Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L12/00—Methods or apparatus for disinfecting or sterilising contact lenses; Accessories therefor
  • A61L12/08—Methods or apparatus for disinfecting or sterilising contact lenses; Accessories therefor using chemical substances
  • A61L12/14—Organic compounds not covered by groups A61L12/10 or A61L12/12
  • A61L12/143—Quaternary ammonium compounds
• • 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
  • A61K31/16—Amides, e.g. hydroxamic acids
• • 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
  • A61K31/21—Esters, e.g. nitroglycerine, selenocyanates
  • A61K31/215—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
  • A61K31/22—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acyclic acids, e.g. pravastatin
• • 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
  • A61K31/21—Esters, e.g. nitroglycerine, selenocyanates
  • A61K31/215—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
  • A61K31/22—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acyclic acids, e.g. pravastatin
  • A61K31/23—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acyclic acids, e.g. pravastatin of acids having a carboxyl group bound to a chain of seven or more carbon atoms
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P27/00—Drugs for disorders of the senses
  • A61P27/02—Ophthalmic agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
  • A61P31/02—Local antiseptics

Definitions

• the present invention is directed toward the use of quaternary ammonium esters for disinfection and preservation. More particularly, the present invention is directed toward the use of quaternary ammonium esters for disinfection and preservation of ophthalmic solutions and devices.
• the hard or rigid comeal type lenses are formed from materials prepared by the polymerization of acrylic esters, such as poly(methyl methacrylate) (PMMA).
• the gel, hydrogel or soft type lenses are made by polymerizing such monomers as 2-hydroxyethyl methacrylate (HEMA) or, in the case of extended wear lenses, by polymerizing siloxy-containing monomers or macromonomers.
• HEMA 2-hydroxyethyl methacrylate
• Both the hard and soft types of contact lenses are exposed to a broad spectrum of microbes during normal wear and become soiled relatively quickly. Contact lenses whether hard or soft therefore require routine cleaning and disinfecting. Failure to routinely clean and disinfect contact lenses properly can lead to a variety of problems ranging from mere discomfort when being worn
• Ocular infections caused by virulent microbes such as Pseudomonas aeruginosa can lead to loss of the infected eye(s) if left untreated or if allowed to reach an advanced stage before initiating treatment.
• the present invention relates to the use of one or more quaternary ammonium esters for disinfection of medical devices such as contact lenses and for preservation of ophthalmic compositions such as pharmaceuticals, artificial tears and comfort drops against microbial contamination.
• the quaternary ammonium esters of the present invention are generally represented by the structure of Formula 1 below
• Ri is a saturated or unsaturated and branched or unbranched Ci- 24 alkyl
• Ci- 24 alkene C 6 - 2 4 aryl, C 6 . 3 6 arylalkyl, C1-24 alkyloxy, C ⁇ haloalkyl or C 6 -2 4 haloaryl;
• R 2 is branched or unbranched d-2 4 alkylene, C 6 - 36 alkylenearylene, C 6 -
• R 3 groups may be the same or different saturated or unsaturated and branched or unbranched C- ⁇ - 24 alkyl, C 6 . 36 arylalkyl, C1-24 hydroxyalkyl, C1-2 4 alkoxyalkyl, C ⁇ _ 24 alkoxyalkoxyalkyl or C ⁇ . 24 haloalkyl; and X is a halide, a C ⁇ - 24 alkylsulfate, a C6-36 arylsulfate, or other pharmaceutically acceptable salt.
• the subject quaternary ammonium esters are effective antimicrobial agents useful in the manufacture of disinfecting systems that are non-toxic, simple to use and do not cause ocular irritation.
• compositions useful as antimicrobial agents in the manufacture of ophthalmic disinfecting systems.
• Another object of the present invention is to provide a method for using compositions useful as antimicrobial agents.
• Another object of the present invention is to provide compositions useful in ophthalmic systems for disinfecting contact lenses.
• Another object of the present invention is to provide compositions useful in preserving ophthalmic systems from microbial contamination.
• Another object of the present invention is to provide compositions useful in ophthalmic systems for disinfecting contact lenses with reduced or eliminated eye irritation. Another object of the present invention is to provide enhanced surface activity and, hence, cleaning.
• Still another object of the present invention is to provide a method of making compositions useful as antimicrobial agents.
