HPLC同时测定桑白皮中绿原酸、东莨菪内酯、白藜芦醇、桑色素4种成分的含量

目的:分析HPLC同时测定桑白皮中绿原酸、东莨菪内酯、白藜芦醇、桑色素4种成分含量的有效性.方法:对桑白皮中桑色素、白藜芦醇、东莨菪内酯、绿原酸四种成分含量采用HPLC法进行测定,并对其测定结果进行分析.结果:平均加样回收率在98.4％～99.4％之间,12h内,供试品具有良好稳定性,白藜芦醇在产地为湖北桑白皮中的含量最多,桑色素、绿原酸、东莨菪内酯在产地为河南桑白皮中的含量最多.结论:HPLC同时测定桑白皮4种成分含量的准确度、精密度高.     

桑白皮的混淆品-构树、柘树根皮生药学鉴定研究

目的通过对桑白皮的混淆品构树和柘树根皮的生药学研究比较,为桑白皮的鉴定提供科学的依据。并通过对混淆品构树、柘树根皮的显微鉴别性状对比,为二者后续鉴别研究提供指导意见。方法采用生药学常用鉴别方法对构树、柘树根皮的性状、显微鉴别特征进行对比研究。结果构树、柘树根皮在性状鉴别特征和显微鉴别的茎横切面、粉末特征方面具有专属性。结论对构树、拓树性状鉴别、显微鉴别的方法真实准确,鉴定结果可以作为桑白皮混淆品区分鉴定的科学依据。     

桑的药理研究(Ⅱ)─一桑叶、桑枝、桑白皮抗炎药理作用的初步比较研究

桑的药理研究（Ⅱ）─一桑叶、桑枝、桑白皮抗炎药理作用的初步比较研究陈福君，林一星，许春泉，李芸沈阳药科大学中药系１１００１５桑叶是中药中清热解表之要药，具有疏散风热，清肝明目之功能；桑枝则具有祛风除湿、利关节的效用；而桑白皮则长于泻肺平喘、利尿消肿．...     

基于UPLC指纹图谱与色度值的桑白皮生品和炮制品的鉴别及炮制终点研究

目的:为桑白皮生品和其炮制品(蜜桑白皮)的鉴别及蜜桑白皮炮制终点的确定提供参考。方法:采用超高效液相色谱(UPLC)法进行测定。色谱柱为Waters BEH Shield RP C18;流动相为乙腈-0.1%磷酸溶液(梯度洗脱);流速为0.30 mL/min;柱温为30℃;程序波长为280 nm(0~4 min)、320 nm(4~35 min)。使用《中药色谱指纹图谱相似度评价系统》(2012版)分别建立13批桑白皮和蜜桑白皮的UPLC指纹图谱以及进行相似度评价,并结合对照品图谱对色谱峰进行指认。测定13批桑白皮和蜜桑白皮粉末的色度值(L、a、b)并计算其平均总色度值(E),结合偏最小二乘法判别分析(OPLS-DA)法和聚类分析法分析桑白皮炮制前后指纹图谱和色度值的差异性;同时分析不同炮制时间下蜜桑白皮指纹图谱和色度值的动态变化规律,以确定其炮制终点。结果:桑白皮炮制前后指纹图谱存在明显差异,13批桑白皮和蜜桑白皮样品的相似度均在0.9以上。桑白皮、蜜桑白皮图谱中分别共标定了21、23个共有峰,其中峰1、峰2是桑白皮经蜜炙后新产生的化合物;同时,指认了峰2、峰7、峰14、峰19分别为5-羟甲基糠醛、桑皮苷A、氧化白藜芦醇、桑黄酮G。OPLS-DA分析结果显示,峰1、峰2、峰18、峰20的峰面积/称样量比值以及色度值(L、a、b)是影响蜜桑白皮炮制前后差异最主要的因素;以E范围75.84~80.88作为蜜桑白皮的炮制终点,确定炮制时间为22~34 min。结论:所建立的UPLC指纹图谱和色度值的测定方法可用于桑白皮生品和炮制品的鉴别以及蜜桑白皮炮制终点的确定。     

