B. Bwijo et al., REPETITIVE DOSING OF ARTEMISININ AND QUININE AGAINST PLASMODIUM-FALCIPARUM IN-VITRO - A SIMULATION OF THE IN-VIVO PHARMACOKINETICS, Acta Tropica, 65(1), 1997, pp. 11-22
Plasmodium falciparum (F32) parasites were exposed to artemisinin and
quinine for 3 and 4 h, respectively, once or twice daily and for 3, 5
or 7 days. Between the peaks the parasites were exposed to trough conc
entrations. Continuous drug exposure was also assessed for comparison.
After drug exposure, the cultures were extended for an observation pe
riod of up to 30 days to assess the viability of the parasites remaini
ng after drug exposure. For artemisinin, a critical threshold concentr
ation of 3 x 10(-8) M was required for growth inhibition. Dosing twice
daily for at least 5 days was also critical. Prolonging the duration
of drug exposure to 7 days further increased the efficacy. For quinine
the results were quite different. The concentration dependency of the
efficacy was more gradual. On the other hand dosing once daily appear
ed to be nearly as effective as twice daily and radical clearance was
obtained even after 3 days of exposure at peak concentrations of 10(-5
) M. A concentration of 10(-6) M provided the same effect if the durat
ion was extended to 7 days. There was a strong similarity between esti
mated concentrations of free unbound drug required for radical clearan
ce in vitro and those empirically required for clinical efficacy in vi
vo. This suggests that the in vitro model represents an appropriate mo
del for estimating drug efficacy and pharmacodynamics if the in vitro
system is adapted to simulate in vivo pharmacokinetics. (C) 1997 Elsev
ier Science B.V.