Comparative Enhancing Effects of Phenobarbital, Amobarbital

Total Page:16

File Type:pdf, Size:1020Kb

Comparative Enhancing Effects of Phenobarbital, Amobarbital [CANCER RESEARCH 35,2884 2890, October 1975] Comparative Enhancing Effects of Phenobarbital, Amobarbital, Diphenylhydantoin, and Dichlorodiphenyltrichloroethane on 2-Acetylaminofluorene-induced Hepatic Tumorigenesis in the Rat Carl Peraino, R. J. Michael Fry, Everett Staffeldt, and John P. Christopher 2 Division of Biological and Medical Research, Argonne National Laboratory, Argonne, Illinois 60439 SUMMARY INTRODUCTION Earlier studies showed that phenobarbital feeding en- In earlier studies (27, 29), the prolonged feeding of hanced hepatic tumorigenesis in rats previously fed 2- phenobarbital to rats that had previously been fed AAF 3 for acetylaminofluorene for a brief period. As part of an a brief period markedly increased the subsequent incidence investigation of the mechanism of this enhancement, the of liver tumors. Using this sequential feeding regime, the present study evaluated the relative enhancing abilities of present study evaluated the relative tumorigenic enhancing amobarbital, diphenylhydantoin, and dichlorodiphenyltri- abilities of other compounds that, to varying degrees, chloroethane (DDT), agents that resemble phenobarbital to resemble phenobarbital in their effects on liver structure and varying degrees in their effects on liver structure and metabolism. The substances examined were amobarbital, metabolism. A comparison of hepatic tumor yields in rats diphenylhydantoin, and DDT. Table 1 compares relevant fed 2-acetylaminofluorene, followed by the test substance characteristics of these agents with those of phenobarbital, (sequential treatment), showed that amobarbital and di- reviewed previously (27, 29). Amobarbital is closest to phenylhydantoin had no enhancing activity, whereas the phenobarbital in structure and, like phenobarbital, alters enhancing effect of DDT was similar to that of phenobarbi- the metabolism of other drugs by the liver. Diphenylhydan- tal. These results show that the sequential treatment toin is less closely related to phenobarbital structurally but technique readily distinguishes among substances differing has analogous effects on DNA synthesis and drug metabo- in enhancing ability and should prove useful in screening lism. DDT and phenobarbital are structurally dissimilar but additional substances for this activity. The comparative are closely analogous in their effects on the liver. biochemical effects of these substances in the liver can then The major objective of this study was the identification of be correlated with their relative enhancing abilities to a series of compounds that differ in ability to enhance liver provide information on the molecular events specifically tumorigenesis. Correlations of these differing enhancing associated with enhancement. Such correlations were initi- abilities with the effects of these compounds on metabolic ated in this study by comparing the effects of the four test processes in the liver can then be undertaken. Such correla- substances on liver weight and DNA synthesis. The results tions should facilitate the identification of those molecular showed that the enhancers, phenobarbital and DDT, each events that are essential to enhancement. stimulated liver DNA synthesis and increased liver weight, whereas the nonenhancers, amobarbital and diphenylhydan- toin, had neither effect. MATERIALS AND METHODS Phenobarbital and DDT both increased the early tumor incidence rate and maintained an increment in tumor Tumor Incidence Study. Male Sprague-Dawley rats at 22 incidence over that in the other treatment groups through- days of age were fed either a control diet or one containing out the experiment, although it is not clear whether this 0.02% AAF for 18 days, after which they were all fed the increment would persist indefinitely. In addition, although control diet for 7 days. The control and AAF-fed rats were the spectrum of tumor types observed ranged from highly then separately divided into 5 groups. Of the rats not fed differentiated to poorly differentiated in all treatment AAF, each group contained 48 animals; of those fed AAF groups, DDT and phenobarbital selectively increased the each group contained 120 rats. Both sets of groups were incidence of highly differentiated tumors throughout most given the following diets for the duration of the experiment: of the experiment. Group 1, control; Group 2, phenobarbital (Mallinckrodt Chemical Works, St. Louis, Mo.); Group 3, amobarbital (Sigma Chemical Co., St. Louis, Mo.); Group 4, diphenyl- ~This work was supported by the United States Energy Research and Development Administration. 