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At least 1,711 records · Page 95Linked to original sources
PubMed2003

Over-the-counter and prescription medicine misuse in Cape Town--findings from specialist treatment centres.

OBJECTIVE: To provide community-level public health surveillance information on over-the-counter (OTC) and prescription medicine misuse. METHODS: A retrospective study of OTC and prescription medicine misuse among 9,063 patients from 23 specialist substance abuse treatment centres in Cape Town, South Africa, between 1998 and 2000. RESULTS: OTC and prescription medicine misuse places a burden on health and social services in South Africa. This is evidenced through the constant demand for treatment for OTC/prescription medicine misuse. Benzodiazepines are the class of medicines for which users most often receive treatment, followed by analgesics. Analgesic misuse is most often accounted for by the use of codeine-containing medicines, many of which are available over the counter. Patients using OTC/prescription medicines as their primary drug of abuse are significantly more likely to be female, and aged over 40 years. In contrast, patients using OTC/prescription medicine as an additional drug of abuse tend to be male and over 40 years of age. CONCLUSIONS: This study points to the need to develop primary health care protocols for detection, management and referral of patients misusing OTC/prescription drugs and the need to debate the re-scheduling of codeine as a prescription-only substance. The study also points to the need for further community-based research on the nature and extent of OTC/prescription drug misuse among the general population.

Adult↗
PubMed1997

[Determination of alkaloids in Pericarpium papaveris (Yingsuqiao) by high performance capillary electrophoresis].

Codeine, morphine and papaverine in Pericarpium papaveris (Yingsuqiao) were determined by HPCE. These three compounds in Pericarpium papaveris were entirely separated. The HPCE conditions were as follows: buffer: 50 mmol/L phosphate, pH 7.0; V = 25 kV; l(eff.) = 50 cm; L = 64.5 cm; i.d. = 50 microm; lambda = 212 nm; T = 25 degrees C; sample size = 15 kPa x s. The recoveries of codeine, morphine and papaverine were 96.61%, 95.90% and 95.37% respectively, which shows that this method is simple, accurate and reproducible and can be used for the quality control of the Chinese herbal medicine.

Alkaloids↗
PubMed2005

[Hypersensitivity to poppy seeds].

UNLABELLED: Hypersensitivity to poppy seeds is rare and it may develop due to immune (allergy) and non-immune reactions of fulminant course. Two cases of hypersensitivity to poppy seeds are presented: in a 21-year-old woman and 32-year-old man in whom life-threatening symptoms and signs of anaphylaxis (SSA) developed after consumption of poppy seeds in various situations, e.g in the street after consumption of a roll with poppy seeds or a cake prepared on a moulding board on which poppy seeds were previously squeezed. In the case of the woman, history data pointed to familial and individual occurrence of atopy, and positive cutaneous prick tests with allergens of grass/crop and weed pollen and tree pollen (birch, hazel) as well as hazelnuts. In the man the anamnesis and skin prick tests were negative. Serum concentrations of allergen-specific IgE (asIgE) for poppy seeds and, additionally, for food allergens, which, according to patients, also could be the cause of SSA: celery, pineapple, mixture of spices and nuts were determined. In the woman elevated concentrations of asIgE for celery (class 2) and nut mixture (class 2) with negative result for poppy were noted, whereas in the man elevated concentrations of asIgE for poppy (class 2) and nut mixture (class 2) were found. Additionally, in the male patient skin tests were performed with topical anesthetics and narcotic analgesics derived from poppy (morphine, codeine) finding positive reactions to xylocaine and codeine. CONCLUSIONS: The two presented cases illustrate that hypersensitivity to poppy seeds may occur in IgE-dependent or non-immune mechanisms and the presence of atopy is not decisive of its mechanism.

Adult↗
PubMed2006

Evaluation of self-medication prevalence, diagnosis and prescription in migraine in Kerman, Iran.

