![]() |
|
|
Vol. 29, Issue 1, 82-88, January 2001
Drug Metabolism and Pharmacokinetics, SmithKline Beecham Pharmaceuticals Research and Development, King of Prussia, Pennsylvania
| |
Abstract |
|---|
|
|
|---|
The purpose of this study was to develop an in vivo screening method for rapid preclinical characterization of absorption and bioavailability of large numbers of compounds. This effort involved several steps. First, a pharmacokinetic characterization of a reference compound was conducted in the monkey. These data were used to verify theoretical calculations of a maximal portal dose-normalized area under the concentration-time curve. Next, a monkey screen was implemented using mixtures of up to five compounds each (i.e., cassettes) to estimate the bioavailability of approximately 200 compounds. Cassettes were administered as a single intraduodenal dose to a single monkey followed by simultaneous portal and systemic blood sampling. Definitive studies were then conducted to determine absolute bioavailability of 14 of these compounds. The studies with the reference compound demonstrated that the theoretical methodology based on a single intraduodenal dose with portal and systemic sampling provided consistent estimates of bioavailability. In the screen studies, approximately 75% of the test compounds were excluded from further evaluation due to poor absorption. Of the 14 compounds selected for follow-up evaluation from both well and poorly absorbed compounds, the absolute bioavailability of 10 of them were correctly classified from the screening data. The remaining 4 compounds were false positives, which showed low bioavailability; no false negatives were encountered. This approach allows for a rapid and reliable screen to evaluate absorption and bioavailability using a single dose in a preclinical model.
| |
Introduction |
|---|
|
|
|---|
The iterative
process of characterizing the preclinical pharmacokinetic properties of
new chemical entities is an important component of lead compound
selection and optimization in drug discovery. In recent years, the
deployment of combinatorial and array chemistries has resulted in the
synthesis of escalating numbers of potential drug candidates that
require preclinical pharmacokinetic evaluation (Rodrigues, 1997
).
Accordingly, reliable techniques are needed that can rapidly generate
requisite pharmacokinetic parameters for increased numbers of
compounds. The use of "N-in-one" or "cassette" dosing as a
means to improve throughput has been described in the literature (Frick
et al., 1998
; Shaffer et al., 1999
), as has the use of analytical
sample "pooling" (Hop et al., 1998
; Kuo et al., 1998
). While these
techniques have proven useful and reliable, they may not completely
meet the need for increased-throughput pharmacokinetic evaluation.
Thus, further advances in methodology to address the needs of
higher-throughput pharmacokinetic characterization would be
advantageous in driving the demands of drug discovery.
Many drug candidates are targeted for oral delivery. Therefore, early
estimation of the absorption properties of discovery compounds is often
desired to provide guidance to the iterative chemistry effort.
Furthermore, since oral bioavailability is primarily limited by either
high first-pass hepatic extraction or low delivery to the portal
circulation (due to low solubility, poor absorption, and/or intestinal
extraction), it is often of interest to determine the relative
importance of these two factors for a given compound or structural
series (Kwan, 1997
). Even with cassette dosing techniques, this process
can excessively consume time and resources, as well as compound supply,
and traditionally involves administration of test compounds by three
different routes of administration (oral, intraportal, and intravenous,
ideally in a crossover design) to fully characterize the factors
limiting bioavailability. Thus, improvements in preclinical strategies
for estimating absorption and/or hepatic extraction would increase
efficiency and improve iterative cycle times used in drug discovery.
Over the past several years, we have refined an increased-throughput in vivo screen that allows estimation of the extent of absorption and first-pass hepatic extraction. This screening method has proven generally applicable to a wide variety of compound classes in several preclinical species, although a description of this screen has not been presented to date. The objective of the present study was to describe the screening method developed in this laboratory and to demonstrate the general utility of this methodology in the rapid preclinical classification of absorption and bioavailability.
Experimental Procedures
Theoretical.
The rate of drug delivery from the gut lumen to the portal circulation
may be described by the following equation (Kwan, 1997
):
|
(1) |
|
(2) |
|
|
(3) |
|
(4) |
Materials.
All compounds were synthesized by the Department of Medicinal Chemistry
at SmithKline Beecham Pharmaceuticals (King of Prussia, PA) and were
90% pure (typical purity >95%). All other materials were purchased
from standard vendors and were of the highest available purity. All
dosages were prepared as aqueous solutions with
20% hydroxypropyl-
-cyclodextrin (Cerestar, Hammond, IN) and
3%
dimethyl sulfoxide; typical dimethyl sulfoxide content was
1%. All dosages were administered at a final volume of 4 ml/kg.
