DOCSLIB.ORG

The Effect of Ethanol on Residual Plasma Methaqualone Concentrations and Behaviour in Volunteers Who Have Taken Mandrax

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Effect of Ethanol on Residual Plasma Methaqualone Concentrations and Behaviour in Volunteers Who Have Taken Mandrax Br. J. clin. Pharmac. (1977), 4 LETTERS TO THE EDITORS 245 In conclusion, butriptyline produces mild HARTMANN, E. & CRAVENS, J. (1973). Long-term sedation and promotes sleep, but it is also possible drug effects on human sleep. In Sleep, ed. Koella, W.P. to detect a sleep-disturbing action of a type found & Levin, P., pp. 477-485. Basel: S. Karger. with other tricyclic drugs. Compared with other JARAMILLO, J. & GREENBERG, R. (1975). Com- parative pharmacological studies on butriptyline and related drugs butriptyline causes less unpleasant some related standard tricycic antidepressants. Can. J. subjective effects. PhysioL Pharmac., 53, 104-112. MILLER, R.G. (1966). Simultaneous Statistical Inference. VLASTA BREZINOVA, SHARON BORROW, I. New York: McGraw-Hill. OSWALD & DOROTHY ROBINSON OSWALD, I. LEWIS, S.A., DUNLEAVY, D., BREZINOVA, V. & BRIGGS, M. (1971). Drugs of University Department of Psychiatry, Royal dependence though not of abuse: fenfluramine and Edinburgh Hospital, Morningside Park, Edinburgh imipramine. Br. med. J., 3, 70-73. EH10 SHF, Scotland OSWALD, I., BkEZINOVA, V. & DUNLEAVY, D. (1972). On the slowness of action of tricyclic Received October 4, 1976 antidepressant drugs. Br. J. Psychiat., 120, 673-677. PUGSLEY, T.A. & LIPPMANN, W. (1974). Effect of butriptyline on the brain uptake mechanisms for noradrenaline and 5-hydroxytryptamine. J. Pharm. References Pharmac., 26, 778-782. RECHTSCHAFFEN, A. & KALES, A. (1968). A Manual DUNLEAVY, D., BkEZINOVA, V., OSWALD, I., of Standardized Terminology, Techniques and Scoring MACLEAN, A. & TINKER, M. (1972). Changes System for Sleep Stages of Human Subjects. Washing- during weeks in effects of tricyclic drugs on the ton, D.C.: U.S. Government Printing Office, N.I.H. human sleeping brain. Br. J. Psychiat., 120, 663-672. publication no. 204. GRIVOIS, H. (1971). Butriptyline, a new antidepressant SIEGEL, S. (1956). Nonparametric Statistics for the compound. J. Med. (Basel), 2, 276-289. Behavioural Sciences. New York: McGraw-Hill. THE EFFECT OF ETHANOL ON RESIDUAL PLASMA METHAQUALONE CONCENTRATIONS AND BEHAVIOUR IN VOLUNTEERS WHO HAVE TAKEN MANDRAX It has been demonstrated that hypnotics with long Twelve healthy volunteers, six male and six half lives impair performance in both simple and female, aged 21-39 years took part in the trial. complex tasks several hours after their therapeutic They normally drank alcohol only in moderation effect has ceased (Malpas, Rowan, Joyce & Scott, and were receiving no other current medication. 1970; Borland & Nicholson, 1975; Bond & Lader, During the course of the study they were 1975). We have undertaken a preliminary study to requested to abstain from alcohol for 10 h prior to investigate the possibility that ethanol might taking the hypnotic until the tests were complete interact with residual concentrations of Mandrax on the third evening each week. The subjects were present 24, 48 and 72 h after a single dose and so allocated at random under double blind conditions produce even greater impairment of performance to each of the following three treatments which on behavioural tests than either alcohol or drug were arranged in a fully balanced design over three alone. Since recent reports have shown that consecutive weeks. ethanol may modify drug concentrations in body fluids (Mould, Curry & Binns, 1972; Rubin, Gang, A Two Mandrax tablets (methaqualone 250 mg, Misra & Leiber, 1970) and earlier studies (Swaby, diphenhydramine hydrochloride 25 mg) to be 1973; Williams, 1975) have indicated that it taken at 22 h 30 min on day 1 and a weight interacts with methaqualone residues to modify related dose of flavoured ethanol mixture (0.5 g performance, plasma levels of the drug were ethanol/kg) at 17 h 30 min on each of the measured on each evening of the study to establish following three evenings. any possible relationship between behavioural B Two Mandrax placebo tablets and ethanol as in changes