DOCSLIB.ORG

A Fast Analytical LC/MS/MS Method for the Simultaneous Analysis of Barbiturates and 11-Nor-9-Carboxy-Δ9- Tetrahydrocannabinol (THC-A) in Urine

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read 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. Quantitative analysis was performed using multiple reaction monitoring (MRM) transition pairs for each analyte and an internal standard in the negative ionization mode. The isobaric pair, amobarbital and pentobarbital, were not separated under these chromatographic conditions. Good linearity and reproducibility were obtained for the concentration range from 5 to 1,000 ng/mL with a coefficient of determination >0.995 for all analytes. Excellent reproducibility was observed for all analytes (CV <15 %). A fast, specific, and accurate quantitative LC/MS/MS analytical method was developed and verified for the simultaneous measurement of barbiturates and THC-A in urine. Introduction Compounds in large drug panels are O O O O O O O O O O analyzed using positive ionization mode. However, barbiturates and HN NH HN NH HN NH HN NH HN N 11-nor-9-carboxy-Δ9-THC (THC-A) O O O O O perform better in negative ionization Amobarbital Butabarbital Butalbital Methohexital Pentobarbital mode using a separate assay with the mobile phase pH favorable for negative O ionization. Included in the analysis were NH OH eight barbiturates and THC-A (Figure 1). O O O O O H3C barbiturates included: amobarbital, O O HN NH N HN NH OH butabarbital, butalbital, methohexital, CH pentobarbital, phenobarbital, O 3 O O hexobarbital, and secobarbital. This Phenobarbital Hexobarbital Secobarbital 11-nor-9-Carboxy-∆9-THC work developed a fast analytical method Figure 1. Analyte structures. combining barbiturates and THC-A in a single analysis using alternating column regeneration (ACR) to increase Experimental sample throughput. This analytical method used the ability of LC/MS/MS LC Configuration and parameters to detect compounds over a wide range Configuration of concentrations simultaneously. The Pump Two Agilent 1290 Infinity II binary pumps (p/n G7120A) calibration concentrations ranged from Multisampler Agilent 1290 Infinity II multisampler (p/n G7167A) 0.1 ng/mL to 5,000 ng/mL. The standard Agilent 1290 Infinity thermostatted column compartment with a 2-position 10 port valve Column compartment curve preparation was generated using (p/n G7116B) matrix-matched standards, diluting 1:10 Needle wash 50:20:20:10 IPA:MeOH:ACN:H2O and injecting into the LC/MS/MS system. Autosampler temperature 10 °C The methodology was developed on an Injection volume 10 µL Agilent 1290 Infinity II UHPLC and an Analytical column 2 Agilent Poroshell 120 EC-C18, 2.1 × 100 mm, 1.9 µm, LC columns (p/n 695775-902) Agilent 6470 LC/TQ mass spectrometer Column temperature 55 °C with a 5-minute analytical gradient. ACR Mobile phase A 5 mM Ammonium acetate in water reduced the analysis time by 26 %, to Mobile phase B Acetonitrile 3.7 minutes injection to injection. Flow rate 0.35 mL/min Eluent pump Regeneration pump Time (min) %B Time (min) %B 0.00 35 0.00 98 Gradient 1.60 45 1.40 98 1.61 98 1.50 35 3.00 98 3.01 45 3.59 45 Stop time Eluent pump: 3.65 minutes Regeneration pump: no limit 0.00 minutes Current position Valve position 3.59 minutes Next position 2 Chemicals and reagents Column 2 Human urine used for matrix-matched Valve (V1) position 1 calibrators was purchased from Golden West Biologicals, Inc, (Temecula, CA). 1 10 29 Standards and internal standards were Eluent pump Autosampler Waste bought from Cerillant Corporation 38 (Round Rock, TX). Sample preparation V1 47 and LC solvents were acquired from Regeneration Detector Honeywell (Muskegon, MI). pump 56 Sample preparation Standards were spiked into drug-free Column 1 human urine solution (10 %). The calibration curve was created by serial dilution following a pattern of Column 2 1:2:2:2.5. Concentrations ranged from Valve (V1) position 2 0.5 to 5,000 ng/mL. Internal standards were added to a final concentration of 1 10 29 200 ng/mL. Then, 10 μL were injected Eluent pump Autosampler Waste onto the LC/MS system. 