USRE32919E - Method of enhancing the effect of t-PA - Google Patents
Method of enhancing the effect of t-PA Download PDFInfo
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- USRE32919E USRE32919E US07/066,732 US6673287A USRE32919E US RE32919 E USRE32919 E US RE32919E US 6673287 A US6673287 A US 6673287A US RE32919 E USRE32919 E US RE32919E
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K38/00—Medicinal preparations containing peptides
- A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
- A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
- A61K38/38—Albumins
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/13—Amines
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
- A61K31/415—1,2-Diazoles
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K38/00—Medicinal preparations containing peptides
- A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
- A61K38/43—Enzymes; Proenzymes; Derivatives thereof
- A61K38/44—Oxidoreductases (1)
- A61K38/446—Superoxide dismutase (1.15)
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K38/00—Medicinal preparations containing peptides
- A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
- A61K38/43—Enzymes; Proenzymes; Derivatives thereof
- A61K38/46—Hydrolases (3)
- A61K38/48—Hydrolases (3) acting on peptide bonds (3.4)
- A61K38/49—Urokinase; Tissue plasminogen activator
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
- A61K47/16—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing nitrogen, e.g. nitro-, nitroso-, azo-compounds, nitriles, cyanates
- A61K47/18—Amines; Amides; Ureas; Quaternary ammonium compounds; Amino acids; Oligopeptides having up to five amino acids
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
- A61M5/178—Syringes
- A61M5/20—Automatic syringes, e.g. with automatically actuated piston rod, with automatic needle injection, filling automatically
- A61M5/2066—Automatic syringes, e.g. with automatically actuated piston rod, with automatic needle injection, filling automatically comprising means for injection of two or more media, e.g. by mixing
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
- A61M5/178—Syringes
- A61M5/19—Syringes having more than one chamber, e.g. including a manifold coupling two parallelly aligned syringes through separate channels to a common discharge assembly
Definitions
- This invention relates to the treatment of coronary prone individuals in the throes of a suspected myocardial infarction in such a way as to minimize damage to the heart muscle and, more particularly, to improvements in such treatments enabling the same to be commenced at the earliest possible time, even before direct qualified personal care of the individual can be established.
- Examples of life threatening or very serious clot formation in arterial vessels are cerebral thrombosis, renal thrombosis, opthalmic artery thrombosis, and very importantly, thrombosis of a coronary artery.
- a thrombus is found in the coronary artery preventing blood from flowing to the heart muscle (myocardium) and supplying it with essential oxygen and other nutrients.
- myocardium heart muscle tissue that does the pumping of blood.
- Heart muscle deprived of it's blood supply does not die immediately but does promptly begin the process of becoming dead. The extent of the damage which is done to the heart muscle is, therefore, a function of the time during which the supply of blood to the infarct zone is restricted by the occuluding thrombus.
- the treatment undertaken in the hospital environment involves certain procedures for establishing reperfusion in the infarct zone of the patient's heart.
- the available procedures included mechanical catheterization and the administration of thrombolytic agents.
- thrombolytic agents such as streptokinase or urokinase required intracoronary infusion or the slow infeed of the agent within the vessel at the site of occlusion by means of a catheter.
- intravenous infusion of streptokinase has been shown to be effective.
- tissue-type plasminogen activator tissue-type plasminogen activator
- t-PA tissue-type plasminogen activator
- tissue-type plasminogen activiator is particularly exciting because of the clot specific properties of t-PA.
- coronary thrombolysis its potential advantages include: safety and efficacy of intravenous administration of high doses; effective clot lysis without induction of a systemic lytic state; prompt implementation without the need for extensive characterization of the coagulation and fibrinolytic systems in each patient prior to and during therapy; avoidance of frank allergic reactions or variations in dose-response relation due to immune complex formation; ease of minute-by-minute adjustment of dosage and prompt termination of fibrinolysis when needed because of the short biological half-life of t-PA and the lack of induction of a systemic lytic state".
- a vial is a container for a quantity of liquid medicine or diluent having a rubber stopper capable of being pierced by a hypodermic needle of a syringe to enable the operator of the syringe to withdraw a predetermined dosage of the liquid from the vial.
- the dosage could then be injected into the mother liquid container of an infusion assembly.
- the necessity to administer the drug by intravenous infusion or by intravenous injection presents a significant barrier to self-administration from a practical view point, particularly when considering the disconcerting circumstances of the individual undergoing the symptoms of a myocardial infarction.
