Italiano Farmacia on line: comprare cialis senza ricetta, acquistare viagra internet.
J Clin Periodontol 2005; 32: 163–166 doi: 10.1111/j.1600-051X.2005.00653.x
Metronidazole concentrations in Ene-Renate Pa¨hkla1, Taive Koppel1,
2Pharmacology, University of Tartu, Tartu,Estonia
Pa¨hkla E-R, Koppel T, Saag M, Pa¨hkla R: Metronidazole concentrations in plasma,saliva and periodontal pockets in patients with periodontitis. J Clin Peridontol 2005;32:163–166. doi: 10.1111/j.1600–051X.2005.00653.x. r Blackwell Munksgaard,2005.
AbstractObjectives: Metronidazole is widely used antibacterial compound in the treatment ofsome types of periodontal disease. Pharmacokinetics of metronidazole in plasma hasbeen well-described but few data exist about penetration f the drug to the gingivalcrevice fluid. The aim of the present study was to compare the concentrations ofmetronidazole in plasma, saliva and gingival crevice fluid in patients withperiodontitis after multiple administration.
Materials and methods: Eleven patients with severe generalised adult periodontitisparticipated in the study. Metronidazole, 500 mg, was administered orally two or threetimes per day for at least 2 days before sample collection. Samples were collected 2 hafter last dose. Metronidazole concentrations in all fluids were measured with high-performance liquid chromatography.
Results: Mean drug concentrations in palsma, saliva and crevice fluid were 14.33,15.15 and 12.86 mg/ml, respectively. Difference between plasma and crevice fluid orbetween plasma and saliva did not reach statistical significance.
Conclusion: Present study revealed that metronidazole penetrates well into gingivalcrevice fluid and saliva. Metronidazole concentrations in crevice fluid are about equal
Key words: gingival fluid; metronidazole;
to the protein unbound drug concentrations in plasma. Therefore, general
pharmacokinetic data of metronidazole can be also applied in the treatment ofperiodontal disease and in the design of respective treatment regimens.
Berglundh et al. 1998, Winkel et al.
periodontitis (van Winkelhoff et al.
netics of drug at the infection site (Slots
et al. 2001, Slots & Ting 2002). Several
Table 1. Number of tablets taken by patients per day and individual and mean Æ SD
metronidazole concentrations (mg/l) in plasma, saliva and gingival crevice fluid
parison, concentrations in adipous tissue
and colonic mucosa were significantlylower than respective plasma or serum
formed almost two decades ago whenprecise determination methodology was
not available. Bioassay measuring thetotal bacteriostatic activity of the sam-
flow rate of gingival crevice fluid (Britt
dontitis after multiple administration.
were kept frozen overnight at À 201C.
labelled plastic microtube per patient.
ethics committee of University of Tartu.
tion of study protocol and signed written
was transferred to the autosampler vial.
tamination of sampling area with saliva.
periodontitis were selected to the study.
perature 22–251C (room temperature).
specificity, limit of detection and quan-
fluid samples, for calibration curve con-
tification, linearity, precision and accu-
variability, stability in the freezer and
over concentration range 0.1–50 mg/ml.
Metronidazole pharmacokinetics in periodontitis
between plasma and tissue was reached.
ness of fit of linear regression, r2, was
flow rate. As antibiotics are used in the
(coefficient of variation in the determi-
state is a key factor of effectiveness. In
dent from the results table, the percent-
all patients included to the present study
À 3.66 to 0.33% in all concentrations.
(Winkel et al. 1997, Slots & Ting 2002).
tions in samples of different origin with
height (Lau et al. 1992, Lamp et al.
microdialysis (Karjagin et al. 2004).
the infection site are of critical impor-
events were registered during the study.
study at the same patients but as results
crevice fluid obtained per patient ranged
into gingival crevice fluid and saliva.
unbound drug concentrations in plasma.
did not reach statistical significance.
good circulation, e.g. muscular tissue.
collection after drug administration.
