Proposta de um algoritmo híbrido de agendamento de grants baseado na priorização de filas para gerenciamento de recursos em WDM-PONs

As Redes Ópticas Passivas (Passive Optical Networks - PONs) vêm experimentando um sólido crescimento nas últimas décadas por terem sido concebidas como uma excelente alternativa para a solução de um dos maiores problemas para as redes de telecomunicações: o gargalo nas redes de acesso. A próxima geração desta tecnologia, as chamadas Next Genaration PONs (NG-PON), surgem como consequência da evolução das tecnologias ópticas e oferecem suporte aos serviços de próxima geração, melhorando os parâmetros de desempenho das TDM-PONs e inclusive aumentando a área de cobertura destas redes. Esta expansão geográfica beneficia as empresas de telecomunicações que passam a focar seus esforços na simplificação de suas infra-estruturas através da unificação das redes metropolitanas, de acesso e de backhaul, reduzindo a quantidade de nós e, consequentemente, de custos operacionais e financeiros. Trata-se de uma significativa mudança no cenário das redes de acesso que passam a ter grandes distâncias entre as Optical Network Units (ONUs) e o Central Office (CO) e uma imensa variedade de serviços, tornando fundamental a presença de algoritmos de agendamento capazes de gerenciar todos os recursos compartilhados de forma eficiente, ao mesmo tempo que garantem controle e justeza na alocação dinâmica dos tráfegos upstream e downstream. É a partir deste contexto que esta dissertação tem como objetivo geral apresentar a proposta de um algoritmo híbrido de agendamento de grants baseado na priorização de filas (Hybrid Grant Scheduler based on Priority Queuing – HGSPQ), que além de gerenciar todos os recursos em WDM-PONs, busca oferecer eficiência e controle ao Optical Line Terminal (OLT) no agendamento dinâmico dos tráfegos. Os resultados apresentados foram extraídos de cenários desenvolvidos em ambiente de simulação computacional e se baseiam nas métricas de atraso e vazão para avaliação de seu desempenho. Também será avaliado como a quantidade de recursos no OLT interfere nestas métricas.

Proveniência e idade do metamorfismo das rochas da Faixa Brasília, na Região de Tapira (SW de Minas Gerais)

A Faixa Brasília na região de Tapira, no SW do estado de Minas Gerais, exibe quatro domínios litotectônicos diferentes, imbricados através de falhas de empurrão, com vergência para o Cráton do São Francisco. Foram conduzidos estudos isotópicos através do método Sm/Nd, que revelam diferentes idades modelo e de metamorfismo para estas escamas. As rochas da escama inferior apresentam idade de metamorfismo de 543 Ma, enquanto a escama que a superpõem, apresentam idade de metamorfismo de 581 Ma. As idades modelo (TDM) são similares para as duas escamas, variando entre 1,7 e 2,2 Ga. Em função das características litológicas essas escamas são interpretadas como derivadas de rochas depositadas em plataforma continental distal, que tiveram como fonte principal rochas de idades paleoproterozóicas do Cráton do São Francisco. As rochas da escama superior apresentam idade de metamorfismo de 612 Ma e uma distribuição bimodal das idades modelo (TDM), 1,3 e 1,9 - 2,0 Ga. Em função das características litológicas e isotópicas as rochas dessas escamas são interpretadas como depositadas em ambiente de talude continental ou assoalho oceânico, tendo os sedimentos fonte mista, de idades paleo- e mesoproterozóicas do Cráton do São Francisco. Embora, com as limitações impostas tanto pelo pequeno número de amostras analisadas, quanto pelas incertezas do método Sm/Nd, interpreta-se que o metamorfismo não foi síncrono nas diferentes escamas. Isto é esperado em um sistema de cavalgamento, no qual as escamas mais metamórficas justapõem-se às escamas menos metamórficas.