38 V1 Data analysis 47 Regeneration Data acquisition was performed using Detector pump Agilent MassHunter Acquisition Software 56 (B.08.00). MS/MS transitions were obtained using Agilent MassHunter Acquisition optimizer software to Column 1 determine optimal parent and product Figure 2. Alternating column regeneration (ACR) valve configuration. ions, fragmentor voltages, and collision energies. Data were analyzed using Gradient run Agilent MassHunter Quantitative Analysis Rinse Eluent pump Software (B.08.00) and Qualitative V1 column 1 %B 0.6 minutes Analysis Software (B.07.00). 3 minutes Regeneration Column wash pump Column equilibration %B 1.4 minutes column 1 2.2 minutes ACR Analysis cycle time = 3.65 minutes Overlapped Draw and inject injection 0.85 minutes Figure 3. Graphical timeline for ACR analysis. 3 Results and discussion LC/TQ Mass spectrometer configuration and parameters Configuration Chromatography Instrument Agilent 6470 triple quadrupole mass spectrometer with Agilent Jet Stream The main emphasis of this work was MS/MS mode MRM increased throughput. Therefore, under Ionization mode Negative these chromatographic conditions, the Drying gas temperature 150 °C isobars amobarbital and pentobarbital Drying gas flow 11 L/min did not separate, and are reported as Nebulizer pressure 30 psi a single peak (Figure 4). If separation Sheath gas temperature 350 °C between amobarbital and pentobarbital Sheath gas flow 11 L/min is required, adjust the gradient and the Nozzle voltage 2,000 V run time to achieve baseline separation Capillary voltage 6,000 V between those isobars, as shown in Delta EMV 800 V Figure 6. Q1/Q2 resolution Unit/Unit Dwell time 50 ms Cell accelerator voltage 4 V MS/MS Compound information for analytes and internal standards Precursor ion Product ion Fragmentor Collision energy Compound ISTD? (m/z) (m/z) RT (min) (V) (V) Amo/Pentobarbital 225.1 182 1.78 105 12 Amo/Pentobarbital 225.1 42 1.78 105 24 AmoPentobarbital-D5 230.1 42 1.78 105 24 Butabarbital 211.1 168 1.32 165 12 Butabarbital 211.1 42 1.32 165 40 Butalbital 223.1 180 1.45 165 8 Butalbital 223.1 42 1.45 165 36 Butalbital-D5 228.1 42 1.45 165 36 Hexobarbital 235.1 42 1.85 85 20 Methohexital 261.1 42 2.66 65 20 Phenobarbital 231.1 188 1.17 140 8 Phenobarbital 231.1 42 1.17 140 36 Phenobarbital-D5 236.1 42 1.17 140 36 Secobarbital 237.1 194 2.02 170 12 Secobarbital 237.1 42 2.02 170 36 Secobarbital-D5 242.1 42 2.02 170 36 THC-A 343.2 299.2 2.88 125 24 THC-A 343.2 245 2.88 125 36 THC-A-D9 352.2 254.1 2.88 125 32 4 ×105 2.6 2.4 2.2 Hexobarbital 2.0 THC-A 1.8 1.6 1.4 1.2 Counts Amo/pentobarbital 1.0 Butalbital 0.8 Phenobarbital 0.6 Butabarbital Secobarbital Methohexital 0.4 0.2 0 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 3.0 Acquisition time (min) Figure 4. dMRM Chromatogram showing elution of the nine compounds at 500 ng/mL. 2 ×102 ×102 ×102 ×10 Phenobarbital Butabarbital Butalbital 9 Amo/pentobarbital 7 5 ng/mL 5 pg OC* 6 5 ng/mL 5 pg OC 6 5 ng/mL 5 pg OC 8 0.5 ng/mL 500 fg OC 6 1,106.16 5 987.33 5 7 5 987.80 6 1,651.10 4 4 4 5 3 3 4 Counts 3 Counts Counts Counts 3 2 2 2 2 1 1 1 1 0 0 0 0 1.0 1.1 1.2 1.3 1.2 1.3 1.4 1.5 1.3 1.4 1.5 1.6 1.7 1.8 1.6 1.7 1.8 1.9 Acquisition time (min) Acquisition time (min) Acquisition time (min) Acquisition time (min) ×103 ×102 ×102 ×103 2.4 Hexobarbital 7 Secobarbital 6 Methohexital THC-A 2.4 2.0 0.5 ng/mL 500 fg OC 6 5 ng/mL 5 pg OC 5 5 ng/mL 5 pg OC 50 pg/mL 50 fg OC 2.0 1.6 5 4,093 3,409.85 888.02 4 604.16 1.6 4 1.2 3 1.2 Counts 3 Counts Counts Counts 0.8 2 2 0.8 0.4 1 1 0.4 0 0 1.7 1.8 1.9 2.0 1.9 2.0 2.1 2.2 2.5 2.6 2.7 2.8 2.5 2.6 2.7 2.8 Acquisition time (min) Acquisition time (min) Acquisition time (min) Acquisition time (min) Figure 5.