OBJECTIVE: To investigate different diagnosis aspects, prescribed drugs and self-medications of migraine in Iran. METHODS: We selected 210 migraineurs from high school and university students in Kerman, Iran over a period of 6 months in 2002 by multistage randomized screening based on the International Headache Society criteria. We classified them into 2 groups on the basis of whether they had consulted a physician or not. We then evaluated the physician prescriptions, and prevalence of self-medications. RESULTS: Only 49% of migraineurs consulted a physician, and only 53% were correctly diagnosed by physicians according to the International Headache Society criteria. Our study shows that 69% of general practitioners diagnoses were wrong. In spite of indications for prophylactic treatment, it was not prescribed in 76% of the patients, and 50% of the general practitioners prescribed it without any indications. Furthermore, 91% of patients used self-medication; Acetaminophen and Codeine were the most common. CONCLUSION: General practitioners misdiagnosis and mismanagement of the migraineurs, and easy access to various drugs in Iran, have led to a high rate of self-medication. Self-medication with Codeine, with regard to its side effects, such as increase of secondary headaches and dependency is the major problem. Consequently, medical education systems, physician reevaluating methods, and the concept of self-medication among patients have to be revised.

Adolescent↗
PubMedDate not supplied

[The effect of narcotic analgesics on the central nervous system as an index of their drug addiction potential].

The relationship between the average effective doses causing disturbances of the statokinetic reflex and the average effective doses of the analgesic and hyperthermic actions of morphine, fentanyl, codeine and tilidine was studied in the experiments on Wistar rats. The effective analgesic and hyperthermic doses of morphine (the agent with the highest drug-addiction properties) approach the dose inducing coordination disorders. In this respect fentanyl and codeine are close to morphine. The effective doses of tilidine (the agent with the lowest drug-addiction properties among the studied agents) possess significant differences. The importance of the relationship between the mentioned effective doses and the drug-addiction properties of the analgesics.

Analgesics, Opioid↗
PubMed1990

Investigations with the novel non-opioid analgesic flupirtine in regard to possible benzodiazepine-like abuse inducing potential.

Flupirtine (D-9998, Katadolon, CAS 56995-20-1); CAS 56995-20-1), a novel non-opioid analgesic was investigated for possible benzodiazepine-like activities. In receptor binding studies flupirtine and its metabolite were found to reveal no affinity for specific 3H-flunitrazepam binding up to a concentration of 10 mumol/l. In drug discrimination studies, rats were trained to discriminate the novel analgesic flupirtine (10 mg/kg i.p.) from no drug (NaCl 0.9%) under a two-choice fixed-ratio 5 shock-termination schedule. Flupirtine yielded a dose-response curve with an ED50 of 3.9 mg/kg i.p. In generalization tests with a benzodiazepine-type compound lorazepam (0.3 mg/kg, i.p.) did not generalize to the flupirtine training dose. In physical dependence studies using rats, during and after chronic oral administration of flupirtine (2 x 80 mg/kg p.o.) over 45 days no signs of benzodiazepine- and opiate-like physical dependence were observed in rats after withdrawal of the drug. In contrast diazepam (2 x 5 bzw. 2 x 10 mg/kg p.o.) induced typical symptoms of physical dependence. A significant weight loss of the codeine treated animals (2 x 60 mg/kg p.o.) and other typical side effects were also observed after withdrawal of codeine. These results clearly demonstrate that flupirtine has no affinity for benzodiazepine receptors and is free of benzodiazepine or opiate/opioid-like abuse potential.

Aminopyridines↗
PubMed1978

The pharmacology of 1841 CERM, a new analgesic.

A new non-narcotic analgesic, 2(3-trifluormethyl)-phenyl-tetrahydro-1,4-oxazine (1841 CERM) was compared with morphine, codeine and acetylsalicylic acid (ASA) in various pharmacological tests for analgesic activity. Studies for possible tolerance and physical dependence liability were also carried out. In these tests, 1841 CERM was a more powerful analgesic than morphine, and particularly codeine when given orally. It did not lead to tolerance or physical dependence.

Analgesics↗
PubMed1979

The general pharmacology of a novel antitussive compound RU 20201.

1,2,3,4,4a,9b-Hexahydro-8,9b-dimethyl-4[3-(4-methyl piperazin-1-yl)propionamido] dibenzofuran-3-one dihydrochloride (RU 20201) is an antitussive compound with a potency comparable to that of codeine. Unlike codeine, RU 20201 is devoid of any apparent CNS effects and does not depress the respiratory system. It has no adverse effect on the gastrointestinal tract no has it any analgesic or anti-inflammatory properties. Only at very high doses was a local anaesthetic effect observed.

Analgesics↗
PubMed1988

Assessment of the antitussive effect of vadocaine hydrochloride using citric acid-induced cough in healthy volunteers.