• the quaternary ammonium ester compositions of the present invention can be used with all contact lenses such as conventional hard and soft lenses, as well as, rigid and soft gas permeable lenses. Such lenses include both hydrogel and non-hydrogel lenses, but the quaternary ammonium ester compositions of the present invention are especially useful for soft lenses such as silicone and fluorine-containing lenses. Of primary interest are soft lenses fabricated from a material having a proportion of hydrophilic repeat units such that the water content of the lens during use is at least 20 percent by weight.
• the term "soft contact lens” as used herein generally refers to those contact lenses that readily flex under small amounts of force.
• soft contact lenses are formulated from polymers having a certain proportion of repeat units derived from monomers such as 2-hydroxyethyl methacrylate and/or other hydrophilic monomers, typically crosslinked with a crosslinking agent.
• monomers such as 2-hydroxyethyl methacrylate and/or other hydrophilic monomers
• crosslinked with a crosslinking agent typically crosslinked with a crosslinking agent.
• newer soft lenses, especially for extended wear are being made from high-Dk silicone-containing materials.
• the quaternary ammonium ester compositions of the present invention are useful in contact lens care solutions for disinfecting contact lenses.
• a solution of the present invention must contain in deionized water one or more of the present quaternary ammonium ester compositions in sufficient concentrations to destroy harmful microorganisms on the surface of a contact lens within the recommended minimum soaking time.
• the recommended minimum soaking time is included in the package instructions for use of the solution.
• the term "disinfecting solution” does not exclude the possibility that the solution may also be useful as a preserving solution, or that the disinfecting solution may be useful for other purposes such as daily cleaning, rinsing, and storage of contact lenses, depending on the particular formulation containing the subject compositions.
• the quaternary ammonium compositions of the present invention can be used in conjunction with other known disinfecting or preserving compounds if desired. Solutions according to the present invention are physiologically
• the solution must be "ophthalmically safe" for use with a contact lens, meaning that a contact lens treated with the solution is generally
• An ophthalmically safe solution has a tonicity and pH that is compatible with the eye and comprises materials, and amounts thereof, that are non-cytotoxic according to ISO (International Standards Organization) standards and U.S. FDA (Food and Drug Administration) regulations.
• the solution should be sterile in that the absence of microbial contaminants in the product prior to release must be statistically demonstrated to the degree necessary for such products.
• Solutions of the present invention include at least one quaternary ammonium ester composition of the present invention as generally represented by the structure of Formula 1 below
• Ri is a saturated or unsaturated and branched or unbranched C ⁇ _ 24 alkyl such as for example but not limited to methyl, propyl, hexyl or tridecyl, C 1 . 24 alkene such as for example but not limited to hexene or dodecene, C ⁇ - 24 aryl such as for example but not limited to phenyl, naphthyl or biphenyl, C 6 - 36 arylalkyl such as for example but not limited to alkyl-substituted phenyl groups or phenyl- substituted alkyl groups, C1-24 alkyloxy such as for example but not limited to propoxy or butoxy, C ⁇ _ 2 4 haloalkyl such as for example but not limited to fluoro-, chloro-, or bromo-substituted alkyl groups or C ⁇ -24 haloaryl such as for example but not limited to chlorophenyl; R 2 is branched or unbranched C ⁇
• the R 3 groups may be the same or different saturated or unsaturated and branched or unbranched C 1 - 24 alkyl such as for example but not limited to methyl or butyl, C6-36 arylalkyl such as for example but not limited to alkyl-substituted phenyl groups or phenyl-substituted alkyl groups, C ⁇ - 24 hydroxyalkyl such as for example but not limited to hydroxyethyl or hydroxypropyl, C1-24 hydroxyalkoxyalkyl such as for example but not limited to hydroxyethoxyethyl or hydroxyethoxypropyl, C 1 .24 alkoxyalkyl such as for example but not limited to ethoxyethyl or ethoxypropyl, C ⁇ - 24 alkoxyalkoxyalkyl such as for example but not limited to methoxyethoxyethyl or
• haloalkyl such as for example but not limited to fluoromethyl or chloropentyl
• X is a halide such as for example but not limited to chloride, bromide or iodide, a C ⁇ - 24 alkylsulfate, a C 6 - 36 arylsulfate or other pharmaceutically acceptable salt.
• X " an anion such as for example but not limited to Cl “ , Br “ , I “ or CH 3 SO 4 "
• R an alkylating group
• a hydroxyamine (0.0932 mole) in 100 ml of chloroform was added dropwise to a cold, i.e., 0 °C, chloroform solution (300 ml) of acid chloride (0.0810 mole). After the addition was complete, the cold bath was removed and the reaction stirred overnight under nitrogen. A 400 ml saturated sodium bicarbonate solution was added and the mixture stirred for 45 minutes. The organic layer was washed with 200 ml of aqueous sodium bicarbonate/sodium chloride solution, dried over magnesium sulfate, filtered and concentrated in vacuum. The compounds were used the synthesis of quaternary ammonium esters without further purification.
