Avataneo Valeria, De Nicolò Amedeo, Rabbia Franco, Sciandra Mauro, Tosello Francesco, Cusato Jessica, Perlo Elisa, Fatiguso Giovanna, Allegra Sarah, Favata Fabio, Mulatero Paolo, Veglio Franco, Di Perri Giovanni, D'Avolio Antonio
Laboratory of Clinical Pharmacology and Pharmacogenetics(1), University of Turin, Department of Medical Sciences, Amedeo di Savoia Hospital, Turin, Italy.
Division of Internal Medicine and Hypertension Unit, University of Turin, Department of Medical Sciences, AOU "Città della Salute e della Scienza", Turin, Italy.
J Pharmacol Toxicol Methods. 2018 Nov-Dec;94(Pt 2):29-35. doi: 10.1016/j.vascn.2018.08.003. Epub 2018 Aug 28.
Nowadays, the treatment of hypertension represents an important issue, particularly in developed countries. While in most cases the standard therapeutic approaches, consisting in the administration of 1 to 3 drugs, are adequate to reach adequate blood pressure levels, in some cases more drugs are needed: this condition is called "resistant hypertension". In this context, the administration of a diuretic, such as spironolactone or canrenoate salts, represents a standard practice. Since a reliable discrimination of real cases of resistant hypertension from cases of poor therapeutic adherence is currently difficult to obtain, the adoption of therapeutic drug monitoring has been suggested as a useful tool for this purpose. In this work, the authors developed and validated a simple, cheap and fast dilute-and-shot method with UHPLC-PDA analysis for the quantification of spironolactone and its metabolite canrenone in human urine samples.
Standards and quality controls were prepared in urine. Only 100 μL of sample were added with 80 μL of internal standard (6,7-dimethyl-2,3-di(2-pyridyl)quinoxaline) working solution and 820 μL of phosphate buffer 10 mM pH 3.2 (phase A):acetonitrile (phase B) 90:10 v:v solution. Chromatographic separation was performed on an Acquity® UPLC HSS T3 1.8 μm 2.1 × 150 mm column, with a binary gradient for 11 min at 40 °C.
Accuracy, intra-day and inter-day precision, selectivity and sensitivity fitted FDA guidelines for all analytes (LLOQ and LOD were 156.25 ng/mL and 78.12 ng/mL, respectively, for both analytes) and recovery resulted high and reproducible. Method performances were tested on urine samples from hypertensive patients with good results.
This simple analytical method could represent a useful tool for the management of antihypertensive therapy.
如今,高血压的治疗是一个重要问题,在发达国家尤为如此。虽然在大多数情况下,使用1至3种药物的标准治疗方法足以使血压达到适当水平,但在某些情况下需要更多药物:这种情况被称为“顽固性高血压”。在此背景下,使用利尿剂(如螺内酯或坎利酸钾盐)是一种标准做法。由于目前难以可靠地区分真正的顽固性高血压病例和治疗依从性差的病例,因此有人建议采用治疗药物监测作为实现这一目的的有用工具。在这项工作中,作者开发并验证了一种简单、廉价且快速的稀释进样方法,用于通过超高效液相色谱-光电二极管阵列(UHPLC-PDA)分析定量测定人尿液样本中的螺内酯及其代谢物坎利酮。
在尿液中制备标准品和质量控制样品。仅向100μL样品中加入80μL内标(6,7-二甲基-2,3-二(2-吡啶基)喹喔啉)工作溶液和820μL 10 mM pH 3.2的磷酸盐缓冲液(A相):乙腈(B相)90:10 v:v溶液。在Acquity® UPLC HSS T3 1.8μm 2.1×150 mm色谱柱上进行色谱分离,在40°C下进行11分钟的二元梯度洗脱。
所有分析物的准确度、日内和日间精密度、选择性和灵敏度均符合美国食品药品监督管理局(FDA)指南(两种分析物的定量下限(LLOQ)和检测限(LOD)分别为156.25 ng/mL和78.12 ng/mL),回收率高且可重现。该方法在高血压患者尿液样本上进行了测试,结果良好。
这种简单的分析方法可能是抗高血压治疗管理的有用工具。