ABSTRACT
BACKGROUND: Particularly outpatients want to reach the ability for driving a car as soon as possible after pupillary dilatation. Dapiprazole is an alpha-1 adrenergic inhibitor that antagonizes the mydriatic effect of phenylephrine in a direct competitive way. The aim of this study was to determine restoration of traffic related functions after dapiprazole application in accordance with the guidelines of the German Society of Ophthalmology (DOG). SUBJECTS: 65 eyes of 33 subjects were tested (17 females, 16 males). All had driving licenses without restrictions. Before mydriasis and after reversal with dapiprazole traffic-related functions were evaluated (photopic visual acuity, mesopic vision, sensitivity to glare, colour vision, accommodation, visual field). RESULTS: No relevant changes of the parameter responsible for the ability to drive a motor vehicle could be shown after reaching premydriatic pupil diameters. CONCLUSIONS: There is evidence that reaching normal pupil diameters after reversal of mydriasis by dapiprazole is a valid sign of restoration of traffic related functions.
Subject(s)
Adrenergic alpha-Antagonists/therapeutic use , Automobile Driving/standards , Mydriasis/drug therapy , Mydriatics/adverse effects , Phenylephrine/adverse effects , Triazoles/therapeutic use , Vision, Ocular/drug effects , Adolescent , Adult , Cross-Over Studies , Female , Germany , Humans , Male , Middle Aged , Mydriasis/chemically induced , Mydriatics/antagonists & inhibitors , Phenylephrine/antagonists & inhibitors , Piperazines , Prospective Studies , Pupil/drug effects , Treatment OutcomeABSTRACT
A noninvasive and nonocclusive skin patch (Sudormed) was investigated for the systematic collection of drugs of abuse over a period of several days. First, the applicability and user friendliness were tested by volunteers. The permeability of the polyurethane dressing from the outside to the inside for an aqueous solution was shown by incubating the outside layer with Rhodamine B. No fluorescence could be detected in the cotton pad beneath. A single dose experiment using theophylline as a model compound showed that there was a delay in time before the substance could be determined in the pad. The drug content decreased with increasing time of patch application. When eight volunteers participating in a methadone treatment were monitored, the substitute drug could always be detected in the patch associated with a minor concentration of EDDP. Besides, in some of the patches investigated, indications for an abuse of cocaine and heroin were found. The so-called sweat patch appears to be a valuable tool in clinical and forensic toxicology, as it offers a longer and prospective surveillance period compared with blood and urine testing.
Subject(s)
Drug Monitoring/methods , Forensic Medicine/methods , Specimen Handling/methods , Humans , Methadone/therapeutic use , Patient Acceptance of Health Care , Patient Compliance , Permeability , Substance-Related Disorders/diagnosis , Sweat/metabolism , Theophylline/pharmacokineticsABSTRACT
Twenty hair samples obtained from Bolivian mine workers who chewed 3-8 g of coca leaves daily for several years were analyzed for cocaine and its main metabolites, benzoylecgonine (BZE) and ecgonine methyl ester (EME). A new method was developed for the detection and quantitation of cocaine and its metabolites, BZE and EME, from hair in a single procedure. The hair samples were washed, cut into 56 segments (2-cm length), pulverized, and incubated with phosphate buffer and the enzyme beta-glucuronidase-arylsulfatase. After solid phase extraction and derivatization with pentafluoropropionic anhydride/pentafluoropropanol, the drugs were identified and measured by gas chromatography/mass spectrometry (GC/MS) using deuterated cocaine, BZE, and EME as internal standards. The method is reproducible (cocaine, CV = 8%; BZE, CV = 14%) and the detection limit for cocaine and BZE was 0.1 ng/mg, for EME 1 ng/mg. In the different hair segments, cocaine was found to be present in concentrations between 1.4 to 50.6 ng/mg, benzoylecgonine from 0.4 to 17.6 ng/mg, and ecgonine methyl ester traces below the calibration curve of approximately 12.9 ng/mg. In 95% of the cases cocaine exceeded BZE and EME in concentration.
Subject(s)
Coca/metabolism , Cocaine/analogs & derivatives , Cocaine/analysis , Hair/chemistry , Plants, Medicinal , Adolescent , Adult , Aged , Cocaine/metabolism , Gas Chromatography-Mass Spectrometry/methods , Humans , Mastication , Middle Aged , Reproducibility of Results , Sensitivity and Specificity , Substance Abuse Detection/methodsABSTRACT
The Saarland and Saxony have not only been located at the western respectively at the eastern border of Germany (or of the then separated both German states). Different law regulations and lifestyles seemed to be an additional reason for different incidences of blood alcohol. Therefore, the blood alcohol cases of the university institutes for legal medicine of both provinces were statistically compared for 1989. Beyond some difficulties in the comparison itself due to different definitions and managements, equal or similar patterns dominated by far against discrepancies. The slightly different regulations for quality assurance were also compared with the expectation of their equalisation during the next future.