- Another object is to enhance the absorption rate of t-PA in the blood when introduced intramuscularly.
- the invention includes packaging t-PA and an agent enhancing the absorption of t-PA in the blood.
- the agent preferably is hydroxylamine hydrochloride, in a known emergency type automatic injector and injecting the two medicament agents into the muscle tissue, e.g. after having received a decision to do so over the telephone from a qualified source and at a time prior to the establishment of direct contact qualified personal care.
- t-PA may be regarded as a clot selective thrombolytic agent
- tests thus far performed show that the concentration can be increased to the point that a systemic lytic state can be induced.
- Intramuscular injection involves the introduction of concentrated dosage of t-PA in an area contiguous to and substantially surrounding the wound caused by the penetration and withdrawal of the injection of the hypodermic needle. Consequently, it would be expected that at least a localized lytic state would be induced resulting in hemorrhage from the needle wound. Unexpectedly, tests have shown that no such hemorrhage does in fact occur.
- t-PA is a large protein. It would not be expected that it would be absorbed into the blood stream in discernible quantities. Extravascular levels of protein are about 1/10 that of intra-vascular protein. It is thought that this is so because the capillary pores through which transport of protein can occur are small relative to the molecular size of protein and limit protein transport because of electrical charge. It was thus highly problematical as to whether a large protein such as t-PA, when given intra-muscularly, i.e. outside the blood vessels, would find its way rapidly into the blood stream in discernible quantities. Application tests have indeed shown that by itself t-PA does not find its way rapidly into the blood stream in therapeutically significant quantities after intramuscular injection.
- the actual treatment of the system must therefore include intramuscular injection of an absorption enhancing agent simultaneously or substantially simultaneously with the intramuscular injection of the t-PA so as to produce effective thrombolytic blood levels.
- DMSO has proven ineffective as an absorption enhancing agent for t-PA.
- the absorption rate of t-PA in the blood is enhanced by utilizing with the t-PA dosage, a dosage of an absorption enhancing agent for t-PA, preferably hydroxylamine hydrochloride.
- the absorption enhancing agent such as hydroxylamine hydrochloride is mixed in with the t-PA dosage to form a single mixed dosage which is then injected intramuscularly (i.m.), e.g. as described in the parent application.
- the absorption enhancing agent such as hydroxylamine hydrochloride
- an amount of absorption enhancing agent such as hydroxylamine hydrochloride, which is added to the t-PA dosage, as previously described, to form a single mixed dosage is an amount of from 0.1 to 85 e.g. 0.1 to 40 or 1 to 85 milligrams per kilogram of body weight.
- hydroxylamine is preferably employed in the form of a non-toxic water soluble salt.
- hydroxylamine salts such as hydroxylamine hydrochloride, hydroxylamine hyrobromide, hydroxylamine hydroiodide, hydroxylamine sulfate, hydroxylamine nitrate, hydroxylamine acetate, and hydroxylamine propionate.
- absorption enhancing agents for t-PA in accordance with the invention compounds such as ammonia (ammonium hydroxide), ammonium carbonate and other ammonium salts, e.g. ammonium chloride, ammonium acetate, ammonium bromide and ammonium sulfate, urea, mono and dialkyl ureas, e.g. methyl urea, ethyl urea, propyl urea, butyl urea, N,N-dimethyl urea, N,N-diethyl urea, N,N-diisopropyl urea, mono and diaryl ureas, e.g.
- ammonia ammonium hydroxide
- ammonium carbonate and other ammonium salts e.g. ammonium chloride, ammonium acetate, ammonium bromide and ammonium sulfate
- urea mono and dialkyl ureas, e.g
- the substituted ureas, hydrazines and hydroxylamines likewise can be used in the form of salts, e.g. as hydrochlorides.
- t-PA and absorption enhancing agent are primarily intended for human use, it is within the scope of the invention that they be administered to other mammals, e.g. dogs, cats, cattle, and horses.
- hydroxylamine e.g. as the hydrochloride, dissociates t-PA from its naturally occurring inhibitor in tissue culture, Levin. Proc. Natl. Acad. Sci. USA 80, 6804-6808 (1983). It is also known that hydroxylamine inhibits platelet aggregation, see Iizuka, Chem. Pharmacol. Bull. 20 614-616 (1972) and elicits smooth muscle relaxation potentially enhancing vasodilation and hence absorption at the injection site, see Diamond, J. Pharmacol, Exp. Therap. 225, 422-426 (1983). These properties may contribute to its success in the present invention.