Load more

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]
  • Determination of Barbiturates and 11-Nor-9-Carboxy-Δ9-THC in Urine
    Determination of Barbiturates and 11-Nor-9-carboxy- 9-THC in Urine using Automated Disposable Pipette Extraction (DPX) and LC/MS/MS Fred D. Foster, Oscar G. Cabrices, John R. Stuff, Edward A. Pfannkoch GERSTEL, Inc., 701 Digital Dr. Suite J, Linthicum, MD 21090, USA William E. Brewer Department of Chemistry and Biochemistry, University of South Carolina, 631 Sumter St. Columbia, SC 29208, USA KEYWORDS DPX, LC/MS/MS, Sample Preparation, High Throughput Lab Automation ABSTRACT This work demonstrates the use of disposable pipette extraction (DPX) as a fast and automated sample preparation technique for the determination of barbiturates and 11-nor-9- carboxy- 9-THC (COOH-THC) in urine. Using a GERSTEL MultiPurpose Sampler (MPS) with DPX option coupled to an Agilent 6460 LC-MS/MS instrument, 8 barbiturates and COOH-THC were extracted and their concentrations determined. The resulting average cycle time of 7 min/ sample, including just-in-time sample preparation, enabled high throughput screening. Validation results show that the automated DPX-LC/ AppNote 1/2013 MS/MS screening method provides adequate sensitivity for all analytes and corresponding internal standards that were monitored. Lower limits of quantitation (LLOQ) were found to be 100 ng/mL for the barbiturates and 10 ng/mL for COOH-THC and % CVs were below 10 % in most cases. INTRODUCTION The continuously growing quantity of pain management sample extract for injection [1-2]. The extraction of the drugs used has increased the demand from toxicology Barbiturates and COOH-THC is based on the DPX-RP- laboratories for more reliable solutions to monitor S extraction method described in an earlier Application compliance in connection with substance abuse and/or Note detailing monitoring of 49 Pain Management diversion.
