Can finger-prick sampling replace venous sampling to determine the pharmacokinetic profile of oral paracetamol?

Baba S. Mohammed, Gary Alexander Cameron, Lindsay Cameron, Gabrielle H. Hawksworth, Peter J. Helms, James S. McLay

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

WHAT IS ALREADY KNOWN ABOUT THE SUBJECT

• Finger-prick blood samples are increasingly used for the clinical and biomedical measurement of drugs and endogenous substance concentration.

• The use of different sampling sites can give rise to different drug concentration measurements.

WHAT THIS STUDY ADDS

• During the absorption phase, the paracetamol concentration in finger-prick blood samples is significantly greater than that in venous blood samples, following oral administration.

• Finger-prick and venous blood samples will result in equivalent pharmacokinetic parameters of oral paracetamol only after distribution equilibrium is attained.

The drive to increase the availability of paediatric pharmacokinetic data with minimum blood loss has led to the development of micro-sampling techniques. However studies have suggested that pharmacokinetic data from venous or capillary blood samples may not be directly comparable.

AIM
The aim of this study was to determine whether paracetamol demonstrates concentration differences between finger-prick and venous blood samples.

METHODS
Paired finger-prick and venous blood samples were taken at 0, 15, 30 and 60 min following 1 g oral paracetamol, from 12 male adult subjects. Paracetamol concentration was determined using HPLC and UV detection with a LLOQ of 2200 pg on column. Intra-assay coefficient of variation for paracetamol at the LLOQ was 3%.

RESULTS
At 15, 30, and 60 min post dose the median finger-prick paracetamol concentration was 349%, 72%, and 9.3% greater than the equivalent venous concentrations, respectively. Regression analysis confirmed a significant relationship between finger-prick and venous paracetamol concentrations at 15 min (r2 = 0.81, P = 0.006), at 30 min (r2 = 0.82, P < 0.0001) and at 60 min (r2 = 0.87, P < 0.0001) post dose. The regression equation for venous and finger-prick blood concentrations at 15, 30 and 60 min post dose were Venous15 = Finger15 - 3.4, Venous30 = Finger30 - 3.4 and Venous60 = 0.68Finger60 + 3.06, respectively.

CONCLUSIONS
Paracetamol demonstrates an arteriovenous difference in concentration, and the use of finger-prick samples may give rise to results which differ from those obtained with traditional venous sampling especially during the first 1 h following drug ingestion.
Original languageEnglish
Pages (from-to)52-56
Number of pages5
JournalBritish Journal of Clinical Pharmacology
Volume70
Issue number1
Early online date22 Mar 2010
DOIs
Publication statusPublished - Jul 2010

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Acetaminophen
Fingers
Pharmacokinetics
Pharmaceutical Preparations
Oral Administration
Eating
High Pressure Liquid Chromatography
Regression Analysis
Pediatrics

Keywords

  • arterio-venous concentration difference
  • dried blood spot
  • finger-prick
  • micro-sampling
  • paracetamol
  • pharmacokinetics
  • dried blood spots
  • tandem mass-spectrometry
  • validation
  • acetaminophen
  • adult
  • blood specimen collection
  • drug monitoring
  • fingers
  • human
  • male
  • middle aged
  • veins

Cite this

Can finger-prick sampling replace venous sampling to determine the pharmacokinetic profile of oral paracetamol? / Mohammed, Baba S.; Cameron, Gary Alexander; Cameron, Lindsay; Hawksworth, Gabrielle H.; Helms, Peter J.; McLay, James S.

In: British Journal of Clinical Pharmacology, Vol. 70, No. 1, 07.2010, p. 52-56.

Research output: Contribution to journalArticle

Mohammed, Baba S. ; Cameron, Gary Alexander ; Cameron, Lindsay ; Hawksworth, Gabrielle H. ; Helms, Peter J. ; McLay, James S. / Can finger-prick sampling replace venous sampling to determine the pharmacokinetic profile of oral paracetamol?. In: British Journal of Clinical Pharmacology. 2010 ; Vol. 70, No. 1. pp. 52-56.
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AU - Mohammed, Baba S.

AU - Cameron, Gary Alexander

AU - Cameron, Lindsay

AU - Hawksworth, Gabrielle H.

AU - Helms, Peter J.

AU - McLay, James S.