MORPHOGENESIS AND PRODUCTION OF TANZANIA, MOMBACA AND MULATO GRASSES UNDER NITROGEN FERTILIZATION

A field trial was conducted designed in a completely randomized block in a 4 x 3 factorial arrangement to evaluate the application of nitrogen doses (N) (0, 40, 80 and 160 kg/ha) on the morphogenical characteristics and dry matter partition of three forage grasses (Panicum maximum cvs. Mombasa and Tanzania and Brachiaria sp. Hybrid Mulato). The leaf appearance (LAR, leaf/day) and stretching (LER; mm/day) rates, the number of green leaves per tiller (NLT) and the average weight of tillers (MTW; g) presented s positive linear response to the N dose while the phyllochron (Phil; day/leaves) showed a negative linear response. The highest LER, IAL and final leaf length (FLL; cm) occurred in the Mombaca and Tanzania grasses, while the highest LAR occurred in the Mulato grass. There was a negative quadratic effect of the N dose on the stem elongation rate (SER; mm/day) and LF. The Mombaca and Tanzania grasses presented the highest SER; however, in just two forages. The production of total dry matter (TDM; kg/ha), leaves (LDM; kg/ha) and stems (SDM; kg/ha) increased linearly and quadratically with the N dose, respectively, for the Mombaca and Tanzania grasses. There was a high positive correlation among DM, LDM and SDM and the Mombaca grass MTW. The dry matter production and morphogenic characteristics were influenced by the nitrogen fertilization as a result of the substantial increase in the flow of tissues stimulated by fertilization, proving the importance of N for forage biomass accumulation.

Determination of anticonvulsants in human plasma using SPME in a heated interface coupled online to liquid chromatography (SPME-LC)

A simple and sensitive method using solid phase microextraction (SPME) and liquid chromatography (LC) with heated online desorption (SPME-LC) was developed and validated to analyze anticonvulsants (AEDs) in human plasma samples. A heated lab-made interface chamber was used in the desorption procedure, which allowed the transference of the whole extracted sample. The SPME conditions were optimized by applying an experimental design. Important factors are discussed such as fiber coating types, pH, extraction time and desorption conditions. The drugs were analyzed by LC, using a C18 column (150 mm 4.6 mm 5 mm); and 50 mmol L1 , pH ¼ 5.50 ammonium acetate buffer : acetonitrile : methanol (55 : 22 : 23 v/v) as the mobile phase with a flow rate of 0.8 mL min1 . The suggested method presented precision (intra-assay and inter-assay), linearity and limit of quantification (LOQ) all adequate for the therapeutic drug monitoring (TDM) of AEDs in plasma.

Geoquímica e geocronologia U-Pb e ­Sm-Nd dos ortognaisses da região de Pontalina (GO), Brasil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Use of recent geoid models to estimate mean dynamic topography and geostrophic currents in South Atlantic and Brazil Malvinas confluence

The use of geoid models to estimate the Mean Dynamic Topography was stimulated with the launching of the GRACE satellite system, since its models present unprecedented precision and space-time resolution. In the present study, besides the DNSC08 mean sea level model, the following geoid models were used with the objective of computing the MDTs: EGM96, EIGEN-5C and EGM2008. In the method adopted, geostrophic currents for the South Atlantic were computed based on the MDTs. In this study it was found that the degree and order of the geoid models affect the determination of TDM and currents directly. The presence of noise in the MDT requires the use of efficient filtering techniques, such as the filter based on Singular Spectrum Analysis, which presents significant advantages in relation to conventional filters. Geostrophic currents resulting from geoid models were compared with the HYCOM hydrodynamic numerical model. In conclusion, results show that MDTs and respective geostrophic currents calculated with EIGEN-5C and EGM2008 models are similar to the results of the numerical model, especially regarding the main large scale features such as boundary currents and the retroflection at the Brazil-Malvinas Confluence.

