INTERNATIONAL COLLABORATIVE EXERCISES (ICE) Summary Report

Total Page:16

File Type:pdf, Size:1020Kb

INTERNATIONAL COLLABORATIVE EXERCISES (ICE) Summary Report INTERNATIONAL QUALITY ASSURANCE PROGRAMME (IQAP) INTERNATIONAL COLLABORATIVE EXERCISES (ICE) Summary Report BIOLOGICAL SPECIMENS 2013/1 INTERNATIONAL QUALITY ASSURANCE PROGRAMME (IQAP) INTERNATIONAL COLLABORATIVE EXERCISES (ICE) Table of contents Introduction Page 3 Comments from the International Panel of Forensic Experts Page 3 Codes and Abbreviations Page 4 Sample 1 Analysis Page 5 Identified substances Page 5 Statement of findings Page 7 Identification methods Page 11 Summary Page 13 Z-Scores Page 14 Sample 2 Analysis Page 18 Identified substances Page 18 Statement of findings Page 20 Identification methods Page 24 Summary Page 26 Z-Scores Page 27 Sample 3 Analysis Page 33 Identified substances Page 33 Statement of findings Page 34 Identification methods Page 38 Summary Page 40 Z-Scores Page 41 Sample 4 Analysis Page 43 Identified substances Page 43 Statement of findings Page 44 Identification methods Page 48 Summary Page 50 Test Samples Information Samples Comments on samples Sample 1 To prepare BS-1, urine was spiked with Morphine sulphate (3057ng/ml, 2300ng base/ml), Codeine (1150ng base/ml) and 6-Monoacetylmorphine (576 ng base/ml). The spiked urine was dispensed in 50ml aliquots and lyophilised. Sample 2 To prepare BS-2, urine was spiked with Amfetamine sulfate (1562ng/ml, 1143ng base/ml), Nordazepam (1727ng/ml), Oxazepam (457ng/ml) and Temazepam (464ng/ml). The spiked urine was dispensed in 50ml aliquots and lyophilised. Sample 3 To prepare BS-3, urine was spiked with Sodium gammahydroxybutyrate (14427ng GHB/ml, ). The spiked urine was dispensed in 50ml aliquots and lyophilised Sample 4 BS-4 was a blank test sample prepared from urine containing no substance in the ICE menu. The sample contained urine spiked with Ephedrine hydrochloride (2700ng/ml, 2308ng base/ml). The spiked urine was dispensed in 50ml aliquots and lyophilised. Samples Substances Concentrations Comments on substances Sample 1 Morphine (Total) 2300 ng/ml 6-Monoacetylmorphine (6-MAM) 576 ng/ml Codeine 1150 ng/ml Sample 2 Nordazepam 1727 ng/ml Oxazepam 457 ng/ml Amfetamine 1143 ng/ml Temazepam 464 ng/ml Sample 3 gamma-Hydroxybutyric acid (GHB) 14427 ng/ml Sample 4 [blank sample] 2013/1-BS (2) Copyright (c) 2013 UNODC Introduction An important element of the UNODC International Quality Assurance Programme (IQAP) is the implementation of the International Collaborative Exercises (ICE). The exercises allow laboratories, from both developing and developed countries, to continuously monitor their performance in drug testing on a truly global scale. Two rounds are offered per year with each round presenting participants with four different test samples for analysis. This report provides information on the analytical results of laboratories participating in the Biological Specimens (BS) group. In order to maintain confidentiality, the participating laboratories have been assigned random “Web Codes”, which change every round. The analytical results returned by laboratories participating in ICE are evaluated by UNODC and a confidential report is provided to each laboratory on its own performance. The overall analytical results are reviewed by the UNODC’s International Panel of Forensic Experts which oversees the implementation of these exercises, and offers guidance and support in addressing relevant quality issues. The exercises provide an overview of the performance and capacity of participating laboratories and enable UNODC to tailor technical support in the laboratory sector for greatest impact. Comments from the International Panel of Forensic Experts Participation of laboratories Samples within both the Seized materials (SM) and Biological Specimens (BS) test group were sent to 167 laboratories in 57 countries. 