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1.
Acta Chim Slov ; 67(4): 1053-1060, 2020 Dec.
Article En | MEDLINE | ID: mdl-33533475

The electrochemical behavior of chlorzoxazone at the carbon paste electrode was investigated in 0.04 mol/L Britton-Robinson buffer pH 6.50 using cyclic and differential pulse voltammetric techniques. Cyclic voltammetric studies indicated that the oxidation of the drug was irreversible and controlled mainly by diffusion. Experimental and instrumental parameters were optimized (50 mV/s scan rate, 50 mV pulse amplitude, and 0.04 mol/L Britton-Robinson (BR) buffer pH 6.50 as a supporting electrolyte) and a sensitive differential pulse anodic voltammetric method has been developed for the determination of the drug over the concentration range 0.17-1.68 µg/mL chlorzoxazone, with detection and quantitation limits of 0.05 and 0.16 µg/mL, respectively. The proposed voltammetric method was successfully applied to the determination of the drug in its pharmaceutical formulation (Myoflex tablets), and in spiked human urine samples.


Chlorzoxazone/urine , Electrochemical Techniques/methods , Muscle Relaxants, Central/urine , Carbon/chemistry , Chlorzoxazone/chemistry , Electrodes , Humans , Limit of Detection , Muscle Relaxants, Central/chemistry , Oxidation-Reduction , Tablets/analysis
2.
Ann Pharm Fr ; 77(5): 418-425, 2019 Sep.
Article En | MEDLINE | ID: mdl-31296331

Cyclobenzaprine hydrochloride, a skeletal muscle relaxant has been determined using an ecofriendly micellar HPLC method in its pure form and tablets. The chromatographic determination was performed using C8 monolithic column (100mm×4.6mm i.d., 5µm particle size) and micellar eluent which was composed of sodium dodecyl sulfate (0.15M), n-propanol (15%), 0.02M orthophosphoric acid (pH 4.5) and 0.3% triethylamine using UV detection of effluent was set at 225nm. The calibration plot showed good linearity over concentration range from 2-40µg/mL. The assay results were statistically validated for linearity, accuracy, precision and specificity according to ICH guidelines. Additionally, regarding USP guidelines, the uniformity of tablets content and in-vitro dissolution test of the tablets was tested using the proposed method. Simple and rapid applicability of the developed method allowed determination of the drug in its pure and tablet dosage forms. Moreover, the major advantage of micellar HPLC technique is to determine the drug in biological fluids without prior extraction steps. Depending on this, the estimation of cyclobenzaprine in spiked human urine was so simple without traditional tedious procedures. The proposed method offers the advantages of sensitivity and simplicity in addition to short analysis time which didn't exceed 6 minutes.


Amitriptyline/analogs & derivatives , Green Chemistry Technology/methods , Muscle Relaxants, Central/analysis , Amitriptyline/analysis , Amitriptyline/urine , Chromatography, High Pressure Liquid , Gastric Juice/chemistry , Guidelines as Topic , Humans , Limit of Detection , Micelles , Muscle Relaxants, Central/urine , Reference Standards , Reproducibility of Results , Sensitivity and Specificity , Solubility , Spectrophotometry, Ultraviolet , Tablets/analysis
3.
Talanta ; 179: 760-768, 2018 Mar 01.
Article En | MEDLINE | ID: mdl-29310305

A superparamagnetic molecularly imprinted biopolymer (SMIBP) was utilized as an eco-friendly and worth welting bio-sorbent and subsequently was applied for selective dispersive solid phase extraction (d-SPE) and selective separation of baclofen from urine samples. This effective solid phase was biopolymer network with imprinted cavities grafted on the surface of Fe3O4 cores possessing an influential SiO2 layer. The present sorbent easily achieved via co-precipitation and sol-gel processes followed by impressive bio-polymerization route under green and mild reaction conditions. The prepared SMIBP was subsequently characterized by different techniques including SEM, VSM, FT-IR, XRD, TEM and TGA verifying high suitability of the proposed solid phase for trapping and accumulation of target compound. Under optimized conditions recommended by experimental design, understudy SMIBP-d-SPE procedure supplied linear response over 1.0-2500.0µgL-1 with a satisfactory detection limit close to 0.26µgL-1, while repeatability assign to intra-day and inter-day precision as coefficients of variation was lower than 3.9% in both case. These appropriate validation imply high ability of proposed microextraction procedure for clean and effective enrichment of target analyte in complex human urine sample cause consequently leading to accurate analyses at ultra-trace levels.