• compositions of the present invention are set forth below in Table 1.
• N-caproyloxypropyl-N,N,N-trirnethylammonium iodide Formula: C 16 H 34 NO 2 l m.p. (°C): 120-1 22 Structure:
• BBS borate buffered saline
• Microbial challenge inoculums were prepared using Pseudomonas aeruginosa (ATCC 9027), Staphylococcus aureus (ATCC 6538), Serratia marcescens (ATCC 13880), Candida albicans (ATCC 10231) and Fusarium solani (ATCC 36031 ).
• test organisms were cultured on appropriate agar and the cultures were harvested using sterile DPBST (Dulbecco's Phosphate Buffered Saline plus 0.05 percent weight/volume polysorbate 80) or a suitable diluent and transferred to a suitable vessel. Spore suspensions were filtered through sterile glass wool to remove hyphal fragments. Serratia marcescens, as
• the suspension was centrifuged at no more than 5000 x g for a maximum of 30 minutes at 20 to 25 °C.
• the supernatant was poured off and resuspended in DPBST or other suitable diluent.
• the suspension was centrifuged a second time, and resuspended in DPBST or other suitable diluent.
• All challenge bacterial and fungal cell suspensions were adjusted with DPBST or other suitable diluent to 1 x 10 7 to 1 x 10 8 cfu/ml.
• the appropriate cell concentration may be estimated by measuring the turbidity of the suspension, for example, using a spectrophotometer at a preselected wavelength, for example 490 nm.
• One tube was prepared containing a minimum of 10 ml of test solution per challenge organism.
• Each tube of the solution to be tested was inoculated with a suspension of the test organism sufficient to provide a final count of 1 x 10 5 to 1 x 10 6 cfu/ml, the volume of the inoculum not exceeding 1 percent of the sample volume. Dispersion of the inoculum was ensured by vortexing the sample for at least 15 seconds.
• the inoculated product was stored at 10 to 25 °C. Aliquots in the amount of 1.0 ml were taken of the inoculated product for determination of viable counts after certain time periods of disinfection. The time points for the bacteria were, for example, 1 , 2, 3 and 4 hours when the proposed regimen soaking time was four hours.
• Yeast and mold were tested at an additional timepoint of 16 hours (4 times the regimen time).
• the suspension was mixed well by vortexing vigorously for at least 5 seconds.
• the 1.0 ml aliquots removed at the specified time intervals were subjected to a suitable series of decimal dilutions in validated neutralizing media.
• the suspensions were mixed vigorously and incubated for a suitable period of time to allow for neutralization of the microbial agent at room temperature.
• the viable count of organisms was determined in appropriate dilutions by preparation of triplicate plates of trypticase soy (TSA) agar for bacteria and Sabouraud dextrose agar (SDA) for mold and yeast.
• TSA trypticase soy
• SDA Sabouraud dextrose agar
• the bacterial recovery plates were incubated at 30 to 35 °C for two to four days.
• the yeast was incubated at 20 to 30 °C for two to four days and mold recovery plates were incubated at 20 to 25 °C for three to seven days.
• the average number of colony forming units was determined on countable plates.
• Countable plates refer to 30 to 300 cfu/plates for bacteria and yeast, and 8 to 80 cfu/plate for mold except when colonies are observed only for the 10° or 10 "1 dilution plates.
• the microbial reduction was then calculated at the specified time points.
• inoculum controls were made by dispersing an identical aliquot of the inoculum into a suitable diluent, for example DPBST, using the same volume of diluent used to suspend the organism as listed above. Following inoculation in a validated neutralizing broth and incubation for an appropriate period of time, the inoculum control must be between 1.0 x 10 5 to 1.0 x 10 6 cfu/ml.
• the stand-alone test challenges a disinfecting product with a standard inoculum of a representative range of microorganisms and establishes the extent of viability loss at predetermined time intervals comparable with those during which the product may be used.
• the primary criteria for a given disinfection period (corresponding to a potential minimum recommended disinfection period) is that the number of bacteria recovered per mL must be reduced by a mean value of not less than 3.0 logs within the given disinfection period.
• the number of mold and yeast recovered per ml must be reduced by a mean value of not less than 1.0 log within the minimum recommended disinfection time with no increase at four times the minimum recommended disinfection time.