    [Show full text]
  • And Calcium, Magnesium, Potassium and Sodium Oxybates (Xywav™)
    Louisiana Medicaid Sodium Oxybate (Xyrem®) and Calcium, Magnesium, Potassium and Sodium Oxybates (Xywav™) The Louisiana Uniform Prescription Drug Prior Authorization Form should be utilized to request clinical authorization for sodium oxybate (Xyrem®) and calcium, magnesium, potassium and sodium oxybates (Xywav™). These agents have Black Box Warnings and are subject to Risk Evaluation and Mitigation Strategy (REMS) under FDA safety regulations. Please refer to individual prescribing information for details. Approval Criteria • The recipient is 7 years of age or older on date of request; AND • The recipient has a documented diagnosis of narcolepsy or cataplexy; AND • The prescribing provider is a Board-Certified Neurologist or a Board-Certified Sleep Medicine Physician; AND • By submitting the authorization request, the prescriber attests to the following: o The prescribing information for the requested medication has been thoroughly reviewed, including any Black Box Warning, Risk Evaluation and Mitigation Strategy (REMS), contraindications, minimum age requirements, recommended dosing, and prior treatment requirements; AND o All laboratory testing and clinical monitoring recommended in the product prescribing information have been completed as of the date of the request and will be repeated as recommended; AND o The recipient has no inappropriate concomitant drug therapies or disease states. Duration of initial authorization approval: 3 months Reauthorization Criteria • The recipient continues to meet all initial approval criteria; AND
    [Show full text]
  • Prescription Drug Management
    Check out our new site: www.acllaboratories.com Prescription Drug Management Non Adherence, Drug Misuse, Increased Healthcare Costs Reports from the Centers for DiseasePrescription Control and Prevention (CDC) say Drug deaths from Managementmedication overdose have risen for 11 straight years. In 2008 more than 36,000 people died from drug overdoses, and most of these deaths were caused by prescription Nondrugs. Adherence,1 Drug Misuse, Increased Healthcare Costs The CDC analysis found that nearly 40,000 drug overdose deaths were reported in 2010. Prescribed medication accounted for almost 60 percent of the fatalities—far more than deaths from illegal street drugs. Abuse of painkillers like ReportsOxyContin from and the VicodinCenters forwere Disease linked Control to the and majority Prevention of the (CDC) deaths, say deaths from according to the report.1 medication overdose have risen for 11 straight years. In 2008 more than 36,000 people died from drug overdoses, and most of these deaths were caused by prescription drugs. 1 A health economics study analyzed managed care claims of more than 18 million patients, finding that patients undergoing opioid therapyThe CDCfor chronic analysis pain found who that may nearly not 40,000 be following drug overdose their prescription deaths were regimenreported in 2010. Prescribed medication accounted for almost 60 percent of the fatalities—far more than deaths have significantly higher overall healthcare costs. from illegal street drugs. Abuse of painkillers like OxyContin and Vicodin were linked to the majority of the deaths, according to the report.1 ACL offers drug management testing to provide information that can aid clinicians in therapy and monitoring to help improve patientA health outcomes.
    [Show full text]
  • Additional Requested Drugs
    PART 1 PART PATIENT PRESCRIBED MEDICATIONS: o ACTIQ o DESIPRAMINE o HYDROCODONE o MORPHINE o ROXICODONE o ADDERALL o DIAZEPAM* o HYDROMORPHONE o MS CONTIN o SOMA o ALPRAZOLAM* o DILAUDID o IMIPRAMINE o NEURONTIN o SUBOXONE o AMBIEN o DURAGESIC o KADIAN o NORCO o TEMAZEPAM o AMITRIPTYLINE o ELAVIL o KETAMINE o NORTRIPTYLINE o TRAMADOL* o ATIVAN o EMBEDA o KLONOPIN o NUCYNTA o TYLENOL #3 o AVINZA o ENDOCET o LORAZEPAM o OPANA o ULTRAM o BUPRENEX o FENTANYL* o LORTAB o OXYCODONE o VALIUM o BUPRENORPHINE o FIORICET o LORCET o OXYCONTIN o VICODIN o BUTRANS o GABAPENTIN o LYRICA o PERCOCET o XANAX o CLONAZEPAM* o GRALISE o METHADONE o RESTORIL TO RE-ORDER CALL RITE-PRINT 718/384-4288 RITE-PRINT CALL TO RE-ORDER ALLIANCE DRUG PANEL (SEE BELOW) o ALCOHOL o BARBITURATES o ILLICITS o MUSCLE RELAXANTS o OPIODS (SYN) ETHANOL PHENOBARBITAL 6-MAM (HEROIN)* CARISPRODOL FENTANYL* BUTABARBITAL a-PVP MEPROBAMATE MEPERIDINE o AMPHETAMINES SECOBARBITAL BENZOYLECGONINE NALOXONE AMPHETAMINE PENTOBARBITAL LSD o OPIODS (NATURAL) METHADONE* METHAMPHETAMINE BUTALBITAL MDA CODEINE METHYLPHENEDATE MDEA MORPHINE o NON-OPIOID o BENZODIAZEPINES MDMA ANALGESICS o OPIODS (SEMI-SYN) o ANTICONVULSIVES ALPRAZOLAM* MDPV TRAMADOL BUPRENORPHINE* GABAPENTIN CLONAZEPAM* MEPHEDRONE TAPENTADOL DIHROCODEINE PREGABALIN DIAZEPAM METHCATHINONE DESOMORPHINE o NON-BENZODIAZEPINE FLUNITRAZEPAM* METHYLONE HYDROCODONE HYPNOTIC o ANTIDEPRESSANTS FLURAZEPAM* PCP HYDROMORPHONE ZOLPIDEM* AMITRIPTYLINE LORAZEPAM THC* OXYCODONE DOXEPIN OXAZEPAM CBD ° OXYMORPHONE o MISCELLANEOUS DRUGS IMIPRIMINE
    [Show full text]
  • Nembutal [Pentobarbital] Injection and Seconal [Secobarbital] Capsules