Determination of anticonvulsants in human plasma using SPME in a heated interface coupled online to liquid chromatography (SPME-LC)

A simple and sensitive method using solid phase microextraction (SPME) and liquid chromatography (LC) with heated online desorption (SPME-LC) was developed and validated to analyze anticonvulsants (AEDs) in human plasma samples. A heated lab-made interface chamber was used in the desorption procedure, which allowed the transference of the whole extracted sample. The SPME conditions were optimized by applying an experimental design. Important factors are discussed such as fiber coating types, pH, extraction time and desorption conditions. The drugs were analyzed by LC, using a C18 column (150 mm x 4.6 mm x 5 mm); and 50 mmol L-1, pH 5.50 ammonium acetate buffer : acetonitrile : methanol (55 : 22 : 23 v/v) as the mobile phase with a flow rate of 0.8 mL min(-1). The suggested method presented precision (intra-assay and inter-assay), linearity and limit of quantification (LOQ) all adequate for the therapeutic drug monitoring (TDM) of AEDs in plasma.

Comparison of different delivery systems of DNA vaccination for the induction of protection against tuberculosis in mice and guinea pigs

The great challenges for researchers working in the field of vaccinology are optimizing DNA vaccines for use in humans or large animals and creating effective single-dose vaccines using appropriated controlled delivery systems. Plasmid DNA encoding the heat-shock protein 65 (hsp65) (DNAhsp65) has been shown to induce protective and therapeutic immune responses in a murine model of tuberculosis (TB). Despite the success of naked DNAhsp65-based vaccine to protect mice against TB, it requires multiple doses of high amounts of DNA for effective immunization. In order to optimize this DNA vaccine and simplify the vaccination schedule, we coencapsulated DNAhsp65 and the adjuvant trehalose dimycolate (TDM) into biodegradable poly (DL-lactide-co-glycolide) (PLGA) microspheres for a single dose administration. Moreover, a single-shot prime-boost vaccine formulation based on a mixture of two different PLGA microspheres, presenting faster and slower release of, respectively, DNAhsp65 and the recombinant hsp65 protein was also developed. These formulations were tested in mice as well as in guinea pigs by comparison with the efficacy and toxicity induced by the naked DNA preparation or BCG. The single-shot prime-boost formulation clearly presented good efficacy and diminished lung pathology in both mice and guinea pigs.

Use of recent geoid models to estimate mean dynamic topography and geostrophic currents in South Atlantic and Brazil Malvinas confluence

The use of geoid models to estimate the Mean Dynamic Topography was stimulated with the launching of the GRACE satellite system, since its models present unprecedented precision and space-time resolution. In the present study, besides the DNSC08 mean sea level model, the following geoid models were used with the objective of computing the MDTs: EGM96, EIGEN-5C and EGM2008. In the method adopted, geostrophic currents for the South Atlantic were computed based on the MDTs. In this study it was found that the degree and order of the geoid models affect the determination of TDM and currents directly. The presence of noise in the MDT requires the use of efficient filtering techniques, such as the filter based on Singular Spectrum Analysis, which presents significant advantages in relation to conventional filters. Geostrophic currents resulting from geoid models were compared with the HYCOM hydrodynamic numerical model. In conclusion, results show that MDTs and respective geostrophic currents calculated with EIGEN-5C and EGM2008 models are similar to the results of the numerical model, especially regarding the main large scale features such as boundary currents and the retroflection at the Brazil-Malvinas Confluence.

Innovative analytical methods for Central Nervous System Drug analysis in biological fluids

