DOCSLIB.ORG

Drug Adulterants and Their Effects on the Health of Users: a Critical Review

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Drug Adulterants and Their Effects on the Health of Users: a Critical Review N S N O O O N N N N O N DRUG ADULTERANTS AND N N THEIR EFFECTS ON THE O N HEALTH OF USERS: A CRITICAL REVIEW N N O CICAD Luis Almagro Farah Urrutia Secretary General Secretary for Multidimensional Security Organization of American States Organization of American States Nestor Mendez Adam E. Namm Assistant Secretary General Executive Secretary Organization of American States Inter-American Drug Abuse Control Commission Organization of American States OAS Cataloging-in-Publication Data Inter-American Drug Abuse Control Commission. Inter-American Observatory on Drugs. Adulterantes de las drogas y sus efectos en la salud de los usuarios: una revisión crítica / [Observatorio Interamericano sobre Drogas (OID) de la Comisión Interamericana para el Control del Abuso de Drogas (CICAD]. v. ; cm. (OAS. Documentos oficiales ; OEA/Ser.L/XIV.6.71) ISBN 978-0-8270-6872-8 1. Drug abuse--Health aspects. 2. Substance abuse--Health aspects. 3. Drug adulteration. 4. Psychotropic drugs. 5. Designer drugs. I. Title. II. Organization of American States. Secretariat for Multidimensional Security. III. Series. OEA/Ser.L/XIV.6.71 COPYRIGHT© (2019) Organization of American States. All the rights reserved under International and Panamerican Conventions. No portion of the content of this material may be reproduced or transmitted in any form, nor by any electronic or mechanical means, totally or partially, without the express consent of the Organization. Prepared and published by the Inter-American Drug Abuse Control Commission (CICAD), Organization of American States (OAS), Report on Drug Use in the Americas 2019, Washington, D.C., 2019. Comments on the report are welcome and can be sent to: [email protected] The contents expressed in this document are presented exclusively for informational purposes and do not necessarily represent the opinion or official position of the Organization of American States, its General Secretariat or its member states. DRUG ADULTERANTS AND THEIR EFFECTS ON THE HEALTH OF USERS: A CRITICAL REVIEW Overall coordination of the document: M.H.S. Marya Hynes. Head of the Inter-American Observatory on Drugs (OID) of the Inter-American Drug Abuse Control Commission (CICAD), Organization of American States (OAS). Thom Browne. CEO, Colombo Plan Secretariat. Primary author: Dr. Antonio Pascale Prieto, M.D., Specialist in Clinical Toxicology. Associate Professor of Clinical Toxicology, Montevideo, Uruguay. Member of REDLA (Network of Latin American Drug Researchers). Consultants for Brazil (tables and summaries of selected studies): Dr. Alice A. da Matta Chasin, Ph.D. in Toxicology from the University of São Paulo. Full Professor of Toxicology in the Oswaldo Cruz School; Expert in Forensic Toxicology, 1976-2004; Visiting Professor at the University of São Paulo, 2003-2014; Representative of TIAFT in Brazil, 1995-2018. Natália Giancotti Ferreira, Criminal Expert of the state of São Paulo, Brazil. Degree in Pharmacy and a Master of Science from the Postgraduate Program in Toxicology, Ribeirão Preto School of Pharmaceutical Sciences of the University of São Paulo. Consultant for bibliographical search and tables: Dr. Federico Pose Mazzella, M.D., Resident in Clinical Toxicology, Montevideo, Uruguay. Conflict of interest: The authors of this paper hereby state that they have no conflict of interest. DRUG ADULTERANTS AND THEIR EFFECTS ON THE HEALTH OF USERS: A CRITICAL REVIEW KEY POINTS: • The purity of drugs is highly variable and depends on the region or epidemiological context. Evidence shows that there is a broad spectrum of adulterants in the drugs that are most prevalent worldwide. • Drug adulteration is constantly changing, with an overall trend toward a decline in the purity of most drugs over the past 10 years. Some adulterants enhance the psychoactive effects of a drug and may contribute to its addictive potential. • Some adulterants are associated with a significant increase in the risk of overdose and death due to acute poisoning (e.g., fentanyl in cocaine or heroin, adulterants in MDMA and LSD, adulterations of new psychoactive substances or NPS); others are related to complications that appear following chronic use in subjects who may be genetically predisposed (e.g., levamisole in cocaine). • Deaths in the studies examined appear to be related to the drugs involved, to poly-drug use, and to the dose consumed. • Considering the gaps in knowledge, it would seem necessary to conduct a standardized analysis of chemical composition and expand it to include a broader spectrum of substances, using similar protocols with more representative samples in the various countries and regions, to obtain a complete chemical characterization of the drugs analyzed. • The quality of the information and evidence available on the harms to health caused by some adulterants varies widely. While the most common adulterations of some substances are well known, the emergence of NPS has led to gaps in knowledge about the drugs being used and their composition. • Coordination among supply control agencies and those organizations that have access to samples obtained directly from users appears to be needed to achieve common objectives. Early warning systems in the different countries are fundamental to such coordination. • In the current context of legalization or regularization of the marijuana market in a number of countries, more rigorous research must be conducted on possible 1 contamination by pesticides used on crops, and their possible effects on cannabis use -- particularly smoked cannabis, given current evidence linking adulterations of marijuana with respiratory disease. • Studies