    Pharmacy Benefit Coverage Criteria Effective Date .......................................... 12/1/2020 Next Review Date… ................................... 12/1/2021 Coverage Policy Number ................................ P0095 Nembutal [pentobarbital] injection and Seconal [secobarbital] capsules Table of Contents Related Coverage Resources Overview .............................................................. 1 Coverage Policy ................................................... 1 FDA Summary ..................................................... 1 General Background ............................................ 2 References .......................................................... 2 INSTRUCTIONS FOR USE The following Coverage Policy applies to health benefit plans administered by Cigna Companies. Certain Cigna Companies and/or lines of business only provide utilization review services to clients and do not make coverage determinations. References to standard benefit plan language and coverage determinations do not apply to those clients. Coverage Policies are intended to provide guidance in interpreting certain standard benefit plans administered by Cigna Companies. Please note, the terms of a customer’s particular benefit plan document [Group Service Agreement, Evidence of Coverage, Certificate of Coverage, Summary Plan Description (SPD) or similar plan document] may differ significantly from the standard benefit plans upon which these Coverage Policies are based. For example, a customer’s benefit plan document may contain a specific
    [Show full text]
  • Intravenous Anesthetics  a Drug That Induces Reversible Anesthesia  the State of Loss of Sensations, Or Awareness
    DR.MED. ABDELKARIM ALOWEIDI AL-ABBADI ASSOCIATE PROF. FACULTY OF MEDICINE THE UNIVERSITY OF JORDAN Goals of General Anesthesia Hypnosis (unconsciousness) Amnesia Analgesia Immobility/decreased muscle tone (relaxation of skeletal muscle) Reduction of certain autonomic reflexes (gag reflex, tachycardia, vasoconstriction) Intravenous Anesthetics A drug that induces reversible anesthesia The state of loss of sensations, or awareness. Either stimulates an inhibitory neuron, or inhibits an excitatory neuron. Organs are divided according to blood perfusion: High- perfusion organs (vessel-rich); brain takes up disproportionately large amount of drug compared to less perfused areas (muscles, fat, and vessel-poor groups). After IV injection, vessel-rich group takes most of the available drug Drugs bound to plasma proteins are unavailable for uptake by an organ After highly perfused organs are saturated during initial distribution, the greater mass of the less perfused organs continue to take up drug from the bloodstream. As plasma concentration falls, some drug leaves the highly perfused organs to maintain equilibrium. This redistribution from the vessel-rich group is responsible for termination of effect of many anesthetic drugs. Compartment Model Inhibitory channels : GABA-A channels ( the main inhibitory receptor). Glycine channels. Excitatory channels : Neuronal nicotic. NMDA. Rapid onset (mainly unionized at physiological pH) High lipid solubility Rapid recovery, no accumulation during prolonged infusion Analgesic
    [Show full text]
  • Veterinary Anesthetic and Analgesic Formulary 3Rd Edition, Version G
    Veterinary Anesthetic and Analgesic Formulary 3rd Edition, Version G I. Introduction and Use of the UC‐Denver Veterinary Formulary II. Anesthetic and Analgesic Considerations III. Species Specific Veterinary Formulary 1. Mouse 2. Rat 3. Neonatal Rodent 4. Guinea Pig 5. Chinchilla 6. Gerbil 7. Rabbit 8. Dog 9. Pig 10. Sheep 11. Non‐Pharmaceutical Grade Anesthetics IV. References I. Introduction and Use of the UC‐Denver Formulary Basic Definitions: Anesthesia: central nervous system depression that provides amnesia, unconsciousness and immobility in response to a painful stimulation. Drugs that produce anesthesia may or may not provide analgesia (1, 2). Analgesia: The absence of pain in response to stimulation that would normally be painful. An analgesic drug can provide analgesia by acting at the level of the central nervous system or at the site of inflammation to diminish or block pain signals (1, 2). Sedation: A state of mental calmness, decreased response to environmental stimuli, and muscle relaxation. This state is characterized by suppression of spontaneous movement with maintenance of spinal reflexes (1). Animal anesthesia and analgesia are crucial components of an animal use protocol. This document is provided to aid in the design of an anesthetic and analgesic plan to prevent animal pain whenever possible. However, this document should not be perceived to replace consultation with the university’s veterinary staff. As required by law, the veterinary staff should be consulted to assist in the planning of procedures where anesthetics and analgesics will be used to avoid or minimize discomfort, distress and pain in animals (3, 4). Prior to administration, all use of anesthetics and analgesic are to be approved by the Institutional Animal Care and Use Committee (IACUC).