- t-PA and the absorption enhancing agent would usually be administered intramuscularly they can also be administered singly or in combination intravenously since hydroxylamine has been shown (see Levin, loc. cit) to disassociate t-PA inhibitor from t-PA, thereby enhancing the effect of the infused exogenous t-PA or the hydroxyl amine and thus reducing the amount of t-PA required to accomplish thrombolysis.
- the hydroxylamine will usually be administered in the form of a non-toxic salt, preferably the hydrochloride.
- the dosage of absorption enhancing agent, e.g. hydroxylamine hydrochloride can be in the range previously mentioned.
- t-PA inhibitor disassociating agents In place of hydroxylamine in this place of the invention there can be added other t-PA inhibitor disassociating agents.
- electrical stimulation of the muscle at the injection site was employed in concert with the inclusion of an absorption-enhancing agent, specifically hydroxylamine hydrochloride, in the injectate in a number of the following examples using intramuscular injection. Electrical stimulation augments and enhances the absorption of the absorption enhancing agent of the invention.
- an automatic injector device suitable for intramuscular self-administration of t-PA can be employed, the examples set forth below were performed by administering the t-PA and hydroxylamine hydrochloride directly into the muscle with a conventional needle and syringe. Administration of the agent with an automatic injector, however, it is believed will lead to even higher blood levels than those obtainable by manual injection.
- the t-PA employed was either harvested from melanoma cell supernatant fractions (mt-Pa) as previously described (Bergmann, Science 220 1181-1183 (1983) or produced by recombinant DNA technology, Van der Werf, Circulation 69 605-610 (1984) (rt-PA, Genentech Corp., lot BH004 DAX). Results with the two preparations were indistinguishable and therefore the preparations were pooled. Concentrations of 0.5 mg t-PA per ml buffer (0.3 M NaCl, 0.01% Tween 80, 0.01M potassium phosphate buffer pH 7.5) were used. For studies in dogs, rt-PA (Genentech, lot TE031A) was concentrated 20-fold with an Amicon membrane filter system.
- mt-Pa melanoma cell supernatant fractions
- rt-PA Genentech Corp., lot BH004 DAX
- DMSO methyl methoxysulfoxide
- Hydroxylamine hydrochloride was used in concentrations of 43.75 mg per ml of t-PA solution. This concentration was compatible with a total hydroxylamine hydrochloride dose of approximately 13 mg/kg shown to be well tolerated physiologically.
- the muscle was stimulated for 2.0 msec at 14 volts with five pulses per second with two 27-gauge, 0.5 inch stainless steel needles. A single negative distal electrode was used as well. A total of 1 mg of t-PA/kg body weight was injected manually divided in 1 ml aliquots in each of 4 sites.
- Coronary thrombosis was induced in fasted anesthetized dogs weighing approximately 23 kg, see Bergmann Science 220. 1181-1183 (1983). Occlusive thrombus formed within five to 10 minutes and was confirmed angiographically.
- Serial venous blood samples were obtained through an indwelling inferior vena caval catheter. Electrical field stimulation at the injection site was implemented with three 27-gauge stainless steel, one serving as the negative reference. Parameters were the same as those used in rabbits.
- t-PA was injected directly into exposed sartorius muscle in 1.5 ml aliquots per site such that the total dose was 3 mg/kg body weight and the total volume of injectate was 6 ml in aggregate for each dog.
- t-PA activity was determined as well Bergman, loc. cit and Tiefenbrunn, Circulation 71, 110-116 (1985). Blood samples were obtained at 0° to 4° C. in sodium citrate vacutainer tubes before intramuscular injection of t-PA or vehicle alone, immediately after injection, and at selected intervals from one to 60 minutes subsequently.
- t-PA Serial changes in blood levels of t-PA were evaluated in 56 rabbits comprising several groups. Blood levels were assessed before and at selected intervals after intramuscular injection of buffer with or without absorption-enhancing agent alone; or t-PA in buffer, buffer with DMSO, buffer with hydroxylamine (as the hydrochloride), or buffer with DMSO and hydroxylamine (as the hydrochloride).