Baclofen/urine , Ferrosoferric Oxide/chemistry , Magnetite Nanoparticles/chemistry , Molecular Imprinting/methods , Muscle Relaxants, Central/urine , Solid Phase Extraction/methods , Adsorption , Chitosan/chemistry , Green Chemistry Technology , Humans , Limit of Detection , Magnetite Nanoparticles/ultrastructure , Observer Variation , Silicon Dioxide/chemistry , Water/chemistry
4.
Methods Mol Biol ; 1383: 105-14, 2016.
Article En | MEDLINE | ID: mdl-26660179

Carisoprodol and meprobamate are centrally acting muscle relaxant/anxiolytic drugs that can exist in a parent-metabolite relationship (carisoprodol → meprobamate) or as a separate pharmaceutical preparation (meprobamate aka Equanil, others). The monitoring of the use of these drugs has both clinical and forensic applications in pain management applications and in overdose situations. LC-MS/MS is used to analyze urine or plasma/serum extracts with deuterated analogs of each analyte as internal standards to ensure accurate quantitation and control for any potential matrix effects. Positive ion electrospray is used to introduce the analytes into the mass spectrometer. Selected reaction monitoring of two product ions for each analyte allows for the calculation of ion ratios which ensures correct identification of each analyte, while a matrix-matched calibration curve is used for quantitation.


Carisoprodol/blood , Carisoprodol/urine , Meprobamate/blood , Meprobamate/urine , Muscle Relaxants, Central/blood , Muscle Relaxants, Central/urine , Tandem Mass Spectrometry/methods , Chromatography, Liquid/methods , Humans
5.
J Anal Toxicol ; 38(3): 122-8, 2014 Apr.
Article En | MEDLINE | ID: mdl-24488112

Carisoprodol is a skeletal muscle relaxant prescribed to treat pain. Carisoprodol is metabolized to meprobamate, an active metabolite with anxiolytic effects, by the genetically polymorphic CYP2C19 enzyme. Concomitant use of CYP2C19 substrates or inhibitors may alter carisoprodol metabolism, with therapeutic and/or toxic implications for effectively treating patients with pain. This was a retrospective analysis of urinary excretion data collected from patients with pain from March 2008 to May 2011. Carisoprodol and meprobamate urine concentrations were measured by liquid chromatography-tandem mass spectrometry, and the metabolic ratio (MR) of meprobamate to carisoprodol concentrations was determined in 14,965 subjects. The MR geometric mean and 95% confidence interval (95% CI) of the young group (105, 95% CI = 99.1-113) were ∼47.4% higher than the middle-aged group (71.9, 95% CI = 70-73.8) and nearly two times higher than the elderly group (54.4, 95% CI = 51.3-57.6). Females had a 20.7% higher MR compared with males. No significant change in the MR was observed with overall CYP2C19 inhibitor or substrate use. However, evaluation of individual inhibitors showed co-administration with esomeprazole or fluoxetine was associated with a 31.8 and 24.6% reduction in MR, respectively, compared with controls (P < 0.05). Omeprazole did not significantly affect the MR. Patient-specific factors such as age, sex and co-medications may be important considerations for effective carisoprodol therapy.


Carisoprodol/pharmacokinetics , Carisoprodol/urine , Muscle Relaxants, Central/pharmacokinetics , Muscle Relaxants, Central/urine , Pain/drug therapy , Adolescent , Adult , Aged , Aged, 80 and over , Aryl Hydrocarbon Hydroxylases/antagonists & inhibitors , Aryl Hydrocarbon Hydroxylases/metabolism , Chromatography, Liquid , Cytochrome P-450 CYP2C19 , Dose-Response Relationship, Drug , Drug Interactions , Esomeprazole/administration & dosage , Female , Fluoxetine/administration & dosage , Humans , Male , Meprobamate/pharmacokinetics , Meprobamate/urine , Middle Aged , Retrospective Studies , Specimen Handling , Tandem Mass Spectrometry , Young Adult
6.
Eur J Pediatr ; 171(10): 1541-7, 2012 Oct.
Article En | MEDLINE | ID: mdl-22729246

UNLABELLED: The number of reports on baclofen intoxication has increased in recent years. We report a 15-year-old boy who was referred in a state of deep coma (Glasgow Coma Scale = 3). On clinical examination, he showed sinus bradycardia with normal blood pressure. On admission to the hospital, he presented intermittent short episodes of generalized tonic-clonic seizures. While results of imaging procedures and initial toxicological screening (including standard HPLC analysis and urine test) were negative, a nonconvulsive status epilepticus was diagnosed by electroencephalography (EEG). Identification of baclofen as causative agent was possible after the boy's father reported abusive baclofen intake. Subsequent toxicological target analysis of blood and urine samples confirmed the excessive intake of baclofen and showed a typical elimination pattern with a secondary release. Following 112 h of mechanical ventilation, the boy rapidly regained consciousness and recovered normal neurological behavior. CONCLUSIONS: The present case demonstrates the importance of considering baclofen overdosage in cases of severe coma in combination with an abnormal EEG pattern and sinus bradycardia with normal blood pressure levels, in particular as the substance is popular in internet reports promoting baclofen as a rather harmless "fun drug." Furthermore, it underlines the difficulty to identify baclofen as a causative agent without anamnestic information. Nevertheless, by reviewing existing literature on oral baclofen overdosage, it is possible to picture a nearly specific pattern of clinical symptoms in baclofen intoxication.