During recent years a consistent number of central nervous system (CNS) drugs have been approved and introduced on the market for the treatment of many psychiatric and neurological disorders, including psychosis, depression, Parkinson disease and epilepsy. Despite the great advancements obtained in the treatment of CNS diseases/disorders, partial response to therapy or treatment failure are frequent, at least in part due to poor compliance, but also genetic variability in the metabolism of psychotropic agents or polypharmacy, which may lead to sub-therapeutic or toxic plasma levels of the drugs, and finally inefficacy of the treatment or adverse/toxic effects. With the aim of improving the treatment, reducing toxic/side effects and patient hospitalisation, Therapeutic Drug Monitoring (TDM) is certainly useful, allowing for a personalisation of the therapy. Reliable analytical methods are required to determine the plasma levels of psychotropic drugs, which are often present at low concentrations (tens or hundreds of nanograms per millilitre). The present PhD Thesis has focused on the development of analytical methods for the determination of CNS drugs in biological fluids, including antidepressants (sertraline and duloxetine), antipsychotics (aripiprazole), antiepileptics (vigabatrin and topiramate) and antiparkinsons (pramipexole). Innovative methods based on liquid chromatography or capillary electrophoresis coupled to diode-array or laser-induced fluorescence detectors have been developed, together with the suitable sample pre-treatment for interference removal and fluorescent labelling in case of LIF detection. All methods have been validated according to official guidelines and applied to the analysis of real samples obtained from patients, resulting suitable for the TDM of psychotropic drugs.

Development of original analytical methods for the therapeutic drug monitoring of CNS druges: Antipsychotics, Antidepressants and Anxiolytics-hypnotics

Great strides have been made in the last few years in the pharmacological treatment of neuropsychiatric disorders, with the introduction into the therapy of several new and more efficient agents, which have improved the quality of life of many patients. Despite these advances, a large percentage of patients is still considered “non-responder” to the therapy, not drawing any benefits from it. Moreover, these patients have a peculiar therapeutic profile, due to the very frequent application of polypharmacy, attempting to obtain satisfactory remission of the multiple aspects of psychiatric syndromes. Therapy is heavily individualised and switching from one therapeutic agent to another is quite frequent. One of the main problems of this situation is the possibility of unwanted or unexpected pharmacological interactions, which can occur both during polypharmacy and during switching. Simultaneous administration of psychiatric drugs can easily lead to interactions if one of the administered compounds influences the metabolism of the others. Impaired CYP450 function due to inhibition of the enzyme is frequent. Other metabolic pathways, such as glucuronidation, can also be influenced. The Therapeutic Drug Monitoring (TDM) of psychotropic drugs is an important tool for treatment personalisation and optimisation. It deals with the determination of parent drugs and metabolites plasma levels, in order to monitor them over time and to compare these findings with clinical data. This allows establishing chemical-clinical correlations (such as those between administered dose and therapeutic and side effects), which are essential to obtain the maximum therapeutic efficacy, while minimising side and toxic effects. It is evident the importance of developing sensitive and selective analytical methods for the determination of the administered drugs and their main metabolites, in order to obtain reliable data that can correctly support clinical decisions. During the three years of Ph.D. program, some analytical methods based on HPLC have been developed, validated and successfully applied to the TDM of psychiatric patients undergoing treatment with drugs belonging to following classes: antipsychotics, antidepressants and anxiolytic-hypnotics. The biological matrices which have been processed were: blood, plasma, serum, saliva, urine, hair and rat brain. Among antipsychotics, both atypical and classical agents have been considered, such as haloperidol, chlorpromazine, clotiapine, loxapine, risperidone (and 9-hydroxyrisperidone), clozapine (as well as N-desmethylclozapine and clozapine N-oxide) and quetiapine. While the need for an accurate TDM of schizophrenic patients is being increasingly recognized by psychiatrists, only in the last few years the same attention is being paid to the TDM of depressed patients. This is leading to the acknowledgment that depression pharmacotherapy can greatly benefit from the accurate application of TDM. For this reason, the research activity has also been focused on first and second-generation antidepressant agents, like triciclic antidepressants, trazodone and m-chlorophenylpiperazine (m-cpp), paroxetine and its three main metabolites, venlafaxine and its active metabolite, and the most recent antidepressant introduced into the market, duloxetine. Among anxiolytics-hypnotics, benzodiazepines are very often involved in the pharmacotherapy of depression for the relief of anxious components; for this reason, it is useful to monitor these drugs, especially in cases of polypharmacy. The results obtained during these three years of Ph.D. program are reliable and the developed HPLC methods are suitable for the qualitative and quantitative determination of CNS drugs in biological fluids for TDM purposes.

