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PubMed2004

Determination of multiple drugs of abuse in human urine using capillary electrophoresis with fluorescence detection.

Methods for separation and determination of multiple drugs of abuse in biological fluids using capillary electrophoresis (CE) with native fluorescence and laser-induced fluorescence (LIF) detection are described herein. Using native fluorescence, normorphine, morphine, 6-acetyl morphine (6-AM), and codeine were analyzed by CE without any derivatization procedure and detected at an excitation wavelength of 245 nm with a cut-off emission filter of 320 nm, providing a rapid and simple analysis. The detection limits were in the range of 200 ng/mL. For a highly sensitive analysis, LIF detection was also examined using a two-step precolumn derivatization procedure. In this case, drugs extracted from human urine were first subjected to an N-demethylation reaction involving the use of 1-chloroethyl chloroformate (ACE-Cl) and then derivatized using fluorescein isothiocyanate isomer I (FITC) and analyzed by CE coupled to a LIF detector. Variables affecting this derivatization: yield of demethylation reaction, FITC concentration, reaction time and temperature, were studied. The estimated instrumental detection limits of the FITC derivatives were in the range of 50-100 pg/mL, using LIF detection with excitation and emission wavelengths of 488 nm and 520 nm, respectively. The linearity, reproducibility and reliability of the methods were evaluated. In addition, a comparison of the characteristics for both native fluorescence and LIF detections was also discussed.

Codeine↗

PubMedDate not supplied

Combined routes of administration to assay oral analgesia in postoperative pain.

To increase the sensitivity of the method for evaluating oral analgesics in postoperative patients, we designed a combined oral/parenteral bioassay. Drugs studied were parenteral morphine, parenteral propiram, and oral codeine at two dose levels each and oral propiram at four dose levels. Results from data on 308 patients suggest that future studies designed to establish the relative potencies of oral analgesics should use parenteral morphine as the standard in a combined oral/parenteral study because this approach provides a very sensitive measure of analgesia. Further, with one drug as the reference compound, results from many sources would be more readily compared.

Administration, Oral↗

PubMed1981

The visual analog scale in multiple-dose evaluations of analgesics.

A double-blind, randomized trial was carried out in patients suffering from pain after removal of an impacted lower wisdom tooth. The analgesic effects of a codeine preparation (Staralgin), a dextropropoxyphene preparation (Doleron novum), and paracetamol were compared in a multiple-dose study of 94 patients. The assessments of pain were made hourly on a visual analog scale, and the evaluation was carried out according to a method which takes into account both duration of effect and number of tablets taken. The most pronounced pain reduction and the highest proportion of pain-free patients were reached with the dextropropoxyphene preparation. The reported side effects were few and equally distributed among the treatment groups. The method of evaluation is discussed, and it was noted that the pain score at tablet intake might be of significant importance in comparison of analgesics.

Acetaminophen↗

PubMed1988

Preoperative flurbiprofen in oral surgery: a method of choice in controlling postoperative pain.

The analgesic efficacy of a single 50-mg preoperative dose of flurbiprofen was compared with ACC-30 (aspirin 375 mg, codeine 30 mg, caffeine 30 mg) and a placebo. Forty patients scheduled for the surgical removal of impacted maxillary third molars were enrolled in a double-blind, randomized study. Using a within-subject design we compared the analgesic efficacy of (1) preoperative flurbiprofen 50 mg with placebo in 20 patients, and (2) preoperative ACC-30 with placebo in 20 other patients. Using a between-group design, we then compared the analgesic efficacy of (3) each drug given preoperatively and postoperatively, and (4) each drug given postoperatively only. Patients rated 2 pain dimensions, intensity and unpleasantness, hourly for 8 hours after the presurgical dose. The results of this study indicate that better analgesia was obtained when flurbiprofen was given preoperatively compared to only after surgery. Conversely, preoperative administration of ACC-30 did not demonstrate any significant influence on postsurgical analgesia. When comparing the 2 drugs, flurbiprofen proved to be superior in providing pain relief only when it was given prior to surgery. There was no difference between them when given only after surgery. Side effects were moderate and not significantly different between patients receiving flurbiprofen and those receiving ACC-30.

Adult↗

PubMed1976

Analysis of alkaloid mixtures by charge-transfer complexation.