Baclofen/adverse effects , Coma/chemically induced , Drug Overdose/diagnosis , Muscle Relaxants, Central/blood , Status Epilepticus/chemically induced , Adolescent , Baclofen/blood , Baclofen/urine , Bradycardia/chemically induced , Humans , Male , Muscle Relaxants, Central/urine , Seizures/chemically induced
7.
J Anal Toxicol ; 36(4): 221-31, 2012 May.
Article En | MEDLINE | ID: mdl-22511696

Using urinary carisoprodol data from pain patients, our objectives were to determine the relationship between carisoprodol concentration and its conversion to meprobamate, and quantify the intra-subject and inter-subject variability in carisoprodol metabolism. Liquid chromatography-tandem mass spectrometry was used to quantitate carisoprodol and meprobamate concentrations in urine specimens. The log creatinine-corrected carisoprodol versus log creatinine-corrected meprobamate showed a marginal positive relationship (R(2) = 0.395), with a 29.1-fold variance between subjects at the mean carisoprodol concentration. The geometric mean carisoprodol and meprobamate urine concentrations were 0.519 ± 3.38 mg and 28.2 ± 2.34 mg analyte per gram creatinine, respectively. The log metabolic ratio (MR) versus log creatinine-corrected carisoprodol displayed a marginal positive correlation. A subpopulation of outliers with higher carisoprodol and lower meprobamate levels were considered poor metabolizers and represented 0.483% (n = 21) of the study population. Using a curve-fit mathematical model, we estimated 0.318% (n = 10) to be ultra-rapid metabolizers. The inter-subject population geometric standard deviation (SD) of the MR was 3.64. The intra-subject geometric median and mean SD of the MR were 1.60 (interquartile range: 1.28, 2.07) and 1.72 ± 1.60, respectively. Inter-subject variability was 2.27 times greater than the median intra-subject variability. With a better understanding of urine carisoprodol and meprobamate concentrations and variability, urine drug testing provides a useful monitoring reference for clinicians.


Carisoprodol/pharmacokinetics , Chronic Pain/drug therapy , Meprobamate/urine , Muscle Relaxants, Central/pharmacokinetics , Carisoprodol/urine , Chromatography, High Pressure Liquid , Chronic Pain/metabolism , Drug Monitoring , Female , Humans , Male , Models, Biological , Muscle Relaxants, Central/urine , Reference Values , Reproducibility of Results , Tandem Mass Spectrometry , Urinalysis
8.
J Anal Toxicol ; 35(2): 108-12, 2011 Mar.
Article En | MEDLINE | ID: mdl-21396230

The objective of this project was to validate a new high-throughput homogeneous enzyme immunoassay (HEIA) for the rapid detection of carisoprodol in human urine. Carisoprodol (Soma(®)) and meprobamate are widely prescribed as musculoskeletal pain relief drugs and are listed as one of the 10 most frequently identified drugs associated with DUI cases. Carisoprodol has a short elimination half-life of 1-3 h; however, its major active metabolite, meprobamate, has a longer elimination half-life of 6-17 h. As a result, it is important for an immunoassay to cross-react with both compounds. The advantage of this new assay is that cutoff concentrations can be adjusted between 100 and 500 ng/mL. The reportable range was 25 to 1000 ng/mL for carisoprodol and 50 to 10,000 ng/mL for meprobamate. The intraday coefficient of variation (% CV) for the semi-quantitative assay was less than 1%. The homogeneous assay was validated with a total of 86 urine samples previously analyzed by liquid chromatography-tandem mass spectrometry with carisoprodol concentrations ranging from 50 to 10,000 ng/mL. The accuracy was found to be 100% when immunoassay cutoff concentrations of carisoprodol and meprobamate were set at 100 and 1000 ng/mL, respectively.


