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Did Internet-Purchased Diet Pills Cause Serotonin Syndrome?
Did Internet-purchased diet pills cause serotonin syndrome? Phentermine also may have increased patient’s neuroleptic malignant syndrome risk s. G, age 28, presents to a tertiary® careDowden hospital Health Media with altered mental status. Six weeks ago she Mstarted taking phentermine, 37.5 mg/d, to lose weight. Her body mass indexCopyright is 24 kg/mFor2 (normal personal range), use only and she obtained the stimulant agent via the Internet. Her family reports Ms. G was very busy in the past week, staying up until 2 AM cleaning. They say she also was irritable with her 5-year-old son. Two days ago, Ms. G complained of fatigue and nausea without emesis. She went to bed early and did not awaken the next morning. Her sister found her in bed, minimally re- DIONISI sponsive to verbal stimuli, and brought her to the hospital. Patients have used phentermine as a weight-reducing IMAGES/SANDRA GETTY agent since the FDA approved this amphetamine-like © compound in 1960.1 Phentermine’s mechanism of ac- tion is thought to involve dopaminergic, noradrenergic, Kyoung Bin Im, MD and serotonergic effects.2 Stimulation of norepineph- Chief resident Internal medicine and psychiatry combined residency program rine (NE) release is its most potent effect, followed Departments of internal medicine and psychiatry by NE reuptake inhibition, stimulation of dopamine Jess G. Fiedorowicz, MD (DA) release, DA reuptake inhibition, stimulation of Associate in psychiatry serotonin (5-HT) release, and 5-HT reuptake inhibition Department of psychiatry (weak).3 Roy J. and Lucille A. Carver College of Medicine Because phentermine could in theory cause serotonin 4 University of Iowa syndrome, its use is contraindicated with monoamine Iowa City oxidase inhibitors (MAOIs) and not recommended with selective serotonin reuptake inhibitors (SSRIs).5 One case report describes an interaction between fl uox- etine and phentermine that appears consistent with se- rotonin syndrome.6 We are aware of no case reports of Current Psychiatry serotonin syndrome caused by phentermine alone. -
Screening/Spot Test of Narcotics
Indian Journal of Forensic and Community Medicine 2020;7(4):160–165 Content available at: https://www.ipinnovative.com/open-access-journals Indian Journal of Forensic and Community Medicine Journal homepage: https://www.ipinnovative.com/journals/IJFCM Review Article Screening/spot test of narcotics A K Jaiswal1,*, Kamna Sharma2, Rohit Kanojia3, Sally Lukose4 1Dept. of Forensic Medicine & Toxicology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India 2Galgotias University, Greater Noida, Uttar Pradesh, India 3Dept. of Chemistry, University of Delhi, New Delhi, India 4CTM-IRTE, Faridabad, Haryana, India ARTICLEINFO ABSTRACT Article history: Narcotics are the substances used to treat moderate to severe pain. They could be natural like opiates such Received 25-11-2020 as morphine, codeine etc., synthetic like fentanyl, methadone etc., and semi-synthetic like oxycodone, Accepted 02-12-2020 hydrocodone etc. These drugs act as pain relievers, induces the state of stupor or sleep, and increase Available online 08-01-2021 the physical dependence on them. In forensic autopsy case, the forensic pathologist may require a complete toxicological investigation for different poisons including stimulants. In India, Forensic Science Laboratories run by Government under the Home ministry usually carry out this. The samples must be Keywords: analysed by the forensic toxicologist/chemists/scientist. This article deals with the screening/spot test for Narcotics narcotics. It attempts to simplify the standard procedures in a step-wise manner, which can be of handy Screening reference for the forensic toxicologist. Spot test Drugs © This is an open access article distributed under the terms of the Creative Commons Attribution Opioids etc License (https://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. -
