Ultrasonication-aided synthesis of nanoplates-like iron molybdate: Fabricated over glassy carbon electrode as an modified electrode for the selective determination of first generation antihistamine drug promethazine hydrochloride.

The innovation of novel and proficient nanostructured materials for the precise level determination of pharmaceuticals in biological fluids is quite crucial to the researchers. With this in mind, we synthesized iron molybdate nanoplates (Fe2(MoO4)3; FeMo NPs) via simple ultrasonic-assisted technique (70 kHz with a power of 100 W). The FeMo NPs were used as the efficient electrocatalyst for electrochemical oxidation of first-generation antihistamine drug- Promethazine hydrochloride (PMH). The as-synthesized FeMo NPs were characterized and confirmed by various characterization techniques such as XRD, Raman, FT-IR, FE-SEM, EDX and Elemental mapping analysis and electron impedance spectroscopy (EIS). In addition, the electrochemical characteristic features of FeMo NPs were scrutinized by electrochemical techniques like cyclic voltammetry (CV) and differential pulse voltammetry technique (DPV). Interestingly, the developed FeMo NPs modified glassy carbon electrode (FeMo NPs/GCE) discloses higher peak current with lesser anodic potential on comparing to bare GCE including wider linear range (0.01-68.65 µM), lower detection limit (0.01 µM) and greater sensitivity (0.97 µAµM-1cm-2). Moreover, the as-synthesized FeMo NPs applied for selectivity, reproducibility, repeatability and storage ability to investigate the practical viability. In the presence of interfering species like cationic, anionic and biological samples, the oxidation peak current response doesn't cause any variation results disclose good selectivity towards the detection of PMH. Additionally, the practical feasibility of the FeMo NPs/GCE was tested by real samples like, commercial tablet (Phenergan 25 mg Tablets) and lake water samples which give satisfactory recovery results. All the above consequences made clear that the proposed sensor FeMo NPs/GCE exhibits excellent electrochemical behavior for electrochemical determination towards oxidation of antihistamine drug PMH.

Pink urine.

A 55-year-old man was admitted after a suspected hypnotic overdose of valerian extracts. In addition to altered consciousness, the first clinical symptoms included not only diffuse rash on the face, trunk, and limbs, but also an inspiratory dyspnea with a marked hypoxemia. A major laryngeal edema was noted during orotracheal intubation. After correction of hypoxemia, the patient became agitated and propofol was administered by continuous infusion. In addition, the patient passed pink urine staining the urine collection bag. The presence of an unidentified toxic substance was suspected.

Promethazine misuse among methadone maintenance patients and community-based injection drug users.

OBJECTIVE: Promethazine has been reported to be misused in conjunction with opioids in several settings. Promethazine misuse by itself or in conjunction with opioids may have serious adverse health effects. To date, no prevalence data for the nonmedical use of promethazine have been reported. This study examines the prevalence and correlates of promethazine use in 2 different populations in San Francisco, California: methadone maintenance clinic patients and community-based injection drug users (IDUs). METHODS: We analyzed urine samples for the presence of promethazine and reviewed the clinical records for 334 methadone maintenance patients at the county methadone clinic. Separately, we used targeted sampling methods to recruit and survey 139 community-based opioid IDUs about their use of promethazine. We assessed prevalence and factors associated with promethazine use with bivariate and multivariate statistics. RESULTS: The prevalence of promethazine-positive urine samples among the methadone maintenance patients was 26%. Only 15% of promethazine-positive patients had an active prescription for promethazine. Among IDUs reporting injection of opiates in the community-based survey, 17% reported having used promethazine in the past month; 24% of the IDUs who reported being enrolled in methadone treatment reported using promethazine in the past month. CONCLUSIONS: The finding that one-quarter of methadone maintenance patients in a clinic or recruited in community settings have recently used promethazine provides compelling evidence of significant nonmedical use of promethazine in this patient population. Further research is needed to establish the extent and nature of nonmedical use of promethazine.

[Simultaneous determination of chlorpromazine and promethazine and their main metabolites by capillary electrophoresis with electrochemiluminescence].