Carisoprodol/urine , Muscle Relaxants, Central/urine , Carisoprodol/chemistry , Half-Life , Humans , Immunoassay/methods , Meprobamate/urine , Muscle Relaxants, Central/chemistry , Substance Abuse Detection/methods
9.
J Chromatogr A ; 1216(15): 3192-8, 2009 Apr 10.
Article En | MEDLINE | ID: mdl-19233363

During the last 2 years, the knowledge on the metabolic pathway of tetrazepam, a muscle relaxant drug, was expanded by the fact that diazepam was identified as a degradation product of tetrazepam. The present study demonstrates that this metabolic conversion, recently discovered by in vivo studies, can also be predicted on the basis of a purely instrumental method, consisting of an electrochemical cell (EC) coupled to online liquid chromatography (LC) and mass spectrometry (MS). By implementing a new electrochemical cell type into the EC-LC-MS set-up and by an enhanced oxidation potential range up to 2V, one limitation of the electrochemical metabolism simulation, the hydroxylation of alkanes and alkenes, has been overcome. Instead of commonly used flow-through cell with a porous glassy carbon working electrode, a wall-jet cell with exchangeable electrode material was used for this study. Thereby, the entire metabolic pathway of tetrazepam, in particular including the hydroxylation of the tetrazepam cyclohexenyl moiety, was simulated. The electrochemical results were not only compared to microsomal incubations, but also to in vivo experiments, by analysing urine samples from a patient after tetrazepam delivery. For structure elucidation of the detected metabolites, MS/MS experiments were performed. The comparison of electrochemistry to in vitro as well as to in vivo experiments underlines the high potential of electrochemistry as a fast screening tool in the prediction of metabolic transformations in drug development.


Benzodiazepines/analysis , Diazepam/analysis , Electrochemical Techniques/methods , Muscle Relaxants, Central/analysis , Benzodiazepines/metabolism , Benzodiazepines/urine , Chromatography, Liquid , Diazepam/metabolism , Diazepam/urine , Electrodes , Humans , Hydroxylation , Microsomes/metabolism , Muscle Relaxants, Central/metabolism , Muscle Relaxants, Central/urine , Online Systems , Tandem Mass Spectrometry
10.
Res Vet Sci ; 85(3): 563-9, 2008 Dec.
Article En | MEDLINE | ID: mdl-18321539

The pharmacokinetics of orphenadrine (ORPH) following a single intravenous (i.v.) dose was investigated in six camels (Camelus dormedarius). Orphenadrine was extracted from the plasma using a simple sensitive liquid-liquid extraction method and determined by gas chromatography/mass spectrometry (GC/MS). Following i.v. administration plasma concentrations of ORPH decline bi-exponentially with distribution half-life (t(1/2)(alpha)) of 0.50+/-0.07h, elimination half-life (t(1/2)(beta)) of 3.57+/-0.55h, area under the time concentration curve (AUC) of 1.03+/-0.10g/hl(-1). The volume of distribution at steady state (Vd(ss)) 1.92+/-0.22lkg(-1), volume of the central compartment of the two compartment pharmacokinetic model (V(c)) 0.87+/-0.09lkg(-1), and total body clearance (Cl(T)) of 0.60+/-0.09l/hkg(-1). Three orphenadrine metabolites were identified in urine samples of camels. The first metabolite N-desmethyl-orphenadrine resulted from N-dealkylation of ORPH with molecular ion m/z 255. The second N,N-didesmethyl-orphenadrine, resulted from N-didesmethylation with molecular ion m/z 241. The third metabolite, hydroxyl-orphenadrine, resulted from the hydroxylation of ORPH with molecular ion m/z 285. ORPH and its metabolites in camel were extensively eliminated in conjugated form. ORPH remains detectable in camel urine for three days after i.v. administration of a single dose of 350mg orphenadrine aspartate.


Camelus/metabolism , Orphenadrine/blood , Orphenadrine/pharmacokinetics , Animals , Area Under Curve , Chromatography, Ion Exchange , Gas Chromatography-Mass Spectrometry , Half-Life , Injections, Intravenous , Kinetics , Male , Muscle Relaxants, Central/administration & dosage , Muscle Relaxants, Central/blood , Muscle Relaxants, Central/pharmacokinetics , Muscle Relaxants, Central/urine , Orphenadrine/administration & dosage , Orphenadrine/urine
11.
Drug Metabol Drug Interact ; 23(3-4): 311-21, 2008.
Article En | MEDLINE | ID: mdl-19326774