68 laboratories participated in the BS test group and 58 (85%) laboratories submitted the results of their analysis in time for inclusion in the summary report, with 96% using the ICE portal for return of results. The almost universal usage of the ICE portal continues to be a high endorsement of its utility. Qualitative and Quantitative Analysis of the biological specimens test samples Overall, the level of performance in identification of the test samples was good given the inherently higher level of difficulty in the analysis of biological specimens compared to seized materials. The complexity of the test samples in ICE 2013/1 was increased in order to challenge the participants. BS-1 contained morphine, 6-monoacetylmorphine and codeine, which were identified by 79%, 79% and 91% of participants respectively. It is encouraging to note that 71% of participants identified all three components in BS-1 and only five false positive results were reported. BS-2 contained amphetamine and a mixture of three benzodiazepines (nordazepam, oxazepam and temazepam). While only 42% of participants identified all four components, 86% identified at least one of the benzodiazepines and 65% identified the amphetamine present. There were eight false positive results including four for diazepam. While the benzodiazepines present are metabolites of diazepam, their presence alone does not represent use of diazepam. BS-3 contained gammahydroxybutyric acid (GHB), a new substance on the ICE menu for the BS test group and 22% of participants identified its presence, while 64% of participants did not carry out analysis for identification of GHB. It is recognized that while GHB may not be commonly analysed by all participants, it has been included in the ICE menu as it represents an example of a more recently abused substance and at the Commission on Narcotic Drugs in March 2013, GHB was transferred from schedule IV to schedule II of the Convention of Psychotropic Substances of 1971. BS-4 was a blank test sample containing no substances from the ICE menu. Although it did contain ephedrine, a precursor to methamphetamine. 19% of participants identified the ephedrine and among five false positives, there was one for methamphetamine. The results for quantitative analysis within the BS test group were excellent. For BS-1 24 out of 25 (96%) laboratories quantified the morphine, 21 out of 22 (95%) quantified 6-MAM and 22 out of 23 (96%) quantified codeine with acceptable Z-scores. Within BS-2, the quantitation results were equally as good with 20 of 21 (95%) laboratories quantifying the amfetamine, 20 out of 22 (91%) the nordazepam, 13 of 16 (81%) the oxazepam and 14 out of 16 (88%) the temazepam with acceptable Z-scores. Within BS-3, 7 out of 9 (87%) participants quantified the GHB present with acceptable Z-scores. It is encouraging to note that of those laboratories who did carry out quantification, 52% performed quantification on at least seven of the eight substances in all test samples. The predominant analytical techniques used by participants for quantification within the BS test group were GC/MS (79%), followed by LC/MS (38%) and others at (17%). Laboratories are encouraged to carry out quantification as it can improve the quality of laboratory analyses and can be helpful in assessing the significance of the results. Also, laboratories reporting false positive or false negative results should investigate the reasons for this and corrective actions should be taken in order to continuously improve performance. Participation in ICE also helps in monitoring the effect of corrective actions. (3) INTERNATIONAL QUALITY ASSURANCE PROGRAMME (IQAP) INTERNATIONAL