Recommended Methods for the Identification and Analysis of Barbiturates and Benzodiazepines ­Under International Control

Total Page:16

File Type:pdf, Size:1020Kb

Recommended Methods for the Identification and Analysis of Barbiturates and Benzodiazepines ­Under International Control Recommended methods for the Identification and Analysis of Barbiturates and Benzodiazepines under International Control MANUAL FOR USE BY NATIONAL DRUG ANALYSIS LABORATORIES Photo credits: UNODC Photo Library; UNODC/Ioulia Kondratovitch; Alessandro Scotti. Laboratory and Scientific Section UNITED NATIONS OFFICE ON DRUGS AND CRIME Vienna Recommended Methods for the Identification and Analysis of Barbiturates and Benzodiazepines under International Control MANUAL FOR USE BY NATIONAL DRUG ANALYSIS LABORATORIES UNITED NATIONS New York, 2012 Note Operating and experimental conditions are reproduced from the original reference materials, including unpublished methods, validated and used in selected national laboratories as per the list of references. A number of alternative conditions and substitution of named commercial products may provide comparable results in many cases, but any modification has to be validated before it is integrated into laboratory routines. Mention of names of firms and commercial products does not imply the endorse- ment of the United Nations. ST/NAR/46 © United Nations, June 2012. All rights reserved. The designations employed and the presentation of material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area, or of its authorities, or concerning the delimitation of its frontiers or boundaries. This publication has not been formally edited. Publishing production: English, Publishing and Library Section, United Nations Office at Vienna. ii Acknowledgements The UNODC Laboratory and Scientific Section (LSS, headed by Dr. Justice Tettey), wishes to express its appreciation and thanks to Professor Alexander Gray, Strath- clyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, United Kingdom, for the preparation of the first draft of the present manual, and to Dr Pirjo Lillisunde, Head of Drug Laboratory, National Institute for Health and Welfare, Finland, for the expert review of the document. The preparation of this manual was coordinated by Dr. Iphigenia Naidis, staff member of LSS. The contri- bution of other UNODC staff is gratefully acknowledged. iii Contents Page Acknowledgements ................................................ iii Introduction ...................................................... 1 Background ................................................... 1 Purpose and use of the manual ................................... 1 I. Barbiturates ................................................. 3 1. Classifications and definitions ................................. 3 2. Description of pure compounds ............................... 4 3. Qualitative and quantitative analysis of materials containing barbiturates ................................................ 5 3.1 Sampling. 5 3.2 Extraction and sample preparation ......................... 6 3.3 Presumptive tests ....................................... 7 3.4 Thin-layer chromatography (TLC) ......................... 9 3.5 Gas chromatography (GC) with flame ionization detector (FID) 11 3.6 Gas chromatography - mass spectrometry (GC-MS) .......... 13 3.7 High performance liquid chromatography (HPLC) ............ 16 3.8 Infrared spectroscopy .................................... 19 II. Benzodiazepines and related substances ............................ 21 1. Classifications and definitions ................................. 21 2. Description of pure compounds (see also annex II). 22 3. Qualitative and quantitative analysis of materials containing benzodiazepines. 23 3.1 Sampling. 23 3.2 Extraction and sample preparation ......................... 23 3.3 Presumptive tests ...................................... 24 3.4 Thin-layer chromatography (TLC) ......................... 25 3.5 Gas chromatography (GC) with flame ionization detector (FID) 28 3.6 Gas chromatography - mass spectrometry (GC-MS) .......... 30 3.7 High performance liquid chromatography (HPLC) ........... 31 3.8 Infrared spectroscopy .................................... 35 v Page References ...... ................................................. 37 Further reading .................................................... 40 Annex I. Description of barbiturates under international control ................ 42 II. Description of benzodia zepines under international control ............. 49 vi Introduction Background Barbiturates and benzodiazepines are used in medicine as anticonvulsants, anxioly- tics, hypnotics, sedatives, skeletal muscle relaxants and tranquilizers. Currently, twelve barbiturates and thirty-five benzodiazepines are under international control. Those that have found their way into illicit use have mainly been diverted from the licit market. Seizures of benzodiazepines and barbiturates increased by more than 50 per cent between 2005 and 2009 according to the World Drug Report 2011 [1]. The use of benzodiazepines is common among drug users, including substitution treatment clients. The non-medical use of barbiturates, benzodiazepines and other sedatives together with opioids has been a commonly observed phenomenon in many regions. The existence of parallel markets is observed, where prescription drugs are sold outside the control of the health authorities as well as through illegally operating Internet pharmacies. Benzodiazepines, specifically aprazolam and diazepam, are among the most often diverted and abused psychotropic substances [2]. However, given the absence of information on overall drug use patterns, it is difficult to estimate the extent of non-medical prescription