Previous experience has indicated minimal impact on the
pharmacokinetics of compounds by this dose volume and excipients.
Animals. Adult male Cynomolgus monkeys (Macaca fascicularis; Charles River Primate Labs, Houston, TX) were housed according to the National Institutes of Health Guide for the Care and Use of Laboratory Animals in individual cages in unidirectional airflow rooms with controlled temperature (22 ± 2°C) and relative humidity (50 ± 10%) and 12-h light/dark cycles. Filtered tap water was available ad libitum. Animals were fed a standard animal diet (Purina Mills, St. Louis, MO) except for overnight periods before dosing. Whenever overnight fasting was used, food was provided after the 240-min blood sample was obtained on the following study day. All animal use was conducted according to protocols approved by the Institutional Animal Care and Use Committee before the study. Surgeries were conducted under aseptic conditions, and a postsurgical recovery of at least 1 month was allowed before commencement of any studies. A complete blood chemistry panel was performed before each study; studies were not conducted unless the blood chemistry values were within normal ranges. Monkeys also were conditioned for the restraint system used to collect blood samples before the study.
Pharmacokinetics of SB-250231. Previous preliminary observations suggested that SB-250231 (2-pyridyl-Z-leucine amide; Fig. 1) demonstrated essentially complete absorption with moderate to high first-pass hepatic extraction in the monkey (data not shown). In the present study, a complete pharmacokinetic investigation of SB-250231 was performed to verify the corrected portal DNAUCmax described above. The study was conducted using a crossover design on 3 separate study days at least 7 days apart. The monkeys (n = 3) had permanently implanted femoral and hepatic portal vein catheters and an indwelling duodenal access port. On study day 1, monkeys received SB-250231 (5 µmol/kg) as a 60-min intravenous infusion into a contralateral saphenous vein. On study day 2, the monkeys received SB-250231 (5 µmol/kg) as a 60-min intraportal vein infusion. On study day 3, the monkeys received SB-250231 (10 µmol/kg) as an intraduodenal bolus. Blood was collected from the femoral catheter on study days 1 and 2 and from both the hepatic portal vein and femoral vein simultaneously on study day 3. Plasma was prepared by centrifugation and analyzed for SB-250231.
|
Screening Studies. The screening method consisted of administering a test mixture containing up to five compounds at a time at dosages of 4 µmol/kg for each component to a single monkey. Studies were conducted on 1 study day per week, with 6 to 7 days between studies, and a 2-week cycle interval (i.e., 2 weeks on, 2 weeks off). Each monkey received only one cassette per study day; however, monkeys were used on more than 1 study day. Each monkey had received permanently implanted femoral and hepatic portal vein catheters and an indwelling duodenal access port before the study. In each screening study, a monkey received the test mixture as an intraduodenal bolus, with serial plasma samples collected from the femoral and hepatic portal veins for up to 4 h after administration. Compounds in each mixture were selected for compatibility with the analytical methodology to maximize the molecular weight difference between compounds in each compound set. Concentrations of each compound in the dose solutions and plasma samples were determined as described below. Definitive pharmacokinetic parameters were obtained for compounds of interest using conventional study designs similar to that described for SB-250231 above.
Analytical Procedures. All samples were analyzed for drug concentration by the Drug Analysis group within the Department of Drug Metabolism and Pharmacokinetics at SmithKline Beecham Pharmaceuticals. All plasma samples were subjected to protein precipitation by acetonitrile and quantified using a Sciex API 365 tandem mass spectrometer with a turbo-ionspray interface (Perkin Elmer Sciex Instruments, Ontario, Canada). Specific assay conditions were dependent upon the structural characteristics of the compounds constituting each cassette. For the definitive pharmacokinetic study with SB-250231, the mobile phase was 70% acetonitrile and 30% 10 mM ammonium acetate (pH 4.0); positive ion multiple reaction monitoring was used for detection. The lower limit of quantification for SB-250231 and for all compounds in the screening studies was 10.0 ng/ml for 50 µl of plasma. All parameters were derived from plasma concentrations within the validated range of the analytical method for each compound.
Data Analysis.