• Example III Amoebacidal Study Procedure A. Acanthamoeba polyphaga:
• Cysts were prepared from trophozoite cultures using the axenic medium supplemented with 50 mM MgCI 2 .
• the encystment medium was inoculated with approximately 2 x 10 5 /ml trophoxoites for culture at 30 °C in a shaking incubator (100 rpm) for 7 days. Cells were enumerated using haemocytometer counting. Microscopic examination showed greater than 90% mature cysts, which were stored at 4 °C for testing within 14 days.
• the plate was then incubated at 32 °C for up to 7 days. 7. The plate was inspected daily for 7 days for the presence of amoebal growth, either trophozoite replication or excystment and trophozoite replication, in the wells.
• Example IV Sodium Fluorescein Permeability Assay of Compositions 1 and 14
• Millicell HA 13 mm inserts (Millipore, Bedford, Massachusetts). The inserts were transferred into 24 well plates containing 0.5 ml of minimum essential medium
• a disinfecting amount of antimicrobial agent is an amount that will at least partially reduce the microorganism population in the formulations employed.
• a disinfecting amount is that which will reduce the microbial burden of representative bacteria by three log orders in four hours and of representative fungi by one log order in one hour.
• a disinfecting amount is an amount which will eliminate the microbial burden on a contact lens when used according to its regimen for the recommended soaking time (FDA Chemical Disinfection Efficacy Test - July 1985 Contact Lens Solution Draft Guidelines).
• Solutions of the present invention may likewise include at least one surfactant that has known advantages in terms of cleaning efficacy and comfort. See, for example, U.S. Patent Number 4,820,352 incorporated herein in its entirety by reference.
• the surfactant should be soluble in the lens care solution, not become turbid, and should be non-irritating to eye tissues.
• Suitable viscosity agents include for example but are not limited to cellulose polymers like hydroxyethyl, hydroxypropyl or hydroxypropylmethyl cellulose, guar, hydroxypropylguar, povidone, poly(vinyl alcohol) and the like. Viscosity agents may be employed in amounts ranging from about 0.01 to about 4.0 weight percent or less.
• Solutions of the present invention may likewise include a buffering system such as those known to those skilled in the art.
• the buffer system includes at least one phosphate buffer and at least one borate buffer, which buffering system has a buffering capacity of 0.01 to 0.5 mM, preferably 0.03 to 0.45, of 0.01 N of HCI and 0.01 to 0.3, preferably 0.025 to 0.25, of 0.01 N of NaOH to change the pH one unit. Buffering capacity is measured by a solution of the buffers only.
• Solutions o ⁇ the present invention may likewise include one or more tonicity agents to approximate the osmotic pressure of normal lachrymal fluids which is equivalent to a 0.9 percent solution of sodium chloride or 2.5 percent glycerine solution.
• suitable tonicity agents include but are not limited to sodium and potassium chloride, dextrose, mannose, glycerin, calcium and magnesium chloride. These agents are typically used individually in amounts ranging from about 0.01 to 2.5 percent w/v and preferably, from about 0.2 to about 1.5 percent w/v.
• the tonicity agent is employed in an amount to provide a final osmotic value of 200 to 450 mOsm/kg and more preferably between about 220 to about 350 mOsm/kg, and most preferably between about 220 to about 320 mOsm/kg.
• the pH of lens care solutions of the present invention is preferably maintained within the range of 5.0 to 8.0, more preferably about 6.0 to 8.0, most preferably about 6.5 to 7.8.
• contact lenses are disinfected by contacting the lens with the subject aqueous solution. Although this may be accomplished by simply soaking a lens in the subject solution, greater cleaning can be achieved if a few dorps of the solution are initially placed on each side of the lens, and rubbing the lens for a period of time, for example, approximately 20 seconds. The lens can then be subsequently immersed within several milliliters of the subject solution. Preferably, the lens is permitted to soak in the solution for at least four hours. The lenses are then removed from the solution, rinsed with the same or a different solution, for example a preserved isotonic saline solution and then replaced on the eye.
• Solutions containing one or more quaternary ammonium ester compositions of the present invention may be formulated into specific contact lens care products for use as customary in the field of ophthalmology.
• Such products include but are not limited to wetting solutions, soaking solutions, cleaning and conditioning solutions, as well as multipurpose type lens care solutions and in-eye cleaning and conditioning solutions.

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• 2003
  • 2003-04-11 US US10/412,796 patent/US20040115160A1/en not_active Abandoned
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