Based on the phenomenon that each of chlorpromazine (CPZ), promethazine (PMZ), chlorpromazine sulfoxide (CPZSO) and promethazine sulfoxide (PMZSO) could enhance the electrochemiluminescence (ECL) intensity of tris(2,2'-bipyridyl) ruthenium, a novel and sensitive method was proposed for the simultaneous determination of CPZ, PMZ and their main metabolites using capillary electrophoresis (CE) coupled with ECL detection. The influences of several experimental parameters were explored. The optimum experimental conditions were as follows: detection potential of 1. 20 V (Ag/AgCl), 40 mmol/L of phosphate buffer solution (pH 6.5) containing 5 mmol/L tris(2,2'-bipyridyl) ruthenium in ECL detection cell, running buffer solution of 18 mmol/L (pH 4.8), sample injection of 8 s at 11 kV, and separation voltage of 13.5 kV. The detection limits (3sigma) of this method were 8.3 x 10(-7) g/L for CPZ, 7.2 x 10(-6) g/L for PMZ, 1.9 x 10(-5) g/L for CPZSO and 3.7 x 10(-6) g/L for PMZSO. The linear ranges of ECL intensity versus mass concentration of medicaments were 7. 1 x 10(-6) - 6. 3 x 10(-3) g/L for CPZ, 7.5 x 10(-5) - 4.6 x 10(-3) g/L for PMZ, 9.7 x 10(-5) - 3.6 x 10(-3) g/L for CPZSO and 8.1 x 10(-5) - 7.7 x 10(-3) g/L for PMZSO. The relative standard deviations (RSDs) of the four target compounds were not more than 3% for ECL intensity and 1% for migration time. This method has the merits of simplicity, speediness, sensitivity, small sample injection, and free from interference. This method was successfully utilized to directly and simultaneously detect CPZ, PMZ, CPZSO and PMZSO in urine samples of pet dogs.

A drug toxicity death involving propylhexedrine and mitragynine.

A death involving abuse of propylhexedrine and mitragynine is reported. Propylhexedrine is a potent α-adrenergic sympathomimetic amine found in nasal decongestant inhalers. The decedent was found dead in his living quarters with no signs of physical trauma. Analysis of his computer showed information on kratom, a plant that contains mitragynine, which produces opiumlike effects at high doses and stimulant effects at low doses, and a procedure to concentrate propylhexedrine from over-the-counter inhalers. Toxicology results revealed the presence of 1.7 mg/L propylhexedrine and 0.39 mg/L mitragynine in his blood. Both drugs, as well as acetaminophen, morphine, and promethazine, were detected in the urine. Quantitative results were achieved by gas chromatography-mass spectrometry monitoring selected ions for the propylhexedrine heptafluorobutyryl derivative. Liquid chromatography-tandem mass spectrometry in multiple reactions monitoring mode was used to obtain quantitative results for mitragynine. The cause of death was ruled propylhexedrine toxicity, and the manner of death was ruled accidental. Mitragynine may have contributed as well, but as there are no published data for drug concentrations, the medical examiner did not include mitragynine toxicity in the cause of death. This is the first known publication of a case report involving propylhexedrine and mitragynine.

Ionophore-based potentiometric sensors for the flow-injection determination of promethazine hydrochloride in pharmaceutical formulations and human urine.

Plasticised poly(vinyl chloride)-based membranes containing the ionophores (α-, ß- and γ-cyclodextrins (CD), dibenzo-18-crown-6 (DB18C6) and dibenzo-30-crown-10 (DB30C10) were evaluated for their potentiometric response towards promethazine (PM) in a flow injection analysis (FIA) set-up. Good responses were obtained when ß- and γ-CDs, and DB30C10 were used. The performance characteristics were further improved when tetrakis(4-chlorophenyl) borate (KTPB) was added to the membrane. The sensor based on ß-CD, bis(2-ethylhexyl) adipate (BEHA) and KTPB exhibited the best performance among the eighteen sensor compositions that were tested. The response was linear from 1 × 10(-5) to 1 × 10(-2) M, slope was 61.3 mV decade(-1), the pH independent region ranged from 4.5 to 7.0, a limit of detection of 5.3 × 10(-6) M was possible and a lifetime of more than a month was observed when used in the FIA system. Other plasticisers such as dioctyl phenylphosphonate and tributyl phosphate do not show significant improvements in the quality of the sensors. The promising sensors were further tested for the effects of foreign ions (Li(+), Na(+), K(+), Mg(2+), Ca(2+), Co(2+), Cu(2+), Cr(3+), Fe(3+), glucose, fructose). FIA conditions (e.g., effects of flow rate, injection volume, pH of the carrier stream) were also studied when the best sensor was used (based on ß-CD). The sensor was applied to the determination of PM in four pharmaceutical preparations and human urine that were spiked with different levels of PM. Good agreement between the sensor and the manufacturer's claimed values (for pharmaceutical preparations) was obtained, while mean recoveries of 98.6% were obtained for spiked urine samples. The molecular recognition features of the sensors as revealed by molecular modelling were rationalised by the nature of the interactions and complexation energies between the host and guest molecules.