For the definitive studies with SB-250231 and other compounds of
interest, concentration versus time profiles were obtained for each
animal. Pharmacokinetic parameters were derived using the
noncompartmental module of WinNonlin Professional version 2.1 (Pharsight, Mountain View, CA). Bioavailability (F) was estimated by
dividing the intraduodenal systemic DNAUC by the intravenous DNAUC.
Similarly, Fh of SB-250231 was estimated by dividing the systemic DNAUC
after hepatic portal vein administration by the intravenous DNAUC.
Using these values for F and Fh, absorption (Fa) of SB-250231 in the
monkey was estimated as
|
(5) |
| |
Results |
|---|
|
|
|---|
SB-250231 displayed low clearance in the monkey (13 ± 5 ml/min/kg) with a distributional volume of 0.86 ± 0.83 l/kg and a half-life of 61 ± 34 min (Table 2). First-pass hepatic extraction was approximately 35% after intraportal vein administration. Due to technical difficulties during the intraduodenal leg of the experiment, no data were obtained for one monkey. Bioavailability was 32 and 70% in the two monkeys successfully completing the experiment. In these monkeys, hepatic extraction (from the intraportal infusion) was 46 and 35%. Comparison of the portal and systemic DNAUC after intraduodenal dosing according to eq. 4 suggested a hepatic extraction of 60 and 58% in these two monkeys. Considering only the intraduodenal data, and applying the corrected portal DNAUCmax concept, predicted bioavailability of SB-250231 in the monkey would be approximately 41%, based on 100% absorption and 59% hepatic extraction.
|
Next, a screening study was initiated in the monkey using the single-dose cassette design. Over approximately 12 months, the absorption and hepatic extraction characteristics of 218 new chemical entities were evaluated. During this period, none of the monkeys displayed any apparent compound- or dose vehicle-related toxicity, and blood chemistry values consistently returned to normal values before each study leg using the 2-week on/2-week off dosing cycle.
The 218 compounds tested in the screen model were structurally diverse, representing several different research efforts and chemical classes. The average molecular weight was 505 ± 72 (range = 322-888), with a calculated octanol:water partition coefficient of 3.41 ± 1.17 (range = 0.23-7.10). No clear correlation between molecular weight or lipophilicity and the measured DNAUC values was observed. A wide range of portal and systemic DNAUC values was achieved; the distribution of corrected portal DNAUC values is displayed in Fig. 2. Of the 218 compounds, predicted bioavailability (based on the portal and systemic DNAUC values) was 0% for 147 of the analogs, and ranged from 0 to 10% for an additional 50 compounds. Only 21 of the 218 compounds screened demonstrated predicted bioavailability in excess of 10%. Of the initial set of screening compounds, 14 were selected, including representatives across the range of absorption and bioavailability values, for follow-up evaluation in the monkey using a conventional study design. The average molecular weight of the follow-up compounds was 497 ± 48 (range = 442-565), with an octanol:water partition coefficient of 3.26 ± 0.75 (range = 2.27-4.66). These values were not significantly different from the initial 218 compounds. The bioavailabilities achieved in the follow-up studies were then compared with those predicted from the single-dose, single-animal screen studies. The data for these 14 compounds for the screen and follow-up studies are displayed in Table 3. The follow-up compounds demonstrated a wide range of pharmacokinetic parameters, including clearance (7-40 ml/min/kg), distributional volume (0.2-3.9 l/kg), and oral bioavailability (0-31%), a range that encompasses parameter values typically seen in discovery.
|
|
The relationship between the bioavailability predicted by the screen and that determined in follow-up evaluation is displayed in Fig. 3. To convert this relationship into nominal data for the purpose of "grading" the screen performance, a 10% bioavailability estimate was selected as a cutoff point. That is, if the screen predicted oral bioavailability to be above 10%, the compound was considered to offer promise as a candidate molecule, and could be further investigated, whereas those compounds demonstrating predicted bioavailability of below 10% would be abandoned or assigned a lower follow-up priority. Of the 14 follow-up compounds, all 6 (compounds 1-4, 8, and 9) that were identified in the screen as having low bioavailability were correctly classified. Furthermore, of the remaining eight compounds that were identified in the screen as having promising oral bioavailability, four (compounds 11-17) were correctly classified. The remaining four compounds tested (compounds 5-7 and 10) were "false positives", that is, the bioavailability predicted from the screen exceeded that determined in the follow-up work. Of these four incorrectly classified compounds, no major differences in clearance (7-20 ml/min/kg), volume of distribution (0.4-1.1 l/kg), or bioavailability (3-8%) were observed compared with the larger follow-up data set (Table 3). Finally, none of the compounds tested in the follow-up studies were identified as "false negatives", having apparently poor bioavailability when tested in the screen, but demonstrating favorable bioavailability in follow-up studies. Overall, the screen over-predicted bioavailability in the follow-up studies by about 2.5-fold (an average 6% overprediction of F); all of the compounds demonstrated higher predicted bioavailability in the screen than in the follow-up study, with the exception of compound 12 (11 versus 17% for the screen and follow-up, respectively). When the four false positives were set aside, the overprediction averaged only 1.6-fold (a 1.5% overprediction of F); the average overprediction for compounds 5 through 7 and 10 was 5-fold (18% overprediction).