and differences in drug concentrations. A. 246 LETTERS TO THE EDITORS Br. J. clin. Pharmac. (1977), 4 1.2_ Ratings on the VAS showed an interaction between residual methaqualone and ethanol. Treatment A induced greater mental and physical -gE 1.0_X sedation on the third evening than ethanol alone. Similarly the Stroop test showed a significant c 0 reduction in cognitive skills on the third evening (P < 0.01). Differences in KVA were not signifi- cantly different on any occasion but this may have been due to the very large effect of ethanol alone Eco 0.6 - which could have swamped any small change due to the presence of methaqualone. E This preliminary study therefore showed that co 0.4 - residual levels of methaqualone present after a single dose of Mandrax will interact with ethanol 72 h later and result in greater subjective mental 0.2_ and physical sedation and impairment of cognitive tasks than either drug residual or ethanol alone. In addition, the regular moderate consumption of 01 ethanol resulted in higher methaqualone con- 24 48 72 centrations than those obtained after placebo Time(h) alcohol. A similar investigation has been carried out Figure 1 Mean plasma methaqualone concentrations with nitrazepam (Mogadon®) using the same obtained from twelve volunteers, after two Mandrax study design. However, preliminary analysis shows tablets, who were subsequently challenged with that no interaction between nitrazepam and placebo (e) and alcohol (a) mixtures. alcohol can be detected in any of the tests carried out during the three evenings after the drug was taken. Information on plasma nitrazepam levels is not at present available. C Two Mandrax tablets and a similar volume of The authors would like to thank Roussel Laboratories Ltd placebo alcohol mixture which contained a for a grant towards the cost of this study. little ethanol to impart the characteristic smell and taste. S. RODEN, P. HARVEY' & M. MITCHARD On each of the three evenings following the Department of Therapeutics & Clinical ingestion of the tablets, the volunteers were Pharmacology and 1 Department of Psychiatry, required to complete a visual analogue scale (VAS) Queen Elizabeth Hospital, Birmingham B15 2TH (Norris, 1971) in order to measure subjective feelings, including those of mental and physical Received August 11, 1976 sedation. They then received the dose of alcohol or placebo mixture which they sipped slowly over 10 min. Twenty minutes later a blood sample was withdrawn for assay of blood ethanol (Curry, Walker & Simpson, 1966) and plasma metha- References qualone (Mitchard & Williams, 1972) concentra- BOND, A.J. & LADER, M.H. (1975). Residual effects of tions by g.l.c. A second VAS was then completed flunitrazepam. Br. J. clin. Pharmac., 2, 143-150. and measurements of kinetic visual acuity (KVA) BORLAND, R.G. & NICHOLSON, A.N. (1975). Com- (Clayton, 1972) and cognitive skills using the parison of the residual effects of two benzodiazepines Stroop Colour Word test (Stroop. 1935; Jensen & (nitrazepam and flurazepam hydrochloride) and Rohwer, 1966; Dyer, 1973) were made. pentobarbitone sodium on human performance. Br. J. The mean plasma methaqualone concentrations clin. Pharmac., 2, 9-17. detected after treatments A (Mandrax + ethanol) CLAYTON, A.B. (1972). The effects of certain tran- + quilUisers and alcohol upon kinetic visual acuity. and C (Mandrax placebo alcohol) are shown in Proceedings of the 16th conference of the American Figure 1. Although the levels obtained on the first Association for Automotive Medicine, Chapel Hill evenings were similar they were subsequently N.C. 199-215. higher after treatment A than C, the difference CURRY, A.S., WALKER, G.W. & SIMPSON, G.S. (1966). being highly significant on the third evening The determination of ethanol in blood by gas (P < 0.005). chromatography. Analyst, 91, 742-743. Br. J. clin. Pharmac. (1977), 4 LETTERS TO THE EDITORS 247 DYER, F.N. (1973). The Stroop phenomenon and its use NORRIS, H. (1971). The action of sedatives on brain in the study of perceptual, cognitive and response stem oculomotor systems in man. Neuropharmac., 10, processes. Memory and Cognition, 1, 106-120. 