DOCSLIB.ORG

Investigation of the Origin of Ephedrine and Methamphetamine by Stable Isotope Ratio Mass Spectrometry: a Japanese Experience*

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Investigation of the Origin of Ephedrine and Methamphetamine by Stable Isotope Ratio Mass Spectrometry: a Japanese Experience* Investigation of the origin of ephedrine and methamphetamine by stable isotope ratio mass spectrometry: a Japanese experience* Y. Makino Narcotics Control Department, Kanto-Shin’etsu Regional Bureau of Health and Welfare, Ministry of Health, Labour and Welfare, Japan Y. Urano and T. Nagano Graduate School of Pharmaceutical Sciences, University of Tokyo, Japan ABSTRACT Illicit drug abuse is a serious global problem that can only be solved through international cooperation. In Asian countries, the abuse of methamphetamine is one of the most pressing problems. To assist in the control of methamphetamine, the authors investigated in detail the character of ephedrine, which is a key precursor for the illicit manufacture of methamphetamine. Commercial ephedrine is produced by one of three methods: (a) extraction from Ephedra plants, (b) full chemical synthesis or (c) via a semi-synthetic process involving the fermentation of sugar, followed by amination. Although chemically there is no difference between ephedrine samples from different origins (natural, synthetic or semi-synthetic), scientific and analytical tools such as drug-characterization and impurity-profiling programmes may provide valuable information for law enforce- ment and regulatory activities as part of precursor control strategies. During the research under discussion in the present article, in addition to classi- cal impurity profiling of manufacturing by-products, the use of stable isotope ratio mass spectrometry was investigated for determining the origin of the ephedrine that had been used as a precursor in seized methamphetamine samples. The results of car- bon and nitrogen stable isotope ratio (ͳ13C and ͳ15N) analysis of samples of crys- talline methamphetamine seized in Japan suggested that the drug had been synthesized from either natural or semi-synthetic ephedrine and not from synthetic ephedrine. Stable isotope ratio analysis is expected to be a useful tool for tracing the origins of seized methamphetamine. It has attracted much interest from precursor control authorities in Japan and the East Asian region and may prove useful in the international control of precursors. Keywords: drug profiling; IRMS; methamphetamine; ephedrine; precursor; origin. *The authors wish to express their gratitude to Naoki Kurashima of the Central Customs Laboratory, Ministry of Finance, Japan, and Rie Satou of the Shoko company of Japan for the measurement of the stable isotope ratios of samples. The research was supported by a health sciences research grant from the Ministry of Health, Labour and Welfare of Japan. 63 64 Bulletin on Narcotics, vol. LVII, Nos. 1 and 2, 2005 Introduction Illicit drug abuse is a serious global problem that can only be solved through international cooperation. The abuse of methamphetamine is one of the most pressing drug problems in Asian countries. Methamphetamine is illicitly pro- duced across the region, as demonstrated by the dismantling of clandestine laboratories in China, Indonesia, Malaysia, Myanmar, the Philippines, Taiwan Province of China and Viet Nam. At many such laboratories, precursors and chemicals for methamphetamine production have been seized together with crystalline methamphetamine. The prevention of production is one of the most effective drug control measures. In the case of synthetic drugs, precursor control is an important com- ponent of the strategy for preventing production. Many government agencies have cooperated in international activities to prevent the diversion of precursors and chemical substances, such as Operation Topaz to counter the illicit produc- tion of heroin, Operation Purple against cocaine and Project Prism against amphetamine-type stimulants (ATS). International efforts to monitor the distri- bution of precursor chemicals and to promote the rapid exchange of informa- tion about suspicious imports and exports have met with some success. For example, chemical information from drug impurity profiling programmes is increasingly recognized as a valuable supplement to precursor control strategies. Information about precursors and synthetic routes of illicit manufacture may help drug law enforcement authorities trace the source of precursors or obtain other information of strategic relevance. In view of the