High-performance liquid chromatographic assay for thiopental in human plasma. Application to pharmacokinetic studies.

A simple assay method for the measurement of thiopental by reversed-phase high-performance liquid chromatography (HPLC) with ultraviolet absorbance detection was developed. The method involved a protein precipitation with methanol. Carbamazepine was used as internal standard. The mobile phase was acetonitrile-water (32:62, v/v). The elution was isocratic and the column temperature was ambient. Linear detection response was obtained for concentrations ranging from 1-100 microg ml(-1). Recovery from plasma averaged 88%. Precision, expressed as coefficient of variation (%), was in the range of 0.2-8%. Percent recovery was at least 93%. Stability studies showed that plasma samples should be processed as promptly as possible. This method has been used in therapeutic monitoring and for the determination of pharmacokinetic parameters of thiopental in patients treated with a high dose over a long time to decrease intracranial pressure.

[Lactulose-neomycin combination versus placebo in the treatment of acute hepatic encephalopathy. Results of a randomized controlled trial]. / Association lactulose-néomycine versus placebo dans le traitement de l'encéphalopathie hépatique aiguë. Résultats d'un essai contrôlé randomisé.

OBJECTIVES: The effectiveness of the association of lactulose with neomycin in the treatment of acute hepatic encephalopathy has never been assessed. The aim of this study was to compare the effects of lactulose-neomycin combination versus placebo in acute hepatic encephalopathy. METHODS: Eighty patients with cirrhosis were randomly treated for 5 days with placebo (n = 40) or with lactulose-neomycin (n = 40). Both groups were similar for all variables. RESULTS: The course of encephalopathy was similar in both groups. In the lactulose-neomycin group: 26 PATIENTS recovered, 3 remained unchanged, 3 worsened, 6 died, 2 were lost to follow-up. In the placebo group: 28 recovered, 2 remained unchanged, 2 worsened, 6 died, one was lost the follow-up, one dropped out of the study. Lactulose-neomycin treatment was not well tolerated in a significant number of patients. CONCLUSION: Lactulose-neomycin combination should not be used in the treatment of acute hepatic encephalopathy.