COLLABORATIVE EXERCISES (ICE) Codes and Abbreviations (+) “positive”: Indicates that the analyte is identified; for presumptive tests (e.g. colour reactions), indicates that a positive reaction was obtained. (-) “negative”: Indicates that the analyte is not identified. (ANP): Analysis not performed. Tech Code Name 100 Agglutination Techniques 110 Enzyme Immunoassay Techniques 120 Fluorescence Polarization Immunoassay 130 Radioimmunoassay 140 Colorimetric reactions 141 Marquis reagent (sulphuric acid, formaldehyde) 142 Cobalt thiocyanate 150 Thin Layer Chromatography 160 High/Ultra High Performance Liquid Chromatography 161 High Performance Liquid Chromatography with diode array detection 170 Gas Chromatography NPD 171 Gas Chromatography FID 172 Gas Chromatography ECD 180 Gas Chromatography/Mass Spectrometry 190 Fourier Transform Infrared Spectrometry 200 Spectrophotometry (visible, UV) 210 Others (specify) 211 NMR 220 Microcrystal test 230 Liquid chromatography/mass spectrometry 231 Liquid chromatography/tandem mass spectrometry 2013/1-BS (4) Copyright (c) 2013 UNODC INTERNATIONAL QUALITY ASSURANCE PROGRAMME (IQAP) INTERNATIONAL COLLABORATIVE EXERCISES (ICE) Sample 1 Analysis Identified substances for Test Sample 1 Code Identified Substances 0709WO 6-MAM, Morphine, Codeine 1C2WN2 opiates 1M39MI codeine, morphine, 6-monoacetylmorphine 2I1J7W codeine, 6 MAM and morphine 3ESBDT CODEINE, ACETYLMORPHINE 5A0LTW morphine, 6-MAM, codeine 5D8EIT Morphine, Heroin and Codeine 6H33U3 Codeine and 6-MAM 6ZZZCD morphine,codeine, 6-monoacethylmorphine 76JL37 morphine, 6-MAM, codeine 7HEM7O Codeine 98KDM8 Morphine, codeine and monoacetly-morphine ABBR1D Morphine,O6-monoacetylmorphine,codeine AKQ21O morphine, codeine and 6-acetyl-morphine ANXWGY Codeine, morphine and 6-Monoacethylmorphine BBRB0E Morphine BJG4OO 6-MAM, codeine, morphine BPL9ZY morphine, 6-MAM, codeine BVABMB 6-MAM, codeine, morphine CUH0QQ CODEINE, MORPHINE AND MORPHINE-6-ACETYL. CWOOM9 codeine, morphine, 6-mam CZJD27 morphine, codeine D7TTWV OPIÁCEOS DONO2Y 6-MAM, codeine, morphine ERWOWW Codeine FNSUKR 6-monoacetilmorfina, morfina, codeina ILS9UP Codeine, Morphine, 6-Monoacetylmorphine
Recommended publications
  • Ionization Energies of Benzodiazepines Salvatore Millefiori, Andrea Alparone
    Electronic properties of neuroleptics: ionization energies of benzodiazepines Salvatore Millefiori, Andrea Alparone To cite this version: Salvatore Millefiori, Andrea Alparone. Electronic properties of neuroleptics: ionization energies of benzodiazepines. Journal of Molecular Modeling, Springer Verlag (Germany), 2010, 17 (2), pp.281- 287. 10.1007/s00894-010-0723-7. hal-00590996 HAL Id: hal-00590996 https://hal.archives-ouvertes.fr/hal-00590996 Submitted on 6 May 2011 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. Editorial Manager(tm) for Journal of Molecular Modeling Manuscript Draft Manuscript Number: JMMO1191R1 Title: Electronic properties of neuroleptics: ionization energies of benzodiazepines Article Type: Original paper Keywords: Benzodiazepines; vertical ionization energies; vertical electron affinities; DFT calculations; electron propagator theory calculations. Corresponding Author: Prof. Salvatore Millefiori, Corresponding Author's Institution: First Author: Salvatore Millefiori Order of Authors: Salvatore Millefiori; Andrea Alparone Abstract: Abstract. Vertical ionization energies (VIEs) of medazepam and nordazepam and of their molecular subunits have been calculated with the electron propagator method in the P3/CEP-31G* approximation. Vertical electron affinities (VEAs) have been obtained with a ΔSCF procedure at the DFT-B3LYP/6-31+G* level of theory. Excellent correlations have been achieved between IEcalc and IEexp allowing reliable assignment of the ionization processes.