extent of the problem of methamphetamine abuse in Japan and the East and South-East Asian regions, Japan has taken a significant interest in this field. At two expert meetings held in Japan, recognition was accorded to the role of drug experts and scientists in facilitating the sharing of chemical information on illicit drugs and the development of analytical methods under the coordination of the United Nations Office on Drugs and Crime (UNODC). The first of the two meetings was a consultative one on pro- filing and the characterization of methamphetamine and other ATS, organized by UNODC and held in Tokyo in 1998, and the second was a Group of Eight (G8) ad hoc meeting of drug experts, held in Miyazaki in 2000. In addition, as part of the overall drug control approach with a focus on ATS in the Japanese five-year plan, Japan also hosted two international forums on the control of precursors for ATS; these were held in 2004 and 2005. In terms of chemical analytical research, Japan has been involved for some years in developing methods for the impurity profiling of methamphetamine [1-3]. More recently, the research group responsible for the research under discus- sion in the present article has also investigated carbon and nitrogen stable isotope ratio analysis as a promising new tool for the characterization of methamphetamine [4]. This technique already has an established place in the fields of bio- chemistry and food chemistry, where it is used to identify the geographical Investigation of the origin of ephedrine and methamphetamine: a Japanese experience 65 origin of natural products, such as tea, wine and honey. It is based on the fact that most elements exist in several different isotopic forms (that is, forms of the same element that differ slightly in their atomic masses) and that the abun- dances of the different isotopes vary according to environmental conditions, thus allowing a differentiation according to origin. Since ephedrine, the main precursor for the synthesis of methamphetamine, may be of natural, semi-synthetic or synthetic origin, the research team inves- tigated whether the stable isotope ratio values for carbon and nitrogen enabled the discrimination of ephedrine according to its origin. It was further investi- gated whether the carbon and nitrogen stable isotope ratio values of ephedrine used as a precursor were correlated with the corresponding values in the end product, methamphetamine. The present article describes the approaches to sample comparison with the overall aim of identifying the sources and synthesis routes of illicitly manufactured methamphetamine and its precursors, in particular ephedrine. Preliminary research is presented on the potential of a promising new technique, carbon and nitrogen stable isotope ratio analysis by isotope ratio mass spectro- metry (IRMS) [4], together with an application example for some metham- phetamine samples. The usefulness and limitations of chemical information in drug precursor control are discussed. Comparative analyses Determination of the synthetic route of methamphetamine by impurity profiling Methamphetamine is synthesized in clandestine laboratories by a variety of routes, as shown in figure I [5]. The two main precursors used for clandestine methamphetamine synthesis are ephedrine (or pseudoephedrine), and 1-phenyl- 2-propanone (P-2-P). Clandestine methamphetamine often contains impurities arising from incomplete reaction. The traditional means of comparative sample analysis of illicitly manufac- tured drugs is a technique known as “drug characterization/impurity profiling”. It is based on the analysis of impurities and by-products from the manufactur- ing process, that is, organic compounds that are present in the illicit drug end product due to clandestine manufacturing conditions. Many methods have been reported for the isolation and identification of the characteristic impurities of the various synthetic pathways of methamphet- amine [1, 6-9]. In a study funded by a health sciences research grant from the Ministry of Health, Labour and Welfare of Japan, the impurity profiling of methamphetamine was investigated, focusing on the synthetic route and the precursor [3, 10-12]. As part of the research activities, methamphetamine was synthesized in the laboratory by the four main synthetic methods, that is, the Nagai, Emde and Leuckart methods and reductive amination (see figure I), and 66 Bulletin on Narcotics, vol. LVII, Nos. 1 and 2, 2005 Figure I. Interrelationship of methamphetamine and main precursor substances Cl OH Benzylchloride O Methylformamide N Leuckart method (Formic acid) N P-2-P N-formylmethamphetamine Benzylcyanide Methylamine, AA (acetic anhydride), Aluminum, Hydrochloric acid sodium acetate anhydride OH Mercuric chloride Reductive amination O Phenylacetic acid OH H H Lithium (or sodium) in liquid ammonia N N Birch reduction O Hydriodic acid, red phosphorus H Nagai method Ephedrine (or Methamphetamine pseudoephedrine) Perchloric acid, hydrogen gas, Benzaldehyde palladium-barium sulfate Rosenmund method Hydrogen gas, Thionyl chloride Cl palladium-barium H sulfate N Emde method Chloropseudoephedrine the impurities specific to each method were identified from among the many impurities generated. The following