drug use worldwide. Purpose and use of the manual The present manual is one in a series of similar UNODC publications dealing with the identification and analysis of various types of drugs under international control. These manuals are the outcome of a programme pursued by UNODC since the early 1980s, aimed at the harmonization and establishment of recommended methods of analysis for national drug analysis laboratories. The present manual combines and updates the two existing manuals on Recommended methods for testing barbiturate derivatives [3] and benzodiazepine derivatives [4] under international control, published in 1989 and 1989 respectively. It has been prepared taking into account developments in analytical technology with a view to 1 2 Recommended Methods for the Identification and Analysis of Barbiturates and Benzodiazepines providing the basis for reliable forensic evidence on seized materials containing barbiturate or benzodiazepine derivatives. It is divided into two parts which provide analytical methodologies for the two types of substances with reference to validated techniques. Description of the individual barbiturates and benzodiazepines under international control is provided in two annexes. In line with the overall objective of the series of UNODC publications, this manual suggests approaches that may assist drug analysts in the selection of methods appro- priate to the sample under examination and provide data suitable for the purpose at hand, leaving room also for adaptation to the level of sophistication of different laboratories and the various legal needs. Therefore, the methods described here should be understood as practical guidance, that is, minor modifications to suit local circumstances should normally not change the validity of the results. Not all methods described in this manual need to be applied to all samples suspected to consist of or contain barbiturates or benzodiaze- pines. The choice of the methodology and approach to analysis as well as the deci- sion as to whether or not additional methods are required remain with the analyst and may also be dependent on the availability of appropriate instrumentation and the level of legally acceptable proof in the jurisdiction within which the analyst works. The reader should be aware that there are a number of other methods, includ- ing those published in forensic science literature, which may also produce acceptable results. However, any new method that is about to be used in a laboratory must be validated and/or verified prior to routine use. Attention is also drawn to the importance of the availability to drug analysts of reference materials and literature on drugs of abuse and analytical techniques. More- over, the analyst must of necessity keep abreast of current trends in drug analysis, consistently following current analytical and forensic science literature. UNODC Laboratory and Scientific Section welcomes observations on the contents and usefulness of the present manual. Comments and suggestions may be addressed to: Laboratory and Scientific Section United Nations Office on Drugs and Crime Vienna International Centre P.O. Box 500 1400 Vienna Austria Fax: (+43-1) 26060-5967 E-mail: [email protected] All manuals, as well as guidelines and other scientific-technical publications may be requested by contacting the address above. I. Barbiturates The abuse of barbiturates is widespread and it has often been found mixed with other substances of abuse such as heroin. The international nature of the illicit market means that any forensic laboratory may encounter a range of these compounds. However, virtually all of the barbiturates in the illicit market result from diversion from legitimate sources and there is no reported evidence of clandestine manufacture. The twelve barbiturate derivatives under international control (1971 Convention on Psychotropic Substances) appear
Recommended publications
  • Kava (Piper Methysticum) and Its Methysticin Constituents Protect Brain Tissue Against Ischemic Damage in Rodents
    5 Refs: Arletti R et al, Stimulating property of Turnera diffusa and Pfaffia paniculata extracts on the sexual-behavior of male rats. Psychopharmacology 143(1), 15-19, 1999. Berger F, Handbuch der drogenkunde . Vol 2, Maudrich, Wien, 1950. Martinez M, Les plantas medicinales de Mexico . Cuarta Edicion Botas Mexico , p119, 1959. Tyler VE et al, Pharmacognosy , 9 th edition, Lea & Febiger, Philadelphia, 1988. KAVA ( Piper methysticum ) - A REVIEW The Kava plant (Piper methysticum) is a robust, well-branching and erect perennial shrub belonging to the pepper family (Piperaceae). The botanical origin remains unknown, although it is likely that early Polynesian explorers brought the plant with them from island to island. Numerous varieties of Kava exist, and today it is widely cultivated in several Pacific Island countries both for local use as well as the rapidly growing demand for pharmaceutical preparations. The dried rhizomes (roots) are normally used. The first description to the western world of the ceremonial use of an intoxicating beverage prepared from Kava was made by Captain James Cook following his Pacific voyage in 1768. The drink, prepared as an infusion in an elaborate manner after first chewing the root, is consumed on formal occasions or meetings of village elders and chiefs, as well as in reconciling with enemies and on a more social basis. It remains an important social custom in many Pacific Island countries today. Most of the islands of the Pacific possessed Kava prior to European contact, particularly those encompassed by Polynesia, Melanesia and Micronesia. After drinking the Kava beverage a pleasantly relaxed and sociable state develops, after which a deep and restful sleep occurs.