Chlorzoxazone, a centrally acting muscle relaxant, is a probe for cytochrome P450 2E1 (CYP2E1). The first part of the study consisted of oral administration of 250 mg of chlorzoxazone (Paraflex 250 tablet) alone to 12 healthy male volunteers. Blood samples were collected from the antecubital vein at intervals of 0, 0.5, 1, 2, 3, 4, 5, 6, 7, and 8 hours and urine voided during 0-4 and 4-8 hours was collected after the administration of chlorzoxazone. The second part of the study was conducted after a wash-out period of 7 days; 500 mg of diosmin (Venex 500) was administered daily for 9 days. On day 10, 250 mg of chlorzoxazone was administered. Blood and urine samples were obtained as mentioned above. Serum levels of chlorzoxazone were determined by HPLC. Pharmacokinetic parameters were determined based on non-compartmental model analysis using the computer program RAMKIN. Diosmin pretreatment significantly enhanced AUC, C(max) and t1/2 with a concomitant reduction in CL/f. The urinary excretion of 6-hydroxychlorzoxazone was decreased and unchanged chlorzoxazone was increased over 8 hours. Urinary metabolic ratios of 6-hydroxychlorazoxazone and chlorazoxazone were increased. After pretreatment with diosmin, overall excretion (0-8 h) of 6-hydroxychlorazoxazone and chlorazoxazone were decreased. Diosmin might have inhibited the microsomal CYP2E1-mediated hydroxylation of chlorazoxazone.


Chlorzoxazone/pharmacokinetics , Diosmin/pharmacology , Muscle Relaxants, Central/pharmacokinetics , Adult , Chlorzoxazone/blood , Chlorzoxazone/urine , Chromatography, High Pressure Liquid/methods , Cytochrome P-450 CYP2E1/physiology , Cytochrome P-450 CYP2E1 Inhibitors , Drug Interactions , Enzyme Inhibitors/pharmacology , Humans , Male , Muscle Relaxants, Central/blood , Muscle Relaxants, Central/urine , Young Adult
12.
Int J Legal Med ; 121(3): 169-74, 2007 May.
Article En | MEDLINE | ID: mdl-17021899

The benzodiazepine tetrazepam is primarily muscle relaxant with comparably lower central sedating effects and is therefore commonly prescribed for muscle spasms of different origins. To evaluate tetrazepam metabolism, a study was conducted with ten healthy volunteers. Blood and urine samples were regularly collected after the intake of 50 mg tetrazepam. Toxicological analyses revealed that tetrazepam is also metabolized to diazepam and further to nordazepam, which has not yet been reported. Tetrazepam and diazepam could be detected in urine samples at least 72 h after intake, the diazepam concentration being 33% (+/-14% SD), on average, of the tetrazepam concentration. On the basis of three case histories, the importance of the detection of these newly described metabolites is shown as necessary to prevent false accusations and potential negative legal consequences for examined persons.


Benzodiazepines/pharmacokinetics , Muscle Relaxants, Central/pharmacokinetics , Adult , Benzodiazepines/blood , Benzodiazepines/urine , Diazepam/blood , Diazepam/urine , Female , Forensic Toxicology , Gas Chromatography-Mass Spectrometry , Half-Life , Humans , Male , Molecular Structure , Muscle Relaxants, Central/blood , Muscle Relaxants, Central/urine , Nordazepam/urine
13.
J Anal Toxicol ; 30(5): 302-5, 2006 Jun.
Article En | MEDLINE | ID: mdl-16839465

A rapid, sensitive, and ready-to-use gas chromatography-mass spectrometry method for meprobamate assay using carisoprodol as internal standard is described. The method involves extracting a 0.2-mL sample with chloroform, previously acidified with HCl 0.2N. For the quantitative analysis, we used selected-ion monitoring mode, selecting the ion m/z 144 for quantification of meprobamate and m/z 245 for carisoprodol. Excellent linearity was found between 0 and 200 mg/L plasma. The limit of detection was 0.58 mg/L, and the limit of quantification was 1.93 mg/L. A high reproducibility [intra-assay coefficient of variation (CV) range of 2.3-4.3% and interassay CV range of 5.5-12.3%] and accuracy (intra-assay range of 96.8-112.3% and interassay range of 85.5-99.3%) were observed. Recoveries were concentration-independent (87.0%, 76.2%, and 81.2% for 20, 75 and 150 mg/L, respectively). No interference from endogenous compounds, other metabolites of meprobamate, or frequently coadministered drugs was detected. This sensitive, simple assay for meprobamate in plasma, whole blood, and urine meets the current requirements for bioanalytical assays in overdose cases.