    [Show full text]
  • <17> PRESCRIPTION CONTAINER LABELING PF 37(1)
    Compendial Deferrals for USP35-NF30, First Supplement Monograph Title Monograph Section Scientific Liaison Title, INTRODUCTION, PRESCRIPTION CONTAINER LABEL <17> PRESCRIPTION CONTAINER STANDARDS TO PROMOTE PATIENT UNDERSTANDING, Shawn LABELING PF 37(1) Pg. ONLINE Becker REFERENCES <31> VOLUMETRIC APPARATUS PF USE&mdash;, STANDARDS OF ACCURACY&mdash; Horacio 37(2) Pg. ONLINE Pappa <111> DESIGN AND ANALYSIS OF STEPS PRECEDING THE CALCULATION OF POTENCY, Tina Morris BIOLOGICAL ASSAYS PF 36(4) Pg. 952 EXPERIMENTAL ERROR AND TESTS OF ASSAY VALIDITY INTRODUCTION, LIMITS OF ELEMENTAL IMPURITIES, OPTIONS FOR DESCRIBING LIMITS OF ELEMENTAL <232> ELEMENTAL IMPURITIES-- IMPURITIES, ANALYTICAL PROCEDURES, SPECIATION, Kahkashan LIMITS PF 37(3) Pg. ONLINE ROUTES OF EXPOSURE, DRUG PRODUCTS, DRUG Zaidi SUBSTANCE AND EXCIPIENTS, ANALYTICAL TESTING, Title INTRODUCTION, COMPENDIAL PROCEDURES 1 AND 2, ALTERNATE PROCEDURE VALIDATION, LIMIT PROCEDURES, QUANTITATIVE PROCEDURES, Title, <233> ELEMENTAL IMPURITIES - ALTERNATIVE PROCEDURE VALIDATION REQUIREMENTS, Kahkashan PROCEDURES PF 37(3) Pg. ONLINE Zaidi VALIDATION OF LIMIT PROCEDURES, VALIDATION OF QUANTITATIVE PROCEDURES, REFEREE PROCEDURES 1 AND 2, CALCULATIONS AND REPORTING <621> CHROMATOGRAPHY PF 37(3) SYSTEM SUITABILITY Horacio Pg. ONLINE Pappa <797> PHARMACEUTICAL DEFINITIONS, IMMEDIATE-USE CSPS, HAZARDOUS COMPOUNDING--STERILE DRUGS AS CSPS, RADIOPHARMACEUTICALS AS CSPS, Shawn Becker PREPARATIONS PF 36(3) Pg. 714 ENVIRONMENTAL QUALITY AND CONTROL Title, INTRODUCTION, LIMITS OF ELEMENTAL CONTAMINANTS,
    [Show full text]
  • Control Substance List
    Drugs DrugID SubstanceName DEANumbScheNarco OtherNames 1 1-(1-Phenylcyclohexyl)pyrrolidine 7458 I N PCPy, PHP, rolicyclidine 2 1-(2-Phenylethyl)-4-phenyl-4-acetoxypiperidine 9663 I Y PEPAP, synthetic heroin 3 1-[1-(2-Thienyl)cyclohexyl]piperidine 7470 I N TCP, tenocyclidine 4 1-[1-(2-Thienyl)cyclohexyl]pyrrolidine 7473 I N TCPy 5 13Beta-ethyl-17beta-hydroxygon-4-en-3-one 4000 III N 6 17Alpha-methyl-3alpha,17beta-dihydroxy-5alpha-androstane 4000 III N 7 17Alpha-methyl-3beta,17beta-dihydroxy-5alpha-androstane 4000 III N 8 17Alpha-methyl-3beta,17beta-dihydroxyandrost-4-ene 4000 III N 9 17Alpha-methyl-4-hydroxynandrolone (17alpha-methyl-4-hyd 4000 III N 10 17Alpha-methyl-delta1-dihydrotestosterone (17beta-hydroxy- 4000 III N 17-Alpha-methyl-1-testosterone 11 19-Nor-4-androstenediol (3beta,17beta-dihydroxyestr-4-ene; 4000 III N 12 19-Nor-4-androstenedione (estr-4-en-3,17-dione) 4000 III N 13 19-Nor-5-androstenediol (3beta,17beta-dihydroxyestr-5-ene; 4000 III N 14 19-Nor-5-androstenedione (estr-5-en-3,17-dione) 4000 III N 15 1-Androstenediol (3beta,17beta-dihydroxy-5alpha-androst-1- 4000 III N 16 1-Androstenedione (5alpha-androst-1-en-3,17-dione) 4000 III N 17 1-Methyl-4-phenyl-4-propionoxypiperidine 9661 I Y MPPP, synthetic heroin 18 1-Phenylcyclohexylamine 7460 II N PCP precursor 19 1-Piperidinocyclohexanecarbonitrile 8603 II N PCC, PCP precursor 20 2,5-Dimethoxy-4-(n)-propylthiophenethylamine 7348 I N 2C-T-7 21 2,5-Dimethoxy-4-ethylamphetamine 7399 I N DOET 22 2,5-Dimethoxyamphetamine 7396 I N DMA, 2,5-DMA 23 3,4,5-Trimethoxyamphetamine
    [Show full text]
  • S1 Table. List of Medications Analyzed in Present Study Drug
