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Increased responses to inhaled oxitropium bromide in asthmatic patients with active hepatitis C virus infection.

STUDY OBJECTIVES: The interaction between chronic hepatitis C virus (HCV) infection and bronchial asthma is of considerable interest. This study was designed to examine whether differences in airway responses to an inhaled anticholinergic agent exist between asthmatic patients with and without active HCV infection. DESIGN: Controlled cross-sectional analysis. SETTING: University hospital. PATIENTS: Sixteen HCV-negative asthmatic patients and 36 HCV-positive asthmatic patients. INTERVENTIONS: All HCV-positive patients received interferon (INF) therapy for 6 months (INF responders, 16 patients; INF nonresponders, 20 patients). No patient had received INF within 3 years of the start of the study. MEASUREMENTS AND RESULTS: Airway hyperreactivity to methacholine (ie, the provocative concentration of methacholine causing a 20% fall in FEV(1) [PC(20)]), maximal increase in FEV(1), and forced expiratory flow between 25% and 75% of FVC (FEF(25-75)) after the administration of oxitropium bromide (200 micro g) were examined. At the start of the study, the groups were well-matched with respect to age, body mass index, and baseline lung function, including methacholine PC(20). The mean (SD) increase in FEV(1) after oxitropium bromide administration was significantly greater in patients with active HCV (95 [7] mL) than in HCV-negative asthmatic patients (68 [12] mL) and asthmatic patients with inactive HCV infection (69 [6] mL; p < 0.001). The increase in FEF(25-75) after oxitropium bromide administration was also significantly greater (250 [90] mL/s vs 170 [90] and 180 [80] mL/s, respectively; p < 0.029). CONCLUSIONS: In patients with asthma, active HCV infection is associated with increased bronchodilator responses to inhaled oxitropium bromide. HCV infection may modulate acetylcholine-mediated airway tone.

Administration, Inhalation↗

Large-scale, on-site confirmatory, and varietal testing of a methyl bromide quarantine treatment to control codling moth (Lepidoptera: Tortricidae) in nectarines exported to Japan.

In total, 30,491 codling moth, Cydia pomonella (L.), 1-d-old eggs on May Grand nectarines in two large-scale tests, and 17,410 eggs on Royal Giant nectarines in four on-site confirmatory tests were controlled with 100% mortality after fumigation with a methyl bromide quarantine treatment (48 g3 for 2 h at > or = 21 degrees C and 50% volume chamber load) on fruit in shipping containers for export to Japan. Ranges (mean +/- SEM) were for percentage sorption 34.7 +/- 6.2 to 46.5 +/- 2.5, and for concentration multiplied by time products 54.3 +/- 0.9 to 74.5 +/- 0.6 g.h/m3 in all tests. In large-scale tests with May Grand nectarines, inorganic bromide residues 48 h after fumigation ranged from 6.8 +/- 0.7 to 6.9 +/- 0.5 ppm, which were below the U.S. Environmental Protection Agency tolerance of 20 ppm; and, organic bromide residues were < 0.01 ppm after 1 d and < 0.001 ppm after 3 d in storage at 0-1 degree C. After completion of larger-scale and on-site confirmatory test requirements, fumigation of 10 nectarine cultivars in shipping containers for export to Japan was approved in 1995. Comparison of LD50s developed for methyl bromide on 1-d-old codling moth eggs on May Grand and Summer Grand nectarines in 1997 versus those developed for nine cultivars in the previous 11 yr showed no significant differences in codling moth response among the cultivars.

Citrus↗

Brain microdialysis study of the effects of hazardous chemicals on the central nervous system. 1. Changes in monoamine metabolites induced by cerebral methyl bromide administration measured by two-probe microdialysis (TPMD) method.