181-191. JENSEN, A. & ROHWER, W. (1966). The Stroop Colour RUBIN, E., GANG, H., MISRA, P.S. & LIEBER, C.S. Word Test. A review. Acta Psychologica, 25, 36-93. (1970). Inhibition of drug metabolism by acute MALPAS, A., ROWAN, A.J., JOYCE, C.R.B. & SCOTT, ethanol intoxication. A hepatic microsomal D.F. (1970). Persistent behavioural and electro- mechanism. Am. J. Med., 49, 801-806. encephalographic changes after single doses of STROOP, J.R. (1935). Studies of interference in serial nitrazepam and amylobarbitone sodium. Br. med. J., verbal reactions. J. exp. PsychoL, 18, 643.662. 2, 762-764. SWABY, M.C.A. (1973). The effects of Mandrax with MITCHARD, M. & WILLIAMS, M.E. (1972). An alcohol. Unpublished M.Sc. dissertation, University of improved quantitative gas liquid chromatographic Birmingham. assay for the estimation of methaqualone in biological WILLIAMS, M.E. (1975). Biopharmaceutical studies on fluids. J. Chromatog., 72, 29-34. methaqualone. Unpublished Ph.D. Thesis, University MOULD, G.P., CURRY, S.H. & BINNS, T.B. (1972). of Birmingham. Interaction of glutethimide and phenobarbitone with ethanol in man. J. Pharm. Pharmac., 24, 894-899. PLASMA URIC ACID AND SPIRONOLACTONE RESPONSE IN HEALTHY SUBJECTS In healthy subjects treated with fludrocortisone sodium and potassium concentration by flame there was a negative relationship between plasma photometry using lithium as the internal standard; uric acid concentration (PUA) and the urinary creatinine by an automated method and canrenone log 10 Na/K ratio following single doses of by a fluorimetric method (Gochman & Gantt, the aldosterone antagonist spironolactone 1962). Statistical methods used were the analysis (Aldactone®, Searle) (Ramsay, Hessian & Tidd, of variance and product moment correlations. Log 1975), a finding which has been confirmed in transformation of the urine Na/K ratio was used as subsequent unpublished studies. Interpretation of this provides a sensitive index of response to these observations has been hampered by the mineralocorticoid antagonists (Ramsay, Harrison, complexity of the studies, involving as they did Shelton & Tidd, 1975).
Load more

Recommended publications
  • Date Rape and Steroid Panels, Updated Feb 1 2010
    DRUG-FACILITATED SEXUAL ASSAULT (aka “DATE RAPE”) AND STEROID PANELS (Effective January 26, 2010) Basic Date Rape Panel Comprehensive Date Rape Panel • GHB (Hair Only) • Ketamine • GHB • Benzodiazepines, including Rohypnol • Benzodiazepines Alprazolam Clonazepam Alprazolam Clonazepam Diazepam Flunitrazepam (Rohypnol) Diazepam Flunitrazepam Lorazepam Oxazepam Lorazepam Oxazepam Temazepam Nitrazepam Temazepam Nitrazepam • Opioids Codeine Hydrocodone Comprehensive Date Rape Panel Meperidine Tramadol (Urine Only) Methadone Fentanyl • GHB • Sedatives/Hypnotics Ketamine Methaqualone • Barbiturates Zolpidem Zopiclone Amobarbital Butalbital Pentobarbital Phenobarbital • Over-The-Counter Drugs Secobarbital Diphenhydramine Dextromethorphan Doxylamine Chlorpheniramine • Benzodiazepines Brompheniramine Promethazine Alprazolam Clonazepam Pheniramine Diazepam Flunitrazepam Lorazepam Oxazepam • Muscle Relaxants Temazepam Nitrazepam Carisoprodol Meprobamate • Opioids Cyclobenzaprine Methocarbamol Codeine Morphine • Hallucinogens (PCP) Hydrocodone Hydromorphone Oxycodone Oxymorphone Meperidine Tramadol ANABOLIC STEROID PANEL Methadone Fentanyl (Urine or Blood) Propoxyphene Buprenorphine Androstenedione Boldenone • Sedatives/Hypnotics Fluoxymesterolone Mesterolone Ketamine Methaqualone 17-a-Methyltestosterone Methenolone Zolpidem Zopiclone Methandrostenolone Nandrolone • Over-The-Counter Drugs Norethandrolone Oxandrolone Diphenhydramine Dextromethorphan Stanozolol Trenbolone Doxylamine Chlorpheniramine Brompheniramine Promethazine Pheniramine For additional steroids, • Muscle Relaxants call for details and pricing Carisoprodol Meprobamate EXPERTOX, INC. Cyclobenzaprine Methocarbamol Blood should only be 1803 CENTER STREET, SUITE A submitted for date rape • Hallucinogens DEER PARK, TX 77536 PCP MDMA panels if within five (5) hours of 281.476.4600 MDA MDEA ingestion. FAX 281.930.8856 Cannabinoids (Carboxy-THC) • WWW.EXPERTOX.COM Turaround Time: Ten (10) Urine must be collected within five (5) days business days from specimen of drug exposure receipt at the lab .
