Detection, identification and measurement of dextropropoxyphene and its principal plasma metabolite, nordextropropoxyphene, can be important in the diagnosis of acute poisoning. A combination of thin-layer chromatography (TLC) and gas-liquid chromatography (GLC) of solvent or solid-phase extracts of urine or gastric contents usually serves to detect these and many other compounds, and an homogeneous enzyme immunoassay (EMIT-DAU) is also available for dextropropoxyphene. Measurement of dextropropoxyphene by GLC is complicated by the instability of this compound under certain conditions. However, a relatively polar stationary phase such as Carbowax 20M together with nitrogen-selective detection can give adequate sensitivity and selectivity for the measurement of the plasma concentrations attained after overdosage. High-performance liquid chromatography (HPLC) has not been widely applied in the assay of dextropropoxyphene and nordextropropoxyphene since these compounds have no pronounced ultraviolet absorption or fluorescence spectra. However, electrochemical oxidation detection can be used with a silica column/non-aqueous ionic eluent system. This gives good selectivity and sensitivity, and can facilitate the measurement of both compounds in plasma specimens after single oral dosage.
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http://dx.doi.org/10.1177/096032718400300112 | DOI Listing |
Eur J Hosp Pharm
September 2020
Pharmaceutical Information Department, Centre Hospitalier Universitaire de Rennes, Rennes, France.
Objective: Pain management in the emergency department (ED) is a key issue that must be regularly evaluated. Practice evaluation gold standard remains patient file analysis, but is highly time consuming. The aim of this study is to evaluate the interest of a defined daily dose (DDD) based analysis in the evaluation of pain management in the ED.
View Article and Find Full Text PDFJ Opioid Manag
March 2019
Universidad de Buenos Aires, Facultad de Medicina, Departamento de Toxicología y Farmacología, Centro de Vigilancia y Seguridad de Medicamentos e Instituto de Investigaciones Cardiológicas "Prof. Dr. Alberto C. Taquini", Buenos Aires, Argentina.
Objective: To evaluate frequency and risk factors for dextropropoxypheneinduced QT-interval prolongation in the clinical setting.
Design: Prospective, noninterventional, observational, longitudinal cohort approach. Electrocardiograms were blindly evaluated by independent professionals.
Clin Toxicol (Phila)
August 2018
a Inserm UMR-S 1144, Paris-Descartes and Paris-Diderot Universities, Paris , France.
Context: Since the banning of dextropropoxyphene from the market, overdoses, and fatalities attributed to tramadol, a WHO step-2 opioid analgesic, have increased markedly. Tramadol overdose results not only in central nervous system (CNS) depression attributed to its opioid properties but also in seizures, possibly related to non-opioidergic pathways, thus questioning the efficiency of naloxone to reverse tramadol-induced CNS toxicity.
Objective: To investigate the most efficient antidote to reverse tramadol-induced seizures and respiratory depression in overdose.
Int J Legal Med
September 2016
Department of Forensic Medicine, University of Helsinki, PO Box 40, Kytösuontie 11, FI-00014, Helsinki, Finland.
The fatal toxicity index (FTI) is the absolute number of fatal poisonings caused by a particular drug divided by its consumption figure. Consequently, it is a useful measure in evaluating toxicity of the drug and its relevance in fatal poisonings. In this study, we assessed the FTI of medicinal drugs in 3 years (2005, 2009, and 2013) in Finland.
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