Geochronological and structural evolution of the western and central Kaoko Belt in NW Namibia

This thesis focusses on the tectonic evolution and geochronology of part of the Kaoko orogen, which is part of a network of Pan-African orogenic belts in NW Namibia. By combining geochemical, isotopic and structural analysis, the aim was to gain more information about how and when the Kaoko Belt formed. The first chapter gives a general overview of the studied area and the second one describes the basis of the Electron Probe Microanalysis dating method. The reworking of Palaeo- to Mesoproterozoic basement during the Pan-African orogeny as part of the assembly of West Gondwana is discussed in Chapter 3. In the study area, high-grade rocks occupy a large area, and the belt is marked by several large-scale structural discontinuities. The two major discontinuities, the Sesfontein Thrust (ST) and the Puros Shear Zone (PSZ), subdivide the orogen into three tectonic units: the Eastern Kaoko Zone (EKZ), the Central Kaoko Zone (CKZ) and the Western Kaoko Zone (WKZ). An important lineament, the Village Mylonite Zone (VMZ), has been identified in the WKZ. Since plutonic rocks play an important role in understanding the evolution of a mountain belt, zircons from granitoid gneisses were dated by conventional U-Pb, SHRIMP and Pb-Pb techniques to identify different age provinces. Four different age provinces were recognized within the Central and Western part of the belt, which occur in different structural positions. The VMZ seems to mark the limit between Pan-African granitic rocks east of the lineament and Palaeo- to Mesoproterozoic basement to the west. In Chapter 4 the tectonic processes are discussed that led to the Neoproterozoic architecture of the orogen. The data suggest that the Kaoko Belt experienced three main phases of deformation, D1-D3, during the Pan-African orogeny. Early structures in the central part of the study area indicate that the initial stage of collision was governed by underthrusting of the medium-grade Central Kaoko zone below the high-grade Western Kaoko zone, resulting in the development of an inverted metamorphic gradient. The early structures were overprinted by a second phase D2, which was associated with the development of the PSZ and extensive partial melting and intrusion of ~550 Ma granitic bodies in the high-grade WKZ. Transcurrent deformation continued during cooling of the entire belt, giving rise to the localized low-temperature VMZ that separates a segment of elevated Mesoproterozoic basement from the rest of the Western zone in which only Pan-African ages have so far been observed. The data suggest that the boundary between the Western and Central Kaoko zones represents a modified thrust zone, controlling the tectonic evolution of the Kaoko belt. The geodynamic evolution and the processes that generated this belt system are discussed in Chapter 5. Nd mean crustal residence ages of granitoid rocks permit subdivision of the belt into four provinces. Province I is characterised by mean crustal residence ages <1.7 Ga and is restricted to the Neoproterozoic granitoids. A wide range of initial Sr isotopic values (87Sr/86Sri = 0.7075 to 0.7225) suggests heterogeneous sources for these granitoids. The second province consists of Mesoproterozoic (1516-1448 Ma) and late Palaeo-proterozoic (1776-1701 Ma) rocks and is probably related to the Eburnian cycle with Nd model ages of 1.8-2.2 Ga. The eNd i values of these granitoids are around zero and suggest a predominantly juvenile source. Late Archaean and middle Palaeoproterozoic rocks with model ages of 2.5 to 2.8 Ga make up Province III in the central part of the belt and are distinct from two early Proterozoic samples taken near the PSZ which show even older TDM ages of ~3.3 Ga (Province IV). There is no clear geological evidence for the involvement of oceanic lithosphere in the formation of the Kaoko-Dom Feliciano orogen. Chapter 6 presents the results of isotopic analyses of garnet porphyroblasts from high-grade meta-igneous and metasedimentary rocks of the sillimanite-K-feldspar zone. Minimum P-T conditions for peak metamorphism were calculated at 731±10 °C at 6.7±1.2 kbar, substantially lower than those previously reported. A Sm-Nd garnet-whole rock errorchron obtained on a single meta-igneous rock yielded an unexpectedly old age of 692±13 Ma, which is interpreted as an inherited metamorphic age reflecting an early Pan-African granulite-facies event. The dated garnets survived a younger high-grade metamorphism that occurred between ca. 570 and 520 Ma and apparently maintained their old Sm-Nd isotopic systematics, implying that the closure temperature for garnet in this sample was higher than 730 °C. The metamorphic peak of the younger event was dated by electronmicroprobe on monazite at 567±5 Ma. From a regional viewpoint, it is possible that these granulites of igneous origin may be unrelated to the early Pan-African metamorphic evolution of the Kaoko Belt and may represent a previously unrecognised exotic terrane.