PY - 2010/7

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N2 - WHAT IS ALREADY KNOWN ABOUT THE SUBJECT • Finger-prick blood samples are increasingly used for the clinical and biomedical measurement of drugs and endogenous substance concentration. • The use of different sampling sites can give rise to different drug concentration measurements. WHAT THIS STUDY ADDS • During the absorption phase, the paracetamol concentration in finger-prick blood samples is significantly greater than that in venous blood samples, following oral administration. • Finger-prick and venous blood samples will result in equivalent pharmacokinetic parameters of oral paracetamol only after distribution equilibrium is attained. The drive to increase the availability of paediatric pharmacokinetic data with minimum blood loss has led to the development of micro-sampling techniques. However studies have suggested that pharmacokinetic data from venous or capillary blood samples may not be directly comparable. AIM The aim of this study was to determine whether paracetamol demonstrates concentration differences between finger-prick and venous blood samples. METHODS Paired finger-prick and venous blood samples were taken at 0, 15, 30 and 60 min following 1 g oral paracetamol, from 12 male adult subjects. Paracetamol concentration was determined using HPLC and UV detection with a LLOQ of 2200 pg on column. Intra-assay coefficient of variation for paracetamol at the LLOQ was 3%. RESULTS At 15, 30, and 60 min post dose the median finger-prick paracetamol concentration was 349%, 72%, and 9.3% greater than the equivalent venous concentrations, respectively. Regression analysis confirmed a significant relationship between finger-prick and venous paracetamol concentrations at 15 min (r2 = 0.81, P = 0.006), at 30 min (r2 = 0.82, P < 0.0001) and at 60 min (r2 = 0.87, P < 0.0001) post dose. The regression equation for venous and finger-prick blood concentrations at 15, 30 and 60 min post dose were Venous15 = Finger15 - 3.4, Venous30 = Finger30 - 3.4 and Venous60 = 0.68Finger60 + 3.06, respectively. CONCLUSIONS Paracetamol demonstrates an arteriovenous difference in concentration, and the use of finger-prick samples may give rise to results which differ from those obtained with traditional venous sampling especially during the first 1 h following drug ingestion.

AB - WHAT IS ALREADY KNOWN ABOUT THE SUBJECT • Finger-prick blood samples are increasingly used for the clinical and biomedical measurement of drugs and endogenous substance concentration. • The use of different sampling sites can give rise to different drug concentration measurements. WHAT THIS STUDY ADDS • During the absorption phase, the paracetamol concentration in finger-prick blood samples is significantly greater than that in venous blood samples, following oral administration. • Finger-prick and venous blood samples will result in equivalent pharmacokinetic parameters of oral paracetamol only after distribution equilibrium is attained. The drive to increase the availability of paediatric pharmacokinetic data with minimum blood loss has led to the development of micro-sampling techniques. However studies have suggested that pharmacokinetic data from venous or capillary blood samples may not be directly comparable. AIM The aim of this study was to determine whether paracetamol demonstrates concentration differences between finger-prick and venous blood samples. METHODS Paired finger-prick and venous blood samples were taken at 0, 15, 30 and 60 min following 1 g oral paracetamol, from 12 male adult subjects. Paracetamol concentration was determined using HPLC and UV detection with a LLOQ of 2200 pg on column. Intra-assay coefficient of variation for paracetamol at the LLOQ was 3%. RESULTS At 15, 30, and 60 min post dose the median finger-prick paracetamol concentration was 349%, 72%, and 9.3% greater than the equivalent venous concentrations, respectively. Regression analysis confirmed a significant relationship between finger-prick and venous paracetamol concentrations at 15 min (r2 = 0.81, P = 0.006), at 30 min (r2 = 0.82, P < 0.0001) and at 60 min (r2 = 0.87, P < 0.0001) post dose. The regression equation for venous and finger-prick blood concentrations at 15, 30 and 60 min post dose were Venous15 = Finger15 - 3.4, Venous30 = Finger30 - 3.4 and Venous60 = 0.68Finger60 + 3.06, respectively. CONCLUSIONS Paracetamol demonstrates an arteriovenous difference in concentration, and the use of finger-prick samples may give rise to results which differ from those obtained with traditional venous sampling especially during the first 1 h following drug ingestion.

KW - arterio-venous concentration difference

KW - dried blood spot

KW - finger-prick

KW - micro-sampling

KW - paracetamol

KW - pharmacokinetics

KW - dried blood spots

KW - tandem mass-spectrometry

KW - validation

KW - acetaminophen

KW - adult

KW - blood specimen collection

KW - drug monitoring

KW - fingers

KW - human

KW - male

KW - middle aged

KW - veins

U2 - 10.1111/j.1365-2125.2010.03668.x

DO - 10.1111/j.1365-2125.2010.03668.x

M3 - Article

VL - 70

SP - 52

EP - 56

JO - British Journal of Clinical Pharmacology

JF - British Journal of Clinical Pharmacology

SN - 0306-5251

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