of the toxic health effects of adulterants and their association with the drug that is used are based on experimental studies, and essentially on case reports and case series. Epidemiological context, clinical presentation, complications (as seen clinically and in histopathology), and analytical confirmation are the basic pillars in analyzing the toxicity of an adulterant or an adulterant/drug combination. • Health professionals, the community, and most importantly drug users should be aware of the risks inherent in the adulterations of the drugs they are using, as well as the potential chronic, long-term toxic effects that may be attributable to the presence of one or more adulterants. • Hospitals need to have trained personnel, the necessary material resources, and the means to communicate immediately with local laboratories to identify the adulterants. Early diagnosis makes for better treatment and reduces morbidity and mortality. • To address this public health problem, it is necessary to develop research and action protocols and to strengthen networks involving government agencies (e.g., early warning systems), clinical and forensic laboratories, and nongovernmental organizations with access to users, as well as universities and toxicology centers. 2 Contents 1. INTRODUCTION ......................................................................................................................... 5 2. OBJECTIVES OF THIS STUDY ...................................................................................................... 7 2.1. Overall objective: ............................................................................................................... 7 2.2. Specific objectives: ............................................................................................................. 7 3. METHODOLOGY ........................................................................................................................ 7 3.1. Systematic review .............................................................................................................. 8 3.2. Descriptive review .............................................................................................................. 9 4. ADULTERANTS FOUND IN THE DRUGS TESTED ....................................................................... 11 4.1. Cocaine and its derivatives (cocaine hydrochloride, smokable cocaines) ....................... 11 4.1.1. Presence of adulterants in South America ................................................................ 12 4.1.2. Studies and analyses reported in Europe .................................................................. 31 4.1.3. Analysis of seizures in Africa ..................................................................................... 36 4.1.4. Alerts to presence of fentanyl and derivatives in seizures of cocaine ...................... 36 4.2. Amphetamine-type stimulants (ATS) and NPS ................................................................. 36 4.2.1. The situation in Europe ............................................................................................. 39 4.2.2. United States ............................................................................................................. 41 4.2.3. South America ........................................................................................................... 41 4.2.4. Asia and Oceania ....................................................................................................... 43 4.3. Derivatives of opium, heroin, synthetic opioids (fentanyl and derivatives) .................... 44 4.3.1. Opium ........................................................................................................................ 44 4.3.2. Analysis of samples of heroin .................................................................................... 45
Load more

Recommended publications
  • Hallucinogens - LSD, Peyote, Psilocybin, and PCP
    Hallucinogens - LSD, Peyote, Psilocybin, and PCP Hallucinogenic compounds found in some • Psilocybin (4-phosphoryloxy-N,N- plants and mushrooms (or their extracts) dimethyltryptamine) is obtained from have been used—mostly during religious certain types of mushrooms that are rituals—for centuries. Almost all indigenous to tropical and subtropical hallucinogens contain nitrogen and are regions of South America, Mexico, and classified as alkaloids. Many hallucinogens the United States. These mushrooms have chemical structures similar to those of typically contain less than 0.5 percent natural neurotransmitters (e.g., psilocybin plus trace amounts of acetylcholine-, serotonin-, or catecholamine- psilocin, another hallucinogenic like). While the exact mechanisms by which substance. hallucinogens exert their effects remain • PCP (phencyclidine) was developed in unclear, research suggests that these drugs the 1950s as an intravenous anesthetic. work, at least partially, by temporarily Its use has since been discontinued due interfering with neurotransmitter action or to serious adverse effects. by binding to their receptor sites. This DrugFacts will discuss four common types of How Are Hallucinogens Abused? hallucinogens: The very same characteristics that led to • LSD (d-lysergic acid diethylamide) is the incorporation of hallucinogens into one of the most potent mood-changing ritualistic or spiritual traditions have also chemicals. It was discovered in 1938 led to their propagation as drugs of abuse. and is manufactured from lysergic acid, Importantly, and unlike most other drugs, which is found in ergot, a fungus that the effects of hallucinogens are highly grows on rye and other grains. variable and unreliable, producing different • Peyote is a small, spineless cactus in effects in different people at different times.
