Simple extraction of toxicologically relevant psychotropic compounds and metabolites from whole blood using mini-QuEChERS followed by UPLC-MS/MS analysis.

The determination of psychotropic drugs and metabolites in blood is relevant in the context of both therapeutic drug monitoring and clinical and forensic toxicology. LC-MS/MS is the preferred method for these assays. However, LC-MS/MS is particularly susceptible to matrix ionization effects and appropriate sample preparation is required to minimize these effects. In this study, a simple, single-step, mini-QuEchERS extraction procedure, coupled to UPLC-MS/MS, was developed and validated for the determination of 15 toxicologically relevant compounds in whole blood, including psychoactive drugs and some metabolites. The assay was linear in the range of 25-1,000 ng ml-1 , fulfilling criteria for accuracy and precision. Extraction yields (71.9-87.7%) and matrix effects (-3.3 to +4.4%, with the exception of codeine, which had matrix effects of -35.36 to -28.14%) were acceptable for the majority of the evaluated compounds, using a single internal standard. The assay was applied to 238 clinical specimens from patients admitted to an emergency service, with 22 samples presenting quantifiable concentrations of 11 different compounds. The developed assay is a simple and efficient strategy for determination of target psychotropic drugs and metabolites in forensic and clinical toxicology.

Is coffee a functional food?

Definitions of functional food vary but are essentially based on foods' ability to enhance the quality of life, or physical and mental performance, of regular consumers. The worldwide use of coffee for social engagement, leisure, enhancement of work performance and well-being is widely recognised. Depending on the quantities consumed, it can affect the intake of some minerals (K, Mg, Mn, Cr), niacin and antioxidant substances. Epidemiological and experimental studies have shown positive effects of regular coffee-drinking on various aspects of health, such as psychoactive responses (alertness, mood change), neurological (infant hyperactivity, Alzheimer's and Parkinson's diseases) and metabolic disorders (diabetes, gallstones, liver cirrhosis), and gonad and liver function. Despite this, most reviews do not mention coffee as fulfilling the criteria for a functional food. Unlike other functional foods that act on a defined population with a special effect, the wide use of coffee-drinking impacts a broad demographic (from children to the elderly), with a wide spectrum of health benefits. The present paper discusses coffee-drinking and health benefits that support the concept of coffee as a functional food.

[Hepatic reactions to psychiatric drugs]. / Reacciones hepáticas por psicodrogas.

Hepatic Drug Reactions can be divided in predictable and nonpredictable. The vast majority of drugs produce nonpredictable reactions, unless the patient had a previous reaction with the same drug. There are two main pathological lesions produced by drugs: one is a cholestasis with mild portal inflammation. The other is a viral hepatitic like lesion with variable degree of necrosis. Less frequent are chronic hepatitis, cirrhosis, esteatosis, peliosis, intrahepatic thrombosis. Cholestasis is a benign and reversible lesion. The hepatitic lesion could produce an extensive necrosis with mortality between 2-20 per cent. Very often the diagnosis of drug reaction is made by exclusion of other etiologies. Patients on prolonged treatments with multiple drugs, should be monitored periodically with the study of liver enzymes.

Moclobemida - Interaçöes medicamentosas / Moclobemide: Pharmacokinetic interactions

Este artigo tem o escopo de mostrar a moclobemida, um inibidor reversível da MAOA apresenta um baixo perfil de interaçöes medicamentosas, principalmente no que tange à farmacodinâmica ocupando lugar de destaque na prática clínica para o tratamento de depressäo e alguns transtornos ansiosos

Drug screening of meconium in infants of drug-dependent mothers: an alternative to urine testing.

Meconium specimens (first 3 days' stool) obtained from 20 infants of drug-dependent mothers and five control infants were analyzed by radioimmunoassay for the metabolites of three commonly abused drugs, heroin, cocaine, and cannabinoids. Control stools contained no drug. Meconium from the infants of drug-dependent mothers showed the presence of at least one drug metabolite: 80% of the infants of drug-dependent mothers showed cocaine (range 0.14 to 19.91 micrograms/gm stool), 55% showed morphine (range 0.41 to 14.97 micrograms/gm stool), and 60% showed cannabinoid (range 0.05 to 0.67 micrograms/gm stool). The concentrations of metabolites were highest during the first 2 days; some stools tested positive up to the third day. In contrast, only 37% of the infants had positive results on a urine screen (fluorescent polarization immunoassay method). Paired urine and meconium specimens, both analyzed by radioimmunoassay, showed a higher concentration of drug metabolites in the latter; eight urine samples had no detectable drugs despite a corresponding positive stool test result. We conclude that meconium is useful for drug screening in the neonate.

Reflexöes do clínico sobre psicofarmacoterapia / A clinician's reflections about pharmacotherapy

As pesquisas com psicofármacos têm sempre resultados divergentes em matéria de indicaçöes, dosagem, modo de açäo. Deficiências conceituais explicam em grande parte as contradiçöes dos resultados das pesquisas. O diagnóstico feito por soma de sintomas, a associaçäo de remédios, as megadoses säo conseqüências das bases teóricas insatisfatórias

Os psicofármacos e o paciente idoso / Psychotropic drugs and the aged patient

Revisam-se os fatores responsáveis pelas respostas alteradas do paciente idoso às drogas em geral, e analisam-se os diversos cuidados a serem tomados quando da administraçäo de psicofármacos aos indivíduos nessa faixa etária