Stability of diazepam's phase II metabolites in dried blood spots on filter paper.

Phase II metabolites play an important role in diazepam-related cases. The study aimed to assess the stability of diazepam's phase II metabolites in dried blood spots on filter paper. METHODS: A piece of filter paper was spotted with 100 µL of whole blood (added 1% sodium fluoride as needed) obtained from participant who received 5 mg diazepam orally, air dried for 2 h at room temperature, and then stored at different conditions. Whole spots were cut at 0.1 cm from the outer edge of blood spots at post-consumption time-points of prior (zero), 5, 16, 35, 61, 120 days and 1, 1.5 years. Analytes were extracted with methanol/water mixture (8:2, v/v) and determined using HPLC-MS/MS. Decomposition rules were analyzed by a statistical software "SPSS". RESULTS: Temazepam glucuronide remained stable (0.5-18.6% loss) at 20 â„ƒ and at 20 â„ƒ with 1% sodium fluoride for 16 days, while it was unstable after 5 days at 4 â„ƒ (21.1-26.2% loss) and - 20 â„ƒ (28.9 - 34.4% loss). After 35 days, temazepam glucuronide concentrations began to fluctuate significantly under all conditions, and an obvious increase (290.4-355.1%) was observed in 1.5 years. Oxazepam glucuronide was always unstable after 5 days, the percentage loss was even 100% when it was stored for 61 days and 1.5 years. CONCLUSIONS: Dried blood spots on ordinary filter paper are recommended to be stored at 20 â„ƒ or 20 â„ƒ with 1% sodium fluoride within 16 days. Samples should be analyzed immediately or stored in sterile and dry media.

Simulating dynamic interaction between diazepam and ethanol targeting the GABAA receptor via in silico model.

Combined diazepam-ethanol poisoning is common in forensic toxicology. Both diazepam and ethanol can inhibit the central nervous system via the γ-aminobutyric acid (GABA) ligand gated chloride ion channel, GABAA Receptor (GABAAR). As the common target of diazepam and ethanol, whether GABAAR is the key target of their combined action remains unclear. This study aimed to explore their interaction based on the synergistic mechanisms between diazepam and ethanol targeting the GABAAR. Four models were built in silico based on the crystal structure of GABAAR. Molecular dynamic processes of the four models were simulated by the GPU-accelerated pmemd.cuda program in the Amber18 package. Results showed that ethanol inclined to combine the adjacent GABA or diazepam sites, minimized fluctuations of the root-mean-square deviation (RMSD) in the molecular dynamic process of GABA or diazepam binding the GABAAR, and increased the release of binding energy of GABA or diazepam binding the GABAAR. Results also showed that diazepam had less effect on the RMSD fluctuation or the binding energy release of GABA binding GABAAR. The formation of complex of diazepam and GABAAR could minimize the RMSD fluctuation and increase binding energy release of ethanol binding GABAAR. Thus, ethanol, bridging GABA and diazepam, could strengthen the complex of GABA binding the GABAAR, as well as the complex of diazepam binding the GABAAR. However, whether diazepam binds GABAAR or not, it cannot affect GABA binding the GABAAR; and yet the complex of diazepam and GABAAR can stabilize the complex of ethanol and GABAAR.