    S1 Table. List of medications analyzed in present study Drug class Drugs Propofol, ketamine, etomidate, Barbiturate (1) (thiopental) Benzodiazepines (28) (midazolam, lorazepam, clonazepam, diazepam, chlordiazepoxide, oxazepam, potassium Sedatives clorazepate, bromazepam, clobazam, alprazolam, pinazepam, (32 drugs) nordazepam, fludiazepam, ethyl loflazepate, etizolam, clotiazepam, tofisopam, flurazepam, flunitrazepam, estazolam, triazolam, lormetazepam, temazepam, brotizolam, quazepam, loprazolam, zopiclone, zolpidem) Fentanyl, alfentanil, sufentanil, remifentanil, morphine, Opioid analgesics hydromorphone, nicomorphine, oxycodone, tramadol, (10 drugs) pethidine Acetaminophen, Non-steroidal anti-inflammatory drugs (36) (celecoxib, polmacoxib, etoricoxib, nimesulide, aceclofenac, acemetacin, amfenac, cinnoxicam, dexibuprofen, diclofenac, emorfazone, Non-opioid analgesics etodolac, fenoprofen, flufenamic acid, flurbiprofen, ibuprofen, (44 drugs) ketoprofen, ketorolac, lornoxicam, loxoprofen, mefenamiate, meloxicam, nabumetone, naproxen, oxaprozin, piroxicam, pranoprofen, proglumetacin, sulindac, talniflumate, tenoxicam, tiaprofenic acid, zaltoprofen, morniflumate, pelubiprofen, indomethacin), Anticonvulsants (7) (gabapentin, pregabalin, lamotrigine, levetiracetam, carbamazepine, valproic acid, lacosamide) Vecuronium, rocuronium bromide, cisatracurium, atracurium, Neuromuscular hexafluronium, pipecuronium bromide, doxacurium chloride, blocking agents fazadinium bromide, mivacurium chloride, (12 drugs) pancuronium, gallamine, succinylcholine
    [Show full text]
  • Optimized Determination of Lorazepam in Human Serum by Extraction and High-Performance Liquid Chromatographic Analysis
    Acta Pharm. 56 (2006) 481–488 Short communication Optimized determination of lorazepam in human serum by extraction and high-performance liquid chromatographic analysis AMIR G. KAZEMIFARD1* The present research was designated to evaluate a rapid 2 KHEIROLLAH GHOLAMI and sensitive method for determining low concentra- ALIREZA DABIRSIAGHI1 tions of the highly active drug lorazepam in serum. Iso- 1 Faculty of Pharmacy, Tehran University lation of the drug from biological fluid after addition of of Medical Sciences, Tehran, Iran nordazepam as the internal standard was achieved using a simple liquid-liquid extraction with dichloromethane 2 Department of Clinical Pharmacy and the extracted compounds were quantified by high- Tehran University of Medical Sciences -performance liquid chromatography. Chromatographic Tehran, Iran separation on a reversed phase column containing a sta- tionary phase with low silanol activity resulted in a per- fectly symmetrical peak with a tailing factor of 1.0. The limit of quantitation in serum is 2.5 ng mL–1 for both lo- razepam and internal standard. The procedure is rapid and sensitive enough for determination of lorazepam in serum. Keywords: lorazepam, serum, high-performance liquid Accepted September 5, 2006 chromatography, peak tailing Lorazepam [7-chloro-5-(2-chlorophenyl)-1,3-dihydro-3-hydroxy-2H-1,4-benzodiaze- pine-2-one] is a short-acting benzodiazepine that produces central depression of the CNS. It is administered in the treatment of anxiety states, insomnia associated with anxi- ety and as an anticonvulsant. Numerous clinical studies have adequately demonstrated the importance of blood concentrations of lorazepam to its efficacy and toxicity (1–4). Consequently, knowledge of the lorazepam blood levels is helpful in therapeutic drug monitoring and in the control of overdosed patients.