Automatisierte Flüssigchromatographie mit Säulenschaltung und Ultraviolettspektroskopie oder Massenspektrometrie für therapeutisches Drug Monitoring von Antipsychotika und Antidepressiva

Therapeutisches Drug Monitoring (TDM) wird zur individuellen Dosiseinstellung genutzt, um die Effizienz der Medikamentenwirkung zu steigern und das Auftreten von Nebenwirkungen zu senken. Für das TDM von Antipsychotika und Antidepressiva besteht allerdings das Problem, dass es mehr als 50 Medikamente gibt. Ein TDM-Labor muss dementsprechend über 50 verschiedene Wirkstoffe und zusätzlich aktive Metaboliten messen. Mit der Flüssigchromatographie (LC oder HPLC) ist die Analyse vieler unterschiedlicher Medikamente möglich. LC mit Säulenschaltung erlaubt eine Automatisierung. Dabei wird Blutserum oder -plasma mit oder ohne vorherige Proteinfällung auf eine Vorsäule aufgetragen. Nach Auswaschen von störenden Matrixbestandteilen werden die Medikamente auf einer nachgeschalteten analytischen Säule getrennt und über Ultraviolettspektroskopie (UV) oder Massenspektrometrie (MS) detektiert. Ziel dieser Arbeit war es, LC-Methoden zu entwickeln, die die Messung möglichst vieler Antipsychotika und Antidepressiva erlaubt und die für die TDM-Routine geeignet ist. Eine mit C8-modifiziertem Kieselgel gefüllte Säule (20 µm 10x4.0 mm I.D.) erwies sich in Vorexperimenten als optimal geeignet bezüglich Extraktionsverhalten, Regenerierbarkeit und Stabilität. Mit einer ersten HPLC-UV-Methode mit Säulenschaltung konnten 20 verschiedene Psychopharmaka einschließlich ihrer Metabolite, also insgesamt 30 verschiedene Substanzen quantitativ erfasst werden. Die Analysenzeit betrug 30 Minuten. Die Vorsäule erlaubte 150 Injektionen, die analytische Säule konnte mit mehr als 300 Plasmainjektionen belastet werden. Abhängig vom Analyten, musste allerdings das Injektionsvolumen, die Flussrate oder die Detektionswellenlänge verändert werden. Die Methode war daher für eine Routineanwendung nur eingeschränkt geeignet. Mit einer zweiten HPLC-UV-Methode konnten 43 verschiedene Antipsychotika und Antidepressiva inklusive Metaboliten nachgewiesen werden. Nach Vorreinigung über C8-Material (10 µm, 10x4 mm I.D.) erfolgte die Trennung auf Hypersil ODS (5 µm Partikelgröße) in der analytischen Säule (250x4.6 mm I.D.) mit 37.5% Acetonitril im analytischen Eluenten. Die optimale Flussrate war 1.5 ml/min und die Detektionswellenlänge 254 nm. In einer Einzelprobe, konnten mit dieser Methode 7 bis 8 unterschiedliche Substanzen gemessen werden. Für die Antipsychotika Clozapin, Olanzapin, Perazin, Quetiapin und Ziprasidon wurde die Methode validiert. Der Variationskoeffizient (VK%) für die Impräzision lag zwischen 0.2 und 6.1%. Im erforderlichen Messbereich war die Methode linear (Korrelationskoeffizienten, R2 zwischen 0.9765 und 0.9816). Die absolute und analytische Wiederfindung lagen zwischen 98 und 118 %. Die für das TDM erforderlichen unteren Nachweisgrenzen wurden erreicht. Für Olanzapin betrug sie 5 ng/ml. Die Methode wurde an Patienten für das TDM getestet. Sie erwies sich für das TDM als sehr gut geeignet. Nach retrospektiver Auswertung von Patientendaten konnte erstmalig ein möglicher therapeutischer Bereich für Quetiapin (40-170 ng/ml) und Ziprasidon (40-130 ng/ml) formuliert werden. Mit einem Massenspektrometer als Detektor war die Messung von acht Neuroleptika und ihren Metaboliten möglich. 12 Substanzen konnten in einem Lauf bestimmt werden: Amisulprid, Clozapin, N-Desmethylclozapin, Clozapin-N-oxid, Haloperidol, Risperidon, 9-Hydroxyrisperidon, Olanzapin, Perazin, N-Desmethylperazin, Quetiapin und Ziprasidon. Nach Vorreinigung mit C8-Material (20 µm 10x4.0 mm I.D.) erfolgte die Trennung auf Synergi MAX-RP C12 (4 µm 150 x 4.6 mm). Die Validierung der HPLC-MS-Methode belegten einen linearen Zusammenhang zwischen Konzentration und Detektorsignal (R2= 0,9974 bis 0.9999). Die Impräzision lag zwischen 0.84 bis 9.78%. Die für das TDM erforderlichen unteren Nachweisgrenzen wurden erreicht. Es gab keine Hinweise auf das Auftreten von Ion Suppression durch Matrixbestandteile. Die absolute und analytische Wiederfindung lag zwischen 89 und 107 %. Es zeigte sich, dass die HPLC-MS-Methode ohne Modifikation erweitert werden kann und anscheinend mehr als 30 verschiedene Psychopharmaka erfasst werden können. Mit den entwickelten flüssigchromatographischen Methoden stehen neue Verfahren für das TDM von Antipsychotika und Antidepressiva zur Verfügung, die es erlauben, mit einer Methode verschiedene Psychopharmaka und ihre aktiven Metabolite zu messen. Damit kann die Behandlung psychiatrischer Patienten insbesondere mit Antipsychotika verbessert werden.