    [Show full text]
  • Vasodilators for Primary Raynaud's Phenomenon
    Vasodilators for primary Raynaud's phenomenon Author Su, KYC, Sharma, M, Kim, HJ, Kaganov, E, Hughes, I, Abdeen, MH, Ng, JHK Published 2021 Journal Title Cochrane Database of Systematic Reviews Version Version of Record (VoR) DOI https://doi.org/10.1002/14651858.CD006687.pub4 Copyright Statement © 2021 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2021, Issue 5. Art. No.: CD006687.. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review. Downloaded from http://hdl.handle.net/10072/405317 Griffith Research Online https://research-repository.griffith.edu.au Cochrane Library Cochrane Database of Systematic Reviews Vasodilators for primary Raynaud's phenomenon (Review) Su KYC, Sharma M, Kim HJ, Kaganov E, Hughes I, Abdeen MH, Ng JHK Su KYC, Sharma M, Kim HJ, Kaganov E, Hughes I, Abdeen MH, Ng JH. Vasodilators for primary Raynaud's phenomenon. Cochrane Database of Systematic Reviews 2021, Issue 5. Art. No.: CD006687. DOI: 10.1002/14651858.CD006687.pub4. www.cochranelibrary.com Vasodilators for primary Raynaud's phenomenon (Review) Copyright © 2021 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Cochrane Trusted evidence. Informed decisions. Library Better health. Cochrane Database of Systematic Reviews T A B L E O F C O N T E N T S HEADER........................................................................................................................................................................................................
    [Show full text]
  • Recommended Methods for the Identification and Analysis of Synthetic Cathinones in Seized Materialsd
    Recommended methods for the Identification and Analysis of Synthetic Cathinones in Seized Materials (Revised and updated) MANUAL FOR USE BY NATIONAL DRUG ANALYSIS LABORATORIES Photo credits:UNODC Photo Library; UNODC/Ioulia Kondratovitch; Alessandro Scotti. Laboratory and Scientific Section UNITED NATIONS OFFICE ON DRUGS AND CRIME Vienna Recommended Methods for the Identification and Analysis of Synthetic Cathinones in Seized Materials (Revised and updated) MANUAL FOR USE BY NATIONAL DRUG ANALYSIS LABORATORIES UNITED NATIONS Vienna, 2020 Note Operating and experimental conditions are reproduced from the original reference materials, including unpublished methods, validated and used in selected national laboratories as per the list of references. A number of alternative conditions and substitution of named commercial products may provide comparable results in many cases. However, any modification has to be validated before it is integrated into laboratory routines. ST/NAR/49/REV.1 Original language: English © United Nations, March 2020. All rights reserved, worldwide. The designations employed and the presentation of material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area, or of its authorities, or concerning the delimitation of its frontiers or boundaries. Mention of names of firms and commercial products does not imply the endorse- ment of the United Nations. This publication has not been formally edited. Publishing production: English, Publishing and Library Section, United Nations Office at Vienna. Acknowledgements The Laboratory and Scientific Section of the UNODC (LSS, headed by Dr. Justice Tettey) wishes to express its appreciation and thanks to Dr.
