Intrathecal infusion is often performed using drug combinations. This study was conducted to evaluate the stability of the admixture of morphine sulfate, bupivacaine hydrochloride, and clonidine hydrochloride when used in an implantable pump under simulated clinical use conditions. SynchroMed implantable pumps were filled with an admixture and incubated at 37 degrees C for a period of 90 days. Drug admixture stored in glass vials at 4 degrees C and at 37 degrees C served as controls. Samples which included pump reservoir and catheter delivered aliquots were collected every 30 days and analyzed for drug concentrations using a stability-indicating HPLC method. All drugs contained in the admixture were stable and the original concentrations remained greater than 96%. Over 90 days, and with the pump at the simulated body temperature of 37 degrees C, there were no evident heat catalyzed or device catalyzed reactions.
Following enzymatic hydrolysis of urine, a gas chromatography–mass spectrometry method for the simultaneous determination of codeine, morphine, hydrocodone, and hydromorphone uses hydroxylamine to form oxime derivatives of the keto-opiates (i.e., hydrocodone, hydromorphone, oxycodone, and oxymorphone). These trimethylsilyl-derivatized forms no longer interfere with the detection and quantitation of codeine and morphine. Samples are extracted on solid-phase columns and quantitated by deuterated internal calibrations of each analyte with selected ion monitoring. Codeine, morphine, hydrocodone, and hydromorphone are completely separated, allowing simultaneous quantitation without interference and a chromatographic analysis time <9 min.
The serum and urine from 44 consecutive patients that tested positive for the cocaine metabolite benzoylecgonine (BE) were examined for free cocaine, ecgonine methyl ester (EME), and other metabolites by gas chromatography/ion trap mass spectrometry (GC/MS). In 13 of these patients, unique ethanol-related cocaine metabolites, cocaethylene and ecognine ethyl ester (EEE), were detected in urine and serum. One was from a newborn baby whose mother's blood was positive for cocaine and negative for cocaethylene. In two other patients, isopropanol was also consumed with cocaine and ethanol. In one of these two, cocaisopropylene and ecognine isopropyl ester (EPE) were identified in urine. The urine ethanol concentration in 7 of the 13 cocaethylene-positive patients ranged from 19 to 322 mg/dL. In the other six, ethanol was not detected in the urine. However, each of these latter patients had either prior serum results that were positive for ethanol or admitted to recent alcohol abuse. In the remaining 31 of 44 cocaine-positive patients, ethanol and the alcohol-specific cocaine metabolites were absent. The detection of alcohol-related cocaine metabolites is fairly common in a cocaine-positive patient population.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.