The two-probe microdialysis (TPMD) method, in which two probes were applied simultaneously to the rat head, was developed to directly investigate the effects of chemicals on the brain. The first and the second probes were implanted into the right striatum and the left ventricle, respectively. Chemicals were dissolved in the perfusion fluid and given into the brain by diffusion through the ventricle probe. Monoamine metabolites were recovered through the striatum probe to investigate changes in neurotransmitter substances. Both intraperitoneal and intraventricular administration of haloperidol (a dopamine receptor blocker) increased 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA, dopamine metabolites) concentrations in the striatum. On the other hand, apomorphine (a dopamine receptor stimulant), which was given both intraperitoneally and intraventricularly, decreased striatal DOPAC and HVA concentrations. 5-Hydroxyindoleacetic acid (5HIAA, a serotonin metabolite) concentration was not affected by these drugs. Regarding changes in monoamine neurotransmitters, systemic and intraventricular administration produced similar effects. These findings indicate that the drugs were effectively incorporated into the brain by the TPMD method and the drug effect was observed in the opposite brain hemisphere. In the same procedure as used in the administration of haloperidol and apomorphine, methyl bromide was given into the rat brain. DOPAC and HVA in the striatum were increased by methyl bromide given by the TPMD method. These changes were the same as observed in the homogenate of rat brain exposed to methyl bromide. 5HIAA was reduced by intraventricular administration by the TPMD method, and this change in 5HIAA was not observed in the exposure experiments. We could detect the direct effects of methyl bromide on the brain by the TPMD method.

3,4-Dihydroxyphenylacetic Acid↗

Feasibility of using lignin isolated from forages by solubilization in acetyl bromide as a standard for lignin analyses.

Lignin concentration can be measured in plants by the acetyl bromide-soluble lignin spectrophotometric method; however, as with any spectrophotometric method, a reliable standard is needed. In the present experiments, lignin was extracted from each of the forages under study with the acetyl bromide reagent. The lignin isolated with acetyl bromide (LIAB) was then used as the reference standard in the acetyl bromide-soluble lignin (ABSL) analysis, which was compared with the acid detergent lignin (ADL) and potassium permanganate lignin (PerL) lignin analyses. Two maturity stages of each of the following forages were analyzed: Medicago sativa, Cynodon dactylon var. Coastal, Panicum maximum var. Centenário and var. Colonião, Cynodon plectostachyus, Pennisetum purpureum, Setaria nandi, and Avena sativa. In addition, one wood sample, Eucalyptus sp., was analyzed. In general, ABSL values were highest (P < 0.001), followed by PerL and ADL, which also differed from each other (P < 0.001). Correlations with in vitro dry matter digestibility of samples were highest with the ABSL method. Absorption spectra of LIAB, either from plants of different maturity stages or from different vegetable species, suggested the presence of differences among some of the lignins.

Acetates↗

Ipratropium bromide: bronchodilator action and effect on methacholine-induced bronchoconstriction.

The effects of ipratropium bromide (80 and 200 micrograms) and placebo on the basal bronchial tone and on methacholine-induced bronchoconstriction were investigated in 10 asthmatic patients in a placebo-controlled double-blind manner. Bronchial hyperreactivity to methacholine was confirmed at a pretrial bronchial challenge. The patients were randomly allocated to two groups in which the drug was inhaled from either metered-dose inhalers (MDI) or powder capsules. With the high dosage, the bronchodilation resulting from powder capsules was somewhat more pronounced than that achieved with the MDI. Otherwise the bronchodilator effect of ipratropium bromide and the protection afforded by the drug against methacholine-induced bronchoconstriction were similar in the two groups. In five patients the bronchodilator effect was better and in four patients the tolerance to methacholine was greater after the higher ipratropium dosage than after the lower one. In two patients ipratropium bromide had no bronchodilator effect but gave good protection against methacholine-induced bronchoconstriction. It is concluded that some patients benefit from a dosage of ipratropium bromide higher than that usually recommended and that an anticholinergic effect on the bronchi is possible even in the absence of the bronchodilator effect in the basal state.

Administration, Inhalation↗

Comparison between fenoterol and fenoterol plus oxitropium bromide delivered by metered-dose inhaler with InspirEase to relieve acute asthma attack.