Binary mixtures of weak and strong UV-absorbing alkaloids were analyzed by a charge-transfer spectrophotometric method, utilizing iodine in ethylene dichloride as the acceptor. In the uncomplexed form, the strong absorbing alkaloid (papaverine, quinine, ergotamine, or reserpine) was measured at a wavelength where there was no interference from weak absorbers (at 335, 332, 315, or 300 nm, respectively). The weak absorbing alkaloid (ephedrine, codeine, atropine, or homatropine methylbromide) was determined by computing its contribution to the total charge-transfer band at 295 nm where absorbance was linearly additive for mixtures. The greater increase in the original epsilon-values of the weak absorbers upon complexation with iodine relative to the corresponding increase in the epsilon-values of the strong absorbers led to good recoveries even at the low dose ratios of the weakly absorbing, and often more potent, alkaloids.

Alkaloids↗

PubMed1988

Stability of morphine solutions in plastic syringes determined by reversed-phase ion-pair liquid chromatography.

A reversed-phase ion-pair HPLC assay has been developed for quantitating morphine, codeine, apomorphine, and pseudomorphine in aqueous solutions. Using two types of plastic syringes, the effect of light (25 W) and temperature (22 and 3 degrees C) on the stability of morphine, over a 12-week period, has been investigated in the presence and absence of preservative and antioxidant. The leaching of contaminants from the plastic syringes to water stored in them, for a period of up to 12 weeks, has also been investigated. The results indicate that less than 3% of the morphine is degraded in both types of plastic syringes, stored in light at 22 +/- 2 degrees C. The degradation is even less prominent in the dark or at 3 degrees C. Pseudomorphine has been identified as the major degradation product. Using 5% degradation of drug as the criterion for the determination of the shelf-life of morphine, it was found that in one brand of plastic syringes, morphine has a shelf-life of the order of 20 and 33 weeks, in the absence and presence of preservative and antioxidant, respectively. In the other brand of plastic syringe, the drug has a shelf-life of greater than 1 year. Some unidentified leached contaminants have been detected in water stored in both brands of syringes.

Apomorphine↗

PubMed2005

Principal opium alkaloids as possible biochemical markers for the source identification of Indian opium.

A total of 124 opium samples originating from different licit opium growing divisions of India were analyzed for their principal alkaloid (thebaine, codeine, morphine, papaverine, and narcotine) content by capillary zone electrophoresis (CZE) without derivatization or purification. Absence of papaverine in Bareilly, Tilhar, and most of the samples originating from Kota is a significant observation in relation to the source of Indian opium. Multiple discriminant analysis was applied to the quantitative principal alkaloid data to determine an optimal classifier in order to evaluate the source of Indian opium. The predictive value based on the discriminant analysis was found to be 85% in relation to the source of opium and the study also revealed that all the principal alkaloids have to be analyzed for source identification of Indian opium. Chemometrics performed with principal alkaloids analytical data was used successfully in discriminating the licit opium growing divisions of India into three major groups, viz., group I, II, and III. The methodology developed may find wide forensic application in identifying the source of licit or illicit opium originating from India, and to differentiate it from opium originating from other opium producing countries.

Chromatography, High Pressure Liquid↗

PubMed1986

Opioid responsiveness in patients with neuroleptic-induced akathisia.

Five patients with either acute or tardive neuroleptic-induced akathisia (5 weeks to 1 1/2 years duration) were videotaped before, during, and after a 2-week trial of propoxyphene (Darvon), 100 mg q.i.d., or acetaminophen (Tylenol) with 30 mg codeine, two tabs, q.i.d. Three "blinded" observers, experienced in movement disorders, rated the involuntary movements shown on the videotapes and agreed that, on opioids, all patients showed substantial to complete improvement of their stereotyped restless akathitic movements. Matching placebo was not beneficial. One patient who had improved on opioids was challenged with naloxone while on the opioids. There was a brief but severe reactivation of the akathisia. Our results suggest that opioids offer a selective therapy for patients with neuroleptic-induced akathisia and further suggest that the endogenous opiate system may be involved in patients with neuroleptic-induced akathisia.

Acetaminophen↗

PubMed2002

Impact of incorporating the 2C5 crystal structure into comparative models of cytochrome P450 2D6.