Load more

Recommended publications
  • House Bill No. 2191
    SECOND REGULAR SESSION HOUSE BILL NO. 2191 99TH GENERAL ASSEMBLY INTRODUCED BY REPRESENTATIVE QUADE. 5582H.01I D. ADAM CRUMBLISS, Chief Clerk AN ACT To repeal section 579.060, RSMo, and to enact in lieu thereof one new section relating to controlled substances, with penalty provisions. Be it enacted by the General Assembly of the state of Missouri, as follows: Section A. Section 579.060, RSMo, is repealed and one new section enacted in lieu 2 thereof, to be known as section 579.060, to read as follows: 579.060. 1. A person commits the offense of unlawful sale, distribution, or purchase of 2 over-the-counter methamphetamine precursor drugs if he or she knowingly: 3 (1) Sells, distributes, dispenses, or otherwise provides any number of packages of any 4 drug product containing detectable amounts of ephedrine, levomethamphetamine, 5 phenylpropanolamine, propylhexedrine, or pseudoephedrine, or any of their salts, optical 6 isomers, or salts of optical isomers, in a total amount greater than nine grams to the same 7 individual within a thirty-day period, unless the amount is dispensed, sold, or distributed 8 pursuant to a valid prescription; or 9 (2) Purchases, receives, or otherwise acquires within a thirty-day period any number of 10 packages of any drug product containing any detectable amount of ephedrine, 11 levomethamphetamine, phenylpropanolamine, propylhexedrine, or pseudoephedrine, or any 12 of their salts or optical isomers, or salts of optical isomers in a total amount greater than nine 13 grams, without regard to the number of transactions, unless the amount is purchased, received, 14 or acquired pursuant to a valid prescription; or 15 (3) Purchases, receives, or otherwise acquires within a twenty-four-hour period any 16 number of packages of any drug product containing any detectable amount of ephedrine, 17 levomethamphetamine, phenylpropanolamine, propylhexedrine, or pseudoephedrine, or any EXPLANATION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is intended to be omitted from the law.
    [Show full text]
  • Scientific Assessment of Ephedra Species (Ephedra Spp.)
    Annex 3 Ref. Ares(2010)892815 – 02/12/2010 Recognising risks – Protecting Health Federal Institute for Risk Assessment Annex 2 to 5-3539-02-5591315 Scientific assessment of Ephedra species (Ephedra spp.) Purpose of assessment The Federal Office of Consumer Protection and Food Safety (BVL), in collaboration with the ALS working party on dietary foods, nutrition and classification issues, has compiled a hit list of 10 substances, the consumption of which may pose a health risk. These plants, which include Ephedra species (Ephedra L.) and preparations made from them, contain substances with a strong pharmacological and/or psychoactive effect. The Federal Ministry of Food, Agriculture and Consumer Protection has already asked the EU Commission to start the procedure under Article 8 of Regulation (EC) No 1925/2006 for these plants and preparations, for the purpose of including them in one of the three lists in Annex III. The assessment applies to ephedra alkaloid-containing ephedra haulm. The risk assessment of the plants was carried out on the basis of the Guidance on Safety Assessment of botanicals and botanical preparations intended for use as ingredients in food supplements published by the EFSA1 and the BfR guidelines on health assessments2. Result We know that ingestion of ephedra alkaloid-containing Ephedra haulm represents a risk from medicinal use in the USA and from the fact that it has now been banned as a food supplement in the USA. Serious unwanted and sometimes life-threatening side effects are associated with the ingestion of food supplements containing ephedra alkaloids. Due to the risks described, we would recommend that ephedra alkaloid-containing Ephedra haulm be classified in List A of Annex III to Regulation (EC) No 1925/2006.