Vadocaine hydrochloride (2',4'-dimethyl-6'-methoxy-3-(2-methylpiperidyl)propionanilide+ ++ hydrochloride, OR K-242-HCl; INN: vadocaine) is a novel compound with potent antitussive and local anaesthetic action. The antitussive profile of this compound was evaluated in 40 healthy volunteers in double-blind, placebo-controlled cross-over study design using inhaled citric acid a cough inducer. In Part I, vadocaine was compared in 20 healthy volunteers at two dose levels (10 and 30 mg) with codeine phosphate (50 mg) and a placebo. In part II, vadocaine (30 mg) and a placebo were compared in 20 healthy volunteers. In Part I, no statistically significant differences were found between the 3 compounds tested. However, statistically significant rises from the pre-dose value in the cough threshold stimulus level were observed following 10 and 30 mg doses of vadocaine. Neither codeine phosphate nor the placebo produced any statistically significant change in the cough threshold stimulus level. In Part II, vadocaine at a dose of 30 mg dose was found to be a potent antitussive with a statistically significant difference (p less than 0.0001) as compared with the placebo. The maximum cough threshold stimulus level was achieved 2 h after administration and was 72.6% higher than at pre-dose. With the placebo the cough threshold stimulus level also rose to some extent after 4 h, although the change was not statistically significant. The use of inhaled citric acid in graded concentrations for induction of the cough response was found to be a reliable method when the baseline cough threshold stimulus level is maintained within narrow limits throughout the entire study population.

Adult↗
PubMedDate not supplied

An evaluation of TLC systems for opiate analysis.

The authors selected 38 thin-layer-chromatography (TLC) systems described in the available literature published over the last 10 years and evaluated those systems with respect to their suitability for detection and identification of opiates in urine, opium and heroin, as well as adulterants in heroin. A total of 14 substances: 8 opiates (morphine, 6-monoacetylmorphine, diacetylmorphine, codeine, acetylcodeine, noscapine, papaverine and thebaine) and 6 adulterants (ephedrine, quinine, methadone, caffeine, cocaine and strychnine) were used as test samples for this research. Using laboratory-coated plates and pre-coated plates, 15 and 13 TLC systems, respectively, were found to be able to detect and identify morphine and codeine in urine without interference from the remaining 12 substances. For the detection of opiates in opium samples as well as opiates and adulterants in illicit heroin samples the TLC system: chloroform-n-hexane-triethylamine (9:9:4) which was developed by the National Drug Research Centre, Penang, Malaysia, was found to be most suitable on both laboratory-coated and pre-coated plates. In addition, the following two systems, one on laboratory-coated plates--hexane-chloroform-diethylamine (50:30:7)--and the other on pre-coated plates--benzene-dioxane-ethanol-ammonia (50:40:5:5; T-7)--were also found to be among most suitable TLC systems for the analysis of opiates in opium samples. The article also presents the relative cost of each of the 38 evaluated TLC systems.

Chromatography, Thin Layer↗
PubMedDate not supplied

Parameters for determining the origin of illicit heroin samples.

A method has been evolved for assigning the source of supply or origin of illicit heroin samples. The content of morphine, codeine and acetyl products and the ratios of morphine to codeine and heroin to acetylcodeine obtained from opium samples of known origin as well as the content of heroin (diacetylmorphine) and acetylcodeine and their ratios in illicit heroin samples that have been found to belong to the same source of supply as the known opium samples are used as the basic criteria for a comparison to determine the origin of illicit heroin samples. Because the content of alkaloids in opium and heroin samples varies considerably, the number of opium and illicit heroin samples of known origin analysed should be sufficient to determine a representative composition of alkaloids in such samples for a given geographical area and period of production. It was observed that the theoretical ratio of heroin to acetylcodeine increases two-fold at each stage of the chemical conversion in the series opium-morphine-heroin. The ratios of heroin to acetylcodeine obtained from opium samples of known origin showed significant variation, which enabled the author to make distinct composition profiles of the alkaloids for each geographical area studied. Such profiles made it possible to compare heroin samples of known origin with illicit heroin samples of unknown origin and to determine the geographical area from which the latter originated. This method can also be applied in determining the origin of illicit morphine samples.

Chemical Phenomena↗
PubMed1979

Detection of drugs using XAD-2 resin. I:Choice of resin, chromatographic conditions, and recovery studies.