    [Show full text]
  • Alternative Treatments for Depression and Anxiety
    2019 PCB Conference: Strickland Benzodiazepines (BZDs), Herbal and Alternative Treatments for Anxiety & Depression BZD Learning Objectives • List at least three uses for benzodiazepines • Discuss at least two risk factors associated with benzodiazepine prescriptions Craig Strickland, PhD, Owner Biobehavioral Education and Consultation https://sites.google.com/site/bioedcon 1 2 BZD Pharmacokinetics Clinical Uses of BZDs Generic Name Trade Name Rapidity ½ Life Dose (mg) • Treat a variety of anxiety disorders alprazolam Xanax Intermediate Short 0.75-4 • Hypnotics • Muscle relaxants chlordiaze- Librium Intermediate Long 15-100 poxide • To produce anterograde amnesia clonazepam Klonopin Intermediate Long 0.5-4 • Alcohol & other CNS depressant withdrawal • Anti-convulsant therapy diazepam Valium Rapid Long 4-40 triazolam Halcion Intermediate Very short 0.125-0.5 temazepam Restoril Short Short 7.5-30 3 4 1 2019 PCB Conference: Strickland Issues with BZDs Herbal Medication and Alternative Therapies Used in the Treatment of Depression and Anxiety • Addictive potential • Confusion between “anti-anxiety” effects and the “warm-fuzzy) • Large dose ranges • Comparison of BZDs with medications like Buspar, etc. • They work, they work well and they work quickly 5 6 Alternative Tx. Learning Objectives Background Information on herbals: Natural does not necessarily mean “safe” • List several amino acid treatments for depression • Side-effects and adverse reactions • List at least three of the most common herbal – Herbal medications are “drugs” although
    [Show full text]
  • Metabolic-Hydroxy and Carboxy Functionalization of Alkyl Moieties in Drug Molecules: Prediction of Structure Influence and Pharmacologic Activity
    molecules Review Metabolic-Hydroxy and Carboxy Functionalization of Alkyl Moieties in Drug Molecules: Prediction of Structure Influence and Pharmacologic Activity Babiker M. El-Haj 1,* and Samrein B.M. Ahmed 2 1 Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, University of Science and Technology of Fujairah, Fufairah 00971, UAE 2 College of Medicine, Sharjah Institute for Medical Research, University of Sharjah, Sharjah 00971, UAE; [email protected] * Correspondence: [email protected] Received: 6 February 2020; Accepted: 7 April 2020; Published: 22 April 2020 Abstract: Alkyl moieties—open chain or cyclic, linear, or branched—are common in drug molecules. The hydrophobicity of alkyl moieties in drug molecules is modified by metabolic hydroxy functionalization via free-radical intermediates to give primary, secondary, or tertiary alcohols depending on the class of the substrate carbon. The hydroxymethyl groups resulting from the functionalization of methyl groups are mostly oxidized further to carboxyl groups to give carboxy metabolites. As observed from the surveyed cases in this review, hydroxy functionalization leads to loss, attenuation, or retention of pharmacologic activity with respect to the parent drug. On the other hand, carboxy functionalization leads to a loss of activity with the exception of only a few cases in which activity is retained. The exceptions are those groups in which the carboxy functionalization occurs at a position distant from a well-defined primary pharmacophore. Some hydroxy metabolites, which are equiactive with their parent drugs, have been developed into ester prodrugs while carboxy metabolites, which are equiactive to their parent drugs, have been developed into drugs as per se.