Federal Register/Vol. 79, No. 39/Thursday, February 27, 2014/Rules and Regulations
Federal Register / Vol. 79, No. 39 / Thursday, February 27, 2014 / Rules and Regulations 10985 (2) Turkeys— Combination in Zoalene in grams/ton grams per ton Indications for use Limitations Sponsor (i) 113.5 to 170.3 ..... ................................. Growing turkeys: For prevention and con- Feed continuously as sole ration. For tur- 054771 trol of coccidiosis. keys grown for meat purposes only. Do not feed to laying birds. (ii) 113.5 to 170.3 .... Bacitracin methylene Growing turkeys: For prevention and con- Feed continuously as sole ration until 14 054771 disalicylate 4 to 50. trol of coccidiosis; and for increased to 16 weeks of age. For turkeys grown rate of weight gain and improved feed for meat purposes only. Do not feed to efficiency. laying birds. Dated: February 3, 2014. Legal Authority initiated by the Attorney General (1) on Bernadette Dunham, The DEA implements and enforces his own motion; (2) at the request of the Director, Center for Veterinary Medicine. titles II and III of the Comprehensive Secretary of the Department of Health 1 [FR Doc. 2014–02617 Filed 2–26–14; 8:45 am] Drug Abuse Prevention and Control Act and Human Services (HHS), or (3) on the petition of any interested party. 21 BILLING CODE 4160–01–P of 1970, as amended. Titles II and III are referred to as the ‘‘Controlled U.S.C. 811(a). This action is based on a Substances Act’’ and the ‘‘Controlled recommendation from the Assistant DEPARTMENT OF JUSTICE Substances Import and Export Act,’’ Secretary of the HHS and on an respectively, and are collectively evaluation of all other relevant data by Drug Enforcement Administration referred to as the ‘‘Controlled the DEA. -
(12) Patent Application Publication (10) Pub. No.: US 2006/0110428A1 De Juan Et Al
US 200601 10428A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2006/0110428A1 de Juan et al. (43) Pub. Date: May 25, 2006 (54) METHODS AND DEVICES FOR THE Publication Classification TREATMENT OF OCULAR CONDITIONS (51) Int. Cl. (76) Inventors: Eugene de Juan, LaCanada, CA (US); A6F 2/00 (2006.01) Signe E. Varner, Los Angeles, CA (52) U.S. Cl. .............................................................. 424/427 (US); Laurie R. Lawin, New Brighton, MN (US) (57) ABSTRACT Correspondence Address: Featured is a method for instilling one or more bioactive SCOTT PRIBNOW agents into ocular tissue within an eye of a patient for the Kagan Binder, PLLC treatment of an ocular condition, the method comprising Suite 200 concurrently using at least two of the following bioactive 221 Main Street North agent delivery methods (A)-(C): Stillwater, MN 55082 (US) (A) implanting a Sustained release delivery device com (21) Appl. No.: 11/175,850 prising one or more bioactive agents in a posterior region of the eye so that it delivers the one or more (22) Filed: Jul. 5, 2005 bioactive agents into the vitreous humor of the eye; (B) instilling (e.g., injecting or implanting) one or more Related U.S. Application Data bioactive agents Subretinally; and (60) Provisional application No. 60/585,236, filed on Jul. (C) instilling (e.g., injecting or delivering by ocular ion 2, 2004. Provisional application No. 60/669,701, filed tophoresis) one or more bioactive agents into the Vit on Apr. 8, 2005. reous humor of the eye. Patent Application Publication May 25, 2006 Sheet 1 of 22 US 2006/0110428A1 R 2 2 C.6 Fig. -
22-244 Biopharmaceutics Review(S)
