmacokinetic properties similar to those of a solution, or drug insolubility may be leveraged to afford prolonged in vivo release. In both situations, higher dosing may be possible than with a drug solution. This may afford enhanced efficacy at reduced excipient concentrations with potentially less toxicity. We present a brief introduction to the pharmaceutical technology of pure submicron drug particles in relationship to other dosage forms, and study examples are presented to underscore the potential benefits of this approach in parenteral delivery.
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                Author and article information

                Journal
                bjps
                Brazilian Journal of Pharmaceutical Sciences
                Braz. J. Pharm. Sci.
                Universidade de São Paulo, Faculdade de Ciências Farmacêuticas (São Paulo, SP, Brazil )
                2175-9790
                December 2012
                : 48
                : 4
                : 759-772
                Affiliations
                [01] New Delhi orgnameJamia Hamdard orgdiv1Faculty of Pharmacy orgdiv2Department of Pharmaceutics India
                [02] Lucknow orgnameIntegral University orgdiv1Faculty of Pharmacy India
                Article
                S1984-82502012000400020 S1984-8250(12)04800400020
                10.1590/S1984-82502012000400020
                5c037d1b-0d1f-40d9-aeb1-0695cf83739a

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 15 October 2012
                : 23 February 2012
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 24, Pages: 14
                Product

                SciELO Brazil

                Categories
                Articles

                Fármacos,Itraconazole,Vaginal candidiasis,Drugs,Itraconazol,Candidíase vaginal

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