Voltammetric determination of promethazine hydrochloride at a multi-wall carbon nanotube modified glassy carbon electrode.

A simple and sensitive method is described for voltammetric determination of promethazine hydrochloride (PMZ), a widely used phenothiazine drug, based on its electrochemical oxidation at a multi-wall carbon nanotube (MWCNT) modified glassy carbon electrode (GCE). Compared with bare GCE, the MWCNT-modified GCE exhibited excellent enhancement effect on the electrochemical oxidation of PMZ. PMZ yielded two anodic peaks at about 0.61 V and 0.78 V, and the peak at 0.61 V was applied to the determination. Under optimized conditions, the anodic peak current was linear to the concentration of PMZ in the range from 5.0 × 10(-8) to 4.0 × 10(-4) M with the detection limit of 1.0 × 10(-8) M. The relative standard deviation (RSD) was 2.28% for 8.0 × 10(-6) M PMZ (n = 10). To further validate its possible application, the proposed method was successfully used for the quantification of PMZ in pharmaceutical formulations and biological fluids with satisfactory results.

Reduced interference by phenothiazines in amphetamine drug of abuse immunoassays.

CONTEXT: Emergency department physicians frequently request urine drug screens, but many are unaware of their limitations, including the potential for false-positive results. Promethazine, a phenothiazine derivative, is used for the treatment of allergies, agitation, nausea, and vomiting. Many patients taking promethazine are subject to urine drug screens and any potential interferences are important to recognize. DESIGN: During an 11-month period, all patients presenting to the Massachusetts General Hospital emergency department who had a finding of promethazine in their serum drug screen, and who also had a urine drug screen performed, were selected for inclusion in the study. The urine drug screen results (n = 22 patients/samples) were then studied. OBJECTIVE: To determine if promethazine use can cause false-positive urine amphetamine results in widely used drug of abuse immunoassays. RESULTS: Thirty-six percent of patients taking promethazine had false-positive test results for urine amphetamines using the EMIT II Plus Monoclonal Amphetamine/Methamphetamine Immunoassay. Sixty-four percent of patients showed cross-reactivity greater than 20% higher than the blank calibrator rate. In a separate, related study, no promethazine-induced false-positive results were seen with the EMIT II Plus, Triage, and TesTcard 9 amphetamine assays, or the Triage methamphetamine assay. Reduced chlorpromazine interference was also seen with these other assays. CONCLUSIONS: False-positive urine amphetamine results can be obtained in patients taking promethazine. Promethazine metabolite(s), and not the parent compound, are the likely cause of these urine false-positive results obtained with EMIT II Plus Monoclonal Amphetamine/Methamphetamine Immunoassay. Immunoassays from different manufacturers can have very different "interference" profiles, which the pathologist and laboratory scientist must understand and relay to clinicians.

Recovery, enrichment and selectivity in liquid-phase microextraction comparison with conventional liquid-liquid extraction.

Mathematical descriptions for extraction recovery and enrichment were applied for liquid-phase microextraction (LPME) and comparison with conventional two- and three-phase liquid-liquid extraction techniques (LLE) was made. The LPME theoretical calculations were verified by experimental determination of actual partition coefficients and by data obtained with LPME in a robust hollow fibre formate. With hollow fibre LPME operated in the two-phase mode, analytes were extracted from 1 to 4 ml aqueous samples into 25-50 microl of an organic solvent present in the pores and in the lumen of the porous hollow fibres. Compared with conventional two-phase LLE, two-phase LPME provided substantially higher enrichments for compounds with relatively large partition coefficients (K(org)/d>500). In contrast, because of the large volume of organic solvent relative to the sample volume, LLE provided high recovery and moderate enrichment even for compounds with relatively low partition coefficients (K(org)/d>5). Thus, two-phase LPME may be used for substantially enhanced extraction selectivity and enrichment of relatively hydrophobic analytes as compared with LLE whereas conventional two-phase LLE is superior for more hydrophilic analytes. Similar results were found for three-phase LPME where analytes where extracted from 1 to 4 ml aqueous samples through approximately 20 microl organic solvent immobilized within the pores of the hollow fibre and into 25 microl of an aqueous acceptor solution inside the lumen of the hollow fibre. The fundamental differences of LPME and LLE were further demonstrated with practical experiments on extraction of the basic drugs promethazine, methadone, and haloperidol from human plasma and urine.

Quantitation of promethazine and metabolites in urine samples using on-line solid-phase extraction and column-switching.