2 Doctoral candidate in the General Sciences Department, Oregon State 3The abbreviations used are: AAF, 2-acetylaminofluorene; DDT, University, Corvallis, Ore. 9733 I. dichlorodiphenyltrichloroethane or l,l,l-trichloro-2,2 bis(p-chlorophe- Received March 27, 1975; accepted July 9, 1975. nyl)ethane. 2884 CANCER RESEARCH VOL. 35 Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 1975 American Association for Cancer Research. Enhancement of A A F-induced Hepatic Tumorigenesis Table 1 Comparison of known effects Of phenobarbital, amobarbital, diphenvlhvdantoin, and DDT in the liver The numbers in parentheses are references, including primary sources and review articles. Effect in liver Hypertrophy and smooth DNA synthesis endoplasmic Microsomal and hyper- RNA RNA reticular enzyme Agent Structure plasia synthesis degradation proliferation activity Phenobarbital H Increases (I, Increases Decreases Increases(1, Increases c%-c"e~lO.-f--"N"-yO /" 27, 29) (27, 29) (27, 29) 27, 29) (13, 27, 29) Amobarbital H Unknown Unknov~n Unknown Unknown Increases 0 .i.-'/N%.O CH3_CH2~ [ |. (21) CH3-CH-CH2-CH2~NH 0 CH3 Diphenylhydantoin ~[/~~H"~ Increases Unknown Unknown No effect Increases N ~o (36) (14) (7, 10 12, 14, 35, 37, NH 38, 44) DDT col3 Increases Increases Decreases Increases Increases ~ f'/,-~~--- ~ ----~,----,'"1A (16) (24) (24) (15, 25, 26, (34, 1 l) 3O) cI Ct hydantoin (Sigma); Group 5, DDT' (Matheson, Coleman, Beginning on Day 26, the rats were given single daily i.p. and Bell, Cincinnati, Ohio). The dietary concentration of injections (between 7 a.m. and 9 a.m.) of phenobarbital each agent was 0.05%. Based on measurements of food sodium (83 mg/kg), amobarbital (75 mg/kg), diphenyl- consumption, it was estimated that the average daily intake hydantoin sodium (44 mg/kg), or DDT (1 12 mg/kg). The of these agents ranged from approximately 50 mg/kg of DDT was dissolved in cottonseed oil; the other agents were body weight during the 1st 4 to 6 months of the experiment dissolved in distilled water. Control rats received equivalent down to approximately 20 mg/kg of body weight by the volumes of water or cottonseed oil. The dosages of pheno- 15th month. No symptoms of sedation or toxicity were barbital, amobarbital, and DDT were equimolar; the dosage observed in any of the rats throughout the experiment. of diphenylhydantoin was one-half that of the other agents, Rats were killed at intervals (see "Results"; Chart 1) owing to the mortality observed in rats given higher doses. throughout the experiment and examined for tumors. Liv- The rats given phenobarbital or amobarbital slept for 2 to 3 ers were sliced with a razor blade into sections that were 5 hr following treatment. mm thick to reveal tumors beneath the surface. The largest Twenty-four hr after receiving its last dose of test agent, diameter of each tumor was recorded, and samples of these each rat was given an i.p. injection of [aH]thymidine (500 and other grossly observable lesions were taken for light uCi/kg; specific activity, 0.36 Ci/mmole; Schwarz/Mann, microscopy. Additional experimental details (rats, diets, Orangeburg, N. Y.) and was killed by cervical dislocation 1 husbandry, and histological preparations) were described hr later. Liver nuclei were isolated by the method of Biobei previously (27, 29). and Potter (3), and were counted in a hemocytometer. Acute Exposure Study. Weanling rats were fed the control For the determination of acid-insoluble radioactivity, diet for 25 days before being exposed to the test substances. 0.5-ml aliquots of the nuclear suspensions were placed on 9-cm filter papers folded to fit into Coplin jars. The samples ' Technical grade, containing: p,pI-DDT (see Footnote 3), 70%; o,p I- were then dried under a heat lamp and given a series of DDT [ 1, I, I-trichloro-2,2-(o-chlorophenyl-parachlorophenyl)ethane],12~: 10-rain washes, 3 times with 10% trichloroacetic acid, then p,pt-DDT [i,l-dichloro-2,2-bis(p-chlorophenyl)ethane], 3% p,pl-DDE [I,l-dichioro-2,2-bis(p-chlorophenyljethylene], 15%. Analysis, courtesy o1 twice with 95% ethanol. The samples were dried again, the Department of Agricultural Chemistry, Oregon State University, combusted in a Packard sample oxidizer, and counted in