    [Show full text]
  • Drug and Alcohol Withdrawal Clinical Practice Guidelines - NSW
    Guideline Drug and Alcohol Withdrawal Clinical Practice Guidelines - NSW Summary To provide the most up-to-date knowledge and current level of best practice for the treatment of withdrawal from alcohol and other drugs such as heroin, and other opioids, benzodiazepines, cannabis and psychostimulants. Document type Guideline Document number GL2008_011 Publication date 04 July 2008 Author branch Centre for Alcohol and Other Drugs Branch contact (02) 9424 5938 Review date 18 April 2018 Policy manual Not applicable File number 04/2766 Previous reference N/A Status Active Functional group Clinical/Patient Services - Pharmaceutical, Medical Treatment Population Health - Pharmaceutical Applies to Area Health Services/Chief Executive Governed Statutory Health Corporation, Board Governed Statutory Health Corporations, Affiliated Health Organisations, Affiliated Health Organisations - Declared Distributed to Public Health System, Ministry of Health, Public Hospitals Audience All groups of health care workers;particularly prescribers of opioid treatments Secretary, NSW Health Guideline Ministry of Health, NSW 73 Miller Street North Sydney NSW 2060 Locked Mail Bag 961 North Sydney NSW 2059 Telephone (02) 9391 9000 Fax (02) 9391 9101 http://www.health.nsw.gov.au/policies/ space space Drug and Alcohol Withdrawal Clinical Practice Guidelines - NSW space Document Number GL2008_011 Publication date 04-Jul-2008 Functional Sub group Clinical/ Patient Services - Pharmaceutical Clinical/ Patient Services - Medical Treatment Population Health - Pharmaceutical
    [Show full text]
  • Chronic Use of Opioid Medications Before and After Bariatric Surgery
    Supplementary Online Content Raebel MA, Newcomer SR, Reifler LM, et al. Chronic use of opioid medications before and after bariatric surgery. JAMA. doi:10.1001/jama.2013.278344 eFigure. Opioid Dispensings in 60 Days Before and 60 Days After Bariatric Surgery eTable 1. Opioid Classification and Morphine Equivalents Conversion Factors for Opioids Administered by Tablet, Capsule, Liquid, Transdermal Patch, and Transmucosal Formulations eTable 2. ICD-9 Codes for Comorbid Diagnosis of Substance Abuse, Anxiety, Posttraumatic Stress Disorder, and/or Depression eTable 3. ICD-9 Codes for Inclusion and Exclusion of Chronic Pain Diagnoses eTable 4. Therapeutic Classes, Generic Names, and Selected Brand Names of Covariate Medications eTable 5. Types of Opioids Dispensed During the Year Before and the Year After Bariatric Surgery Among Presurgery Chronic Opioid Users eTable 6. Types of Opioids Used Before and After Bariatric Surgery Among 933 Individuals With Chronic Opioid Use Before Bariatric Surgery eTable 7. Unadjusted Characteristics of Chronic Opioid Users According to Whether or Not Both Presurgery and Postsurgery Body Mass Indexes (BMIs) Data Were Available eTable 8. Presurgery and Postsurgery Use of Opioids and Selected Other Analgesic and Adjunctive Pain Medication Classes Among Presurgery Chronic Opioid Users With Presurgery Chronic Pain Diagnoses This supplementary material has been provided by the authors to give readers additional information about their work. © 2013 American Medical Association. All rights reserved. Downloaded From:
    [Show full text]
  • Risk Based Requirements for Medicines Handling
    Risk based requirements for medicines handling Including requirements for Schedule 4 Restricted medicines Contents 1. Introduction 2 2. Summary of roles and responsibilities 3 3. Schedule 4 Restricted medicines 4 4. Medicines acquisition 4 5. Storage of medicines, including control of access to storage 4 5.1. Staff access to medicines storage areas 5 5.2. Storage of S4R medicines 5 5.3. Storage of S4R medicines for medical emergencies 6 5.4. Access to storage for S4R and S8 medicines 6 5.5. Pharmacy Department access, including after hours 7 5.6. After-hours access to S8 medicines in the Pharmacy Department 7 5.7. Storage of nitrous oxide 8 5.8. Management of patients’ own medicines 8 6. Distribution of medicines 9 6.1. Distribution outside Pharmacy Department operating hours 10 6.2. Distribution of S4R and S8 medicines 10 7. Administration of medicines to patients 11 7.1. Self-administration of scheduled medicines by patients 11 7.2. Administration of S8 medicines 11 8. Supply of medicines to patients 12 8.1. Supply of scheduled medicines to patients by health professionals other than pharmacists 12 9. Record keeping 13 9.1. General record keeping requirements for S4R medicines 13 9.2. Management of the distribution and archiving of S8 registers 14 9.3. Inventories of S4R medicines 14 9.4. Inventories of S8 medicines 15 10. Destruction and discards of S4R and S8 medicines 15 11. Management of oral liquid S4R and S8 medicines 16 12. Cannabis based products 17 13. Management of opioid pharmacotherapy 18 14.