    [Show full text]
  • Identification and Quantification of Adulterants in Coffee
    foods Communication Identification and Quantification of Adulterants in Coffee (Coffea arabica L.) Using FT-MIR Spectroscopy Coupled with Chemometrics Mauricio Flores-Valdez 1 , Ofelia Gabriela Meza-Márquez 2 , Guillermo Osorio-Revilla 2 and Tzayhri Gallardo-Velázquez 1,* 1 Instituto Politécnico Nacional, Escuela Nacional de Ciencias Biológicas-Santo Tomás, Departamento de Biofísica, Prolongación de Carpio y Plan de Ayala S/N, Col. Santo Tomás, Alcaldía Miguel Hidalgo, Ciudad de México C.P. 11340, Mexico; [email protected] 2 Instituto Politécnico Nacional, Escuela Nacional de Ciencias Biológicas-Zacatenco, Departamento de Ingeniería Bioquímica, Av. Wilfrido Massieu S/N, Esq. Cda, Miguel Stampa, Col. Unidad Profesional Adolfo López Mateos, Zacatenco, Alcaldía Gustavo A. Madero, Ciudad de México C.P. 07738, Mexico; [email protected] (O.G.M.-M.); [email protected] (G.O.-R.) * Correspondence: [email protected]; Tel.: +52-(55)-5729-6000 (ext. 62305) Received: 24 May 2020; Accepted: 28 June 2020; Published: 30 June 2020 Abstract: Food adulteration is an illegal practice performed to elicit economic benefits. In the context of roasted and ground coffee, legumes, cereals, nuts and other vegetables are often used to augment the production volume; however, these adulterants lack the most important coffee compound, caffeine, which has health benefits. In this study, the mid-infrared Fourier transform spectroscopy (FT-MIR) technique coupled with chemometrics was used to identify and quantify adulterants in coffee (Coffea arabica L.). Coffee samples were adulterated with corn, barley, soy, oat, rice and coffee husks, in proportions ranging from 1–30%. A discrimination model was developed using the soft independent modeling of class analogy (SIMCA) framework, and quantitative models were developed using such algorithms as the partial least squares algorithms with one variable (PLS1) and multiple variables (PLS2) and principal component regression (PCR).
    [Show full text]
  • Pharmacotherapeutic Considerations for Individuals with Down Syndrome Erik Hefti
    Harrisburg University of Science and Technology Digital Commons at Harrisburg University Harrisburg University Faculty Works 12-8-2016 Pharmacotherapeutic Considerations for Individuals with Down Syndrome Erik Hefti Follow this and additional works at: http://digitalcommons.harrisburgu.edu/faculty-works Part of the Congenital, Hereditary, and Neonatal Diseases and Abnormalities Commons, and the Medicinal and Pharmaceutical Chemistry Commons R EVIEW O F T HERAPEUTICS Pharmacotherapeutic Considerations for Individuals with Down Syndrome Erik Hefti,* and Javier G. Blanco* Department of Pharmaceutical Sciences, The School of Pharmacy and Pharmaceutical Sciences, The State University of New York at Buffalo, Buffalo, New York Down syndrome (DS; trisomy 21) is the most common survivable disorder due to aneuploidy. Individ- uals with DS may experience multiple comorbid health problems including congenital heart defects, endocrine abnormalities, skin and dental problems, seizure disorders, leukemia, dementia, and obesity. These associated conditions may necessitate pharmacotherapeutic management with various drugs. The complex pathobiology of DS may alter drug disposition and drug response in some individuals. For example, reports have documented increased rates of adverse drug reactions in patients with DS treated for leukemia and dementia. Intellectual disability resulting from DS may impact adherence to medication regimens. In this review, we highlight literature focused on pharmacotherapy for individu- als with DS. We discuss reports of altered drug disposition or response in patients with DS and explore social factors that may impact medication adherence in the DS setting. Enhanced monitoring during drug therapy in individuals with DS is justified based on reports of altered drug disposition, drug response, and other characteristics present in this population.
    [Show full text]
  • 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.
    [Show full text]
  • Medical Review Officer Manual
    Department of Health and Human Services Substance Abuse and Mental Health Services Administration Center for Substance Abuse Prevention Medical Review Officer Manual for Federal Agency Workplace Drug Testing Programs EFFECTIVE OCTOBER 1, 2010 Note: This manual applies to Federal agency drug testing programs that come under Executive Order 12564 dated September 15, 1986, section 503 of Public Law 100-71, 5 U.S.C. section 7301 note dated July 11, 1987, and the Department of Health and Human Services Mandatory Guidelines for Federal Workplace Drug Testing Programs (73 FR 71858) dated November 25, 2008 (effective October 1, 2010). This manual does not apply to specimens submitted for testing under U.S. Department of Transportation (DOT) Procedures for Transportation Workplace Drug and Alcohol Testing Programs (49 CFR Part 40). The current version of this manual and other information including MRO Case Studies are available on the Drug Testing page under Medical Review Officer (MRO) Resources on the SAMHSA website: http://www.workplace.samhsa.gov Previous Versions of this Manual are Obsolete 3 Table of Contents Chapter 1. The Medical Review Officer (MRO)........................................................................... 6 Chapter 2. The Federal Drug Testing Custody and Control Form ................................................ 7 Chapter 3. Urine Drug Testing ...................................................................................................... 9 A. Federal Workplace Drug Testing Overview..................................................................