Pharmazeutische Betreuung lebertransplantierter Patienten unter besonderer Berücksichtigung der Compliance mit der immunsuppressiven Therapie

Compliance mit der immunsuppressiven Therapie spielt eine entscheidende Rolle für den langfristigen Erfolg einer Organtransplantation. Strategien zur Förderung der Compliance von organtransplantierten Patienten sind daher von besonderem Interesse. Im Rahmen der vorliegenden Arbeit wurde erstmals in Deutschland ein Konzept zur Pharmazeutischen Betreuung von organtransplantierten Patienten entworfen und mit wissenschaftlichen Methoden auf Durchführbarkeit und Nutzen geprüft. Zu diesem Zweck wurde eine prospektive, randomisierte Studie mit Kontrollgruppendesign initiiert, in die insgesamt 50 Patienten eingeschlossen wurden. Hauptziel der Studie war die Untersuchung des Einflusses einer 12-monatigen Pharmazeutischen Betreuung von lebertransplantierten Patienten auf die Compliance mit der immunsuppressiven Therapie. Zur Messung der Compliance wurden MEMS® (Medication Event Monitoring Systems) herangezogen, die momentan als Goldstandard in der Compliance-Messung angesehen werden. Weitere direkte und indirekte M

Funktionelle Bedeutung von P-Glykoprotein für Wirkungen und Nebenwirkungen von Antipsychotika