    [Show full text]
  • Fatal Toxicity of Antidepressant Drugs in Overdose
    BRITISH MEDICAL JOURNAL VOLUME 295 24 OCTOBER 1987 1021 Br Med J (Clin Res Ed): first published as 10.1136/bmj.295.6605.1021 on 24 October 1987. Downloaded from PAPERS AND SHORT REPORTS Fatal toxicity of antidepressant drugs in overdose SIMON CASSIDY, JOHN HENRY Abstract dangerous in overdose, thus meriting investigation of their toxic properties and closer consideration of the circumstances in which A fatal toxicity index (deaths per million National Health Service they are prescribed. Recommendations may thus be made that prescriptions) was calculated for antidepressant drugs on sale might reduce the number offatalities. during the years 1975-84 in England, Wales, and Scotland. The We used national mortality statistics and prescription data tricyclic drugs introduced before 1970 had a higher index than the to compile fatal toxicity indices for the currently available anti- mean for all the drugs studied (p<0-001). In this group the depressant drugs to assess the comparative safety of the different toxicity ofamitriptyline, dibenzepin, desipramine, and dothiepin antidepressant drugs from an epidemiological standpoint. Owing to was significantly higher, while that ofclomipramine, imipramine, the nature of the disease these drugs are particularly likely to be iprindole, protriptyline, and trimipramine was lower. The mono- taken in overdose and often cause death. amine oxidase inhibitors had intermediate toxicity, and the antidepressants introduced since 1973, considered as a group, had significantly lower toxicity than the mean (p<0-001). Ofthese newer drugs, maprotiline had a fatal toxicity index similar to that Sources ofinformation and methods of the older tricyclic antidepressants, while the other newly The statistical sources used list drugs under their generic and proprietary http://www.bmj.com/ introduced drugs had lower toxicity indices, with those for names.
    [Show full text]
  • National Clearinghouse for Drug Abuse Information Selected Reference Series, Series 1, No
    DOCUMENT RESOHE ED 090 455 CG 008 832 TITLE National Clearinghouse For Drug Abuse Information Selected Reference Series, Series 1, No. 1. INSTITUTION National Inst. of Mental Health (DHEW), Rockville, Hd. National Clearinghouse for Drug Abuse Information.; Student Association for the Study of Hallucinogens, Biloit, His. PDB DATE Nov 73 NOTE 13p. AVAILABLE FROM National Clearinghouse for Drug Abuse Information, p. 0. Box 1908, Rockville, Maryland 20850 EDRS PRICE MF-10.75 HC-S1.50 PLUS POSTAGE DESCRIPTORS ^Bibliographies; *Drug Abuse; *Drug Education; *Drug Therapy; Government Publications; ^Narcotics ABSTRACT One of a series of bibliographies published by the National Clearinghouse for Drug Abuse Information, this reference focuses on the drug, methagualone. Literature is selected for inclusion on the basis of its currency, significance in the field, and its availability to the public. Materials are directed toward researchers, educators, lawyers, physicians, and members of the public with more than a general need for information. Citations are not annotated. (Author/CJ) SERIES 7, No.l NOVEMBER 1973 Each bibliography of the National Clearinghouse for Drug Abuse 3- Information Selected Reference Series is a representative listing of citations on subjects of topical interest. The selection of o literature is based on its currency, its significance in the field, and its availability in local bookstores or research libraries. The scope of the material is directed toward students writing research papers, special interest groups, such as educators, lawyers and phy­ sicians, and the general public requiring more resources than public information materials can provide. Each reference series is meant to present an overview of the existing literature, but is not meant to be comprehensive or definitive in scope.