    [Show full text]
  • Alprazolam Extended-Release Tablets
    Revision Bulletin Official August 1, 2011 Alprazolam 1 Add the following: Apparatus 1: 100 rpm . Time: 1, 4, 8, and 12 h I Mobile phase: Acetonitrile, tetrahydrofuran, and Me- Alprazolam Extended-Release Tablets dium (7:1:12) Standard stock solution: 0.5 mg/mL of USP Alprazolam DEFINITION RS in acetonitrile Alprazolam Extended-Release Tablets contain NLT 90.0% Standard solution: (L/500) mg/mL of USP Alprazolam and NMT 110.0% of the labeled amount of alprazolam RS in Medium from the Standard stock solution, where L (C17H13CIN4). is the label claim in mg/Tablet IDENTIFICATION Sample solution: Pass a portion of the solution under A. The retention time of the major peak of the Sample test through a suitable filter. solution corresponds to that of the Standard solution, as Chromatographic system obtained in the Assay. (See Chromatography 〈621〉, System Suitability.) Mode: LC ASSAY Detector: UV 254 nm • PROCEDURE Column: 4.6-mm × 10-cm; 5-µm packing L7 Mobile phase: Acetonitrile, water, and phosphoric acid Flow rate: 1 mL/min (350:650:1) Injection size: 100 µL Standard solution: 0.05 mg/mL of USP Alprazolam RS System suitability in methanol Sample: Standard solution Sample solution: Transfer an appropriate number of Suitability requirements Tablets into a suitable volumetric flask to obtain a nomi- Tailing factor: NMT 2.0 nal concentration of about 0.05 mg/mL of alprazolam. Column efficiency: NLT 3000 theoretical plates Sonicate in 80% of the flask volume of methanol for 15 Relative standard deviation: NMT 2.0% min, shake mechanically for 30 min, dilute with metha- Analysis nol to final volume, filter a portion of the solution, and Samples: Standard solution and Sample solution discard the first 3 mL of filtrate.
    [Show full text]
  • Did the New French Pay-For-Performance System Modify
    Rat et al. BMC Health Services Research 2014, 14:301 http://www.biomedcentral.com/1472-6963/14/301 RESEARCH ARTICLE Open Access Did the new French pay-for-performance system modify benzodiazepine prescribing practices? Cédric Rat1,2*, Gaëlle Penhouet1, Aurélie Gaultier3, Anicet Chaslerie4, Jacques Pivette4, Jean Michel Nguyen2,3 and Caroline Victorri-Vigneau5 Abstract Background: French general practitioners (GPs) were enrolled in a new payment system in January 2012. As part of a national agreement with the French National Ministry of Health, GPs were asked to decrease the proportion of patients who continued their benzodiazepine treatment 12 weeks after its initiation and to decrease the proportion of patients older than 65 who were prescribed long half-life benzodiazepines. In return, GPs could expect an extra payment of up to 490 euros per year. This study reports the evolution of the corresponding prescribing practices of French GPs during that period regarding patients who were prescribed a benzodiazepine for the first time. Methods: The national healthcare system's administrative database was used to report the longitudinal follow-up of two historical cohorts of French patients from the Pays de la Loire area. Study patients: The “2011” and “2012” cohorts included all patients who initiated benzodiazepine regimens from April 1 to June 30 in 2011 and 2012, respectively. The primary outcomes were the proportion of those study patients who continued benzodiazepine treatment after 12 weeks and the proportion of study patients >65 years who were prescribed long half-life benzodiazepines. Analyses were performed using a multi-level regression. Results: In total, 41,436 and 42,042 patients initiated benzodiazepine treatment in 2011 and 2012, respectively.
    [Show full text]
  • A Review of the Evidence of Use and Harms of Novel Benzodiazepines
    ACMD Advisory Council on the Misuse of Drugs Novel Benzodiazepines A review of the evidence of use and harms of Novel Benzodiazepines April 2020 1 Contents 1. Introduction ................................................................................................................................. 4 2. Legal control of benzodiazepines .......................................................................................... 4 3. Benzodiazepine chemistry and pharmacology .................................................................. 6 4. Benzodiazepine misuse............................................................................................................ 7 Benzodiazepine use with opioids ................................................................................................... 9 Social harms of benzodiazepine use .......................................................................................... 10 Suicide ............................................................................................................................................. 11 5. Prevalence and harm summaries of Novel Benzodiazepines ...................................... 11 1. Flualprazolam ......................................................................................................................... 11 2. Norfludiazepam ....................................................................................................................... 13 3. Flunitrazolam ..........................................................................................................................