Estonian Science Foundation No. 5756.
tions in human plasma, saliva, and gingival
crevice fluid after single dose. Journal of
Lamster, I. B., Vogel, R. I., Hartley, L. J.,
Position paper: systemic antibiotics in perio-
DeGeorge, C. A. & Gordon, J. M. (1985)
Lactate dehydrogenase, beta-glucuronidase
Goene, R. J., Abbas, F., Winkel, E. G. & de
and arylsulfa-tase activity in gingival crevi-
Graaff, J. (1989) Metronidazole plus amox-
Berglundh, T., Krok, L., Liljenberg, B., West-
ycillin in the treatment of Actinobacillus
felt, E., Serino, G. & Lindhe, J. (1998) The
gingivitis in man. Journal of Periodontology
use of metronidazole and amoxicillin in the
dontitis. Journal of Clinical Periodontology
treatment of advanced periodontal disease. A
Lau, A. H., Lam, N. P., Piscitelli, S. C., Wilkes,
prospective, controlled trial. Journal of
Winkel, E. G., van Winkelhoff, A. J., Timmer-
Clinical Periodontology 25, 354–362.
pharmacokinetics of metronidazole and other
man, M. F., van der Velden, U. & van der
Britt, M. R. & Pohlod, D. J. (1986) Serum and
nitroimidazole antiinfectives. Clinical Phar-
crevicular fluid concentrations after single
metronidazole in the treatment of adultperiodontitis patients. A double-blind place-
Loesche, W. J., Giordano, J., Hujoel, P.,
Schwarcz, J. & Smith, B. A. (1992) Metro-
Elter, J. R., Lawrence, H. P., Offenbacher, S. &
nidazole in periodontitis: reduced need forsurgery. Journal of Clinical Periodontology
Winkel, E. G., van Winkelhoff, A. J., Timmer-
Beck, J. D. (1997) Meta-analysis of the effect
man, M. F., Vangsted, T. & van der Velden,
of systemic metronidazole as an adjunct to
Roberts, M. C. (2002) Antibiotic toxicity,
scaling and root planing for adult perio-
patients with ‘‘refractory’’ periodontitis asso-
dontitis. Journal of Periodontal Research 32,
ciated with Bacteroides forsythus. Journal of
Slots, J. & Ting, M. (2002) Systemic antibiotics
Clinical Periodontology 24, 573–579.
Goodson, J. M. (2003) Gingival crevice fluid
in the treatment of periodontal disease.
flow. Periodontology 2000 31, 43–54.
Karjagin, J., Pa¨hkla, R. & Starkopf, J. (2004)
Perioperative penetration of metronidazole
Metronidazole. In: Hardman, J. G., Gilman,
into muscle tissue: a microdialysis study.
A. G. & Limbird, L. E. (eds) Goodman and
European Journal of Clinical Pharmacology
Therapeutics, 9th edition, pp. 995–998.
Lamp, K., Freeman, C. D., Klutman, N. E. &
Van Oosten, M. A. C., Notten, F. J. W. & Mikx,
pharmacodynamics of nitroimidazole antimi-
Der Einfluss der pharmazeutischen Industrie in der Medizin Jelinek G1 and Neate S: The influence of the pharmaceutical industry in medicine. Journal of Law and Medicine, Volume 17, Number 2, October 2009, 216.2 Pharmazeutische Unternehmen sind dafür bekannt zu den profitabelsten Unternehmen der Welt zu gehören. Die Akten von Rechtsfäl en sowie veröffentlichte Forschungsergebnisse ge
Prof. Abdul-Haqq Sartori, M.D. 111/10 Charoenmuang Road, Soi 3, Chiangmai, 50000 Thailand Mob: +66.(0)6.923.8540 Tel&Fax Message Center: +66.(0)53.436.844 Email: email@example.com NOW THAT YOU HAVE LEARNED THAT YOU HAVE TERMINAL/INCURABLE CANCER Cancer is perhaps the most feared disease on Earth since more and more people find out that the treatments offere