    [Show full text]
  • Chemistry Information Sheet Methaqualone © 2014 Beckman Coulter, Inc
    SYNCHRON System(s) METQ Chemistry Information Sheet Methaqualone © 2014 Beckman Coulter, Inc. All rights reserved. 475021 For In Vitro Diagnostic Use Rx Only ANNUAL REVIEW Reviewed by Date Reviewed by Date PRINCIPLE INTENDED USE METQ reagent, in conjunction with UniCel® DxC 600/800 System(s) and SYNCHRON® Systems Drugs of Abuse Testing (DAT) Urine Calibrators, is intended for the qualitative determination of methaqualone in human urine at a cutoff value of 300 ng/mL. The METQ assay provides a rapid screening procedure for determining the presence of methaqualone (METQ) and its metabolites in urine. This test provides only a preliminary analytical result; a positive result by this assay should be conrmed by another generally accepted non-immunological method such as thin layer chromatography (TLC), gas chromatography (GC), or gas chromatography/mass spectrometry (GC/MS). GC/MS is the preferred conrmatory method.1,2 Clinical consideration and professional judgement should be applied to any drug of abuse test result, particularly when preliminary positive results are used. CLINICAL SIGNIFICANCE Measurements of methaqualone are used as an aid in the diagnosis and treatment of methaqualone use or overdose. METHODOLOGY The Methaqualone assay utilizes a homogenous enzyme immunoassay method.3 The METQ reagent is comprised of specic antibodies which can detect methaqualone and its metabolites in urine. A drug-labeled glucose-6-phosphate dehydrogenase (G6PDH) conjugate competes with any free drug from the urine sample for a xed amount of antibody binding sites. In the absence of free drug from the sample, the drug-labeled G6PDH conjugate is bound by the specic antibody and the enzyme activity is inhibited.
    [Show full text]
  • Injecting Drug Users Etc.)
    Economic and Social Council E/NR/2015/3 Annual Reports Questionnaire Part Three. Extent and patterns of and trends in drug use Report of the Government of: Reporting Year: reporting. Completed on (date): (dd/mm/yyyy) Please upload completed questionnaire to: https://arq.unodc.org/ The completed annual report questionnaire is due on: official March 31, 2016 For technical support, contact: for Phone Fax Email UNODC Vienna (+43-1) 26060-3914 (+43-1) 26060-5866 [email protected] Not Note: This is a printable version of the annual report questionnaire, which is in the form of an Excel spreadsheet and is designed to be completed electronically. In this printable version, definitions of key terms used in the questionnairecopy. are provided in the footnotes, whenever relevant; in the electronic version, these definitions (and additional instructions) are repeated throughout the questionnaire through the “Comments” function in Excel. The Excel spreadsheet also uses drop-down lists for some questions, allowing respondents to simply select from a list the answer that is most appropriate for their country. Sample INSTRUCTIONS The annual report questionnaire consists of the following four parts: Part One. Legislative and institutional framework; Part Two. Comprehensive approach to drug demand reduction; Part Three. Extent, patterns and trends in drug use; Part Four. Extent and patterns of and trends in drug crop cultivation and drug manufacture and trafficking This is part three of the annual report questionnaire. Respondents are asked to complete all questions. Where no data are available, this should be indicated by inserting two dashes (--) or writing "not known" in the appropriate cell.
