The objective of the present study was to evaluate the pharmacokinetic parameters for both S- and R-ibuprofen enantiomers in very premature neonates (gestational age strictly inferior to 28 weeks) and possible relationships between the pharmacokinetic parameters and various covariates. Newborns were randomized to receive ibuprofen or placebo for the prophylactic treatment of patent ductus arteriosus (PDA) at an initial dose of 10 mg/kg ibuprofen within 6 hours after birth, followed by two 5-mg/kg doses at 24-hour intervals (n = 52). If a PDA was still present afterwards, a curative course of ibuprofen using the same dosage regimen was administered (n = 10). A sparse sampling strategy was used because only 2 samples were collected after the third prophylactic injection and 1 after the third curative injection. A model including the chiral transformation of R- to S-ibuprofen was fitted to the concentration-time data using a population approach (NONMEM). R- and S-ibuprofen t(1/2) were about 10 hours and 25.5 hours, respectively. After prophylactic treatment, the mean clearance of R-ibuprofen (CLR = 12.7 mL/h) was about 2.5-fold higher than for S-ibuprofen (CLS = 5.0 mL/h). In addition, clearance of R- and S-ibuprofen increased significantly with gestational age. The mean estimation of R-ibuprofen clearance was found to be higher than for S-ibuprofen, and the clearance of both enantiomers increased with gestational age. This should be considered to assess pharmacokinetic-pharmacodynamic relationships of ibuprofen in premature neonates and subsequently to understand and refine the use of ibuprofen in managing PDA either as a prophylactic or curative treatment.

Torasemide is a loop diuretic licensed in dogs for cardiogenic pulmonary oedema. The aim of this pharmacokinetic-pharmacodynamic (PK/PD) study was to define an optimally effective dosage regimen based on preclinical data. In a first study, 5 dogs received once-daily oral torasemide (0, 0.1, 0.2, 0.4, 0.8 mg/kg/day) for 14 days. A second study compared once-daily oral torasemide (0, 0.1, 0.2, 0.3, 0.4 mg/kg/day) to twice-daily furosemide (1, 2, 4, 8 mg/kg/day). For all doses of the second study, 11 dogs received a first day of treatment, followed by a 3 day washout and resumed daily treatment for 10 days (until Day 14). Blood and urine were collected to measure urinary torasemide excretion and plasma torasemide concentrations and daily diuresis and natriuresis. Torasemide PK was linear. After rapid absorption (T max 0.5-1 h), 61% of the bioavailable torasemide was eliminated unchanged in urine. Diuresis and natriuresis observed with torasemide were similar to the ones obtained after furosemide (daily dose-ratios: 1/20 to 1/10). The average diuresis increased from baseline (220 ± 53 mL/day for 10 kg dogs) to 730 ±120 mL after the first torasemide administration and up to 1150 ± 252 mL after 10 administrations at the highest dose. At higher doses (≥0.3 mg/kg/day), daily diureses after 10 diuretic treatment-days were higher than Day 1 and variable between dogs; in contrast, diureses remained constant over time and less variable for doses up to 0.2 mg/kg/day. Natriuresis peaked after the first day and decreased dramatically after the 2nd treatment-day then stabilized to a value close to baseline, except for 0.4 mg/kg/day. Urinary torasemide excretion predicted pharmacodynamics better than plasma concentrations. The decrease in natriuresis observed was successfully modeled using a resistance mechanism; this is likely due to a reabsorption of sodium which did not seem however to affect the volume of urine excreted. For a daily target diuresis of 460 mL/dog/day in severe pulmonary oedema (net fluid loss 240 mL/dog/day), a computed dose of 0.26 mg/kg/day (3.5 mg/kg/day furosemide-equivalent) was selected for clinical studies. Due to high inter-individual variability in diureses at doses ≥0.3 mg/kg, higher doses should be limited to 3-5 days to avoid supra-clinical effects in high responders.

This study showed that Pedea((R)) (test formulation) is bioequivalent to Imbun((R)) IM (reference formulation) for both R-ibuprofen and S-ibuprofen. The Imbun((R)) IM formulation (lyophilisate) could be replaced by the Pedea((R)) ready-to-use IV solution. Moreover, these results allow a comparison of safety and efficacy data previously generated with either formulation. Consequently, neonatologists, who previously used the IM formulation intravenously for the treatment of patent ductus arteriosus in preterm infants, will now be able to administer the new ready-to-use IV solution of ibuprofen directly.

An exploratory study was carried out to assess the in vivo efficacy of different prototypes of subcutaneous implants containing ivermectin (IVM) for the prevention of canine Dirofilaria immitis infection. The implants consisted of an ethylcellulose matrix containing IVM (3.0, 4.5, and 6.0 mg/implant; from 0.29 to 0.63 mg/kg bw) as active ingredient designed to release approximately 0.1 ng of IVM/mL in the plasma for at least 12 months. Six dogs were implanted on day -365. On day -12, three heartworm-free dogs were included in the study as a control group. All nine dogs were examined on day -7 and day 0 for circulating D. immitis microfilariae and by an antigen ELISA kit to confirm that the dogs were heartworm-free. The dogs were artificially infected with 75 D. immitis infective larvae (L3) each on day 0. Dogs in the control group were humanely euthanized on day 153 to verify the infectivity of the larvae, while implanted dogs were further examined for circulating D. immitis microfilariae and antigen on days 153, 195, and 246. The treated dogs were not necropsied. The pharmacokinetic profile of the IVM implant was assessed in plasma samples taken on day -364, then at different times until the infection day, and again on days, 15, 30, 60, 90, 120, and 153. Throughout the study, body weights were measured during clinical examination on days 0, 30, 60, 90, 120, and 153. At necropsy, all control dogs were found infected, each with 10-11 adult heartworms. Implanted dogs were negative at both microfilaria and D. immitis antigen examinations until day 246 (8 months from the infection). IVM plasma levels ranged 0.06-0.16 ng/mL on day 0 and remained stable until day 60, afterward they gradually decreased under the limit of quantification of the method. Throughout the study, no side effect was observed. On the basis of these results, it was possible to conclude that the different prototypes of implants were able to protect the dogs from D. immitis artificial infection for at least 12 months.

Congestive heart failure (CHF) is a clinical syndrome in dogs caused by heart disease characterized by sodium and water retention resulting in oedema (Hori et al., 2007).Loop diuretics are commonly administered in the treatment and management of CHF in both humans and animals due to their ability to reduce intravascular hydrostatic pressure and reduce the clinical