Although the inhalation of beta2-agonists has frequently been used to relieve acute asthma attacks, the efficacy of anticholinergic agents for acute asthma attacks still remains unclear. This study was designed to compare the inhalation of fenoterol and the inhalation of fenoterol plus oxitropium bromide delivered by a metered-dose inhaler with holding chamber (InspirEase) to relieve acute asthma attacks. To accomplish this, 69 patients who had presented with an acute asthma attack were randomized to receive either fenoterol (1 puff [200 microg/puff] every 1 min for 5 min; total 1000 microg) or fenoterol plus oxitropium bromide (2 puffs [100 microg/puff] every 1 min for 5 min; total 1000 microg). The peak expiratory flow (PEF) and forced expiratory volume in 1 sec (FEV1) values were measured before treatment, and 1, 15, 30, and 60 min after the inhalation therapy. The ratios of improvement, PEF (or FEV1) after treatment divided by PEF (or FEV1) before treatment, were also calculated. Thirty-three patients were evaluated in the combination group and 31 patients were evaluated in the fenoterol group. The PEF value at 60 min after inhalation therapy of the fenoterol plus oxitropium bromide group (261 +/- 18 L/min, mean +/- standard error) was significantly higher compared to that of the fenoterol group (210 +/- 17 L/min). In addition, the ratios of improvement of PEF at 1, 15, 30, and 60 min after inhalation therapy were significantly higher in the fenoterol plus oxitropium bromide group compared with the fenoterol group.

Acute Disease↗

Application of ethidium bromide for high-resolution banding analysis of chromosomes from human malignant cells.

Ethidium bromide was added to cultured human leukemic bone marrow and solid tumor cells to evaluate its inhibitory effect on mitotic chromosome condensation and its possible application to high-resolution banding analysis. In most experiments ethidium bromide treatment resulted in a high proportion of mitotic cells having elongated chromosomes, without remarkable reduction in either the mitotic index or quality of metaphase chromosomes. Optimal effect on chromosome length was obtained by adding 10 micrograms/ml of ethidium bromide during the final 2 hr of culture. Because of the simplicity and reproducibility of the technique involved, ethidium bromide can be used routinely to extend the length of chromosomes for fine-banding analysis of malignant cells.

Chromosome Banding↗

Central and peripheral neurotoxic effects of chronic methyl bromide intoxication.

OBJECTIVE: To examine all methyl bromide poisonings reported to the Marseille Poison Centre and to describe more precisely the infrequent cases of chronic, nonacute exposure. DESIGN: Retrospective observational cohort. METHOD: Data retrieval from the French Poison Centres National Data Bank (ARIT) which contains all the cases of poisonings collected by the Marseille Poison Centre (Hot Line observations, Toxicovigilance, Toxicological intensive care unit). All methyl bromide poisonings 1973-1994 were examined to evaluate to frequency of the different circumstances. RESULTS: Of the 89 methyl bromide intoxications studied, there were two cases of chronic exposure: two workers presented with neurological signs of cerebello-vestibular and pyramidal deficits, visual troubles and peripheral neuropathy of the lower limbs at the end of a season of exposure during which no acute incident involved. In one patient, the symptoms improved within five months; in the other, paresthesia were still present two years later and were associated with visual after-effects. CONCLUSION: The incidence of chronic methyl bromide intoxication is low. The risk for chronic exposure or persistent toxic effects may be masked by the severity of the acute toxic effects. The development of peripheral neuropathy immediately after the central neurological signs was noted in our two subjects. A dying back axonopathy may explain this unique chronological evolution.

Adult↗

Ethidium bromide inhibits mitochondrial phosphorylating oxidation.

Ethidium bromide, in addition to combination with mitochondrial nucleic acids, is a phosphorylation inhibitor during glutamate and succinate respiration by mitochondria. Exhaustive washing of ethidium bromide-treated mitochondria did not relieve the inhibition nor significantly decrease the amount of bound dye. Dialysis against a cation exchange resin at 3 degrees for 17 hr removed about 97% of bound dye. This restored phosphorylating capacity to that of untreated mitochondria which had also been dialyzed against the resin. Since state 3 respiration was diminished and state 4 was unaffected by the presence of the acridine dye, and since neither swelling of mitochondria nor release of latent ATPase was observed, then ethidium bromide was not an electron transport inhibitor nor an uncoupler of oxidative phosphorylation. Inhibition of metabolic processes by ethidium bromide may be due in part to depressed generation of mitochondrial ATP.

Adenosine Triphosphatases↗

Pancuronium bromide.