- heparin 500 U/kg body weight
- Statistical comparisons were performed by analysis of variance with Bonferroni critical limits or with Students test for paired data. Values are expressed as means ⁇ SE.
- hydroxylamine as the hydrochloride (175 mg/ml), 1% DMSO, 3% DMSO, nor concomitant hydroxylamine (as the hydrochloride) and DMSO modified immunoradiometrically detectable t-PA or functionally detectable t-PA activity in samples incubated for 1 hour at 37° C. containing 0.015 to 50 ng rt-PA.
- Fibrin plate assayable functional activity in sham operated dogs ranged from 10 to 53 IU/ml and did not increase in any of four animals tested during the 60 minute sampling interval after electrical stimulation and intramuscular injection of hydroxylamine hydrochloride in buffer without t-PA.
- FIG. 2 is a graph showing the dependence of the peak concentration plasma of immunoradiometrically detectable t-PA on the concentration of hydroxylamine in the injectate. Conditions were the same as those indicated in the legend to FIG. 1 except that the amounts of hydroxylamine hydrochloride in the 4 ml aggregate volume of injectate were varied as indicated in the figure.
- FIG. 3 is a chart showing peak plasma t-PA activity as a function of the amount of t-PA administered intramuscularly in 6 rabbits. Conditions were the same as those indicated in the legend to FIG. 1 except that the total amount of t-PA administered was varied as indicated.
- Panel A depicts immunoradiometrically detectable activity;
- FIG. 4 is a graph showing early changes in plasma t-PA concentrations after facilitated absorption of intramuscularly administered t-PA in each of three rabbits. Conditions were the same as those indicated in the legend to FIG. 1.
- FIG. 5 a graph of serial changes in plasma t-PA assayed immunoradiometrically in a dog which had been subjected to coronary thrombosis.
- Thrombosis was induced with a thrombogenic coil advanced into the left anterior descending coronary artery at the tip of a coronary arterial catheter.
- Coronary thrombolysis was induced by facilitated absorption of intramuscularly administered t-PA.
- the thrombogenic coil elicited formation of a clot evident by lack of distal fill with angiographic dye as well as by lack of opacification of the vessel proximal to the coil that appears as a bright rectangle).
- t-PA injected in buffer alone increased blood levels only minutely.
- the addition of DMSO to the injectate did not increase t-PA levels in plasma.
- hydroxylamine hydrochloride augmented absorption of t-PA yielding peak blood levels five minutes after injection approximately 40-fold higher than those seen in its absence.
- An example of serial changes of immunoradiometrically and functional t-PA activity assayed with fibrin plates after intramuscular absorption of t-PA facilitated by inclusion of hydroxylamine hydrochloride in the injectate and electrical stimulation of muscle at the injection site is shown in FIG. 1.
- immunoradiometrically detectable t-PA peak blood levels were proportional to the amount of hydroxylamine hydrochloride in the injectate.
- Addition of 1% or 3% DMSO to hydroxylamine (as the hydrochloride)-enriched injectates did not increase peak blood levels of t-PA compared with results with hydroxylamine hydrochloride alone when the amount of t-PA was held constant.
- Both immunoradiometrically detectable and functionally active t-PA after administration of exogenous t-PA were proportional to the concentration of t-PA over a four-fold range when the amount and concentration of hydroxylamine hydrochloride in the injectate were held constant (FIG. 3).
- blood levels rose rapidly and peaked between 4 and 5 minutes after injection. Appreciable concentrations of t-PA in plasma were evident as early as one minute after intramuscular injection in each case.
- t-PA Intramuscularly administered t-PA (3 mg/kg) followed by electrical stimulation initiated coronary thrombolysis within 15 minutes heralded by reperfusion arrhythmias. Similar results were obtained in each of the three animals studied. Plasma t-PA values followed a similar time course but were lower than those seen in rabbits. The differences may reflect species differences in the absorption or clearance of human rt-OA or the larger ratio of injectate volume to muscle mass in rabbits. In addition, as shown in FIG. 5, a secondary peak of immunoradiometrically detectable t-PA occurred beginning approximately 40 minutes after the first peak in each dog compatible with lat release from the skeletal muscle depot because of changes in blood flow or slow lymphatic transport of t-PA into the circulation among other possibilities.
- t-PA functionally active t-PA
- coronary thrombolysis can be eliicted by facilitated absorption of intramuscularly injected material.
