Methods of intravenous administration of glyburide and other drugs
Methods of administering glyburide, or other drug, are disclosed. The novel methods disclosed herein include intravenous methods of administering glyburide, or other drug, over periods of more than an hour, preferably over periods of about 72 hours. The novel methods include administering a bolus of glyburide, or other drug, followed by a first continuous infusion administration of glyburide, or other drug; and optionally a second or further bolus administration of glyburide, or other drug, and/or a second or further continuous infusion administration of glyburide, or other drug. These methods are effective to rapidly achieve a desired level of glyburide, or other drug, and to provide a substantially steady level of glyburide, or other drug, over a desired period of time. The methods disclosed herein may be useful for treating a subject in need of treatment for, e.g., acute stroke (ischemic and hemorrhagic), traumatic brain injury (TBI), spinal cord injury (SCI), myocardial infarction (MI), shock (including hemorrhagic shock), organ ischemia, and ventricular arrhythmias. These methods provide for the rapid achievement and maintenance of therapeutic glyburide, or other drug, plasma levels over an extended period of time, and further avoid excessive levels of drug and so avoid possible drug side-effects.
1. A method of treating acute stroke, traumatic brain injury, spinal cord injury, myocardial infarction, shock, organ ischemia, ventricular arrhythmias, ischemic injury, hypoxia/ischemia, or other injuries, conditions, and disorders, in a subject in need of treatment, comprising administration of a first bolus and a second bolus of glyburide followed by a continuous infusion of glyburide to a subject in need of treatment, said administration comprising:
(a) a first bolus administration of glyburide;
(b) a second bolus administration of glyburide, after said first bolus, and
(c) a first continuous infusion administration of glyburide after said second bolus administration of glyburide
effective to provide a substantially steady level of glyburide in the blood of said subject over a desired period of time.
2. A method of treating acute stroke, traumatic brain injury, spinal cord injury, myocardial infarction, shock, organ ischemia, Of ventricular arrhythmias, ischemic injury, hypoxia/ischemia, or other injuries, conditions, and disorders, in a subject in need of treatment, comprising administration of a bolus of glyburide followed by a first and a second continuous infusion of glyburide to a subject in need of treatment, said administration comprising:
(a) a first bolus administration of glyburide;
(b) a first continuous infusion administration of glyburide after said bolus administration of glyburide, wherein in said first continuous infusion glyburide is administered at a first rate of administration for a first period of time; and
(c) a second continuous infusion administration of glyburide after said first continuous infusion of glyburide, wherein in said second continuous infusion glyburide is administered at a second rate of administration for a second period of time
effective to provide a substantially steady level of glyburide in the blood of said subject over a desired period of time.
3. A method of treating acute stroke, traumatic brain injury, spinal cord injury, myocardial infarction, shock, organ ischemia, ventricular arrhythmias, ischemic injury, hypoxia/ischemia, or other injuries, conditions, and disorders, in a subject in need of treatment, comprising administration of a bolus of glyburide followed by a first, a second, and a third continuous infusion of glyburide to a subject in need of treatment, said administration comprising:
(a) a first bolus administration of glyburide;
(b) a first continuous infusion administration of about 125 μg/hr to about 150μg/hr glyburide after said bolus administration of glyburide, wherein in said first continuous infusion glyburide is administered at a first rate of administration for a first period of time; and
(c) a second continuous infusion administration of about 100 μg/hr to about 125 μg/hr glyburide after said first continuous infusion of glyburide, wherein in said second continuous infusion glyburide is administered at a second rate of administration for a second period of time;
(d) a third continuous infusion administration of glyburide after said second continuous infusion of about 15 μg/hr to about 300 μg/hr glyburide, wherein in said third continuous infusion glyburide is administered at a third rate of administration for a third period of time
effective to provide a substantially steady level of glyburide in the blood of said subject over a desired period of time.
4. The method of claim 1 , 2 , or 3 , further comprising an additional bolus administration of glyburide.
5. The method of claim 1 , 2 , or 3 , further comprising an additional continuous infusion administration of glyburide, and further comprising an additional rate of infusion and an additional period of time.
6. The method of claim 1 , 2 , or 3 , further comprising both an additional bolus administration of glyburide, or other drug, and an additional continuous infusion administration of glyburide with an additional rate of infusion and an additional period of time.
7. The method of claim 1 , 2 , or 3 , wherein each rate of administration is about 15 μg/hr to about 300 μg/hr.
8. The method of claim 1 , 2 , or 3 , wherein the each period of time is about 1 hour to about 72 hours.
9. The method of claim 1 , 2 , or 3 , wherein the total amount of glyburide administered is about 6 mg per day or less.
10. The method of claim 1 , 2 , or 3 , wherein the total amount of glyburide administered administration is about 3.5 mg per day or less.
11. The method of claim 1 , 2 , or 3 , wherein the total amount of glyburide administered administration is about 3 mg per day or less.
12. The method of claim 1 , 2 , or 3 wherein the first bolus administration delivers about 125 μg to about 150 μg glyburide.
13. The new method of claim 1 , wherein the second bolus administration delivers about 125 μg to about 150 μg glyburide.
14. The method of claim 1 or 2 , wherein the first continuous infusion administration has a rate of about 15 μg/hr to about 300 μg/hr glyburide.
15. The method of claim 2 , wherein the second continuous infusion administration has a rate of about 15 μg/hr to about 300 μg/hr glyburide.
16. The method of claim 2 , wherein said first rate of administration is greater than said second rate of administration and said first period of time is a period of time of about 1 hour to about 10 hours.
17. The method of claim 16 , wherein said second period of time is a period of time of about 1 hour to about 10 hours.
18. The method of claim 2 , wherein said first bolus administration comprises administration of glyburide over a period of time of about 3 minutes or less.
19. The method of claim 18 , wherein said bolus administration is followed by a continuous infusion of about 150 μg/hr to about 175 μg/hr of glyburide for a period of time of about 6 hours.
20. The method of claim 19 , wherein said continuous infusion is a first continuous infusion, and said first continuous infusion is followed by a second continuous infusion of about 100 μg/hr to about 125 μg/hr glyburide.
21. The method of claim 20 , wherein said second continuous infusion is administered over a period of time of about 66 hours, whereby the sum of the periods of time of the first continuous infusion and of the second continuous infusion total about 72 hours.
22. The method of claim 2 , wherein said first bolus administration comprises administration of about 130 μg of glyburide followed by intravenous infusion of about 163 μg/hr glyburide for 6 hours followed by intravenous infusion of about 112 μg/hr glyburide for 66 hours.