    [Show full text]
  • Incorporating Parents in the Anti-Doping Fight: a Test of the Viability of a Parent-Based Prevention Program
    1 Social Science Research Fund: Incorporating Parents in the Anti-Doping Fight: A Test of the Viability of a Parent-Based Prevention Program Final Report Submitted to: World Anti-Doping Agency Prepared by: Tonya Dodge, Ph.D. Skidmore College* *Investigator will be moving to The George Washington University Contact Information: Tonya Dodge, Ph.D. The George Washington University Department of psychology 2125 G Street, NW Washington, DC 20052 e-mail: [email protected] 2 Table of Contents Executive Summary.............................................................................................................................................. 3 Background ............................................................................................................................................................. 5 Interventions Targeting AS Use ....................................................................................................................... 6 Building Parent-Based Interventions: Considerations ........................................................................... 7 A Parent-Based Framework to Prevent AS and NS Use ......................................................................... 9 Study Aims ............................................................................................................................................................ 10 Methods ................................................................................................................................................................
    [Show full text]
  • Fall TNP Herbals.Pptx
    8/18/14 Introduc?on to Objecves Herbal Medicine ● Discuss history and role of psychedelic herbs Part II: Psychedelics, in medicine and illness. Legal Highs, and ● List herbs used as emerging legal and illicit Herbal Poisons drugs of abuse. ● Associate main plant and fungal families with Jason Schoneman RN, MS, AGCNS-BC representave poisonous compounds. The University of Texas at Aus?n ● Discuss clinical management of main toxic Schultes et al., 1992 compounds. Psychedelics Sacraments: spiritual tools or sacred medicine by non-Western cultures vs. Dangerous drugs of abuse vs. Research and clinical tools for mental and physical http://waynesword.palomar.edu/ww0703.htm disorders History History ● Shamanic divinaon ○ S;mulus for spirituality/religion http://orderofthesacredspiral.blogspot.com/2012/06/t- mckenna-on-psilocybin.html http://www.cosmicelk.net/Chukchidirections.htm 1 8/18/14 History History http://www.10zenmonkeys.com/2007/01/10/hallucinogenic- weapons-the-other-chemical-warfare/ http://rebloggy.com/post/love-music-hippie-psychedelic- woodstock http://fineartamerica.com/featured/misterio-profundo-pablo- amaringo.html History ● Psychotherapy ○ 20th century: un;l 1971 ● Recreaonal ○ S;mulus of U.S. cultural revolu;on http://qsciences.digi-info-broker.com http://www.uspharmacist.com/content/d/feature/c/38031/ http://en.wikipedia.org/nervous_system 2 8/18/14 Main Groups Main Groups Tryptamines LSD, Psilocybin, DMT, Ibogaine Other Ayahuasca, Fly agaric Phenethylamines MDMA, Mescaline, Myristicin Pseudo-hallucinogen Cannabis Dissociative
    [Show full text]
  • Dietary Supplements Containing Ephedrine Alkaloids
    SUMMARY OF DATA FOR CHEMICAL SELECTION Dietary Supplements Containing Ephedrine Alkaloids BASIS OF NOMINATION Dietary supplements containing ephedrine alkaloids from herbal sources (ephedra) are brought to the attention of the CSWG as part of an ongoing National Institutes of Health (NIH) Office of Dietary Supplements (ODS) research initiative on the safety and efficacy of these products. This initiative was recommended by the Senate Committee on Appropriations in fiscal year (FY) 2001. In its Report making FY 2002 appropriations for the Department of Health and Human Services, the Committee expressed pleasure that the ODS followed through on its FY 2001 recommendation and urged the ODS to continue and expand this important effort. The nomination of ephedra­ containing supplements to the National Toxicology Program (NTP) is part of the expanded effort by the ODS. As the Senate Committee noted, the number of Americans taking dietary supplements containing ephedra has risen dramatically. Dietary supplements containing herbal ephedra (chiefly Ephedra sinica Stapf.) are widely used as diet aids and athletic performance enhancers, with over 3 billion servings1 sold each year for weight loss alone. The active ingredients in these supplements are primarily ephedrine and pseudoephedrine with small amounts of other ephedrine alkaloids usually present. Ephedra-based diet aids often contain other stimulants, such as caffeine (guarana), as well as salicin, diuretics, and cathartics. Ephedra-containing performance enhancers often contain caffeine and other ingredients, such as chromium picolinate or l-carnitine, and may be consumed with other performance enhancers, such as androstenedione and creatine monohydrate. The ephedrine alkaloids are sympathomimetic amines, a class of compounds with fairly well characterized short to medium term biological activities.