A chromatographic method for the quantitation of promethazine (PMZ) and its three metabolites in urine employing on-line solid-phase extraction and column-switching has been developed. The column-switching system described here uses an extraction column for the purification of PMZ and its metabolites from a urine matrix. The extraneous matrix interference was removed by flushing the extraction column with a gradient elution. The analytes of interest were then eluted onto an analytical column for further chromatographic separation using a mobile phase of greater solvent strength. This method is specific and sensitive with a range of 3.75-1400 ng/ml for PMZ and 2.5-1400 ng/ml for the metabolites promethazine sulfoxide, monodesmethyl promethazine sulfoxide and monodesmethyl promethazine. The lower limits of quantitation (LLOQ) were 3.75 ng/ml with less than 6.2% C.V. for PMZ and 2.50 ng/ml with less than 11.5% C.V. for metabolites based on a signal-to-noise ratio of 10:1 or greater. The accuracy and precision were within +/- 11.8% in bias and not greater than 5.5% C.V. in intra- and inter-assay precision for PMZ and metabolites. Method robustness was investigated using a Plackett-Burman experimental design. The applicability of the analytical method for pharmacokinetic studies in humans is illustrated.

Separation of promethazine and thioridazine using capillary electrophoresis with end-column amperometric detection.

Promethazine and thioridazine were separated and detected by capillary electrophoresis with end-column amperometric detection. The influence of pH value on oxidation potential, the peak current and the resolution were studied and the following conditions was selected: 0.03 M Na2HPO4 and 0.015 M citric acid at pH 3.0, detection potential at 1.10 V. The detection limits of these two substances were in the range of 10(-8) mol/l. The linear range spanned two to three orders of magnitude. This method was applied to the detection of promethazine and thioridazine spiked in urine.

A liquid chromatographic method for the determination of promethazine enantiomers in human urine and serum using solid-phase extraction and fluorescence detection.

A LC method was developed for the concurrent assay of R(+) and S(-) promethazine from human urine and serum. The method involves the use of solid-phase extraction for sample clean-up. Chromatographic resolution of the enantiomers was performed under isocratic conditions using a mobile phase of hexane-1,2-dichlorethane-absolute ethanol-trifluoroacetic acid (400:150:100:1, v/v/v/v) at a flow rate of 1 ml min-1 on a brush-type column KK-CARNU. The enantiomers were detected by fluorescence using an excitation wavelength of 250 nm and a 280 nm emission cutoff filter. Chlorpromazine was used as the internal standard for urine analysis. Standard addition was used for promethazine analysis from serum. Drug to internal standard ratios were linear from 0.25 to 10 micrograms ml-1 in urine. Serum levels were linear from 2 to 10 ng ml-1.

Rapid, sensitive determination of unchanged promethazine in biological material using a nitrogen-selective flame ionization detector. Identification of metabolites by gas chromatography-mass spectrometry.

A rapid, sensitive method has been developed to study the kinetics of unchanged promethazine (PM) in biological material using a nitrogen-selective flame ionization detector (N-FID). Unchanged PM is distinguished from its desmethyl metabolite. Sample clean-up of several biological fluids (rat plasma, blood, urine, liver and kidney homogenates) was studied and gas chromatographic (GC) conditions optimized. Usually 50 microliters-1.0 ml samples are extracted into n-heptane by shaking with NaOH, re-extracted into H2SO4 and again extracted into n-heptane by addition of NaOH. Finally, the organic phase is separated, concentrated under N2 and PM determined by N-FID. However, a rapid, single-step method requiring only NaOH extraction into n-heptane may be used whenever GC background permits. Imipramine is used as an internal standard for calibration by peak height ratios in the overall range 5--1500 ng PM per sample. Recovery of both methods is high (97--99%) but precision of the single-step method is lower (relative S.D. 10% versus 3--4%). Use of sample volumes up to 1 ml allows accurate determination of concentrations as low as 10 ng/g. Examples of applications to commonly used animal models employing PM are given and simple adaptation for clinical samples suggested.

Determination of low cencentrations of the quaternary ammonium compound thiazinamium methylsulphate in plasma and urine.

A sensitive and selective method for the quantitative determination of the quaternary ammonium antiacetylcholine-compound thiazinamium methylsulphate (Multergan) in plasma and urine is described. The procedure is based on ion pair extraction of the compound with iodide as the counter ion. This is followed by gas chromatography using an alkali flame ionization detector. The detection limit is 2 ng ml-1 with a recovery of 88-0 +/- 6-2% from plasma, 91-4 +/- 4-6% from urine. The described method can also be applied to other quaternary ammonium compounds.