    [Show full text]
  • Cyclic Antidepressant Drugs SI Conversion: [AUQ: Dr
    834 II: THERAPEUTIC DRUGS 127. Spiker DG, Pugh DD. Combining tricyclic and monoamine oxidase inhibi- 145. Chambost M, Liron L, Peillon D, et al. [Serotonin syndrome during fluoxetine tor antidepressants. Arch Gen Psychiatry 1976;33(7):828–830. poisoning in a patient taking moclobemide.] Can J Anaesth 2000;47(3):246– 128. Peebles-Brown AE. Hyperpyrexia following psychotropic drug overdose. 250. Anaesthesia 1985;40(11):1097–1099. 146. Myrenfors PG, Eriksson T, Sandsted CS, et al. Moclobemide overdose. J 129. Tuck JR, Punell G. Uptake of (3H)5-hydroxytryptamine and (3H)noradrenaline Intern Med 1993;233(2):113–115. by slices of rat brain incubated in plasma from patients treated with chlorimi- 147. Pounder DJ, Jones GR. Post-mortem drug redistribution––a toxicological pramine, imipramine or amitriptyline. J Pharm Pharmacol 1973;25(7):573–574. nightmare. Forensic Sci Int 1990;45(3):253–263. 130. Gillman PK. Successful treatment of serotonin syndrome with chlorproma- 148. Lichtenwalner MR, Tully RG, Cohn RD, et al. Two fatalities involving zine. Med J Aust 1996;165(6):345–346. phenelzine. J Anal Toxicol 1995;19(4):265–266. 131. Graham PM. Successful treatment of the toxic serotonin syndrome with 149. Yonemitsu K, Pounder DJ. Postmortem changes in blood tranylcypromine chlorpromazine. Med J Aust 1997;166(3):166–167. concentration: competing redistribution and degradation effects. Forensic 132. Tackley RM, Tregaskis B. Fatal disseminated intravascular coagulation fol- Sci Int 1993;59(2):177–184. lowing a monoamine oxidase inhibitor/tricyclic interaction. Anaesthesia 150. Baselt RC, Shaskan E, Gross EM. Tranylcypromine concentrations and 1987;42(7):760–763.
    [Show full text]
  • Butriptyline Hydrochloride and Imipramine Hydrochloride in the Treatment of Non -Psychotic Depression
    27 April 1974 S.-A. MEDIESE TYDSKRIF 873 Butriptyline Hydrochloride and Imipramine Hydrochloride in the Treatment of Non -Psychotic Depression A DOUBLE-BLIND TRIAL B. LEVINSON SUMMARY and reactive depression, anxiolysis and enuresis control in paediatrics, endogenous depression and involutional A comparison between butriptyline hydrochloride and melancholia, and the post-suicide syndrome.' The dosage one of the most widely-used tricyclic antidepressants, utilised by the investigators on their adult patients varied imipramine hydrochloride, was undertaken in 28 patients from 25 to 50 mg of butriptyline hydrochloride 3 - 4 suffering from non-psychotic depression in a double­ times per day. blind trial. Three criteria-side-effects, depression and The accurate assessment of psychiatric trials is fraught anxiety-were observed at each visit. The scoring system with difficulty. The terminology used is frequently mis­ representing degree of change from one visit to the other leading and often only applicable to separate and specific ranged from - 2 to +10, higher values indicating better schools of psychological thought. The patients themselves reactions to the drug. For each patient, the changes in supply the investigator with a subjective impression which individual criteria were accumulated up to the patient's has to be objectively documented into a statistically last visit. The number of patient observations per pair meaningful format. If the psychiatric investigator writes at weekly or fortnightly intervals varied between 2 and down impressions such as good, worse, mild deterioration, 5. Butriptyline hydrochloride was superior to imipramine etc., these subjective descriptive impressions pertain to hydrochloride in accumulated change on all three criteria, his assessment of the patient on that specific day only, the difference being statistically significant at the 99% hence uniformity is lost.
    [Show full text]
  • METHAQUALONE Latest Revision: February 15, 1999
    METHAQUALONE Latest Revision: February 15, 1999 1. SYNONYMS CFR: Methaqualone CAS #: Base: 72-44-6 Hydrochloride: 340-56-7 Other Names: 2-Methyl-3-(2-methylphenyl)-4-(3H)-quinazolinone 2-Methyl-3-o-tolyl-4-(3H)-quinazolinone Dormogen Metolquizolone Mandrax MAOA Motolon Quaalude Sopor 2. CHEMICAL AND PHYSICAL DATA 2.1. CHEMICAL DATA Form Chemical Formula Molecular Weight Melting Point (°C) Base C16H14N2O 250.3 114-116 Hydrochloride C16H15N2OCl 286.8 255-265 2.2. SOLUBILITY Form A C E H M W Base *** S P *** PS I Hydrochloride S S I *** S PS 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 3. SCREENING TECHNIQUES 3.1. COLOR TESTS REAGENT COLOR PRODUCED Acidified cobalt thiocyanate Blue Fischer-Morris Pink 3.2. CRYSTAL TESTS REAGENT CRYSTALS FORMED Potassium permanganate solution Plates Sodium carbonate solution Needles 3.3. THIN-LAYER CHROMATOGRAPHY Visualization Acidified iodoplatinate solution Brown-violet Dragendorff spray Yellow-orange RELATIVE R1 COMPOUND System System System TLC6 TLC5 TLC7 mecloqualone 0.8 1.0 1.0 methaqualone 1.0 1.0 1.0 o-toluidine 1.3 1.6 1.6 3.4. GAS CHROMATOGRAPHY Methaqualone is a thermally stable compound well suited for gas chromatography. It may however, have a similar retention time with cocaine in certain temperature programs. Method MEQ-GCS1 Instrument: Gas chromatograph operated in split mode with FID Column: 5% phenyl/95% methyl silicone 12 m x 0.2 mm x 0.33 µm film thickness Carrier gas: Helium at 1.0 mL/min Temperatures: Injector: 270°C Detector: 280°C Oven program: 1) 175°C initial temperature for 1.0 min 2) Ramp to 275°C at 15°C/min 3) Hold final temperature for 3.0 min Injection Parameters: Split Ratio = 60:1, 1 µL injected Samples are to be dissolved in chloroform and filtered.