CENTER FOR DRUG EVALUATION AND RESEARCH APPLICATION NUMBER: 22-244 CLINICAL PHARMACOLOGY AND BIOPHARMACEUTICS REVIEW(S) DEP\RT\IE.'\T OF IIEALTH .\ '\ D Clinical Pharmacology & Biopharmaceutics IH\L\!\ SER\ICES PI HUC IIE\LTH SERVICE (HFD 870) FOOD\'\D DRIG .-\D\""ISTR\TION Tracl"ingl Action Sheet foi' Foi'malllnformai Consults . Iniiii: \rikdllih C. '\dll.lIi_ I'h.I), To: DOCl'\'IENT ROOi\l (LOG-IN and LOC-OlT) Please log-in this consult and review action for the specified IND/NDA submission 1); I I.: II I X::I)I)X ~;\~) :\u.: ND.\ :\u. :::: - ::-1-1 I),\TI 01 DOel "II.NT IIJ' 1:1/::()IJX Sni.11 :\u.: IV-IJIJIJ Class I Resuhiiission '\.\\11.01 imi(, l'I~IORln (()'\ \11)1 R\II ()'\ J).lIC ui' illl,)lli.il.;lmlldl I IJ I Y::()IJX I LlCEDR.\ (Fospropofol) Standanl (ulisLlli: Injection I 1111 :\/\\11 01 \I'O'\\OR: I \1(;1 Pharma I TYPE OF SL InIiSSIO,\ CLI'\I( .\L PIIARMACOI,O(;YIBIOPIL\R\L\CEITlCS RELATED ISSUE o I'I~I.-I:\I) 0 1)IS\OI.11 IO:\I:\-\III~O 1~1I.1 ..\SI. 0 IIN/\1. I'RI1\III) 1..\131 1.1:\( , 0\:\1\ 1\111' III \1\:\ \(\1 IN(i o 1311h \1\11./\131111 Y \ 1(1)11\ ~ L\l31I1NCi RI. VISIO'\ i:\-\iiim \111 ,\HI)I 0 1\\1 0 I "i - \ I \ 0 \\\ I \ I J( i~ Ii)l lSi o (ORRI\I)ONI)IMî o I'R()lI)(.I)1 o Si '1)\( I~II\TII) 0 IWI.(j /\I)VIRTI\I:\( j 01'11\\1. -
Understanding Benzodiazephine Use, Abuse, and Detection
Siemens Healthcare Diagnostics, the leading clinical diagnostics company, is committed to providing clinicians with the vital information they need for the accurate diagnosis, treatment and monitoring of patients. Our comprehensive portfolio of performance-driven systems, unmatched menu offering and IT solutions, in conjunction with highly responsive service, is designed to streamline workflow, enhance operational efficiency and support improved patient care. Syva, EMIT, EMIT II, EMIT d.a.u., and all associated marks are trademarks of General Siemens Healthcare Diagnostics Inc. All Drugs other trademarks and brands are the Global Division property of their respective owners. of Abuse Siemens Healthcare Product availability may vary from Diagnostics Inc. country to country and is subject 1717 Deerfield Road to varying regulatory requirements. Deerfield, IL 60015-0778 Please contact your local USA representative for availability. www.siemens.com/diagnostics Siemens Global Headquarters Global Siemens Healthcare Headquarters Siemens AG Understanding Wittelsbacherplatz 2 Siemens AG 80333 Muenchen Healthcare Sector Germany Henkestrasse 127 Benzodiazephine Use, 91052 Erlangen Germany Abuse, and Detection Telephone: +49 9131 84 - 0 www.siemens.com/healthcare www.usa.siemens.com/diagnostics Answers for life. Order No. A91DX-0701526-UC1-4A00 | Printed in USA | © 2009 Siemens Healthcare Diagnostics Inc. Syva has been R1 R2 a leading developer N and manufacturer of AB R3 X N drugs-of-abuse tests R4 for more than 30 years. R2 C Now part of Siemens Healthcare ® Diagnostics, Syva boasts a long and Benzodiazepines have as their basic chemical structure successful track record in drugs-of-abuse a benzene ring fused to a seven-membered diazepine ring. testing, and leads the industry in the All important benzodiazepines contain a 5-aryl substituent ring (ring C) and a 1,4–diazepine ring. -
5 Part 1300—Definitions
PART 1300—DEFINITIONS (7) 5-androstenediol (3b,17b-dihydroxy- androst-5-ene) Sec. (8) 1-androstenedione ([5a]-androst-1- 1300.01 Definitions relating to controlled en-3,17-dione) substances. (9) 4-androstenedione (androst-4-en- 1300.02 Definitions relating to listed chemi- 3,17-dione) cals. (10) 5-androstenedione (androst-5-en- 1300.03 Definitions relating to electronic or- 3,17-dione) ders for controlled substances and elec- tronic prescriptions for controlled sub- (11) bolasterone (7a,17a-dimethyl-17b- stances. hydroxyandrost-4-en-3-one) 1300.04 Definitions relating to the dis- (12) boldenone (17b-hydroxyandrost-1,4- pensing of controlled substances by diene-3-one) means of the Internet. (13) boldione (androsta-1,4-diene-3,17- 1300.05 Definitions relating to the disposal dione) of controlled substances. (14) calusterone (7b,17a-dimethyl-17b- AUTHORITY: 21 U.S.C. 802, 821, 822, 829, hydroxyandrost-4-en-3-one) 871(b), 951, 958(f). (15) clostebol (4-chloro-17b- SOURCE: 62 FR 13941, Mar. 24, 1997, unless hydroxyandrost-4-en-3-one) otherwise noted. (16) dehydrochloromethyltestosterone (4-chloro-17b-hydroxy-17a-methyl- § 1300.01 Definitions relating to con- androst-1,4-dien-3-one) trolled substances. (17) desoxymethyltestosterone (17a- (a) Any term not defined in this part methyl-5a-androst-2-en-17b-ol) shall have the definition set forth in (a.k.a. ‘madol‘) section 102 of the Act (21 U.S.C. 802), (18) D1-dihydrotestosterone (a.k.a.‘1- except that certain terms used in part testosterone‘) (17b-hydroxy-5a- 1316 of this chapter are defined at the androst-1-en-3-one) beginning of each subpart of that part. -