    [Show full text]
  • Misbruik En Afhankelijkheid Van Benzodiazepines En Verwante Geneesmiddelen Voor De Behandeling Van Slaapproblemen Standpunt Van Een Officina-Apotheker
    Farmacovigilantie: misbruik en afhankelijkheid van benzodiazepines en verwante geneesmiddelen voor de behandeling van slaapproblemen Standpunt van een officina-apotheker Dr Apr Jan Saevels Wetenschappelijk Directeur, APB 15.10.2019 1 Agenda 1) Enkele evoluties in ambulant verbruik 2) Patient met een klacht van slapeloosheid in de apotheek 3) Patient met een voorschrift Primoprescriptie Herhaalvoorschrift 4) Afbouwschema’s 5) Slotbemerkingen Enkele evoluties in ambulant verbruik « Benzodiazepines en verwanten » N03AE01 clonazepam N05BA01 diazepam N05BA02 chlordiazepoxide # packs dispensed N05BA04 oxazepam N05BA05 clorazepate potassium 15 000 000 N05BA06 lorazepam N05BA08 bromazepam 14 500 000 N05BA09 clobazam 14 000 000 N05BA10 ketazolam N05BA11 prazepam 13 500 000 N05BA12 alprazolam N05BA16 nordazepam 13 000 000 N05BA18 ethyl loflazepate N05BA21 clotiazepam 12 500 000 N05BA22 cloxazolam N05CD01 flurazepam 12 000 000 N05CD02 nitrazepam 11 500 000 N05CD03 flunitrazepam N05CD05 triazolam 11 000 000 N05CD06 lormetazepam N05CD07 temazepam 10 500 000 N05CD08 midazolam N05CD09 brotizolam 10 000 000 N05CD11 loprazolam N05CF01 zopiclone N05CF02 zolpidem 2016 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2017 2018 N05CF03 zaleplon 2002 Bron IQVIA Verwerking APB Statistics « Benzodiazepines en verwanten » N03AE01 clonazepam N05BA01 diazepam # DDD dispensed N05BA02 chlordiazepoxide N05BA04 oxazepam 500 000 000 N05BA05 clorazepate potassium N05BA06 lorazepam 490 000 000 N05BA08 bromazepam N05BA09 clobazam 480 000 000 N05BA10 ketazolam
    [Show full text]
  • WO 2008/137960 Al
    (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date PCT 13 November 2008 (13.11.2008) WO 2008/137960 Al (51) International Patent Classification: (74) Agents: GRUMBLING, Matthew, V. et al; Wilson Son- A61K 37/55 (2006.01) sini Goodrich & Rosati, 650 Page Mill Road, Palo Alto, CA 94304-1050 (US). (21) International Application Number: (81) Designated States (unless otherwise indicated, for every PCT/US2008/062961 kind of national protection available): AE, AG, AL, AM, AO, AT,AU, AZ, BA, BB, BG, BH, BR, BW, BY, BZ, CA, (22) International Filing Date: 7 May 2008 (07.05.2008) CH, CN, CO, CR, CU, CZ, DE, DK, DM, DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, HN, HR, HU, ID, (25) Filing Language: English IL, IN, IS, JP, KE, KG, KM, KN, KP, KR, KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, ME, MG, MK, MN, (26) Publication Language: English MW, MX, MY, MZ, NA, NG, NI, NO, NZ, OM, PG, PH, PL, PT, RO, RS, RU, SC, SD, SE, SG, SK, SL, SM, SV, (30) Priority Data: SY, TJ, TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, 60/916,550 7 May 2007 (07.05.2007) US ZA, ZM, ZW (84) Designated States (unless otherwise indicated, for every (71) Applicant (for all designated States except US): kind of regional protection available): ARIPO (BW, GH, QUESTOR PHARMACEUTICALS, INC. [US/US]; GM, KE, LS, MW, MZ, NA, SD, SL, SZ, TZ, UG, ZM, 3260 Whipple Road, Union City, CA 94587 (US).