Pancuronium bromide is a nondepolarizing muscle relaxant approved to induce skeletal muscle relaxation during anesthesia and to facilitate the management of patients undergoing mechanical ventilation. The use of pancuronium bromide during surgery led to the appreciation that it has advantages over drugs previously used for muscle relaxation. Patients in whom pancuronium bromide is of value are (1) hypoxemic patients resisting mechanical ventilation and so cardiovascularly unstable that use of sedatives is precluded, (2) patients with bronchospasm unresponsive to conventional therapy, (3) patients with severe tetanus or poisoning where muscle spasm prohibits adequate ventilation, (4) patients with status epilepticus unable to maintain their own ventilation, (5) shivering patients in whom metabolic demands for oxygen should be reduced, and (6) patients requiring tracheal intubation in whom succinylcholine administration is contraindicated. Without concomitant sedation, use of pancuronium bromide is associated with psychological risks. Other risks are undetected ventilator disconnection, tachyarrythmias, prolonged paralysis and drug interactions.

Animals↗

A distribution study with (14)C-otilonium bromide in the rat: evidence for selective tropism for large intestine after oral administration.

The aim of this study was to determine the plasma levels and the tissue distribution of otilonium bromide, measured as total radioactivity, after oral administration of 2 mg/kg of (14)C-labeled drug to rats. Radioactivity levels were very low in the plasma (ranging from 2.7 ng Eq/ml at 1.5 h to 0.6 ng Eq/ml at 24 h) as compared with those found in the gastrointestinal (GI) tract, indicating negligible systemic otilonium bromide absorption. Results from both quantitative radioluminography of whole body tissue distribution and radioassay of dissected parts of the GI tract carried out with liquid scintillation counting clearly demonstrate the presence of radioactive compounds in the walls of the GI tract at all sacrifice times. In the other tissues and organs examined, radioactivity was only found in trace amounts in the liver. The presence of radioactivity in the GI walls reflected the transit kinetics of drug-enriched contents. The radioactivity in large intestine walls was measurable at otilonium bromide concentrations in the range of micromole equivalents/kg, from 4 to 8 h after drug administration. Total body radioactivity recovery was 95, 101, 24, and 9% at 1.5, 4, 8, and 24 h, respectively. In conclusion, orally administered (14)C-otilonium bromide is poorly absorbed systemically, as indicated by the very low plasma radioactivity levels, but it is able to effectively penetrate into the large intestine walls, a recognized target for drugs oriented toward irritable bowel syndrome therapy.

Administration, Oral↗

[A case of chronic methyl bromide intoxication showing symmetrical lesions in the basal ganglia and brain stem on magnetic resonance imaging].

A 30-year-old man developed paresthesia in the feet, unstable gait and blepharoptosis subsequent to pharyngeal pain while working in a warehouse of imported fruit and vegetable fumigated with methyl bromide and cyanate. Neurological examination showed bilateral blepharoptosis, diplopia, ataxic gait and paresthesia below the inguinal region. The serum concentration of thiociane, a metabolite of cyanide, was within normal limits, but that of bromide was elevated (43.7 mg/l, normal: 3.7-8.6). Thus we diagnosed the patient as intoxication of methyl bromide. Magnetic resonance imaging of the brain (MRI) revealed bilateral symmetrical lesions of high signal intensity in the posterior region of the putamen, the subthalamic nuclei, the dorsal medulla oblongata corresponding to inferior cerebellar peduncles and vestibular nuclei, the inferior colliculi and the periaqueductal gray matter surrounding the oculomotor nucleus of the midbrain. As far as we know, this is the first report of MRI detected cerebral lesions in a case with intoxication of methyl bromide.

Adult↗

Dry powder ipratropium bromide is as safe and effective as metered-dose inhaler formulation: a cumulative dose-response study in chronic obstructive pulmonary disease patients.