Subject(s)
Alcoholic Intoxication/blood , Automobile Driving/legislation & jurisprudence , Ethanol/pharmacokinetics , Alcoholic Intoxication/epidemiology , Cross-Sectional Studies , Germany/epidemiology , Humans , IncidenceABSTRACT
Four column packings for screening volatiles in biological material by gas chromatography are evaluated. Retention data are standardized by the calculation of retention indices, and packing materials are compared by discriminating power and identification power. A combination of 5% Carbowax 20M on Carbopack B and 0.3% Carbowax 20M on Carbopack C appears to be best suited for screening. Hydroxy-n-alkanes are used as reference substances for the calculation of retention indices.
Subject(s)
Solvents/analysis , Chromatography, GasABSTRACT
A prospective randomized study was carried out on 29 patients undergoing transurethral prostatectomy. In addition to the regional anaesthetic given for the operation, the patients received either: 1 mg morphine intrathecally (spinal group), 0.05 mg/kg body weight of morphine i.v. (i.v. group), or 0.05 mg/kg body weight epidurally (PDA group). Two of the intrathecal group patients had to be given an antagonist because of clinically relevant respiratory depression. In one of these cases, this depression could be documented by a continuous fall in respiratory minute volume, and an increase in PCO2. In the other, bradypnoea and vomiting developed within a few minutes of injection. The presence of a central action of intrathecal and epidural opiates was indicated by the significant increase in reaction time found. In the two instances of respiratory depression, the CSF morphine concentration 24 hrs after injection was markedly lower (0 and 18 ng/ml respectively) than in unaffected patients. It must therefore be assumed that the respiratory depression was caused by a more rapid cephelad transport than that occurring in normal cases.
Subject(s)
Morphine/adverse effects , Aged , Anesthesia, Epidural , Anesthesia, Spinal , Clinical Trials as Topic , Dura Mater , Hemodynamics/drug effects , Humans , Injections , Injections, Intravenous , Injections, Spinal , Male , Morphine/administration & dosage , Prospective Studies , Prostatectomy , Random Allocation , Respiration/drug effectsABSTRACT
In a controlled prospective double-blind-study we were able to show that the analgesic duration of epidurally applied morphine is more than four fold longer lasting than intravenous morphine. We found similar pharmacokinetics in both groups, suggesting a rapid absorption of epidurally applied morphine into the vascular system. The identical pharmacokinetics of intravenous and epidurally applied morphine suggest that only small amounts of morphine diffuse across the dura to the spinal cord, where it produces a long lasting analgesia at the opiate receptors. The comparison of serum morphine levels in patients who reported a very short lasting and very long lasting analgesia gave us no pharmacokinetic explanation for this difference.
Subject(s)
Morphine/administration & dosage , Pain, Postoperative/drug therapy , Adult , Double-Blind Method , Drug Evaluation , Epidural Space , Female , Humans , Hysterectomy, Vaginal , Injections , Kinetics , Middle Aged , Morphine/blood , Time FactorsABSTRACT
Eleven patients were given morphine 5 mg via an epidural catheter to provide analgesia after urologic surgery. Morphine levels were determined in serum and urine by radioimmunoassay. Cardiovascular reactions (heart rate, blood pressure) and arterial pO2 were recorded. Analgesia ensued very rapidly and lasted 29 hours on the average. For 4 hours after epidural administration, the serum morphine levels were within the range required for analgesia after intravenous injection. Side effects on the cardiovascular system and the respiratory system were not observed. Epidural morphine application is recommended as a good method for postoperative analgesia.
Subject(s)
Morphine/administration & dosage , Pain, Postoperative/drug therapy , Urinary Tract/surgery , Aged , Blood Pressure/drug effects , Epidural Space , Heart Rate/drug effects , Humans , Injections , Male , Middle Aged , Oxygen/blood , Prostate/surgery , Respiration/drug effectsABSTRACT
The use of the Kovats retention indices for standardization in gas chromatography enables the compilation of gaschromatographic data and the exchange of those data between different laboratories. Factors important for reliable determination of the retention indices, in particular the temperature dependence, are discussed. The gain in information due to the application of the retention indices and their differences on two stationary phases is demonstrated by means of tables with indication of their efficiency in searching for unknown compounds from such files. In the supplement retention indices on OV-1, OV-17 and their differences for 72 compounds frequently encountered in toxicological analyses are given.
Subject(s)
Chromatography, Gas , Pharmaceutical Preparations/metabolism , Toxicology , Forensic Medicine , Germany, West , Humans , Pharmaceutical Preparations/analysis , TemperatureABSTRACT
Morphine in blood and urine spots was detected by the radioimmunoassay (125-J-Abuscreen R, Hoffmann La Roche) in nanogram quantities. Blood and urine drops containing morphine (5 or 20ng) were dropped on wood, fired clay or cotton and stored for perios of 1 to 21 days in a dry or humid environment. Detection in blood stains on cotton was achieved in all cases. Results were more variable in blood spots on clay or wood, but in most cases detection was possible. In urine, morphine was detectable only on cotton. The differences are explained by different degrees of adsorption of blood and urine on the materials and the difficulties of elution thereof.