a Corvallis, Ore. liquid scintillation spectrometer. OCTOBER 1975 2885 Downloaded from cancerres.aacrjournals.org on September 25, 2021. © 1975 American Association for Cancer Research. C. Peraino et al. RESULTS 9 CONTROL A i o PHENOBARBITAL Tumor Incidence Study. The observed hepatic lesions i AAF~ [] DDT were classified into the following types. (a) Hyperplasia and o i 0 AMOBARBITAL hypertrophy. While these lesions appeared to represent a ,oo - D,PHE.YL.YOANTO,N new cell population with an altered proliferation rate and glycogen metabolism, which are attributes of neoplasia, the 80- ~/~-- ---o- main characteristics of normal liver structure were main- 7o,- ~// tained, (b) Adenomas. The characteristics of these lesions ~: 60~ ~ I .4 -o
Recommended publications
  • 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]
  • The Use of Barbital Compounds in Producing Analgesia and Amnesia in Labor
    University of Nebraska Medical Center DigitalCommons@UNMC MD Theses Special Collections 5-1-1939 The Use of barbital compounds in producing analgesia and amnesia in labor Stuart K. Bush University of Nebraska Medical Center This manuscript is historical in nature and may not reflect current medical research and practice. Search PubMed for current research. Follow this and additional works at: https://digitalcommons.unmc.edu/mdtheses Part of the Medical Education Commons Recommended Citation Bush, Stuart K., "The Use of barbital compounds in producing analgesia and amnesia in labor" (1939). MD Theses. 730. https://digitalcommons.unmc.edu/mdtheses/730 This Thesis is brought to you for free and open access by the Special Collections at DigitalCommons@UNMC. It has been accepted for inclusion in MD Theses by an authorized administrator of DigitalCommons@UNMC. For more information, please contact [email protected]. THE USE OF THE BARBITAL COMPOUl~DS IN PRODUCING ANALGESIA AND .AMNESIA.IN LABOR Stuart K. Bush Senior Thesis Presented to the College of Medicine, University of Nebraska, Omaha, 1939 481021 THE USE OF THE BARBITAL COMPOUNDS IN PROLUCING ANALGESIA AND AMNESIA IN LABOR The Lord God said unto Eve, "I will greatly mul­ tiply thy sorrow and thJ conception; in sorrow thou shalt bring forth children." Genesis 3:lti Many a God-fearing man has held this to mean that any attempt to ease the suffering of the child­ bearing mother would be a direct violation of the Lord's decree. Even though the interpretation of this phrase has formed a great barrier to the advance­ ment of the practice of relieving labor pains, attempts to achieve this beneficent goal have been made at va­ rious times throughout the ages.
    [Show full text]
  • HS 172 R5/13 Briefly Review the Objectives, Content and Activities of This Session
    HS 172 R5/13 Briefly review the objectives, content and activities of this session. Upon successfully completing this session the participant will be able to: • Explain a brief history of the CNS Depressant category of drugs. • Identify common drug names and terms associated with this category. • Identify common methods of administration for this category. • Describe the symptoms, observable signs and other effects associated with this category. CONTENT SEGMENTS LEARNING ACTIVITIES A. Overview of the Category Instructor-Led Presentations B. Possible Effects Instructor Led Demonstrations C. OtdDtifEfftOnset and Duration of Effects RdiAiReading Assignmen ts D. Overdose Signs and Symptoms Video Presentations E. Expected Results of the Evaluation Slide Presentations F. Classification Exemplar HS 172 R5/13 9-2 • Explain the typical time parameters, i.e. onset and duration of effects, associated with this category. • List the clues that are likely to emerge when the drug influence evaluation is conducted for a person under the influence of this category of drugs. • Correctly answer the “topics for study” questions at the end of this session. HS 172 R5/13 9-3 A. Overview of the Category CNS Depressants Central Nervous System Depressants slow down the operations of the brain. Point out that other common names for CNS Depressants are “downers” and “sedative-hypnotics.” • Depressants first affect those arareaseas of the brain that control a person’ s conscious, voluntary actions. • Judgment, inhibitions and reaction time are some of the things that CNS Depressants affect first. • As the dose is increased, depressants begin to affect the parts of the brain that control the body’s automatic processes, heartbeat, respiration, etc.