Amberlite XAD-2, a nonionic polystyrene divinylbenzene resin, was first used for the analysis of drugs in urine and a number of reports have described the development at optimal conditions for extraction, including type of resin columns, pH conditions, and eluting solvents. XAD-4 and XAD-7 resins were compared to the similarly structured XAD-2 resin and no significant advantage over the XAD-2 resin for drug screening was observed. A quantity of 5 to 6 g of resin was found to have sufficient capacity for the extraction of 200 ml of pentobarbital solution (1 mg/100ml). A column flow rate of approximately 15 ml/min (gravitational flow) was sufficient for analysis and slower rates were not more efficient. A mixture of ethyl acetate and 1,2-dichloroethane (3:2) was found to give best overall recovery (66 to 94%) of drugs, the resulting extracts being reasonably free of interfering substances. A pH value of 8.5 is recommended as optimum for comprehensive analysis of acidic and basic drugs. Recovery studies were conducted on spiked samples to determine drug losses occuring during various steps in the XAD-2 extraction procedure for four acidic (amobarbital, secobarbital, pentobarbital, and phenobarbital) and four basic (morphine, codeine, meperidine, and methadone) drugs. A relatively small amount (0 to 5%) of the drugs was not adsorbed by the resin and amounts varying from 6 to 40% failed to be desorbed by the eluting solvent. Additional losses occurred during the removal and analysis of TLC spots. Recovery of drugs from aqueous solutions analyzed with the XAD-2 resin were compared to recoveries reported in the literature with other XAD-2 resin methods for the extraction of drugs from urine. Recovery of phenobarbital, morphine, and codeine improved by 4 to 23% while recoveries of amobarbital, pentobarbital, secobarbital, methadone, and meperidine were 4 to 28% less efficient when compared to literature data.

Barbiturates↗
PubMed1979

Detection of drugs using XAD-2 resin. II:Analysis of liver in medical examiner's cases.

Liver tends to concentrate drugs in quantities generally higher than those found in blood or other body compartments. This fact as well as the general availability of liver in postmortem cases makes it an important specimen for comprehensive toxicologic investigation. A scheme for the analysis of liver for drugs with tissue hydrolysis, XAD-2 resin extraction, and TLC has been developed and the parameters affecting recovery have been studied. The hydrolysis of liver specimens at various pH conditions resulted in an improved recovery for morphine by using pH 2 (2N hydrochloric acid). Recoveries of barbiturates, codeine, and meperidine were essentially the same at pH 2 and pH 3. A considerable loss (22 to 55%) was observed for four drugs (pentobarbital, morphine, codeine, and meperidine) as a result of drug binding to the tissue pellets during the process of centrifuging the liver homogenates. This method is recommended as a comprehensive screening procedure for drugs in liver tissue. For quantitative purposes, however, it is necessary to determine a correction factor for all the losses occurring at the various steps of the procedure. This procedure compared favorably with other procedures for liver analysis reported in literature.

Barbiturates↗
PubMed1979

Detection of drugs using XAD-2 resin. III:A routine screening procedure for bile.

The ability of bile to concentrate drugs and metabolites coupled with its general availability make it suitable for analysis and often the fluid of choice in postmorten cases requiring drug screening. Bile (5 to 10 ml) was diluted with water, sulfuric acid was added, and the mixture was autoclaved. The precipitated bile salts were easily removed by filtration and the filtrate (pH adjusted to 8.0 to 8.5) extracted with XAD-2 resin. Drugs were eluted with a mixture of ethyl acetate/1,2-dichloroethane and analyzed with thin-layer chromatography. Varying the dilution of bile improved the recovery of morphine, codeine, methadone, amobarbital, and phenobarbital. Excessive dilution, however, caused a washing phenomenon and reduced recovery of some drugs, as shown with morphine and codeine. The procedure described is useful for the rapid screening of bile specimens for drugs.

Barbiturates↗
PubMed1979

[Neuropharmacological studies on drug dependence (I). Effects due to the difference in strain, sex and drug administration time on physical dependence development and characteristics of withdrawal signs in CNS-affecting drug dependent rats (author's transl)].