Pharmacokinetic Drug–Drug Interactions Among Antiepileptic Drugs, Including CBD, Drugs Used to Treat COVID-19 and Nutrients
International Journal of Molecular Sciences Review Pharmacokinetic Drug–Drug Interactions among Antiepileptic Drugs, Including CBD, Drugs Used to Treat COVID-19 and Nutrients Marta Kara´zniewicz-Łada 1 , Anna K. Główka 2 , Aniceta A. Mikulska 1 and Franciszek K. Główka 1,* 1 Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 60-781 Pozna´n,Poland; [email protected] (M.K.-Ł.); [email protected] (A.A.M.) 2 Department of Bromatology, Poznan University of Medical Sciences, 60-354 Pozna´n,Poland; [email protected] * Correspondence: [email protected]; Tel.: +48-(0)61-854-64-37 Abstract: Anti-epileptic drugs (AEDs) are an important group of drugs of several generations, rang- ing from the oldest phenobarbital (1912) to the most recent cenobamate (2019). Cannabidiol (CBD) is increasingly used to treat epilepsy. The outbreak of the SARS-CoV-2 pandemic in 2019 created new challenges in the effective treatment of epilepsy in COVID-19 patients. The purpose of this review is to present data from the last few years on drug–drug interactions among of AEDs, as well as AEDs with other drugs, nutrients and food. Literature data was collected mainly in PubMed, as well as google base. The most important pharmacokinetic parameters of the chosen 29 AEDs, mechanism of action and clinical application, as well as their biotransformation, are presented. We pay a special attention to the new potential interactions of the applied first-generation AEDs (carba- Citation: Kara´zniewicz-Łada,M.; mazepine, oxcarbazepine, phenytoin, phenobarbital and primidone), on decreased concentration Główka, A.K.; Mikulska, A.A.; of some medications (atazanavir and remdesivir), or their compositions (darunavir/cobicistat and Główka, F.K. -
(19) United States (12) Patent Application Publication (10) Pub
US 20130289061A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2013/0289061 A1 Bhide et al. (43) Pub. Date: Oct. 31, 2013 (54) METHODS AND COMPOSITIONS TO Publication Classi?cation PREVENT ADDICTION (51) Int. Cl. (71) Applicant: The General Hospital Corporation, A61K 31/485 (2006-01) Boston’ MA (Us) A61K 31/4458 (2006.01) (52) U.S. Cl. (72) Inventors: Pradeep G. Bhide; Peabody, MA (US); CPC """"" " A61K31/485 (201301); ‘4161223011? Jmm‘“ Zhu’ Ansm’ MA. (Us); USPC ......... .. 514/282; 514/317; 514/654; 514/618; Thomas J. Spencer; Carhsle; MA (US); 514/279 Joseph Biederman; Brookline; MA (Us) (57) ABSTRACT Disclosed herein is a method of reducing or preventing the development of aversion to a CNS stimulant in a subject (21) App1_ NO_; 13/924,815 comprising; administering a therapeutic amount of the neu rological stimulant and administering an antagonist of the kappa opioid receptor; to thereby reduce or prevent the devel - . opment of aversion to the CNS stimulant in the subject. Also (22) Flled' Jun‘ 24’ 2013 disclosed is a method of reducing or preventing the develop ment of addiction to a CNS stimulant in a subj ect; comprising; _ _ administering the CNS stimulant and administering a mu Related U‘s‘ Apphcatlon Data opioid receptor antagonist to thereby reduce or prevent the (63) Continuation of application NO 13/389,959, ?led on development of addiction to the CNS stimulant in the subject. Apt 27’ 2012’ ?led as application NO_ PCT/US2010/ Also disclosed are pharmaceutical compositions comprising 045486 on Aug' 13 2010' a central nervous system stimulant and an opioid receptor ’ antagonist. -