    [Show full text]
  • Incidence of and Risk Factors for Chronic Opioid Use Among Opioid-Naive Patients in the Postoperative Period
    Supplementary Online Content Sun EC, Darnall BD, Baker LC, Mackey S. Incidence of and risk factors for chronic opioid use among opioid-naïve patients in the postoperative period. JAMA Intern Med. Published online July 11, 2016. doi:10.1001/jamainternmed.2016.3298. eTable 1. List of CPT Codes eFigure. Sample Construction Flow Chart eTable 2. List of Drug Classes eTable 3. List of Medical Comorbidities and ICD-9 Codes eTable 4. Sample Summary Characteristics, by procedure eTable 5. Risk Factors for Chronic Opioid Use Following Surgery Among Opioid Naïve Patients This supplementary material has been provided by the authors to give readers additional information about their work. © 2016 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/29/2021 eTable 1. List of CPT codes CPT Codes Total Knee Arthroplasty1 27447 Total Hip Arthroplasty1 27130 Laparoscopic Cholecystectomy2 47562, 47563, 47564 Open Cholecystectomy3 47600, 47605, 47610 Laparoscopic Appendectomy4 44970, 44979 Open Appendectomy5 44950, 44960 Cesarean Section6 59510, 59514, 59515 FESS7 31237, 31240, 31254, 31255, 31256, 31267, 31276, 31287, 31288 Cataract Surgery8 66982, 66983, 66984 TURP9 52601, 52612, 52614 Simple Mastectomy10‐12 19301, 19302, 19303, 19180 © 2016 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/29/2021 eFigure. Sample Construction Flow Chart © 2016 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/29/2021 eTable 2.
    [Show full text]
  • Receptive-Field Size of S1 Cortical Neurones Is Altered by Methaqualone Via a GABA Mechanism
    THE CANADIAN JOURNAL OF NEUROLOGICAL SCIENCES Receptive-field Size of S1 Cortical Neurones is Altered by Methaqualone via a GABA Mechanism T.P. Hicks, T. Kaneko and J.-I. Oka ABSTRACT: Methaqualone (Mtq; quaaludes or 'ludes) is a controlled substance, having a molecular structure related to the imidiazobenzodiazepine series of drugs, that has gained some notoriety recently due to its history of widespread abuse on the street. Users report experiencing peripheral paresthesia and transient numbness on body parts receiving dense cutaneous innervation (lips, fingertips, etc.). Since the receptive-field (RF)-sizes of many primary somatosensory (SI) cortical neurones are controlled by local, gamma-aminobutyric acid (GABA)-mediated inhibitory processes, we tested Mtq to see whether its clinical symptoms might have a basis in an action through central GABA-mediated synaptic processes. This report supports this contention and describes a likely pharmacological mechanism involved as one being related to the Ro 15-1788-sensitive benzodiazepine (Bzd) recognition site(s) of the GABA receptor complex. RESUME: La taille du champ receptif des neurones corticaux SI est modifiee par la methaqualone via un mecanisme gabaergique La methaqualone (Mtq; quaaludes ou Tudes) est une substance controiee qui a une structure moleculaire reliee aux drogues de la famille des imidiazobenzodiazepines et qui a acquis une certaine notoriete recem- ment a cause d'abus largement repandus chez les usagers de drogues. lis rapportent eprouver des paresthesies peripheriques et des engourdissements transitoires des parties du corps pourvues d'une innervation cutanee dense (les levres, le bout des doigts etc.). Comme la taille du champ receptif de plusieurs neurones corticaux somesthesiques pri- maires (SI) est controiee par des processus inhibiteurs dont la mediation se fait par I'acide gamma-aminobutyrique (GABA), nous avons verifie si les symptomes cliniques de la Mtq pourraient etre en relation avec un mode d'action faisant appel aux processus synaptiques centraux a mediation GABAergique.