Cytochrome P450 2D6 (CYP2D6) metabolizes approximately one third of the drugs in current clinical use. To gain insight into its structure and function, we have produced four different sets of comparative models of 2D6: one based on the structures of P450s from four different microorganisms (P450 terp, P450 eryF, P450 cam, and P450 BM3), another on the only mammalian P450 (2C5) structure available, and the other two based on alternative amino acid sequence alignments of 2D6 with all five of these structures. Principal component analysis suggests that inclusion of the 2C5 crystal structure has a profound effect on the modeling process, altering the general topology of the active site, and that the models produced differ significantly from all of the templates. The four models of 2D6 were also used in conjunction with molecular docking to produce complexes with the substrates codeine and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP); this identified Glu 216 [in the F-helix; substrate recognition site (SRS) 2] as a key determinant in the binding of the basic moiety of the substrate. Our studies suggest that both Asp 301 and Glu 216 are required for metabolism of basic substrates. Furthermore, they suggest that Asp 301 (I-helix, SRS-4), a residue thought from mutagenesis studies to bind directly to the basic moiety of substrates, may play a key role in positioning the B'-C loop (SRS-1) and that the loss of activity on mutating Asp 301 may therefore be the result of an indirect effect (movement of the B'-C loop) on replacing this residue.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗

PubMed1995

Circular dichroism of ferriprotoporphyrin IX-morphine complexes in aqueous solution.

Complexes of ferriprotoporphyrin IX (FP) with (-)-morphine exhibit large optical activity in aqueous solution. Several CD bands of different signs were recorded under different conditions in the wavelength range of 300 to 450 nm. The largest CD band, centered at about 364 nm, showed molar ellipticities of about -5 x 10(5) deg.cm2.dmol-1 based on FP (rotational strength of about -3 DBM). An optimum pH range of 7.4 to 7.8 with regard to optical activity of the complex has been observed. Concomitantly with the formation of optically active complexes, large aggregates are being formed as determined by ultracentrifugation. A mole ratio of 1 between FP and morphine in the complex was estimated from both CD titration and measurement of the amounts of aggregate formed upon variation of the mole fraction of the complex components. Derivatives of morphine such as heroin or codeine do not form optically active complexes and aggregates under similar conditions. As in the analogous FP-quinine and FP-quinidine complexes investigated previously, the optical activity observed is considered to originate at least in part from optical interactions between FP molecules arrayed chirally in the FP-(-)-morphine aggregates.

Circular Dichroism↗

PubMed1996

Mechanism of irritant-induced cough: studies with a kinin antagonist and a kallikrein inhibitor.

It has been suggested that bradykinin may play a role in stimulating cough in at least one pathological condition in humans. We have employed an animal model to investigate the possible role of this peptide in irritant-induced cough. The kinin antagonist Hoe 140 and codeine both produced dose-related inhibition of cough responses to inhalation of citric acid or bradykinin aerosols by conscious guinea pigs. The selective tissue kallikrein inhibitor CH694 inhibited cough caused by citric acid but not by bradykinin. Indomethacin pretreatment attenuated the responses to both stimuli as did phosphoramidon. It is concluded that cough produced by citric acid inhalation may be mediated, at least in part, by generation of kinins; secondary to this, a release of prostanoids also appears to participate in the response.

Administration, Inhalation↗

PubMed1976

Induction of physical dependence in rats by short interval medication.

Rats were intermittently medicated at one hour intervals through an implanted intravenous cannula. Physical dependence on morphine and codeine was developed rapidly and it was detectable with the maintenance dose as low as 9.6 mg/kg/day. Physical dependence on pentazocine was also developed with the maintenance dose of 96 mg/kg/day, but was not with 9.6 mg/kg/day. In the pentazocine-treated rates, body weight loss was observed after the abrupt withdrawal, and abstinence signs were precipitated by naloxone 1 mg/kg. Cross physical dependence between morphine and pentazocine was demonstrated. Pentazocine suppressed the abstinence signs of rats weakly dependent on morphine, and morphine suppressed those of pentazocine-dependent rats. ID-1229, a new benzomorphan analgesic, did not produce dependence in this test and did not suppress the abstinence signs of morphine- and pentazocine-dependent rats.

Animals↗

PubMed1981

Discriminative stimulus effects of etorphine in Rhesus monkeys.

Two rhesus monkeys were trained to discriminate the IM injection of etorphine (0.001 mg/kg) from saline in a task in which 20 consecutive responses on one of two levers resulted in food delivery. In both monkeys, etorphine (0.0001--0.0018), meperidine (0.1--1.0 mg/kg), morphine (0.1--3.2 mg/kg), and codeine (0.3--3.2) produced dose-related increases in the percentage of total session responses that occurred on the etorphine-appropriate lever. In contrast, ethylketazocine, SKF-10047, and pentazocine, at doses up to and including those that suppressed response rates, produced responses primarily on the saline-appropriate lever. Thus, etorphine-like narcotics, including morphine, have discriminative stimulus effects in rhesus monkeys which can be distinguished from those produced by narcotics with nonmorphine-like actions such as ethylketazocine, SKF-10047, and pentazocine.