A multi-center, open, randomized, 2-way crossover study was conducted with chronic obstructive pulmonary disease (COPD) patients to compare the safety and efficacy of cumulative doses of ipratropium bromide administered from a pressurized metered-dose inhaler (MDI) or from a breath-activated dry powder inhaler (DPI). Enrolled in the study were 39 patients with moderate to severe COPD and who showed a > or= 15% increase in baseline forced expiratory volume in the first second (FEV(1)) after 80 microg of ipratropium bromide. Thirty-six patients were evaluable for efficacy analysis, and 38 patients were included in the safety analysis group. A significant improvement in pulmonary function was observed following inhalation of cumulative doses of ipratropium bromide (from 20 to 320 microg), but no statistically significant difference was found between the 2 formulations. The dose-response curves were similar. There was no statistical difference in area-under-the-curve during the 180 min period after the last dose for any of the pulmonary function variables. Overall, effects on pulse rate, blood pressure, and QT interval on electrocardiogram were no different between the devices. Six mild adverse events occurred in 4 patients: ventricular ectopic beats on electrocardiogram at 270 min with MDI, bad taste with both MDI and DPI, slight transient increase in blood pressure in the same patient during each study day with both MDI and DPI. Two moderate adverse events occurred in 2 patients: transient ventricular ectopic beats on electrocardiograms with DPI at 270 min, moderate bronchospasm with MDI at 200 min. Patients expressed a preference for DPI, which was found to have a better acceptability and appeared to be easier to use than MDI. The new lactose powder formulation of ipratropium bromide inhaled via the breath-activated DPI is a safe and effective alternative to the chlorofluorocarbon-propelled MDI.

Adult↗

[The effect of inhaled ipratropium bromide on airway and lung tissue muscarinic receptors in a rat model of COPD].

OBJECTIVE: To observe the effect of inhaled ipratropium bromide on airway and lung tissue muscarinic receptors (MR) in a rat model of chronic obstructive pulmonary disease (COPD). METHODS: The rat model of COPD was established by chronic exposure with high concentrations of SO(2) gas, COPD rats inhaled aerosolized 0.025% ipratropium bromide solution 10 ml (twice/d, 20min/time). The MR was determined by radioligand binding studies with (3)H-QNB as the ligand. RESULTS: Compared with that of control, there was a marked increase in MR density on day 30 of treatment with ipratropium but not on day 5. The MR density decreased and close to normal level on the 6th day after cessation of regular therapy with inhaled ipratropium for 30 days. No significant difference was observed in antagonist affinity (Kd) among different time groups of ipratropium therapy. CONCLUSIONS: Chronic exposure to the anticholinergic agent ipratropium bromide produces an up-regulation of airway MR. The airway MR density can recover to normal when treatment stopped. Up-regulation of airway MR is associated with transient bronchoconstriction following cessation of regular ipratropium therapy and lung function deteriorated following long-term inhaled ipratropium bromide.

Administration, Inhalation↗

[Effect of ipratropium bromide on calcium activated potassium channel in tracheal smooth muscle cells from chronically hypoxic rats].

OBJECTIVE: To study the effects of ipratropium bromide on large conductance calcium activated potassium (BK(Ca)) channel in tracheal smooth muscle cells (TSMC) from chronically hypoxic rat. METHODS: The chronically hypoxic rat model was established. Single TSMC was acutely isolated. Single channel currents were recorded by using the patch clamp technique in inside-out configuration. RESULTS: (1) Chronic hypoxia decreased BK(Ca) channel activity significantly in inside-out recording. Channel open probability (P(0)) of BK(Ca) channel in the chronically hypoxic rats reduced significantly compared with that in the control rats (0.17 +/- 0.07 for the hypoxia, 0.35 +/- 0.10 for the control, n = 30, t = 8.22, P < 0.01). Channel open time constants were significantly shortened in the chronically hypoxic group. The fast and slow open time constants (tau(O1), tau(O2))were significantly different from those in the control [tau(O1) (1.49 +/- 0.41) ms, (0.53 +/- 0.23) ms, respectively, n = 30, t = 12.07, P < 0.01; tau(O2) (11.9 +/- 3.2) ms, (3.8 +/- 1.4) ms, respectively, n = 30, t = 12.60, P < 0.01]. Closing time prolonged significantly. The fast and slow closing time constants (tau(c1), tau(c2)) were significantly different from those in the control [tau(c1) (2.7 +/- 0.9) ms, (5.7 +/- 1.5) ms, respectively, n = 30, t = 8.71, P < 0.01; tau(c2) (12.1 +/- 2.3) ms, (19.4 +/- 2.9) ms, respectively, n = 30, t = 14.05, P < 0.01]. Ipratropium bromide and salbutamol reversed the effect of chronic hypoxia on BK(Ca) channel. P(0) increased, tau(O1) and tau(O2) were prolonged significantly. tau(c1) and tau(c2) were shortened [P(0), 0.15 +/- 0.04, 0.28 +/- 0.09, 0.30 +/- 0.08, respectively, n = 25, F = 39.90, P < 0.01; tau(O1) (0.55 +/- 0.24) ms, (0.89 +/- 0.25) ms, (1.03 +/- 0.33) ms, respectively, n = 25, F = 15.32, P < 0.01; tau(O2) (3.6 +/- 1.4) ms, (6.3 +/- 1.9) ms, (6.9 +/- 2.0) ms, respectively, n = 25, F = 40.10, P < 0.01; tau(c1) (6.1 +/- 1.6) ms, (3.3 +/- 1.2) ms, (3.0 +/- 0.8) ms, respectively, n = 25, F = 57.14, P < 0.01; tau(c2) (20.1 +/- 2.5) ms, (12.4 +/- 2.6) ms, (13.0 +/- 2.0) ms, respectively, n = 25, F = 24.60, P < 0.01]. CONCLUSION: Chronic hypoxia decreased BK(Ca) channel activity. Ipratropium bromide and salbutamol reversed the effect of chronic hypoxia on BK(Ca) channel. The relaxing effect of ipratropium bromide and salbutamol on TSMC may be partly mediated via activation of BK(Ca) channel.