A Review of Carbamate Derivatives Used As Therapeutic Agents 285 Arh Hig Rada Toksikol 2020;71:285-299
Matošević A, Bosak A. Carbamate group as structural motif in drugs: a review of carbamate derivatives used as therapeutic agents 285 Arh Hig Rada Toksikol 2020;71:285-299 Review DOI: 10.2478/aiht-2020-71-3466 Carbamate group as structural motif in drugs: a review of carbamate derivatives used as therapeutic agents Ana Matošević and Anita Bosak Institute for Medical Research and Occupational Health, Zagreb, Croatia [Received in July 2020; Similarity Check in July 2020; Accepted in December 2020] Due to their very good chemical and proteolytic stability, ability to penetrate cell membranes, and resemblance to a peptide bond, carbamate derivatives have received much attention in recent years and got an important role in modern drug discovery and medicinal chemistry. Today, carbamates make structural and/or functional part of many drugs and prodrugs approved and marketed for the treatment of various diseases such as cancer, epilepsy, hepatitis C, HIV infection, and Alzheimer’s disease. In drugs they can play a role in drug-target interaction or improve the biological activity of parent molecules. In prodrugs they are mainly used to delay first-pass metabolism and enhance the bioavailability and effectiveness of compounds. This brief review takes a look at the properties and use of carbamates in various fields of medicine and provides quick insights into the mechanisms of action for some of them. KEY WORDS: anticonvulsants; antiepileptics; cholinesterase inhibitors; neurodegenerative diseases; prodrugs; protease inhibitors Carbamates are derivatives of carbamic acid, whose 8). By varying the substituents at the amino and carboxyl amino and carboxyl termini are substituted by a variety of termini of the carbamate group, it is possible to modulate structurally diverse alkyl, aryl, or alkyl-aryl substituents their biological and pharmacokinetic properties and and are identified by the presence of the -O-CO-NH- linkage improve their stability (7, 8). -
Pharmacology and Toxicology of Amphetamine and Related Designer Drugs
Pharmacology and Toxicology of Amphetamine and Related Designer Drugs U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES • Public Health Service • Alcohol Drug Abuse and Mental Health Administration Pharmacology and Toxicology of Amphetamine and Related Designer Drugs Editors: Khursheed Asghar, Ph.D. Division of Preclinical Research National Institute on Drug Abuse Errol De Souza, Ph.D. Addiction Research Center National Institute on Drug Abuse NIDA Research Monograph 94 1989 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Alcohol, Drug Abuse, and Mental Health Administration National Institute on Drug Abuse 5600 Fishers Lane Rockville, MD 20857 For sale by the Superintendent of Documents, U.S. Government Printing Office Washington, DC 20402 Pharmacology and Toxicology of Amphetamine and Related Designer Drugs ACKNOWLEDGMENT This monograph is based upon papers and discussion from a technical review on pharmacology and toxicology of amphetamine and related designer drugs that took place on August 2 through 4, 1988, in Bethesda, MD. The review meeting was sponsored by the Biomedical Branch, Division of Preclinical Research, and the Addiction Research Center, National Institute on Drug Abuse. COPYRIGHT STATUS The National Institute on Drug Abuse has obtained permission from the copyright holders to reproduce certain previously published material as noted in the text. Further reproduction of this copyrighted material is permitted only as part of a reprinting of the entire publication or chapter. For any other use, the copyright holder’s permission is required. All other matieral in this volume except quoted passages from copyrighted sources is in the public domain and may be used or reproduced without permission from the Institute or the authors. -
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