Animals↗

PubMed1981

Drug-induced changes in the composition of the cerebral free amino acid pool.

The effects of insulin, hydroxybutyrate, deoxypyridoxine, chlorpromazine, codeine, morphine, puromycin, and cycloheximide on the composition of the free amino acids in mouse and rat brain were tested. Significant changes occurred in a number of amino acids with most compounds tested; the largest was of alanine (a 50% increase with glucose, a 50% decrease with drugs); histidine was often increased, and the nonessential amino acids were mostly decreased. The pattern of changes was somewhat different in the mouse brain from that in the rat brain. Changes of amino acid levels may participate in the pharmacological action of a number of compounds.

Amino Acids↗

PubMed1977

Effect of antidiarrheal and antimotility drugs on ileal excreta.

Commonly used antimotility and antidiarrheal drugs were administered to six ileostomized subjects to determine whether their normal ileal excreta and that induced by prune juice could be altered. A total of 49 studies were performed, 21 with and 28 without prune juice. Bismuth subgallate was the only drug which significantly reduced the normal ileal excreta (P less than 0.05). Codeine sulfate decreased the ileal excreta in two of three subjects in either type of study. The third subject was a nonresponder to drugs. Deodorized tincture of opium (DTO) and diphenoxylate (Lomotil) were also effective in some subjects. Propantheline, tincture of belladonna, Sorboquel, and Kaopectate did not appear to decrease ileal excreta. Calcium carbonate, on the other hand, increased ileal excreta; fat excretion was also increased.

Adult↗

PubMed1993

Determination of dihydrocodeine in hair of opiate addicts by GC/MS.

After the examination of more than 300 hair samples of suspected heroin abusers, a large number of which proved positive, we can say that high concentrations of dihydrocodeine can be determined either in addition to, or in the place of, morphine and also frequently in combination with codeine. The opiates were extracted after dissolving the hair samples in NaOH and hydrolysis with HCl. The quantitative determination of dihydrocodeine was achieved by derivatisation with HFBA using GC/MS at m/u = 497. Dihydrocodeine is used in antitussive drugs. After the examination of individual hair samples, it was obvious that some heroin consumers had switched to dihydrocodeine. This may lead to the conclusion that dihydrocodeine itself is used either as an intoxicating drug or to reduce withdrawal symptoms. The increasing number of positive samples should be noted by the legal authorities.

Codeine↗

PubMed1991

[Oral administration of activated charcoal-sorbitol suspension as first aid in prevention of poison resorption?].

Due to its paramount adsorption capacity, activated charcoal is supposed to be the remedy of choice for binding a variety of drugs in the gastrointestinal tract. Hence it is surprising--at least according to the advice of German textbooks--that activated charcoal is only recommended for administration after time-consuming treatments like induced emesis and gastric lavage. Particularly with infants at home, a ready-for-use suspension of activated charcoal would allow the early management of acute poisoning. In such cases, inactivation of the poison by adsorption could be particularly helpful, since the period after ingestion is usually short. The charcoal-sorbitol-suspension (30 g activated charcoal in 150 ml of 70% sorbitol) is a creamy preparation which is easy to drink, because density and viscosity prevent sedimentation. The prescription-free drugs can be dispensed by each pharmacist. The present study was undertaken to investigate the influence of sorbitol on the adsorption capacity of activated charcoal. To this end, adsorption isotherms were established in vitro and compared with results in volunteers to whom NAPAP, diphenhydramine or codeine was administered separately. These drugs are gaining increasing importance in medicinal toxicology since they are constituents of various analgesics and cold remedies. To determine absorption, the cumulative urinary excretion was estimated of the parent drugs and their main metabolites.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetaminophen↗

PubMed1982

[FAB (fast atom bombardment)-mass spectrometry. A new study method in the hands of the (forensic) toxicologist].

The FAB (Fast Atom Bombardment)-mass spectrometric ionization technique, which has now been available for about 1 year, has been successfully employed in forensic toxicology. The mass spectral behaviour of some representative drug-glucuronides (Codeine, p-Nitrophenol and 2-Phenyl-1-propanol) were studied by positive- and negative-ion-FAB-MS. The presented promising results may be of some interest, not only for the analytical toxicologist.

1-Propanol↗