I The present study was designed to investigate both pharmacodynamic and pharmacokinetic interactions of clobazam and alcohol. 2 Eight healthy male volunteers participated in an intraindividual Latin square comparison of (a) clobazam 20 mg; (b) placebo; (c) alcohol + placebo; and (d) alcohol + clobazam 20 mg. Alcohol was administered orally in quantities individually calculated to yield serum alcohol concentrations of about 1000 gg/ml. The comparison of treatments (a) against (b) and (c) against (d) was double blind. Drugfree periods between the trials were 7 days. 3 Pharmacodynamic assessments were carried out before and 2, 3 and 5 h after administration using a series of tests of choice reaction performance, simple reaction time, two-hand coordination and body sway, together with self ratings, side-effects lists, vital signs and blood chemistry. 4 Blood samples were obtained before and 50, 100, 160, 220, 280, 340 and 1440 min after administration. Serum levels of clobazam and alcohol were determined by gas chromatography. 5The dynamic results show significant differences between the alcohol and non-alcohol treatments and no significant difference either between clobazam and placebo, or between alcohol alone and alcohol + clobazam. Numerically, however, the detrimental effects of the combination were consistently stronger, indicating a possible pharmacodynamic interaction. 6 A pharmacokinetic interaction was found, as the serum clobazam levels were higher after combined administration of clobazam and alcohol than after clobazam alone. An enhanced absorption of clobazam and a reduced distribution volume may explain this finding which is comparable to findings obtained with diazepam and alcohol (Hayes et al., 1977). 7 It is concluded that combined ingestion of clobazam and alcohol is likely to be more hazardous than that of alcohol alone.
When patients with gunshot injuries are medically treated, it is also important to examine the wound itself to achieve further information concerning the distance and direction from where the bullet was fired. Besides that, it must be remembered that the bullet does not necessarily penetrate the target in a linear direction, but there can be various curves and angles in the bullet channel and subsequently adjacent organs injured.
Summary. ttyperlipidemias are one of the most frequent pathological disorders of the organism. Physiologically the lipids increase temporarily after ingestion of fatty foods. In most cases this does not significantly effect the results of routine blood alcohol determinations. In extremely rare cases, however, blood alcohol levels based on the analysis of serum samples and using the divisor 1.20 may be too low as the serum/whole blood alcohol ratio may be smaller than 1.10.Zusammen[assung. ttyperlipid~imien gehSren zu den hEufigsten pathologischen StSrungen des 0rganismus, physiologischerweise sind die Lipide nach Aufnahme fettreicher 1Vahrung voriibergehend erh6ht. In bezug auf die I~esultate von Blutalkoholbestimmungen ergeben sieh dadurch in aller Regel jedoch keine Abweichungen yon der l~orm. ]3ei seltenen Extremf~llen ist allerdings die aus dem Serumalkoholgehalt mit ttilfe des Divisors 1,20 errechnete Blutalkoholkonzentration zu niedrig, da das Alkoholverteiinngsverh~ltnis yon Serum und Vollblut dann kleiner als 1,10 sein kann.
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