    [Show full text]
  • Recommended Methods for the Identification and Analysis Of
    Vienna International Centre, P.O. Box 500, 1400 Vienna, Austria Tel: (+43-1) 26060-0, Fax: (+43-1) 26060-5866, www.unodc.org RECOMMENDED METHODS FOR THE IDENTIFICATION AND ANALYSIS OF AMPHETAMINE, METHAMPHETAMINE AND THEIR RING-SUBSTITUTED ANALOGUES IN SEIZED MATERIALS (revised and updated) MANUAL FOR USE BY NATIONAL DRUG TESTING LABORATORIES Laboratory and Scientific Section United Nations Office on Drugs and Crime Vienna RECOMMENDED METHODS FOR THE IDENTIFICATION AND ANALYSIS OF AMPHETAMINE, METHAMPHETAMINE AND THEIR RING-SUBSTITUTED ANALOGUES IN SEIZED MATERIALS (revised and updated) MANUAL FOR USE BY NATIONAL DRUG TESTING LABORATORIES UNITED NATIONS New York, 2006 Note Mention of company names and commercial products does not imply the endorse- ment of the United Nations. This publication has not been formally edited. ST/NAR/34 UNITED NATIONS PUBLICATION Sales No. E.06.XI.1 ISBN 92-1-148208-9 Acknowledgements UNODC’s Laboratory and Scientific Section wishes to express its thanks to the experts who participated in the Consultative Meeting on “The Review of Methods for the Identification and Analysis of Amphetamine-type Stimulants (ATS) and Their Ring-substituted Analogues in Seized Material” for their contribution to the contents of this manual. Ms. Rosa Alis Rodríguez, Laboratorio de Drogas y Sanidad de Baleares, Palma de Mallorca, Spain Dr. Hans Bergkvist, SKL—National Laboratory of Forensic Science, Linköping, Sweden Ms. Warank Boonchuay, Division of Narcotics Analysis, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand Dr. Rainer Dahlenburg, Bundeskriminalamt/KT34, Wiesbaden, Germany Mr. Adrian V. Kemmenoe, The Forensic Science Service, Birmingham Laboratory, Birmingham, United Kingdom Dr. Tohru Kishi, National Research Institute of Police Science, Chiba, Japan Dr.
    [Show full text]
  • Ephedra and Energy Drinks on College Campuses by Daniel Ari Kapner
    INFOFACTSRESOURCES The Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention Ephedra and Energy Drinks on College Campuses by Daniel Ari Kapner The February 2003 death of Baltimore Orioles pitcher levels . alertness and perception.”6,7 Also known found. Half of the events in which ephedra was the Steve Bechler, who according to the coroner’s report as ma huang, ephedra is considered a “natural” main contributing factor affected apparently healthy died after taking ephedrine alkaloids (ephedra), has supplement7 and Chinese herbalists have used the people under age 30.13 garnered national attention for the topic of nutri- herb Ephedra for thousands of years to treat asthma The Annals of Internal Medicine published a study tional supplements and energy drinks.1 While the and colds.8 Ephedra has been used in some over-the- in 2003 suggesting that ephedra accounted for 64 headlines have focused mainly on use by professional counter cold and asthma products in the United States.9 percent of all adverse reactions from herbal products athletes, these substances have gained popularity Until recently, ephedra was found in many weight- in 2001, even though it represented only 4.3 percent of among college-age students and are associated with loss and energy-enhancing products. Popular supple- industry sales in that year.14,15 the deaths of Florida State University linebacker ments that contained ephedra included Metabolife A study published in the New England Journal Devaughn Darling, Northwestern University football and Ripped Fuel, both of which are now available in of Medicine in 2000 examined 140 cases of ephedra- player Rashid Wheeler, and the University at Albany, ephedra-free formulations.