|
| |
Discussion |
|---|
|
|
|---|
This investigation presents the development of an in vivo pharmacokinetic screen that allows rapid and accurate identification of promising oral drug candidates. The experiments using SB-250231 suggested that the maximum corrected portal DNAUC values derived here were in general agreement with the experimental parameters, using literature values for hepatic blood flow and hematocrit. Furthermore, predicted bioavailability of SB-250231 in the monkey was similar to that observed experimentally. Refinement of a corrected portal DNAUCmax value in any given experimental subject, as well as further exploration of the various assumptions required by this model, will likely yield more accurate values (see Discussion below). However, the present data suggest that the proposed model is useful as an in vivo screen in drug discovery that can provide evidence of favorable absorption and eliminate compounds with poor performance.
Using this model and the corrected portal
DNAUCmax approach, a screen was conducted to
evaluate over 200 new chemical entities. Obviously, a complete
pharmacokinetic characterization of this number of molecules in a
nonhuman primate is beyond the reasonable scope of drug discovery.
Therefore, this screen was devised to provide maximum information about
absorption and systemic exposure while deploying minimal resources. The
present data were generated from studies using a single monkey per
experiment, over only a 4-h time course that generated a minimal number
of samples for analysis, and used only ~25 µmol (generally ~15
mg) of each compound. This screen has largely proven successful, for
several reasons. First, the screen effectively identified and excluded
compounds with poor absorption. Nearly 70% of the 218 compounds
screened demonstrated predicted absorption of less than 40%. Even
moderate first-pass extraction for these compounds would result in
bioavailability below that acceptable for development candidates. This
screen thus allows follow-up resources to be focused on those compounds most likely to succeed. Second, this screen also provided reasonable estimates of bioavailability in follow-up studies. Of the compounds evaluated in follow-up studies, the screen correctly classified 71%.
More importantly, none of the incorrectly classified compounds were
"false negatives", in which a promising analog is incorrectly predicted to have poor performance, and would thus not be retested. As
described by Frick et al. (1998)
, false positives may be tolerated in
screening, since such errors will be discovered upon retesting, while
false negatives are more deleterious, since such compounds would be
assigned lower priority for follow-up studies or might be excluded from
further evaluation altogether.
Regarding the four compounds that were false positives, numerous
potential reasons exist for this observation. As in most cassette
dosing studies, drug interactions may occur. For example, inclusion of
a P-glycoprotein inhibitor in a cassette could saturate an intestinal
absorption barrier and produce enhanced absorption (Yu, 1999
).
Similarly, inclusion of a cytochrome P-450 inhibitor could reduce the
rate of hepatic or intestinal metabolism of one or more constituent and
result in higher exposure than when the components are tested as
discrete entities (Thummel et al., 1997
). However, the present data
suggest that inclusion of such an inhibitor does not automatically
yield drug interactions that invalidate the results of the screen. Of
the 14 follow-up compounds in this study, 12 of the cassettes from
which the compounds originated, including each cassette containing the
4 outliers, contained at least 1 compound that was a potent inhibitor
(IC50 < 10 µM) of human cytochrome P-450 1A2,
2C9, 2C19, 2D6, or 3A4 (data not shown). Thus, although a different
P-450 inhibitor was present in each cassette from which the outliers
were obtained, the presence of a P-450 inhibitor in the eight other
cassettes did not yield a false positive result.