- Plasma activity peaked within five minutes after injection and subsequently declined rapidly, consistent with the known half-life of t-PA in the circulation.
- the blood levels obtained were sufficient to induce coronary thrombolysis in dogs within 15 minutes despite the continued presence of an indwelling, coronary, thrombogenic coil.
- Absorption of t-PA was enhanced by inclusion of hydroxylamine in the injectate and by augmentation of skeletal muscle blood flow by electrical stimulation. Gross injury to skeletal muscle did not occur.
- t-PA and other activators of the fibrinolytic system have been given only by direct injection into the blood stream.
- This invention provides an alternative means of administration of t-PA potentially amendable to prompt implementation by paramedical personnel or by telephonically supervised patients at high risk previously instructed in self-medication procedures.
- Hydroxylamine was employed after numerous attempts with other absorption-enhancing media for other compounds failed to yield the desired results with t-PA. Its major side effect, induction of methemoglobinemia does not prohibitively limit tissue oxygenation with the doses used. If the concentration of the hydroxylamine in the injectate is the critical determinant of absorption of t-PA as appears likely judging from the present results, the total dose of hydroxylamine required in human subjects is likely to be so low that induced methemoglobinemia would be of only trivial extent even for patients with ischemic heart disease especially if the injectate volume can be reduced further by increasing the concentration of t-PA.
- Blood levels of t-PA comparable to those obtained in the present investigation induce coronary thrombolysis in experimental animals and patients without inducing a systemic lytic state predisposing to bleeding.
- the time course of elevation of plasma t-PA after facilitated intramuscular absorption is particularly favorable because of its sharp peak.
- subjects would be under direct medical care soon after self-medication with an automatic injector or treatment by relatives of paramedical personnel.
- intravenous infusions could be initiated along with anticoagulants or other measures taken to prevent reocclusion while definitive diagnostic information wa being obtained.
- thromboxane synthetase inhibitor e.g. an imidazole such as 4-(2-[1H-imidazol-1-yl]ethoxy)-benzoic acid hydrochloride (dazoxiben)
- thromboxane A 2 introduces an antagonist for the receptor of the thromboxane A (thromboxane A 2 ) such as [1 ⁇ ,2 ⁇ (5Z), 3 ⁇ (1E), 4 ⁇ ]-7-[3-(3-cyclohexyl-3-hydroxy-1-propenyl)-7-oxabicyclo[2.2.1]hept-2-yl]-5-heptenoic acid) (SQ 27,427).
- the agent for the prevention of reocclusions or platelet aggregations could be administered simultaneously or sequentially in either order with reference to the t-PA and absorption enhancing agent, e.g. hydroxylamine hydrochloride.
- the agent for the prevention of reocclusions or platelet aggregations can be administered in conventional manner, e.g. intramuscularly, intravenously, or even orally.
- the receptor antagonist or other agent for prevention of platelet reocclusions can be administered for example in an amount of 0.1-10 mg/kg body weight.
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Abstract
Description
TABLE 1 ______________________________________ Immunoradiometrically Detectable t-PA In Plasma (ng/ml) After Intramuscularly Administered t-PA t-PA in t-PA in Buffer + Interval After t-PA In Buffer + 3% Hydroxylamine Injection Buffer Alone DMSO Hydrochloride (min) (n = 6) (n = 6) (n = 15) ______________________________________ 0 0 ± 0 0 ± 0 0 ± 0 5 8 ± 2 11 ± 4 431 ± 52* 15 9 ± 2 8 ± 2 146 ± 16* 30 9 ± 2 9 ± 1 85 ± 17* 60 10 ± 3 10 ± 1 53 ± 11* ______________________________________ Values are means ± SE. All injectates contained 2 mg tPA in an aggregate of 4 ml (1 ml per site). The concentration of hydroxylamine hydrochloride was 43.75 mg/ml. All experiments tabulated were performed with electrical stimulation of muscle at the infarction site. *P < .01 compared with tPA in buffer alone or in buffer + DMSO.