We studied the influence of differences in strain, sex and drug administration time on physical dependence of morphine and phenobarbital in rats and also whether or not pole climbing avoidance is useful as an indicator of physical dependence. We then compared the behavioral characteristics seen with morphine-dependence with those of other CNS-affecting drugs. Withdrawal signs involving weight loss in morphine and phenobarbital groups were different in JCL-Wistar, SLC-Wistar, JCL-Sprague Dawley and HOS-Donryu strain rats. Withdrawal signs in males were generally more marked than in females. Withdrawal signs due to the difference of drug administration time were different with the sex and/or kinds of drugs. After administration of morphine-type and barbiturate-type drugs, withdrawal signs of sedation and weight loss, also excitability together with weight loss appeared 24 and 40 hours later, respectively. These signs were generally greatly increased by antagonist-induced withdrawal. Abrupt withdrawal of methamphetamine and cocaine caused no withdrawal signs. Rectal temperature was unchanged on abrupt withdrawal in the case of each drug, though temperatures did decrease with morphine-type drugs, and increased with phenobarbital and chlordiazepoxide groups, on antagonist-induced withdrawal. Inhibition of the avoidance was mild with the abrupt withdrawal of morphine, codeine, phenobarbital chlordiazepoxide and cocaine, but was marked on antagonist-induced withdrawal of morphine and codeine.

Animals↗
PubMedDate not supplied

Central action of narcotic analgesics. VI. Further studies on the participation of serotonin in the action of analgesics.

The effects of agents changing the cerebral serotonin (5-HT) level on the action of morphine, codeine, fentanyl and pentazocine were tested in rats with the tests of catalepsy and analgesia (hot plate). In addition, the effect of analgesics of the level and turnover of cerebral 5-HT was studied. Depression of the cerebral level of 5-HT usually antagonized the behavioral effects of analgesics, but the effect varied with the agent depressing the 5-HT level. The serotonergic influences in catalepsy seem to be more pronounced than in analgesia. An increase in the cerebral level of 5-HT may potentiate the analgesic and prolonged the cataleptogenic effects of some drugs (morphine and pentazocine), not affecting the effect of others (fentanyl, codeine). The potentiation by morphine of the turnover of cerebral 5-HT in rats is not a common property of analgesics agents.

5-Hydroxytryptophan↗
PubMed1984

Comparative analysis of drug distribution costs for controlled versus noncontrolled oral analgesics.

Total costs for controlled substance oral analgesics and non-controlled analgesics were compared for patients at a 548-bed university hospital. During 1983, all cost elements involved in drug delivery (excluding large-volume parenterals) were identified. Direct and indirect pharmacy labor costs were determined. Personnel costs were calculated from time studies of nurses (in 1979-80) and pharmacy technicians (in 1982). Other pharmacy costs, based on the hospital's 1982 data, included inventory holding costs, computer services, supplies, and drug acquisition costs. Costs were calculated for four oral analgesics--acetaminophen with codeine, aspirin with codeine, ibuprofen, and zomepirac sodium--used during a 30-day period in 1981. For all medications, total average cost per dose for 1,949,418 doses was $2.44, of which 41% was drug acquisition cost. Personnel costs for pharmacy and nursing accounted for 43% and 11%, respectively, of total costs. For 46% of 5111 oral analgesic doses, frequency of administration was at least four times daily. Average purchase cost per dose for the oral analgesics was $0.15, while total costs for the controlled and non-controlled drugs were $1.02 and $0.50, respectively. For the four oral analgesics in this study, cost was affected by dosage schedule and controlled or noncontrolled status. Calculation of the total average cost per dose is useful in projecting annual costs and in identifying areas for cost reduction.

Administration, Oral↗
PubMed1983

Pharmacological study of the antitussive and respiratory-analeptic properties of N-(2'-ethylpyrrolidino)diphenylacetamide hydrochloride (F 1459).

The antitussive and respiratory stimulant properties of N-(2'-ethylpyrrolidino)diphenylacetamide hydrochloride (F 1459) in animals are reported. In the mechanical stimulation of the trachea in guinea pigs and after intraperitoneal administration of the product, F 1459 showed a better antitussive action as compared to oxeladin, zipeprol, codeine and clobutinol. Low intraduodenal doses of F 1459 also reduced in cats the cough induced by the electrical stimulation of the superior laryngeal nerve. In anesthetized dogs whose respiratory functions had been depressed by morphine, F 1459 significantly increased the volume inspired per minute, an effect not due to any uncoupling effect on oxidative phosphorylation. F 1459 has local anesthetic and broncholytic properties that may play a role in the mechanism of its antitussive action. Contrarily to codeine, the test compound did not induce a decrease in the intestinal transit.

Anesthetics, Local↗