For the present effort, an apparent false positive rate of
approximately 30% did not hinder the usefulness of the screen. Relatively few compounds were sufficiently well absorbed to merit follow-up evaluation; this set was further limited by factors such as
unacceptable cytochrome P-450 inhibition, inadequate pharmacological potency, or insufficient compound supply to allow follow-up studies. For this compound series, therefore, follow-up investigation of each of
the compounds of interest was possible. However, for a structural
series with more favorable dispositional properties, larger numbers of
compounds could be screened that appear to have acceptable absorption,
and, consequently, the number of false positives could prove an
obstacle to follow-up evaluation. In such instances, modifications to
the screening method may be used that decrease throughput but improve
data quality. For example, the current screen used mixtures of up to
five compounds, in accordance with internal (Potts et al., 1995
) and
external (Berman et al., 1997
; Cox et al., 1999
; Shaffer et al., 1999
)
data describing success with this cassette size. Obviously, decreasing
the cassette size would decrease the risk of false positives if such
errors are due to drug interactions. Also, to minimize variability and optimize absorption, this screen used intraduodenal administration. In
some instances, intraduodenal and oral administration produce similar
absorption, such as with flumequine (Ruiz-Garcia et al., 1999
) or
CGS-20625 (Hirschberg et al., 1995
); a few compounds may demonstrate
better oral than intraduodenal absorption, including selegiline
(Barrett et al., 1996
). However, in most cases, intraduodenal absorption is superior to oral absorption, consistent with gastric metabolism, acid-mediated compound degradation, insolubility at low pH,
or other factors. Examples include 2-(allylthio)pyrazine (Han and Lee,
1999
), nitrofurantoin (Watari et al., 1983
), and omeprazole (Larsson et
al., 1983
). The present data are consistent with these observations;
the intraduodenal screen consistently gave higher bioavailability than
the oral follow-up studies, with the exception of compound 12. Thus, in
designing a screen, oral administration may result in fewer false
positive results. Finally, all of the estimates generated from the
screen were based on literature values for hepatic blood flow and
hematocrit. It is well recognized that these parameters are subject to
extensive variability within animal strain and also are dependent upon
factors such as vendor, housing conditions, disease, posture, and
exercise (Brown et al., 1997
). Furthermore, the indwelling hepatic
portal vein catheter may also have altered hepatic blood flow in this
screening study (Heberer et al., 1985
; Hadengue et al., 1988
). To
derive more accurate parameter estimates, the hematocrit and hepatic
portal blood flow of each animal used in a screen could be determined. Since this may be impractical in a screening initiative, one
alternative could be to determine reference values for animals within
the larger colony from which test subjects are drawn, thereby reaching a more accurate value than relying on literature references.
Apart from modifications to improve accuracy, additional refinements
could be incorporated to customize this screen for a particular
structural series. If the number of compounds to be screened is small,
or if a series proves problematic in cytochrome P-450 inhibition,
decreasing the cassette size may be appropriate. Also, the absorption
of many compounds is dissolution rate-limited. By administering
solutions of such compounds, the likelihood of false positives upon
retesting in a solid dose formulation is increased. In this case, more
useful information may be obtained by administering suspensions rather
than solutions. Finally, another permutation would be to administer
cassettes of compounds in the absence and presence of an inhibitor of
cytochrome P-450 and/or P-glycoprotein (Zhang et al., 1998
). This
approach would allow a direct assessment of the effect of these
potential barriers on a structural series and could help guide the
chemistry effort in a constructive direction.
In summary, the screening method described here provides a rapid and accurate means for evaluating the drug properties of new chemical entities following a single dose in a nonhuman primate model. Although some false positives were observed, and although the predicted bioavailability estimates did not precisely match those generated in follow-up studies, the present data clearly demonstrate that this screening approach is useful for characterizing large numbers of compounds in a relatively rapid fashion. Additional refinements and more robust validation of this model may further advance the utility of this screening method in advancing drug discovery.
| |
Acknowledgments |
|---|
We acknowledge the expert technical assistance of members of the Preclinical Pharmacokinetics group, including Leonard Azzarano, Jayme Mumaw, Theresa Roethke, Gary Stelman, Mike Walsh, and Kelli Zeigler, and the Laboratory Animal Sciences group, including Earl Jenkins and Guy Vaden, in the conduct of the in-life portions of the experiments described here. Also, this work would have been impossible without the invaluable efforts of all the members of the Drug Analysis group, particularly Jeanelle McSurdy-Freed and Yanwen Qian for the development of analytical methodology that allowed cassette dosing and rapid sample turnaround. Particular gratitude is also extended to Yanwen Qian, Amanda Price, and Lorrie Day for the analysis of the monkey samples for the definitive studies with SB-250231.
| |
Footnotes |
|---|
Received June 12, 2000; accepted August 21, 2000.