    [Show full text]
  • 1589361321Unit V Food Adulteration.Pdf
    ~oodMicrobiology and the PFA Act, a trader is guilty if he sells milk to which water has been added Safety (intentional addition) or the cream of the milk has been replaced by cheap vegetable or animal fat (substitution) or simply the cream has been removed and the milk is sold as such, with a low fat content (abstraction). Unintentional contamination of the milk, due to carelessness on part of the trader is also considered as adulteration under the law. For instance, if the cans in which the trader is transporting or storing the milk, had been earlier treated with the chemicals like washing soda or boric acid or some detergent and not been washed thoroughly with water, residues of the chemicals may get mixed with the milk. Such milk would Ire considered adulterated. In addition, food is also considered to be adulterated, if it does not conform to the basic quality standards. For instance, the maximum amount of moisture allowed in a milk powder sample is 4%. If a sample is found to have greater moisture levels, it is considered to be adulterated. The malpractice of food adulteration is still widely prevalent in our country. There are very few studies on the extent and nature of food adulteration in the country. Whatever sFdies are available, are restricted to a select few cities and hence are not adequate to give a true picture for the country as a whole. The only data that are available are the reports from the food testing laboratories of the Central and State Government. According to these official reports, the extent of food adulteration in India bas been gradually diminishing from 3 1% in 1960s to less than 10% in the 1990s.
    [Show full text]
  • The Stimulants and Hallucinogens Under Consideration: a Brief Overview of Their Chemistry and Pharmacology
    Drug and Alcohol Dependence, 17 (1986) 107-118 107 Elsevier Scientific Publishers Ireland Ltd. THE STIMULANTS AND HALLUCINOGENS UNDER CONSIDERATION: A BRIEF OVERVIEW OF THEIR CHEMISTRY AND PHARMACOLOGY LOUIS S. HARRIS Dcparlmcnl of Pharmacology, Medical College of Virginia, Virginia Commonwealth Unwersity, Richmond, VA 23298 (U.S.A.) SUMMARY The substances under review are a heterogenous set of compounds from a pharmacological point of view, though many have a common phenylethyl- amine structure. Variations in structure lead to marked changes in potency and characteristic action. The introductory material presented here is meant to provide a set of chemical and pharmacological highlights of the 28 substances under con- sideration. The most commonly used names or INN names, Chemical Abstract (CA) names and numbers, and elemental formulae are provided in the accompanying figures. This provides both some basic information on the substances and a starting point for the more detailed information that follows in the individual papers by contributors to the symposium. Key words: Stimulants, their chemistry and pharmacology - Hallucinogens, their chemistry and pharmacology INTRODUCTION Cathine (Fig. 1) is one of the active principles of khat (Catha edulis). The structure has two asymmetric centers and exists as two geometric isomers, each of which has been resolved into its optical isomers. In the plant it exists as d-nor-pseudoephedrine. It is a typical sympathomimetic amine with a strong component of amphetamine-like activity. The racemic mixture is known generically in this country and others as phenylpropanolamine (dl- norephedrine). It is widely available as an over-the-counter (OTC) anti- appetite agent and nasal decongestant.