Animals↗

[Onset of action and maximum effect of bronchodilators administered by a metered dose inhaler. Clinical investigations with fenoterol, hexoprenaline, ipratropium bromide, isoprenaline, orciprenaline, salbutamol and terbutaline (author's transl)].

The acute effect of bronchodilatory metered dose inhalers was tested by whole-body plethysmography in patients with chronic obstructive airway disease. All patients had already used metered dose inhalers. The 18 patients of group A were successfully using the parasympatholytic drug ipratropium bromide. The onset of action of hexoprenaline, salbutamol and terbutaline was slightly quicker than that of ipratropium bromide but the maximum bronchodilation was similar. The 18 patients of group B considered adrenergics to be much more effective. Mean values showed that the onset of bronchodilation and maximum effect with fenoterol, isoprenaline, and orciprenaline was quicker and stronger than after ipratropium bromide over the first 20 minutes. Following ipratropium bromide the single resistance diagrams of group B, with the exception of 4 patients, showed bronchodilation equal to that of group A and also to that obtained following adrenergics in group B. The patients apparently judged bronchodilation on the basis of the adrenergic side effects rather than by improvement of dyspnoea. There were 3 patients, however, who repeatedly showed better bronchodilation in response to adrenergics than parasympholytic agents, not depending of the way of application.

Aerosols↗

Anthroylcholine bromide: a fluorescent ligand for the muscarinic receptor.

The action of anthroylcholine bromide, a new fluorescent probe, has been studied at the cellular (contraction of intestinal muscle) and subcellular levels (binding of 3H-quinuclidinyl benzilate to brain cortex membranes, fluorescence and enzyme activity) with the following results: 1. Anthroylcholine bromide competitively antagonized the contractile effect of acetylcholine in isolated rat duodenum (pA2 = 6.12), but had no effect either on the concentration response curves to histamine or to noradrenaline in isolated guinea pig ileum and rat vas deferens. 2. Anthroylcholine bromide displaced competitively 3H-quinuclidinyl benzilate from brain cortex membranes (Ki = 0.77 mumol/l). 3. Direct binding to the muscarinic site could be measured by exploiting the fluorescence properties of the probe. Binding displaceable by atropine (approximately 20% change in fluorescence) had an apparent affinity constant similar to that found with indirect methods. In contrast, d-tubocurarine did not displace the probe from its site, and atropine- or d-tubocurarine-sensitive binding of anthroylcholine bromide to Torpedo marmorata electric organ membranes, rich in nicotinic receptors, was not observed. These properties suggest the applicability of the probe to study the distribution, structure and/or kinetic properties of the muscarinic receptor.

Acetylcholine↗

[Spectrophotometer detection of benzalkonium bromide concentration in seawater].

Benzalkonium bromide is a high-efficiency algaecide. Its concentration in seawater was measured by the method of spectrophotometer. The results indicated that the deposition appeared if the concentration of benzalkonium bromide in seawater was more than 50 mg.L-1, and affected the detection of benzalkonium bromide. But, there was a good linear relationship between concentration and absorbance when the concentration was lower than 50 mg.L-1 (R2 = 0.9996). Therefore, spectrophotometer could be used to detect benzalkonium bromide in seawater.

Benzalkonium Compounds↗