Therapeutisches Drug Monitoring (TDM) ist eine Maßnahme, bei der durch Messung der Medikamentenspiegel im Blut die Dosis ermittelt wird, bei der mit höchster Wahrscheinlichkeit mit Therapieansprechen gerechnet werden kann. Dabei wird angenommen, dass die Konzentrationen im Blut mit denen im Wirkkompartiment korrelieren. Für Antipsychotika wurde gezeigt, dass die Konzentrationen im Blut direkt mit denen im Gehirn korrelieren, die Verteilung zwischen den beiden Kompartimenten ist jedoch für die verschiedenen Antipsychotika sehr unterschiedlich. Die Distribution von Arzneistoffen zwischen Blut und Gehirn wird durch Effluxtransporter in der Blut-Hirn-Schranke kontrolliert. Welche Rolle dabei P-Glykoprotein (P-gp) für die Verteilung von atypischen Antipsychotika spielt und wie die Pharmakokinetik und –dynamik durch diesen Transporter beeinflusst werden, sollte in dieser Arbeit untersucht werden. Für die Messung des neu eingeführten Antipsychotikums Aripiprazol, sowie für seinen aktiven Metaboliten Dehydroaripiprazol, wurde eine hochleistungsflüssigchromatographische (HPLC) Methode mit Säulenschaltung und spektrophotometrischer Detektion etabliert. Die Methode wurde für die Messung von Serumproben schizophrener Patienten eingesetzt, um einen therapeutischen Bereich für Aripiprazol zu ermitteln. Aus der Analyse von 523 Patientenproben wurde herausgefunden, dass Aripiprazol-Serumkonzentrationen von 150 bis 300 ng/ml mit gutem klinischen Ansprechen und einem geringen Risiko für Nebenwirkungen einhergingen. Weiterhin wurde festgestellt, dass die Serumspiegel bei gleichzeitiger Gabe von Inhibitoren und Induktoren der Cytochrom P450 (CYP) Isoenzyme CYP2D6 und CYP3A4 erhöht bzw. gesenkt wurden. Am Modell der P-gp Knockout Maus im Vergleich zu FVB Wildtyp Mäusen wurden Konzentrationsverläufe von Antipsychotika nach i.p. Gabe von Amisulprid, Aripiprazol, Dehydroaripiprazol, Clozapin, Desmethylclozapin, Haloperidol, Olanzapin, Quetiapin, Risperidon und 9-Hydroxyrisperidon sowie der Kontrollsubstanz Domperidon im Gehirn und Blut über 24 Stunden mittels HPLC-Methoden gemessen. Welchen Einfluss eine verminderte Expression von P-gp auf die Pharmakodynamik hat, wurde in zwei Verhaltenstests untersucht. Mit Hilfe des Rotarods wurden motorische Effekte der Arzneistoffe erfasst und mittels Radial Arm Water Maze kognitive Fähigkeiten. Risperidon und sein aktiver Metabolit 9-Hydroxyrisperidon waren die stärksten Substrate von P-gp. 10-fach höhere Konzentrationen im Gehirn der P-gp Knockout Mäuse führten zu 10-fach stärkeren Beeinträchtigungen in den pharmakodynamischen Untersuchungen im Vergleich zu Wildtyp Tieren. Amisulprid, Aripiprazol, Dehydroaripiprazol, Desmethylclozapin und Quetiapin konnten ebenfalls als Substrate von P-gp identifiziert werden. Olanzapin, Haloperidol und Clozapin wurden durch P-gp wenig bzw. nicht in ihrer Pharmakokinetik und –dynamik beeinflusst. Da P-gp von Nagern und Menschen nach derzeitiger Kenntnis in ihren Substrateigenschaften weitgehend übereinstimmen, muss bei einer Behandlung von schizophrenen Patienten mit Antipsychotika, die als Substrate von P-gp identifiziert wurden, davon ausgegangen werden, dass eine Veränderung der Expression oder Aktivität von P-gp, genetisch verursacht oder durch Medikamente bedingt, für das Therapieansprechen oder das Auftreten von Nebenwirkungen bedeutsam sind.