    [Show full text]
  • More Than Expectorant: New Scientific Data on Ambroxol in the Context of the Treatment of Bronchopulmonary Diseases
    Mini Review iMedPub Journals Journal of Intensive and Critical Care 2017 www.imedpub.com ISSN 2471-8505 Vol. 3 No. 3: 37 DOI: 10.21767/2471-8505.100096 More than Expectorant: New Scientific Data Manuel Plomer1* and 2 on Ambroxol in the Context of the Treatment Justus de Zeeuw of Bronchopulmonary Diseases 1 Medical Affairs CHC Germany, Sanofi-Aventis Deutschland GmbH, Industriepark Höchst, D-65926, Frankfurt am Main, Deutschland, German Abstract 2 Medical Specialist for Internal Medicine, Pneumology and Sleep Medicine, Background:Ambroxol has been established for decades in the treatment of Cologne, Germany, German acute and chronic respiratory diseases. A reassessment of the benefit-risk was conducted recently. Objective: What new scientific data, relevant for the treatment of *Corresponding author: bronchopulmonary diseases, were published in the last decade? Dr. Manuel Plomer Method: Systematic literature search via http://www.pubmed.gov with the search term “ambroxol”, covering the publication period from 2006 to 2015. Non- [email protected] relevant publications were excluded manually. Medical Manager, Medical Affairs CHC Results: 64 relevant publications could be identified covering both, clinical and Germany, Sanofi-Aventis Deutschland GmbH, preclinical research. Industriepark Höchst, D-65926 Frankfurt am Conclusion: The traditional indication of ambroxol as an expectorant is confirmed Main, Germany. but new results revealed a better understanding of the various mechanisms of action of ambroxol and the benefits for special patient populations. The Tel: 49 69 305 36803 available data suggest the use of ambroxol as an adjuvant in anti-infective therapy, particularly in case of infections with biofilm-producing pathogens. Lung- protective properties are discussed in both infants and severely ill adult patients.
    [Show full text]
  • Clandestine Drug Lab General Cleanup Guidance
    Clandestine Drug Lab General Cleanup Guidance DIVISION OF ENVIRONMENTAL HEALTH i Minnesota Department of Health (MDH) Division of Environmental Health Minnesota Pollution Control Agency (MPCA) Clandestine Drug Lab General Cleanup Guidance September 2010 VERSION, Clarification to Table 1 March 2013 FOR MORE INFORMATION, CONTACT: MINNESOTA DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH PO BOX 64975 ST. PAUL, MN 55164-0975 TEL: 651-201-4899 TOLL FREE: 888-657-3908 FAX: 651-201-4606 TDD: 651-201-5797 TO REQUEST THIS DOCUMENT IN ANOTHER FORMAT, SUCH AS LARGE PRINT, BRAILLE OR CASSETTE TAPE, CALL 651-201-4911; TDD 651-201-5797 OR TOLL-FREE THROUGH THE MN RELAY SERVICE, 1-800-627-3529.TABLE OF CONTENT ii TABLE OF CONTENTS Clandestine Drug Lab .................................................................................................................. i General Cleanup ..........................................................................................................................i Guidance ..................................................................................................................................i TABLE OF CONTENTS ............................................................................................................. iii ACKNOWLEDGEMENTS ........................................................................................................... v ACKNOWLEDGEMENTS ........................................................................................................... v I. INTRODUCTION ..................................................................................................................
    [Show full text]
  • European Journal of Scientific Exploration Vol 3 №2 2020
    EUROPEAN JOURNAL OF SCIENTIFIC EXPLORATION VOL 3 №2 2020 Determination of Oligomer Content in Benzonatate Drug Substance by HPLC Lakshmi Narasimha Rao Katakam 1 Santhosh Kumar Ettaboina 2 Thirupathi Dongala 2 1Saptalis Pharmaceuticals LLC, New York, USA 2Aurex Pharmaceuticals Inc, East Windsor, USA Abstract. A reverse-phase liquid chromatographic method has developed and validated to determine oligomer content in Benzonatate Drug substances. This method has a separation of relatively few monomer units, which constitutes an oligomer with a minimum adequate chromatographic resolution of 1.0 from each of the subject component peaks. The separation achieved using Phenomenex Luna C18 (250 X 4.6 mm) 5 µm column at a flow rate of 1.0 ml/min with an isocratic elution method. The mobile phase consisting of 0.25% Ammonium formate buffer and methanol in the ratio 350:650 (v/v), respectively. The Oligomer compounds detection carried out at UV 310 nm, and the LC method validated as per the current ICH Q2 guidelines. The method is effectively validated and proved to be precise, specific, linear, robust, and rugged to quantitate oligomer content in Benzonatate drug substance. Key words: benzonatate (BNZ), oligomers, HPLC, method validation. Introduction Benzonatate (BNZ) is an oral antitussive drug used to relieve and suppress cough in patients older than ten years of age (Oligomer Wikipedia, 2020). Currently, BNZ is the only non-narcotic antitussive available as a prescription drug. The chemical structure resembles that of the anesthetic agents in the para-amino-benzoic acid class (such as procaine and tetracaine), BNZ exhibits anesthetic or numbing action. BNZ also inhibits the transmission of impulses of the cough reflex in the medulla's vagal nuclei (Tessalon, 2020).
    [Show full text]