    [Show full text]
  • The Following Studies Received Ethical Approval by Institutional And/Or National Review Committees If Appropriate
    The following studies received ethical approval by institutional and/or national review committees if appropriate. Manchester AVA Spring Meeting April 2017 Cardiovascular findings during pre-anesthetic assessment in dogs undergoing two different pre-anesthetic assessment protocols and usefulness of the diagnostic tests performed S Diez-Bernal1, G Ortiz-Diez2, SP Monteagudo-Franco3, P Ruhi-Velasco4, C Garcia- Echarri4, A Perez-Higueras4, V Salazar-Nussio5. 1Anesthesia Service, University of Bern, Bern, Switzerland; 2Cardiology Service, Alfonso X El Sabio University, Madrid, Spain; 3Diagnostic Imaging Service, Alfonso X El Sabio University, Madrid, Spain; 4Alfonso X El Sabio University, Madrid, Spain; 5Anesthesia Service, Alfonso X El Sabio University, Madrid, Spain. The objectives of this study were to describe cardiovascular abnormalities (CVA) found during pre-anesthetic assessment in dogs in a veterinary teaching hospital and to evaluate the usefulness of the different diagnostic tests performed. One hundred and eight client-owned dogs underwent a basic pre-anesthetic assessment protocol including history, physical examination, hematology and biochemistry performed and evaluated by an anesthesia specialist; and a comprehensive pre-anesthetic assessment protocol that included, in addition to the tests performed in the basic assessment protocol, thoracic radiographs, ECG, and echocardiography evaluated by a licensed veterinarian. CVA were identified in twenty-five of ninety-seven dogs (25.8%) by cardiac auscultation; in 15 dogs (13.9%) by ECG; in 6 dogs (5.6%) by thoracic radiographs; and in 39 dogs (36.1%) by echocardiography (95% of which were diagnosed of chronic valvular heart disease, CVHD). Since CVHD was the cardiovascular condition that showed the highest prevalence, sensitivity, specificity and likelihood ratios of the other performed clinical tests were calculated for the diagnosis of this condition (taking echocardiography as gold standard).
    [Show full text]
  • Benzodiazepines
    Benzodiazepines Using benzodiazepines in Children and Adolescents Overview Benzodiazepines are group of medications used to treat several different conditions. Some examples of these medications include: lorazepam (Ativan®); clonazepam (Rivotril®); alprazolam (Xanax®) and oxazepam (Serax®). Other benzodiazepine medications are available, but are less commonly used in children and adolescents. What are benzodiazepines used for? Benzodiazepines may be used for the following conditions: • anxiety disorders: generalized anxiety disorder; social anxiety disorder; post-traumatic stress disorder (PTSD); panic attacks/disorder; excessive anxiety prior to surgery • sleep disorders: trouble sleeping (insomnia); waking up suddenly with great fear (night terrors); sleepwalking • seizure disorders (epilepsy) • alcohol withdrawal • treatment of periods of extreme slowing or excessive purposeless motor activity (catatonia) Your doctor may be using this medication for another reason. If you are unclear why this medication is being prescribed, please ask your doctor. How do benzodiazepines work? Benzodiazepines works by affecting the activity of the brain chemical (neurotransmitter) called GABA. By enhancing the action of GABA, benzodiazepines have a calming effect on parts of the brain that are too excitable. This in turn helps to manage anxiety, insomnia, and seizure disorders. How well do benzodiazepines work in children and adolescents? When used to treat anxiety disorders, benzodiazepines decrease symptoms such as nervousness, fear, and excessive worrying. Benzodiazepines may also help with the physical symptoms of anxiety, including fast or strong heart beat, trouble breathing, dizziness, shakiness, sweating, and restlessness. Typically, benzodiazepines are prescribed to manage anxiety symptoms that are uncomfortable, frightening or interfere with daily activities for a short period of time before conventional anti-anxiety treatments like cognitive-behavioural therapy or anti-anxiety takes effect.