    [Show full text]
  • First Reported Case of Lorazepam-Assisted Interview in A
    Hindawi Publishing Corporation Case Reports in Psychiatry Volume 2014, Article ID 346939, 4 pages http://dx.doi.org/10.1155/2014/346939 Case Report First Reported Case of Lorazepam-Assisted Interview in a Young Indian Female Presenting with Dissociative Identity Disorder and Improvement in Symptoms after the Interview Raheel Mushtaq,1,2 Sheikh Shoib,1,2 Tasleem Arif,3 Tabindah Shah,4 and Sahil Mushtaq5 1 ECT Clinic, Postgraduate Department of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir 190010, India 2 Memory Clinic, Postgraduate Department of Psychiatry, Government Medical College, Srinagar 190010, India 3 Post Graduate Department of Dermatology, Government Medical College, Srinagar 190010, India 4 Government Medical College, Srinagar, Jammu and Kashmir 190010, India 5 Acharya Shri Chander College of Medical Sciences, Jammu, India Correspondence should be addressed to Raheel Mushtaq; [email protected] Received 30 May 2014; Revised 17 July 2014; Accepted 18 July 2014; Published 5 August 2014 Academic Editor: Toshiya Inada Copyright © 2014 Raheel Mushtaq et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Dissociative identity disorder (DID) is one of the most fascinating disorders in psychiatry. The arduous search to reveal the obscurity of this disorder has led to colossal research in this area over the years. Although drug-assisted interviews are not widely used, they may be beneficial for some patients that do not respond to conventional treatments such as supportive psychotherapy or psychopharmacotherapy. Drug-assisted interviews facilitate recall of memories in promoting integration of dissociative information.
    [Show full text]
  • A Fast Analytical LC/MS/MS Method for the Simultaneous Analysis of Barbiturates and 11-Nor-9-Carboxy-Δ9- Tetrahydrocannabinol (THC-A) in Urine
    Application Note Clinical Research A Fast Analytical LC/MS/MS Method for the Simultaneous Analysis of Barbiturates and 11-nor-9-carboxy-Δ9- tetrahydrocannabinol (THC-A) in Urine Using ESI negative ionization mode and alternating column regeneration Authors Abstract Andre Szczesniewski and Most of the compounds in large drug panels are analyzed using positive ionization Carrie J. Adler mode. However, barbiturates and 11-nor-9-carboxy-Δ9-THC (THC-A) perform better Agilent Technologies, Inc. using electrospray ionization (ESI) in negative mode with the mobile phase pH favorable for negative ionization. This work developed a fast analytical method combining eight barbiturates and THC-A in a single analysis using alternating column regeneration (ACR) to increase sample throughput. Moving the analytes preferring negative ionization into a separate test increases the analytical sensitivity of the compounds, allowing for greater research capabilities. The simple sample preparation techniques used provided rapid analysis, good analytical sensitivity, and quantitation over a wide dynamic range. This analysis used an Agilent 6470 triple quadrupole mass spectrometer with Agilent Jet Stream technology in ESI negative ionization mode and an Agilent Infinity II 1290 UHPLC system. A second pump and 2-position 10-port switching valve were added to facilitate use of the ACR. A 100 µL aliquot of human urine was used for the analysis of barbiturates and THC-A. Chromatographic separation of the analytes was achieved in less than 3 minutes using a gradient method composed of a H2O:acetonitrile mixture with 5 mM ammonium acetate and two Agilent Poroshell 120 EC-C18, 2.1 × 100 mm, 1.9 μm columns.