    [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]
  • 2019 01 07 Classification Substances
    DRUG TESTING STANDARDS AND PRACTICES PROGRAM. Uniform Classification Guidelines for Foreign Substances And Recommended Penalties Model Rule. January, 2019 (V.14.0) © ASSOCIATION OF RACING COMMISSIONERS INTERNATIONAL – 2019. Association of Racing Commissioners International 2365 Harrodsburg Road- B450 Lexington, Kentucky, USA www.arci.com Page 1 of 66 Preamble to the Uniform Classification Guidelines of Foreign Substances The Preamble to the Uniform Classification Guidelines was approved by the RCI Drug Testing and Quality Assurance Program Committee (now the Drug Testing Standards and Practices Program Committee) on August 26, 1991. Minor revisions to the Preamble were made by the Drug Classification subcommittee (now the Veterinary Pharmacologists Subcommittee) on September 3, 1991. "The Uniform Classification Guidelines printed on the following pages are intended to assist stewards, hearing officers and racing commissioners in evaluating the seriousness of alleged violations of medication and prohibited substance rules in racing jurisdictions. Practicing equine veterinarians, state veterinarians, and equine pharmacologists are available and should be consulted to explain the pharmacological effects of the drugs listed in each class prior to any decisions with respect to penalities to be imposed. The ranking of drugs is based on their pharmacology, their ability to influence the outcome of a race, whether or not they have legitimate therapeutic uses in the racing horse, or other evidence that they may be used improperly. These classes of drugs are intended only as guidelines and should be employed only to assist persons adjudicating facts and opinions in understanding the seriousness of the alleged offenses. The facts of each case are always different and there may be mitigating circumstances which should always be considered.
    [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]
  • International Classification of Diseases
    INTERNATIONAL CLASSIFICATION OF DISEASES MANUAL OF THE INTERNATIONAL STATISTICAL CLASSIFICATION OF DISEASES, INJURIES, AND CAUSES OF DEATH Based on the Recommendations of the Eighth Revision Conference, 1965, and Adopted by the Nineteenth World Health Assembly Volume 2 ALPHABETICAL INDEX WORLD HEALTH ORGANIZATION GENEVA 1969 Volume 1 Introduction List of Three-digit Categories Tabular List of Inclusions and Four-digit Sub- categories Medical Certification and Rules for Classification Special Lists for Tabulation Definitions and Recommendations Regulations Volume 2 Alphabetical Index PRINTED IN ENGLAND CONTENTS Introduction Page General arrangement of the Index ....................................... VIII Main sections ............................................................... VIII Structure ..................................................................... IX Code numbzrs .............................................................. x Primary and secondary conditions. ................................... x Multiple diagnoses. ........................................................ XI Spelling....................................................................... XI Order of listing ............................................................. Conventions used in the Index ........................................... XII Parentheses. ................................................................. XII Cross-referexes ........................................................... XI1 Abbreviation NEC. ......................................................
    [Show full text]