    [Show full text]
  • History Lectured on Midwifery at St Bartholomew’S Hospital and and Was in Attendance at the Births of All of Her Children
    J R Coll Physicians Edinb 2012; 42:274–9 Paper http://dx.doi.org/10.4997/JRCPE.2012.317 © 2012 Royal College of Physicians of Edinburgh Sir Charles Locock and potassium bromide MJ Eadie Honorary Research Consultant and Emeritus Professor, Faculty of Health Sciences, University of Queensland, Royal Brisbane and Women’s Hospital, Australia ABSTRACT On 12 May 1857, Edward Sieveking read a paper on epilepsy to the Correspondence to M Eadie Royal Medical and Chirurgical Society in London. During the discussion that Faculty of Health Sciences, followed Sir Charles Locock, obstetrician to Queen Victoria, was reported to have University of Queensland, Royal Brisbane and Women’s commented that during the past 14 months he had used potassium bromide to Hospital, Herston, successfully stop epileptic seizures in all but one of 14 or 15 women with ‘hysterical’ Brisbane 4029, Australia or catamenial epilepsy. This report of Locock’s comment has generally given him credit for introducing the first reasonably effective antiepileptic drug into medical Tel 61 2 (0)7 38311704 e-mail [email protected] practice. However examination of the original reports raises questions as to how soundly based the accounts of Locock’s comments were. Subsequently, others using the drug to treat epilepsy failed to obtain the degree of benefit that the reports of Locock’s comments would have led them to expect. The drug might not have come into more widespread use as a result, had not Samuel Wilks provided good, independent evidence for the drug’s antiepileptic efficacy in 1861. KEYWORDS Epilepsy treatment, Charles Locock, potassium bromide, Edward Sieveking, Samuel Wilks DECLaratIONS OF INTERESTS No conflicts of interest declared.
    [Show full text]
  • BUTALBITAL ANALGESICS Allzital (Butalbital-Acetaminophen
    BUTALBITAL ANALGESICS Allzital (butalbital-acetaminophen), butalbital-aspirin-caffeine, butalbital-aspirin-caffeine- codeine, butalbital-acetaminophen, butalbital-acetaminophen-caffeine, butalbital- acetaminophen-caffeine-codeine, Vanatol LQ (butalbital-acetaminophen-caffeine liquid oral solution) RATIONALE FOR INCLUSION IN PA PROGRAM Background Butalbital containing products are non-opioid analgesics that contain a combination of different drug products indicated for the relief of the symptom complex of tension (or muscle contraction) headache pain. Butalbital is a short to intermediate-acting barbiturate that works in concert with acetaminophen, an antipyretic non-salicylate agent, aspirin, a pain-relieving NSAID, and caffeine, a stimulant that works in the CNS, to decrease pain via a mechanism that isn’t well understood. Butalbital is a habit-forming drug that potentiates the effects of other commonly abuse drugs or substances like alcohol. Caffeine might help increase vasodilation and smooth muscle relaxation, while butalbital is thought to help balance the CNS stimulation caused by caffeine and produces depressant effects (1). Regulatory Status FDA approved indication: Butalbital containing products are used in the relief of the symptom complex of tension or muscle contraction headaches (2-8). Frequent use of acute medications is generally thought to cause medication-overuse headache. To decrease the risk of medication-overuse headache (“rebound headache” or “drug-induced headache”) many experts limit acute therapy to two headache days per week on a regular basis. Based on concerns of overuse, medication-overuse headache, and withdrawal, the use of butalbital-containing analgesics should be limited and carefully monitored. The Allzital limit is set to the maximum of 12 doses per day for acute treatment of 8 headaches per month as this product contains less butalbital than other products.