    [Show full text]
  • Chapter 1.Litho
    exploited by drug trafficking organizations. What is more, the rise in drug abuse in such countries has proven extremely difficult to contain because of INTRODUCTION fragmented and unprepared medical and health authorities. In situations of armed conflict, illicit Governments and international organizations drug revenues – or the drugs themselves – are regularly collect and analyze data on illicit drug regularly exchanged for arms. production, trafficking and consumption. In most cases, however, trends can be identified only indi- In a world that becomes increasingly complex, the rectly due to the inherently clandestine nature of scope for profit-making in the illicit drug trade is the activities. With this constraint acknowledged at rapidly expanding. The relationship between illicit the outset, this chapter seeks to describe global drugs and economic development, for example, is trends on the basis of available information. The far more important than generally recognized: overview may help to place in context trends and while it is widely accepted that illicit cultivation issues described in subsequent parts of this report. occurs in many developing countries, the effects of the illegal trade on local communities is all too The illicit drug phenomenon cannot be viewed often assumed to be cost-free. In fact, the spillover outside the context of contemporary economic, of production into abuse has a negative impact on social and political developments. Changes in the the local workforce. Illicit sector income is unevenly world political economy and advances in distributed; at the lower level of the production technology over the past three decades have had a chain it barely exceeds income in the licit sector.
    [Show full text]
  • Methamphetamine Use: Lessons Learned
    The author(s) shown below used Federal funds provided by the U.S. Department of Justice and prepared the following final report: Document Title: Methamphetamine Use: Lessons Learned Author(s): Dana Hunt, Ph.D.; Sarah Kuck; Linda Truitt, Ph.D. Document No.: 209730 Date Received: February 2006 Award Number: 99-C-008 This report has not been published by the U.S. Department of Justice. To provide better customer service, NCJRS has made this Federally- funded grant final report available electronically in addition to traditional paper copies. Opinions or points of view expressed are those of the author(s) and do not necessarily reflect the official position or policies of the U.S. Department of Justice. ANALYTIC SUPPORT PROGRAM CONTRACT TASK REQUIREMENT T-043: Methamphetamine Use: Lessons Learned Contract No. 99-C-008 Cambridge, MA Lexington, MA Hadley, MA Bethesda, MD Chicago, IL January 31, 2006 Prepared for Raymond C. German Contracting Officer Christine Crossland Senior Social Science Analyst National Institute of Justice Office of Justice Programs Acquisition Management Division 810 Seventh Street, SW Washington, D.C. 20001 Prepared by Dana Hunt, Ph.D. Sarah Kuck Abt Associates Inc. Linda Truitt, Ph.D. 55 Wheeler Street Cambridge, MA 02138 Contents Executive Summary...............................................................................................................iii History of Methamphetamine Use .................................................................................iii Trends.............................................................................................................................iii
    [Show full text]
  • Ecstasy/MDMA
    Ecstasy/MDMA What Is Ecstasy/MDMA? MDMA acts as both a stimulant and psychedelic, producing an energizing effect, distortions in time and perception, and enhanced enjoyment of tactile experiences. Adolescents and young adults use it to reduce inhibitions and to promote: • Euphoria • Feelings of closeness • Empathy • Sexuality Although MDMA is known among users as ecstasy, researchers have determined that many ecstasy tablets contain not only MDMA but also a number of other drugs or drug combinations that can be harmful, such as: • Methamphetamine • Ecstasy/MDMA acts as both a • Ketamine stimulant and psychedelic, • producing an energizing effect, Cocaine distortions in time and perception, • The over-the-counter cough suppressant dextromethorphan (DXM) and enhanced enjoyment of tactile • The diet drug ephedrine experiences. • Caffeine • Many ecstasy tablets contain a In addition, other drugs similar to MDMA, such as MDA or PMA, are often sold as ecstasy, number of other drugs or drug combinations that can be harmful. which can lead to overdose and death when the user takes additional doses to obtain the desired effect. • MDMA can cause unwanted psychological effects such as What Are Common Street Names? confusion, anxiety, depression, paranoia, sleep problems, and drug Common street names include: craving. Adam, Beans, Clarity, Disco Biscuit, E, Ecstasy, Eve, Go, Hug Drug, Lover’s Speed, MDMA, • High doses of MDMA can interfere Peace, STP, X, and XTC with the body’s ability to regulate temperature and can result in a What Does It Look Like? sharp increase in body temperature MDMA is mainly distributed in tablet form. MDMA tablets are sold with logos, creating leading to liver, kidney, and cardiovascular failure.