    [Show full text]
  • Appendix 1 Cross-Reference of Research, Generic and Trade Names of Benzodiazepines
    Appendix 1 Cross-Reference of Research, Generic and Trade Names of Benzodiazepines Table 1. Benzodiazepine research designations with corresponding generic names Research Designation Generic Name lactam demoxepam methyloxazepam temazepam A 101 nordazepam AB 35616 clorazepate AB 39083 clorazepate AH 3232 clorazepate CB 4261 tetrazepam CB 4306 clorazepate CB 4311 clorazepate CGS 8216 (antagonist) CI683 ripazepam CS 370 cloxazolam CS 430 haloxazolam D40TA estazolam EGYT 341 tofisopam ER 115 temazepam HR 158 loprazolam HR376 clobazam HR 4723 clobazam HR930 fosazepam K3917 temazepam 287 THE BENZODIAZEPINES Research Designation Generic Name LA 111 diazepam LM 2717 clobazam ORF 8063 triflubazam Ro 4-5360 nitrazepam Ro 5-0690 chlordiazepoxide Ro 5-0883 desmethy1chlordiazepoxide Ro 5-2092 demoxepam Ro 5-2180 desmethyldiazepam Ro 5-2807 diazepam Ro 5-2925 desmethylmedazepam Ro 5-3059 nitrazepam Ro 5-3350 bromazepam Ro 5-3438 fludiazepam Ro 5-4023 clonazepam Ro 5-4200 flunitrazepam Ro 5-4556 medazepam Ro 5-5345 temazepam Ro 5-6789 oxazepam Ro 5-6901 flurazepam Ro 15-1788 (antagonist) Ro 21-3981 midazolam RU 31158 loprazolam S 1530 nimetazepam SAH 1123 isoquinazepam SAH 47603 temazepam SB 5833 camazepam SCH 12041 halazepam SCH 16134 quazepam U 28774 ketazolam U 31889 alprazolam U 33030 triazolam W4020 prazepam We 352 triflubazam 288 RESEARCH, GENERIC AND TRADE NAMES Research Designation Generic Name We 941 brotizolam Wy 2917 temazepam Wy 3467 diazepam Wy 3498 oxazepam Wy 3917 temazepam Wy 4036 lorazepam Wy 4082 lormetazepam Wy 4426 oxazepam Y 6047
    [Show full text]
  • INTERNATIONAL COLLABORATIVE EXERCISES (ICE) Summary Report
    INTERNATIONAL QUALITY ASSURANCE PROGRAMME (IQAP) INTERNATIONAL COLLABORATIVE EXERCISES (ICE) Summary Report BIOLOGICAL SPECIMENS 2017/1 INTERNATIONAL QUALITY ASSURANCE PROGRAMME (IQAP) INTERNATIONAL COLLABORATIVE EXERCISES (ICE) Table of contents Introduction Page 2 Comments from the International Panel of Forensic Experts Page 2 NPS reported by ICE participants Page 4 Codes and Abbreviations Page 6 Sample 1 Analysis Page 7 Identified substances Page 7 Statement of findings Page 8 Identification methods Page 11 Summary Page 14 Sample 2 Analysis Page 15 Identified substances Page 15 Statement of findings Page 18 Identification methods Page 23 Summary Page 6 2 - Z Scores Page 27 Sample 3 Analysis Page 37 Identified substances Page 37 Statement of findings Page 39 Identification methods Page 44 Summary Page 47 Z- Scores Page 48 Sample 4 Analysis Page 51 Identified substances Page 51 Statement of findings Page 54 Identification methods Page 59 Summary Page 62 Z- Scores Page 63 Test Samples Information Samples Comments on samples Sample 1 BS-1 was a blank urine test sample containing no substances from the ICE menu. Sample 2 To prepare BS-2, urine was spiked with an aqueous solution of amfetamine sulphate (1270ng base/ml) and methanol solutions of nordazepam (1960ng base/ml), oxazepam (570ng/ml) and temazepam (580ng/ml). The spiked urine was dispensed in 50ml aliquots and lyophilised. Sample 3 To prepare BS-3, urine was spiked with an aqueous solution of gamma-hydroxybutyric acid (GHB) (16560ng/ml). The spiked urine was dispensed in 50ml aliquots and lyophilised. Sample 4 To prepare BS-4, urine was spiked with an aqueous solution of morphine sulphate (860ng base/ml).
    [Show full text]