Meprobamate/blood , Meprobamate/urine , Anti-Anxiety Agents/blood , Anti-Anxiety Agents/urine , Biological Assay , Emergency Medicine , Gas Chromatography-Mass Spectrometry , Humans , Muscle Relaxants, Central/blood , Muscle Relaxants, Central/urine , Plasma/chemistry
14.
J Anal Toxicol ; 26(1): 29-34, 2002.
Article En | MEDLINE | ID: mdl-11890177

Quaternary nitrogen muscle relaxants pancuronium, rocuronium, vecuronium, gallamine, suxamethonium, mivacurium, and atracurium and its metabolites were extracted from whole blood and other biological fluids and tissues by using a solid-phase extraction procedure. The extracts were examined by using high-performance liquid chromatography-electrospray ionization mass spectrometry (LC-ESI-MS). The drugs were separated on a ODS column in a gradient of ammonium acetate buffer (pH 5.0) and acetonitrile. Full-scan mass spectra of the compounds showed molecular ions, and MS-MS spectra showed fragments typical of the particular compounds. LC-ESI-MS allowed an unequivocal differentiation of all muscle relaxants involved. The method was applied in a case of rocuronium and suxamethonium administration in a Caesarian section and in a case of intoxication by pancuronium injection. In both cases, the administered drugs could be detected and identified in the supplied samples.


Muscle Relaxants, Central/analysis , Nitrogen Compounds/analysis , Adult , Androstanols/analysis , Androstanols/poisoning , Bile/chemistry , Body Fluids/chemistry , Buffers , Female , Forensic Medicine , Humans , Indicators and Reagents , Liver/chemistry , Male , Mass Spectrometry , Muscle Relaxants, Central/blood , Muscle Relaxants, Central/urine , Neuromuscular Depolarizing Agents/analysis , Neuromuscular Nondepolarizing Agents/analysis , Neuromuscular Nondepolarizing Agents/poisoning , Nitrogen Compounds/blood , Nitrogen Compounds/urine , Pancuronium/analysis , Pancuronium/poisoning , Poisoning/diagnosis , Pregnancy , Reference Standards , Rocuronium , Spectrometry, Mass, Electrospray Ionization , Succinylcholine/analysis , Succinylcholine/poisoning
15.
Forensic Sci Int ; 123(1): 26-32, 2001 Nov 15.
Article En | MEDLINE | ID: mdl-11731193

A fatal suicidal intoxication with unusual drugs is reported. A 56-year-old man was found dead in his house; near by the corpse several empty drugs boxes were found. An autopsy was performed and the biological fluids were submitted to a full toxicological work-up. The analytical results supported the hypothesis of a death due to the acute baclofen (4-amino-3-(p-chlorophenyl)butyric acid) and dipyrone (sodium [N-(1,5-dimethyl-3-oxo-2-phenylpyrazolin-4-yl)-N-methylamino] methanesulfonate) intoxication.


Anti-Inflammatory Agents, Non-Steroidal/poisoning , Baclofen/poisoning , Dipyrone/poisoning , Forensic Medicine/methods , Muscle Relaxants, Central/poisoning , Suicide, Attempted , Anti-Inflammatory Agents, Non-Steroidal/blood , Anti-Inflammatory Agents, Non-Steroidal/urine , Baclofen/blood , Baclofen/urine , Dipyrone/blood , Dipyrone/urine , Fatal Outcome , Gas Chromatography-Mass Spectrometry , Humans , Male , Middle Aged , Muscle Relaxants, Central/blood , Muscle Relaxants, Central/urine
16.
Clin Pharmacol Ther ; 66(6): 554-62, 1999 Dec.
Article En | MEDLINE | ID: mdl-10613610

OBJECTIVE: Inflammation induced by Escherichia coli lipopolysaccharide alters the clearance of several hepatically eliminated drugs. Extensive rat liver research has shown CYP2E1 down-regulation after lipopolysaccharide administration. To further investigate this phenomenon in humans, lipopolysaccharide was administered to healthy male volunteers and chlorzoxazone was used as a CYP2E1 probe drug. METHODS: Twelve healthy men were given 500 mg oral chlorzoxazone after two daily lipopolysaccharide doses (20 endotoxin units/kg/day) and again after administration of saline solution in this balanced crossover study. Serum and urine chlorzoxazone and 6-hydroxychlorzoxazone were quantified, as well as cytokine and C-reactive protein levels. RESULTS: Lipopolysaccharide produced the expected induction of the acute-phase response shown by elevations in tumor necrosis factor, interleukin-6, C-reactive protein, and temperature. Lipopolysaccharide treatment failed to produce a significant change in the chlorzoxazone oral clearance (4.4 +/- 0.9 mL/min/kg for lipopolysaccharide versus 4.2 +/- 1.4 mL/min/kg for control) or the 6-hydroxychlorzoxazone formation clearance (2.8 +/- 0.65 mL/min/kg for lipopolysaccharide versus 2.5 +/- 0.9 mL/min/kg for control). The high intersubject variabilities in oral clearance and formation clearance were not accounted for by changes in protein binding, cytokine, or C-reactive protein values. In contrast, a significant increase in the 6-hydroxychlorzoxazone glucuronide renal clearance was observed (7.5 +/- 1.37 mL/min/kg for lipopolysaccharide versus 6.1 +/- 1.7 mL/min/kg for control). CONCLUSIONS: This study showed that the inflammatory response to lipopolysaccharide (20 endotoxin units/kg/day for 2 days) in humans does not consistently alter chlorzoxazone hepatic metabolism. However, the significant increase in renal clearance of the glucuronidated metabolite suggests that renal tubular secretion may be increased in humans with acute endotoxemia.