1 This work was presented in part at the 2000 Annual Meeting of the American Association of Pharmaceutical Scientists, October 29-November 2, Indianapolis, Indiana.
Send reprint requests to: Keith W. Ward, Ph.D., Drug Metabolism and Pharmacokinetics, SmithKline Beecham Pharmaceuticals R&D, UW 2720, 709 Swedeland Road, King of Prussia, PA 19406. E-mail: keith_w_ward{at}sbphrd.com
| |
Abbreviations |
|---|
Abbreviations used are: AUC, area under the concentration-time curve; C, concentration; DNAUC, dose-normalized AUC; DNAUCmax, maximum theoretical DNAUC; Eh, hepatic extraction; F, bioavailability; Fa, absorbed fraction; pv, portal vein; s, systemic circulation.
| |
References |
|---|
|
|
|---|
This article has been cited by other articles:
![]() |
S. Yamazaki, L. N. Toth, E. Kimoto, J. Bower, J. Skaptason, D. Romero, and T. G. Heath Application of Stable Isotope Methodology in the Evaluation of the Pharmacokinetics of (S,S)-3-[3-(Methylsulfonyl)phenyl]-1-propylpiperidine Hydrochloride in Rats Drug Metab. Dispos., May 1, 2009; 37(5): 937 - 945. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Ogasawara, M. Utoh, K. Nii, A. Ueda, T. Yoshikawa, T. Kume, and K. Fukuzaki Effect of Oral Ketoconazole on Oral and Intravenous Pharmacokinetics of Simvastatin and Its Acid in Cynomolgus Monkeys Drug Metab. Dispos., January 1, 2009; 37(1): 122 - 128. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. M. Fujitaki, E. E. Cable, B. R. Ito, B.-H. Zhang, J. Hou, C. Yang, D. A. Bullough, J. L. Ferrero, P. D. van Poelje, D. L. Linemeyer, et al. Preclinical Pharmacokinetics of a HepDirect Prodrug of a Novel Phosphonate-Containing Thyroid Hormone Receptor Agonist Drug Metab. Dispos., November 1, 2008; 36(11): 2393 - 2403. [Abstract] [Full Text] [PDF] |
||||
![]() |
H. Zhang, D. Zhang, W. Li, M. Yao, C. D'Arienzo, Y.-X. Li, W. R. Ewing, Z. Gu, Y. Zhu, N. Murugesan, et al. Reduction of Site-Specific CYP3A-Mediated Metabolism for Dual Angiotensin and Endothelin Receptor Antagonists in Various in Vitro Systems and in Cynomolgus Monkeys Drug Metab. Dispos., May 1, 2007; 35(5): 795 - 805. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. W. Ward and L. M. Azzarano Preclinical Pharmacokinetic Properties of the P-Glycoprotein Inhibitor GF120918A (HCl salt of GF120918, 9,10-Dihydro-5-methoxy-9-oxo-N-[4-[2-(1,2,3,4-tetrahydro-6,7-dimethoxy-2-isoquinolinyl)ethyl]phenyl]-4-acridine-carboxamide) in the Mouse, Rat, Dog, and Monkey J. Pharmacol. Exp. Ther., August 1, 2004; 310(2): 703 - 709. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. W. Ward, G. J. Stelman, J. A. Morgan, K. S. Zeigler, L. M. Azzarano, J. R. Kehler, J. E. McSurdy-Freed, J. W. Proksch, and B. R. Smith DEVELOPMENT OF AN IN VIVO PRECLINICAL SCREEN MODEL TO ESTIMATE ABSORPTION AND FIRST-PASS HEPATIC EXTRACTION OF XENOBIOTICS. II. USE OF KETOCONAZOLE TO IDENTIFY P-GLYCOPROTEIN/CYP3A-LIMITED BIOAVAILABILITY IN THE MONKEY Drug Metab. Dispos., February 1, 2004; 32(2): 172 - 177. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. D. Christ Cassette Dosing Pharmacokinetics: Valuable Tool or Flawed Science? Drug Metab. Dispos., July 1, 2001; 29(7): 935 - 935. [Full Text] [PDF] |
||||
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||