    [Show full text]
  • Practitioners Guide for Medications in Alcohol and Drug Dependence
    PRACTITIONERS GUIDE FOR MEDICATIONS IN ALCOHOL AND DRUG DEPENDENCE INTRODUCTION It is likely the majority of chemically dependent persons will probably need medications (including both prescriptions and over-the counter) at some point in their recovery. At any time, such medications should only be taken as prescribed by their primary physician in conjunction with their addiction specialist. This Guide is intended to serve as a resource for the recovering chemically dependent person and the medical professional prescribing treatment. It is not meant to be used exclusively or as the sole means for providing advice regarding medications. Indeed, this Guide would be best utilized in conjunction with other concurrent reference materials. Decisions about particular prescription medication(s) should be tailored to the needs of the individual patient under the direction of a health professional. This Guide is not intended to be exhaustive, nor an endorsement of any particular brand name medication. Rather it is intended to provide relevant pharmacological information to the recovering person and health care providers treating those in recovery. GUARDING AGAINST ADDICTION Recovering alcoholics and addicts must be constantly alert to the possibility of triggering a relapse of their disease through the intake of drugs or alcohol. Just as a diabetic needs to be cautious about the intake of sugar, the recovering alcoholic must be sensitive to drugs and the recovering addict must be sensitive to alcohol, and both must be sensitive to other mood-altering drugs, including prescribed and over-the-counter preparations. This Guide is designed to serve as a resource when making decisions regarding what medication(s) to take, as well as a reference tool for those who prescribe medication for persons in recovery.
    [Show full text]
  • Comparison of Intravenous Anesthetic Agents for the Treatment of Refractory Status Epilepticus
    Journal of Clinical Medicine Review Comparison of Intravenous Anesthetic Agents for the Treatment of Refractory Status Epilepticus Michael E. Reznik 1, Karen Berger 2 and Jan Claassen 1,* 1 Department of Critical Care Neurology, Columbia University Medical Center, New York, NY 10032, USA; [email protected] 2 Department of Pharmacy, Weill Cornell Medical Center, New York, NY 10065, USA; [email protected] * Correspondence: [email protected]; Tel.: +1-212-305-7236; Fax: +1-212-305-2792 Academic Editors: Gretchen M. Brophy and Paul M. Vespa Received: 13 April 2016; Accepted: 16 May 2016; Published: 19 May 2016 Abstract: Status epilepticus that cannot be controlled with first- and second-line agents is called refractory status epilepticus (RSE), a condition that is associated with significant morbidity and mortality. Most experts agree that treatment of RSE necessitates the use of continuous infusion intravenous anesthetic drugs such as midazolam, propofol, pentobarbital, thiopental, and ketamine, each of which has its own unique characteristics. This review compares the various anesthetic agents while providing an approach to their use in adult patients, along with possible associated complications. Keywords: status epilepticus; refractory status epilepticus; IV anesthetics 1. Introduction Refractory status epilepticus (RSE) is defined as ongoing seizures that cannot be controlled with first- and second-line agents and has an incidence ranging from 9% to 43% [1–6]. Some patients fail to respond to third-line therapy, and are considered to have super-refractory SE (SRSE), the true incidence of which is unknown. Both of these are associated with progressively-increasing morbidity and mortality, and expert guidelines advocate early initiation of intravenous anesthetic agents to maximize the chance of seizure cessation while minimizing the risk of long-term sequelae [7].