Chlorzoxazone/pharmacokinetics , Cytochrome P-450 CYP2E1/metabolism , Lipopolysaccharides/adverse effects , Muscle Relaxants, Central/pharmacokinetics , Adult , C-Reactive Protein/metabolism , Chlorzoxazone/analogs & derivatives , Chlorzoxazone/blood , Chlorzoxazone/urine , Humans , Interleukin-6/blood , Kidney Tubules/metabolism , Lipopolysaccharides/administration & dosage , Liver/metabolism , Male , Muscle Relaxants, Central/blood , Muscle Relaxants, Central/urine , Reference Values , Serum Albumin/metabolism , Tumor Necrosis Factor-alpha/metabolism
17.
J Anal Toxicol ; 21(4): 301-5, 1997.
Article En | MEDLINE | ID: mdl-9248949

Urine and serum samples collected from four standard-bred mares after and oral regimen administration of methocarbamol were extracted and analyzed. The method consisted of enzyme hydrolysis followed by a one-step liquid-liquid extraction, separation on a reversed-phase (RP-18) column, and detection using an ultraviolet (UV) detector. The confirmation was carried out using a liquid chromatography-atmospheric pressure ionization-mass spectrometry (LC-API-MS) system. Maximum methocarbamol concentrations of 1498, 1734, 1547, 2322 micrograms/mL in urine and 4.9, 1.7, and 3.6 micrograms/mL in serum were observed. The peak concentrations of the drug were detected 1-4 h (urine) and 10-60 min (serum) after administration to four horses. The method validation results and drug elimination profiles for both urine and serum are presented and discussed.


Chromatography, High Pressure Liquid/methods , Horses/blood , Mass Spectrometry/methods , Methocarbamol/blood , Muscle Relaxants, Central/blood , Animals , Atmospheric Pressure , Horses/urine , Methocarbamol/urine , Muscle Relaxants, Central/urine , Reproducibility of Results , Spectrophotometry, Ultraviolet
18.
Br J Clin Pharmacol ; 43(1): 99-103, 1997 Jan.
Article En | MEDLINE | ID: mdl-9056059

AIMS: An investigation was undertaken to compare the effects of isoniazid pretreatment on the CYP2E1-mediated 6-hydroxylation of chlorzoxazone in healthy subjects of known N-acetylator phenotype. METHODS: CYP2E1 activity was estimated based on the 6-hydroxylation of chlorzoxazone following single dose (250 mg) oral administration to seven slow and eight rapid N-acetylators who were in good health. Separate studies were performed prior to and 14 days after the subjects received 300 mg isoniazid daily. Additional investigations were undertaken 2 and 16 days after discontinuing treatment with the antitubercular agent. RESULTS: Concomitant administration of chlorzoxazone with the final dose of isoniazid resulted in reduced metabolism in both phenotypes; however, the extent of inhibition of 6-hydroxylation was greater in the slow N-acetylators-about 80% vs 60%. Two days after stopping isoniazid administration, chlorzoxazone's pharmacokinetic parameters had returned to their baseline values and remained constant for a further 14 days in the rapid acetylators. In contrast, chlorzoxazone's 6-hydroxylation in slow acetylators was increased by about 60% compared with baseline at 2 days after discontinuing isoniazid but had returned to its initial value 14 days later. CONCLUSIONS: The interphenotypic difference in the time-dependent interactions of isoniazid with CYP2E1 probably reflect a higher drug exposure in slow acetylators. Inhibition of CYP2E1 activity occurs in both N-acetylator phenotypes but is less extensive in fast acetylators, during the time that effective levels of isoniazid are present in the body. Increased CYP2E1 activity reflective of enzyme induction, on the other hand, is only observable following isoniazid's elimination and is more extensive in slow than rapid acetylators. Even then, however, such induction is relatively modest and of short duration.