    [Show full text]
  • Antidepressants for Neuropathic Pain (Review)
    Antidepressants for neuropathic pain (Review) Saarto T, Wiffen PJ This is a reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library 2007, Issue 4 http://www.thecochranelibrary.com Antidepressants for neuropathic pain (Review) Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. TABLE OF CONTENTS HEADER....................................... 1 ABSTRACT ...................................... 1 PLAINLANGUAGESUMMARY . 2 BACKGROUND .................................... 2 OBJECTIVES ..................................... 3 METHODS ...................................... 3 RESULTS....................................... 5 DISCUSSION ..................................... 11 AUTHORS’CONCLUSIONS . 12 ACKNOWLEDGEMENTS . 12 REFERENCES ..................................... 13 CHARACTERISTICSOFSTUDIES . 19 DATAANDANALYSES. 65 Analysis 1.1. Comparison 1 Global improvement - number of patients with moderate pain relief or better, Outcome 1 Amitriptylineversusplacebo. 67 Analysis 1.2. Comparison 1 Global improvement - number of patients with moderate pain relief or better, Outcome 2 Desipraminevsplacebo. 68 Analysis 1.3. Comparison 1 Global improvement - number of patients with moderate pain relief or better, Outcome 3 Imipraminevsplacebo. 68 Analysis 1.4. Comparison 1 Global improvement - number of patients with moderate pain relief or better, Outcome 4 Other antidepressants vs placebo. ..... 69 Analysis 1.5. Comparison 1 Global improvement - number of patients
    [Show full text]
  • Ativan/LPD/PK-04 ATIVAN (LORAZEPAM)
    Ativan/LPD/PK-04 ATIVAN (LORAZEPAM) 1. NAME OF THE MEDICINAL PRODUCT ATIVAN 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Tablet contains 1.0 mg or 2.0 mg of lorazepam. 3. PHARMACEUTICAL FORM Oral Tablets DESCRIPTION Active ingredients, active moieties Lorazepam (INN) Lorazepam is a white or almost white, almost odorless crystalline powder. Practically insoluble in water; sparingly soluble in alcohol; slightly soluble in chloroform; sparingly or slightly soluble in dichloromethane. Chemical name 7-chloro-5-(o-chlorophenyl)-1,3-dihydro-3-hydroxy-2H-1,4-benzodiazepin-2-one. Structure H N O Cl N OH Cl Molecular formula C15H10Cl2N202 According to CDS V 6.0 dated: 02 August, 2018; Supersedes CDS V 5.0 dated: 02 June, 2017 Ativan/LPD/PK-04 Molecular weight 321.2 4. CLINICAL PARTICULARS 4.1. THERAPEUTIC INDICATIONS Short-term management of anxiety disorders, including the following: - Short-term relief of symptoms of anxiety - Generalized anxiety disorders - Anxiety in psychotic states - Anxiety associated with somatic symptoms - Anxiety associated with depression or depressive symptoms - Reactive anxiety Insomnia associated with anxiety Alcohol withdrawal Prevention of delirium tremens Surgical premedication Adjunctive therapy to standard antiemetic drugs for the prophylactic and symptomatic treatment of nausea and vomiting associated with cancer chemotherapy 4.2. POSOLOGY AND METHOD OF ADMINISTRATION Dosage and duration of therapy should be individualized. The lowest effective dose should be prescribed for the shortest duration possible. The risk of withdrawal and rebound phenomena is greater after abrupt discontinuation; therefore, the drug should be discontinued gradually (See section 4.4. Special warnings and precautions for use). Extension of the treatment period should not take place without re-evaluation of the need for continued therapy.
    [Show full text]