    [Show full text]
  • Medications to Be Avoided Or Used with Caution in Parkinson's Disease
    Medications To Be Avoided Or Used With Caution in Parkinson’s Disease This medication list is not intended to be complete and additional brand names may be found for each medication. Every patient is different and you may need to take one of these medications despite caution against it. Please discuss your particular situation with your physician and do not stop any medication that you are currently taking without first seeking advice from your physician. Most medications should be tapered off and not stopped suddenly. Although you may not be taking these medications at home, one of these medications may be introduced while hospitalized. If a hospitalization is planned, please have your neurologist contact your treating physician in the hospital to advise which medications should be avoided. Medications to be avoided or used with caution in combination with Selegiline HCL (Eldepryl®, Deprenyl®, Zelapar®), Rasagiline (Azilect®) and Safinamide (Xadago®) Medication Type Medication Name Brand Name Narcotics/Analgesics Meperidine Demerol® Tramadol Ultram® Methadone Dolophine® Propoxyphene Darvon® Antidepressants St. John’s Wort Several Brands Muscle Relaxants Cyclobenzaprine Flexeril® Cough Suppressants Dextromethorphan Robitussin® products, other brands — found as an ingredient in various cough and cold medications Decongestants/Stimulants Pseudoephedrine Sudafed® products, other Phenylephrine brands — found as an ingredient Ephedrine in various cold and allergy medications Other medications Linezolid (antibiotic) Zyvox® that inhibit Monoamine oxidase Phenelzine Nardil® Tranylcypromine Parnate® Isocarboxazid Marplan® Note: Additional medications are cautioned against in people taking Monoamine oxidase inhibitors (MAOI), including other opioids (beyond what is mentioned in the chart above), most classes of antidepressants and other stimulants (beyond what is mentioned in the chart above).
    [Show full text]
  • State Methamphetamine Precursor Control Policies
    The author(s) shown below used Federal funds provided by the U.S. Department of Justice and prepared the following final report: Document Title: From Policy to Practice: State Methamphetamine Precursor Control Policies Author: Jean O’Connor, J.D., M.P.H.; Jamie Chriqui, Ph.D., M.H.S.; Duane McBride, Ph.D.; Shelby Smith Eidson, J.D.; Carissa Baker; Yvonne Terry-McElrath, M.S.; Curt VanderWaal, Ph.D. Document No.: 228133 Date Received: August 2009 Award Number: 2005-IJ-CX-0028 This report has not been published by the U.S. Department of Justice. To provide better customer service, NCJRS has made this Federally- funded grant final report available electronically in addition to traditional paper copies. Opinions or points of view expressed are those of the author(s) and do not necessarily reflect the official position or policies of the U.S. Department of Justice. From Policy to Practice: State Methamphetamine Precursor Control Policies A report on state methamphetamine laws and regulations, effective October 1, 2005 Prepared by: Jean O’Connor, J.D., M.P.H.1 Jamie Chriqui, Ph.D., M.H.S.1 Duane McBride, Ph.D.2 Shelby Smith Eidson, J.D.1 Carissa Baker1 Yvonne Terry-McElrath, M.S.3 Curt VanderWaal, Ph.D. 2 1The MayaTech Corporation 2Andrews University 3University of Michigan March 2, 2007 This document is a research report submitted to the U.S. Department of Justice. This report has not been published by the Department. Opinions or points of view expressed are those of the author(s) and do not necessarily reflect the official position or policies of the U.S.
    [Show full text]