    [Show full text]
  • Benzodiazepine Group ELISA Kit
    Benzodiazepine Group ELISA Kit Benzodiazepine Background Since their introduction in the 1960s, benzodiazepines have been widely prescribed for the treatment of anxiety, insomnia, muscle spasms, alcohol withdrawal, and seizure-prevention as they are depressants of the central nervous system. Despite the fact that they are highly effective for their intended use, benzodiazepines are prescribed with caution as they can be highly addictive. In fact, researchers at NIDA (National Institute on Drug Abuse) have shown that addiction for benzodiazepines is similar to that of opioids, cannabinoids, and GHB. Common street names of benzodiazepines include “Benzos” and “Downers”. The five most encountered benzodiazepines on the illicit market are alprazolam (Xanax), lorazepam (Ativan), clonazepam (Klonopin), diazepam (Valium), and temazepam (Restori). The method of abuse is typically oral or snorted in crushed form. The DEA notes a particularly high rate of abuse among heroin and cocaine abusers. Designer benzodiazepines are currently offered in online shops selling “research chemicals”, providing drug abusers an alternative to prescription-only benzodiazepines. Data defining pharmacokinetic parameters, drug metabolisms, and detectability in biological fluids is limited. This lack of information presents a challenge to forensic laboratories. Changes in national narcotics laws in many countries led to the control of (phenazepam and etizolam), which were marketed by pharmaceutical companies in some countries. With the control of phenazepam and etizolam, clandestine laboratories have begun researching and manufacturing alternative benzodiazepines as legal substitutes. Delorazepam, diclazepam, pyrazolam, and flubromazepam have emerged as compounds in this class of drugs. References Drug Enforcement Administration, Office of Diversion Control. “Benzodiazepines.” http://www.deadiversion.usdoj.gov/drugs_concern/benzo_1.
    [Show full text]
  • Abecarnil/Allobarbital 959 Pharmacopoeias
    Abecarnil/Allobarbital 959 Pharmacopoeias. In Eur. (see p.vii). acamprosate’s action including inhibition of neuronal hyper- maleate in the treatment of anxiety disorders, hiccups, and nau- Ph. Eur. 6.2 (Acamprosate Calcium). A white or almost white excitability by antagonising excitatory amino acids such as sea and vomiting. Acepromazine, as the base, has also been giv- powder. Freely soluble in water; practically insoluble in alcohol glutamate. en in preparations for the management of insomnia. and in dichloromethane. A 5% solution in water has a pH of 5.5 1. Wilde MI, Wagstaff AJ. Acamprosate: a review of its pharmacol- Preparations to 7.0. ogy and clinical potential in the management of alcohol depend- ence after detoxification. Drugs 1997; 53: 1038–53. Proprietary Preparations (details are given in Part 3) Adverse Effects 2. Anonymous. Acamprosate for alcohol dependence? Drug Ther Denm.: Plegicil; Turk.: Plegicil. The main adverse effect of acamprosate is dosage-related diar- Bull 1997; 35: 70–2. Multi-ingredient: Fr.: Noctran. rhoea; nausea, vomiting, and abdominal pain occur less frequent- 3. Mason BJ. Treatment of alcohol-dependent outpatients with acamprosate: a clinical review. J Clin Psychiatry 2001; 62 (suppl ly. Other adverse effects have included pruritus, and occasionally 20): 42–8. a maculopapular rash; bullous skin reactions have occurred rare- 4. Overman GP, et al. Acamprosate for the adjunctive treatment of Aceprometazine (rINN) ly. Depression and fluctuations in libido have also been reported. alcohol dependence. Ann Pharmacother 2003; 37: 1090–9. Hypersensitivity reactions including urticaria, angioedema, and 5. Anton RF, et al. Combined pharmacotherapies and behavioral 16-64 CB; Aceprometazina; Acéprométazine; Aceprometazi- anaphylaxis have been reported very rarely.
    [Show full text]