Claims (7)
Priority Applications (1)
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US07/066,732 USRE32919E (en) | 1984-08-08 | 1987-06-26 | Method of enhancing the effect of t-PA |
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Application Number | Priority Date | Filing Date | Title |
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US06/638,695 US4658830A (en) | 1984-08-08 | 1984-08-08 | Method and apparatus for initiating reperfusion treatment by an unattended individual undergoing heart attack symptoms |
US07/066,732 USRE32919E (en) | 1984-08-08 | 1987-06-26 | Method of enhancing the effect of t-PA |
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US06/638,695 Continuation-In-Part US4658830A (en) | 1984-08-08 | 1984-08-08 | Method and apparatus for initiating reperfusion treatment by an unattended individual undergoing heart attack symptoms |
US06/708,845 Reissue US4661469A (en) | 1984-08-08 | 1985-03-06 | t-PA composition capable of being absorbed into the blood stream and method of administration |
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USRE32919E true USRE32919E (en) | 1989-05-09 |
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US06/638,695 Expired - Lifetime US4658830A (en) | 1984-08-08 | 1984-08-08 | Method and apparatus for initiating reperfusion treatment by an unattended individual undergoing heart attack symptoms |
US06/782,441 Expired - Fee Related US4772585A (en) | 1984-08-08 | 1985-10-01 | Protein thrombolytic agent with absorption enhancing agent |
US07/066,732 Expired - Lifetime USRE32919E (en) | 1984-08-08 | 1987-06-26 | Method of enhancing the effect of t-PA |
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US06/638,695 Expired - Lifetime US4658830A (en) | 1984-08-08 | 1984-08-08 | Method and apparatus for initiating reperfusion treatment by an unattended individual undergoing heart attack symptoms |
US06/782,441 Expired - Fee Related US4772585A (en) | 1984-08-08 | 1985-10-01 | Protein thrombolytic agent with absorption enhancing agent |
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EP (1) | EP0192667B1 (en) |
JP (4) | JPS61502895A (en) |
AT (1) | ATE113213T1 (en) |
AU (1) | AU586830B2 (en) |
CA (1) | CA1265009A (en) |
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US6451831B1 (en) | 2001-02-13 | 2002-09-17 | Nippon Zoki Pharmaceutical Co., Ltd. | Agent for hypoalbuminaemia |
US20040137137A1 (en) * | 2001-05-14 | 2004-07-15 | Villar Elena Lopez | Method for extracting gluten contained in heat-processed and non-heat-processed foodstuffs, compatible with an enzyme-linked immunosorbent assay, composition and kits comprising said composition |
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US5124315A (en) * | 1989-11-16 | 1992-06-23 | Phideatech S.R.L. | Liquid pharmaceutical composition for nasal administration containing a polypeptide as active ingredient |
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US6251929B1 (en) | 1998-11-16 | 2001-06-26 | Nippon Zoki Pharmaceuticals Co., Ltd. | Therapeutic agent for intractable vasculitis |
US6451831B1 (en) | 2001-02-13 | 2002-09-17 | Nippon Zoki Pharmaceutical Co., Ltd. | Agent for hypoalbuminaemia |
US20040137137A1 (en) * | 2001-05-14 | 2004-07-15 | Villar Elena Lopez | Method for extracting gluten contained in heat-processed and non-heat-processed foodstuffs, compatible with an enzyme-linked immunosorbent assay, composition and kits comprising said composition |
US7585529B2 (en) * | 2001-05-14 | 2009-09-08 | Consejo Superior De Investigaciones Cientitificas | Process to extract gluten from food products and kit for achieving same |
Also Published As
Publication number | Publication date |
---|---|
JPS61502869A (en) | 1986-12-11 |
EP0192667A4 (en) | 1988-02-01 |
CA1265009A (en) | 1990-01-30 |
US4772585A (en) | 1988-09-20 |
EP0192667A1 (en) | 1986-09-03 |
JPH069610B2 (en) | 1994-02-09 |
JPS61502893A (en) | 1986-12-11 |
JPS61502892A (en) | 1986-12-11 |
IL76119A0 (en) | 1985-12-31 |
ATE113213T1 (en) | 1994-11-15 |
IL76119A (en) | 1990-07-12 |
AU4722785A (en) | 1986-03-07 |
US4658830A (en) | 1987-04-21 |
DE3587941T2 (en) | 1995-02-23 |
JPS61502895A (en) | 1986-12-11 |
EP0192667B1 (en) | 1994-10-26 |
WO1986001118A1 (en) | 1986-02-27 |
DE3587941D1 (en) | 1994-12-01 |
AU586830B2 (en) | 1989-07-27 |
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