    [Show full text]
  • AMOBARBITAL Latest Revision: January 23, 2006
    AMOBARBITAL Latest Revision: January 23, 2006 1. SYNONYMS CFR: Amobarbital CAS #: Free acid: 57-43-2 Sodium salt: 64-43-7 Other names: 5-Ethyl-5-(3-methylbutyl)-2,4,6-pyrimidinetrione 5-Ethyl-5-isopentylbarbituric acid Amytal 2. CHEMICAL AND PHYSICAL DATA 2.1. CHEMICAL DATA Form Chemical Formula Molecular Weight Melting Point (°C) Free acid C11H18N2O3 226.2 155-158 Sodium salt C11H17N2NaO3 248.2 156 2.2. SOLUBILITY Form A C E H M W Free acid *** S FS *** FS VSS Sodium salt *** I I *** FS VS A = acetone, C = chloroform, E = ether, H = hexane, M = methanol and W = water, VS = very soluble, FS = freely soluble, S = soluble, PS = sparingly soluble, SS = slightly soluble, VSS = very slightly soluble and I = insoluble Note: A saturated aqueous solution of the free acid has a pH about 5.6. A 10% aqueous solution of the sodium salt has a pH not more than 11. 3. SCREENING TECHNIQUES 3.1. COLOR TESTS REAGENT COLOR PRODUCED Dille-Koppanyi Violet Zwikker's Violet Mercurous nitrate Black 3.2. CRYSTAL TESTS REAGENT CRYSTALS FORMED Wagenaar's Light blue needles in clusters Acetic acid Long, branching needles and hexagonal plates 3.3. THIN-LAYER CHROMATOGRAPHY Visualization Mercurous nitrate spray Acidified potassium permanganate RELATIVE R1 COMPOUND System TLC7 System TLC12 barbituric acid 0.0 0.0 phenobarbital 0.9 0.5 amobarbital 1.0 1.0 pentobarbital 1.0 1.0 secobarbital 1.0 1.0 thiobarbital 1.4 1.0 3.4. GAS CHROMATOGRAPHY All gas chromatographic methods should be performed on the free acid of the barbiturate only, due to the poor chromatography of the sodium salts.
    [Show full text]
  • Barbiturates for the Treatment of Alcohol Withdrawal Syndrome: ☆ a Systematic Review of Clinical Trials
    Journal of Critical Care 32 (2016) 101–107 Contents lists available at ScienceDirect Journal of Critical Care journal homepage: www.jccjournal.org Barbiturates for the treatment of alcohol withdrawal syndrome: ☆ A systematic review of clinical trials Yoonsun Mo, MS, Pharm.D., BCPS, BCCCP a,b,⁎, Michael C. Thomas, Pharm.D., BCPS, FCCP a,1, George E. Karras Jr., MD, FCCM b,2 a Department of Pharmacy Practice, Western New England University College of Pharmacy, 1215 Wilbraham Road, Springfield, MA 01119 b Mercy Medical Center, 271 Carew Street, Springfield, MA 01104 article info abstract Keywords: Purpose: To perform a systematic review of the clinical trials concerning the use of barbiturates for the treatment Barbiturates of acute alcohol withdrawal syndrome (AWS). Phenobarbital Materials and Methods: A literature search of MEDLINE, EMBASE, and the Cochrane Library, together with a man- Benzodiazepines ual citation review was conducted. We selected English-language clinical trials (controlled and observational Alcohol withdrawal syndrome studies) evaluating the efficacy and safety of barbiturates compared with benzodiazepine (BZD) therapy for Delirium tremens Systematic review the treatment of AWS in the acute care setting. Data extracted from the included trials were duration of delirium, number of seizures, length of intensive care unit and hospital stay, cumulated doses of barbiturates and BZDs, and respiratory or cardiac complications. Results: Seven studies consisting of 4 prospective controlled and 3 retrospective trials were identified. Results from all the included studies suggest that barbiturates alone or in combination with BZDs are at least as effective as BZDs in the treatment of AWS. Furthermore, barbiturates appear to have acceptable tolerability and safety pro- files, which were similar to those of BZDs in patients with AWS.
    [Show full text]
  • Original Article Effects of Repeated High Dosage of Chloral Hydrate and Pentobarbital Sodium Anesthesia on Hepatocellular System in Rats
    Int J Clin Exp Med 2015;8(7):10568-10576 www.ijcem.com /ISSN:1940-5901/IJCEM0008402 Original Article Effects of repeated high dosage of chloral hydrate and pentobarbital sodium anesthesia on hepatocellular system in rats Jianhong Yu1*, Xuehui Sun2*, Guifeng Sang3 1Department of Anesthesiology, Yuhuangding Hospital, Yantai 264000, China; 2Department of Rheumatology, Yuhuangding Hospital, Yantai 264000, China; 3Operating Room, Yuhuangding Hospital, Yantai 264000, China. *Equal contributors. Received March 24, 2015; Accepted July 2, 2015; Epub July 15, 2015; Published July 30, 2015 Abstract: This study aims to investigate the possible effects of repeated high dosage of chloral hydrate and pen- tobarbital sodium anesthesia on hepatocellular system in rats. Thirty Sprague Dawley rats were randomly divided into 3 groups: control group (group A), chloral hydrate group (group B) and pentobarbital sodium group (group C). Antioxidant enzymes superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), glutathione s transferase (GST) and catalase (CAT) activities and thiobarbituric acid-reactive substances (TBARS) level as well as serum biochemi- cal parameters alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and total bilirubin (T-BIL) were determined. Liver histopathological examinations were performed at termination. Furthermore, Bax and Bcl-2 expression, and caspase-3 activity were also evaluated. The SOD, GSH-Px, GST and CAT activities significantly decreased but TBARS levels increased in group B and C compared with group A. Hepatic injury was evidenced by a significant increase in serum ALT, AST and ALP activities in group B and C, which also con- firmed by the histopathological alterations. Moreover, administration of chloral hydrate and pentobarbital sodium could induce certain hepatic apoptosis accompanied by the upregulated Bax expression, the downregulated Bcl-2 expression and Bcl-2/Bax ratio, and the increase of caspase-3 activity.