Antitubercular Agents/pharmacology , Chlorzoxazone/metabolism , Cytochrome P-450 CYP2E1/drug effects , Isoniazid/pharmacology , Muscle Relaxants, Central/metabolism , Acetylation , Administration, Oral , Adolescent , Adult , Analysis of Variance , Chlorzoxazone/blood , Chlorzoxazone/urine , Cytochrome P-450 CYP2E1/metabolism , Enzyme Induction/drug effects , Female , Humans , Hydroxylation , Male , Muscle Relaxants, Central/blood , Muscle Relaxants, Central/urine , Phenotype
19.
Clin Pharmacol Ther ; 58(5): 498-505, 1995 Nov.
Article En | MEDLINE | ID: mdl-7586943

OBJECTIVE: To determine whether the urinary excretion of 6-hydroxychlorzoxazone is an index of CYP2E1 activity in vivo. METHODS: Male volunteers (n = 27; age range, 17 to 36 years) who were abstinent from alcohol were studied. Chlorzoxazone, 500 mg, was given orally and plasma was collected at 31/2, 41/2, 51/2, and 61/2 hours after dosing. Urine was collected for 8 hours. Ten volunteers participated in full kinetic studies to define the absorption phase and plasma area under the concentration-time curve of chlorzoxazone and the urinary kinetics of the 6-hydroxy metabolite. Chlorzoxazone and the 6-hydroxy metabolite were measured by high-performance liquid chromatography. CYP2E1 activity was expressed as a hydroxylation index (HI = mmole oral chlorzoxazone dose/mmole 6-hydroxychlorzoxazone in 8-hour urine). RESULTS: There was a significant positive correlation between plasma elimination rate constant for chlorzoxazone (Ke) and urinary excretion of the metabolite (n = 27, r = 0.42, p < 0.03) and a significant negative correlation between plasma Ke and HI (n = 27, r = -0.41, p < 0.04). The mean absorption rate constant for chlorzoxazone of 3.11 +/- 4.67 hr-1 was fivefold greater than the plasma Ke of 0.57 +/- 0.17 hr-1 for the full kinetic studies. The formation clearance of the 6-hydroxy metabolite was negative between plasma Ke of the parent compound and disposition rate constant for urinary excretion of the 6-hydroxy metabolite (n = 15, r = 0.85, p < 0.0001). CONCLUSIONS: The urinary excretion of 6-hydroxychlorzoxazone is limited by formation rate and may be useful as an in vivo probe of CYP2E1 activity.


Chlorzoxazone/analogs & derivatives , Chlorzoxazone/metabolism , Cytochrome P-450 Enzyme System/metabolism , Muscle Relaxants, Central/metabolism , Oxidoreductases, N-Demethylating/metabolism , Adolescent , Adult , Chlorzoxazone/pharmacokinetics , Chlorzoxazone/urine , Chromatography, High Pressure Liquid , Cytochrome P-450 CYP2E1 , Humans , Male , Muscle Relaxants, Central/pharmacokinetics , Muscle Relaxants, Central/urine
20.
J Chromatogr B Biomed Appl ; 666(1): 117-26, 1995 Apr 07.
Article En | MEDLINE | ID: mdl-7655609

Sensitive assays for the determination of cyclobenzaprine (I) in human plasma and urine were developed utilizing high-performance liquid chromatography (HPLC) with tandem mass spectrometric (MS-MS) and ultraviolet (UV) absorbance detections. These two analytical techniques were evaluated for reliability and sensitivity, and applied to support pharmacokinetic studies. Both methods employed a liquid-liquid extraction of the compound from basified biological sample. The organic extract was evaporated to dryness, the residue was reconstituted in the mobile phase and injected onto the HPLC system. The HPLC assay with MS-MS detection was performed on a PE Sciex API III tandem mass spectrometer using the heated nebulizer interface. Multiple reaction monitoring using the parent-->daughter ion combinations of m/z 276 --> 215 and 296 --> 208 was used to quantitate I an internal standard (II), respectively. The HPLC-MS-MS and HPLC-UV assays were validated in human plasma in the concentration range 0.1-50 ng/ml and 0.5-50 ng/ml, respectively. In urine, both methods were validated in the concentration range 10-1000 ng/ml. The precision of the assays, as expressed as coefficients of variation (C.V.) was less than 10% over the entire concentration range, with adequate assay specificity and accuracy. In addition to better sensitivity, the HPLC-MS-MS assay was more efficient and allowed analysis of more biological fluid samples in a single working day than the HPLC-UV method.


Amitriptyline/analogs & derivatives , Chromatography, High Pressure Liquid/methods , Mass Spectrometry/methods , Muscle Relaxants, Central/pharmacokinetics , Amitriptyline/blood , Amitriptyline/pharmacokinetics , Amitriptyline/urine , Humans , Muscle Relaxants, Central/blood , Muscle Relaxants, Central/urine , Reproducibility of Results , Spectrophotometry, Ultraviolet
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