    [Show full text]
  • Drug-Facilitated Sexual Assault in the U.S
    The author(s) shown below used Federal funds provided by the U.S. Department of Justice and prepared the following final report: Document Title: Estimate of the Incidence of Drug-Facilitated Sexual Assault in the U.S. Document No.: 212000 Date Received: November 2005 Award Number: 2000-RB-CX-K003 This report has not been published by the U.S. Department of Justice. To provide better customer service, NCJRS has made this Federally- funded grant final report available electronically in addition to traditional paper copies. Opinions or points of view expressed are those of the author(s) and do not necessarily reflect the official position or policies of the U.S. Department of Justice. AWARD NUMBER 2000-RB-CX-K003 ESTIMATE OF THE INCIDENCE OF DRUG-FACILITATED SEXUAL ASSAULT IN THE U.S. FINAL REPORT Report prepared by: Adam Negrusz, Ph.D. Matthew Juhascik, Ph.D. R.E. Gaensslen, Ph.D. Draft report: March 23, 2005 Final report: June 2, 2005 Forensic Sciences Department of Biopharmaceutical Sciences (M/C 865) College of Pharmacy University of Illinois at Chicago 833 South Wood Street Chicago, IL 60612 ABSTRACT The term drug-facilitated sexual assault (DFSA) has been recently coined to describe victims who were given a drug by an assailant and subsequently sexually assaulted. Previous studies that have attempted to determine the prevalence of drugs in sexual assault complainants have had serious biases. This research was designed to better estimate the rate of DFSA and to examine the social aspects surrounding it. Four clinics were provided with sexual assault kits and asked to enroll sexual assault complainants.
    [Show full text]
  • Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: an American Academy of Sleep Medicine Clinical Practice Guideline Michael J
    pii: jc-00382-16 http://dx.doi.org/10.5664/jcsm.6470 SPECIAL ARTICLES Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline Michael J. Sateia, MD1; Daniel J. Buysse, MD2; Andrew D. Krystal, MD, MS3; David N. Neubauer, MD4; Jonathan L. Heald, MA5 1Geisel School of Medicine at Dartmouth, Hanover, NH; 2University of Pittsburgh School of Medicine, Pittsburgh, PA; 3University of California, San Francisco, San Francisco, CA; 4Johns Hopkins University School of Medicine, Baltimore, MD; 5American Academy of Sleep Medicine, Darien, IL Introduction: The purpose of this guideline is to establish clinical practice recommendations for the pharmacologic treatment of chronic insomnia in adults, when such treatment is clinically indicated. Unlike previous meta-analyses, which focused on broad classes of drugs, this guideline focuses on individual drugs commonly used to treat insomnia. It includes drugs that are FDA-approved for the treatment of insomnia, as well as several drugs commonly used to treat insomnia without an FDA indication for this condition. This guideline should be used in conjunction with other AASM guidelines on the evaluation and treatment of chronic insomnia in adults. Methods: The American Academy of Sleep Medicine commissioned a task force of four experts in sleep medicine. A systematic review was conducted to identify randomized controlled trials, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) process was used to assess the evidence. The task force developed recommendations and assigned strengths based on the quality of evidence, the balance of benefits and harms, and patient values and preferences.
    [Show full text]