桑白皮总黄酮的镇咳祛痰作用

目的研究桑白皮总黄酮镇咳祛痰作用。方法采用浓氨水、SO2小鼠引咳法,小鼠气管酚红排泌及大鼠气管毛细管分泌液模型,观察桑白皮黄酮的镇咳祛痰作用。结果125 mg.kg-1显著抑制浓氨水、SO2所致小鼠咳嗽潜伏期,减少氨水引咳次数,桑白皮总黄酮250 mg.kg-1显著减少SO2引咳次数。桑白皮总黄酮125 mg.kg-1增加小鼠气管酚红排泌,桑白皮总黄酮180 mg.kg-1显著增加大鼠气管分泌液。结论桑白皮总黄酮具有镇咳祛痰作用。     

桑白皮提取物对胰岛素抵抗2型糖尿病小鼠的降糖作用

目的观察桑白皮提取物对胰岛素抵抗2型糖尿病小鼠降糖作用。方法采用高脂高糖饮食配以小剂量链脲佐菌素(STZ)的方法,建立伴胰岛素抵抗的2型糖尿病小鼠模型。桑白皮提取物不同剂量连续灌胃给药30d,观察小鼠血糖、血脂、胰岛素及胰岛素抵抗指数的变化。结果桑白皮提取物能明显降低糖尿病小鼠的血糖和胰岛素水平,降低胰岛素抵抗指数,提高胰岛素敏感性;同时,桑白皮提取物也有调节模型小鼠血脂的作用。结论桑白皮提取物能改善胰岛素抵抗,对糖尿病小鼠具有一定的降糖作用。     

桑白皮黄酮类化学成分研究进展

对近十年桑白皮黄酮类化合物的化学成分、总黄酮提取工艺及含量测定方法以及药理学作用的研究进行综述,为桑白皮黄酮类化合物的开发应用提供科学依据.     

微波光波法蜜炙桑白皮的炮制工艺研究

目的优化蜜炙桑白皮的炮制新工艺。方法用微波光波法炮制蜜桑白皮,以桑白皮总黄酮含量为考察指标,采用正交法进行优化。结果微波光波法蜜炙桑白皮的最佳炮制工艺为A3B3C1,即拌蜜润药1 h,用组合3(微波67%+光波33%),加热7 min。3批验证试验结果为:外观金黄色到深黄色,总黄酮平均含量为4.713%。结论此工艺条件可行,可作为蜜桑白皮的炮制改革工艺。     

桑根皮的降压成分桑白皮素C

在进一步的研究中,又从桑白皮中分离出一个新的具有降压活性的异戊烯基黄酮化合物,命名为桑白皮素C(Moracenin C).本文叙述了桑白皮素C的结构测定,阐明了桑白皮素A、B、C的立体结构。桑白皮素C,[α]D—445°(C=0.16,甲醇),经场解吸质谱法确定其分子量为760,结合~(13)C-NMR分析断定其组成为C_(45)H_(44)O_(11)。镁粉-盐酸的阳性反应确定它是一个黄酮类化合物。经 IR、UV、~1H-和~(13)C     

桑白皮药材和黄酮提取物中桑根酮C、D和桑辛素含量测定

测定和比较桑白皮药材和黄酮提取物中桑根酮C、D和桑辛素的含量。方法：薄层色谱法鉴别药材,用硅胶G为薄层板,三氯甲烷-甲酸-甲醇( 5∶ 0.3∶1) 为展开剂,置于365nm紫外灯下检视斑点;紫外分光光度法检测桑白皮药材和黄酮提取物中总黄酮的含量;高效液相色谱法测定桑白皮药材和黄酮提取物中桑根酮C、D和桑辛素的含量。结果：薄层色谱鉴别中,桑根酮D的荧光斑点清晰;紫外分光光度法中桑根酮C在0.0391~0.1564mg/mL与吸光度呈良好线性关系( n = 5) ,平均回收率为96.7%,ＲSD 为1.49% ( n = 5) ;高效液相色谱法中,桑根酮C、D 及桑辛素在进样量范围内线性关系良好,桑根酮C、D 、桑辛素线性范围分别为0.185~1.48μg、0.086~0.43μg、0.233~2.097μg,平均回收率分别为97.09%、 98.2 %、 97.3%,RSD分别为1.85 %、2.32 %、1.55%（n=6）。结论：该方法简单有效,可准确测定桑白皮药材和黄酮提取物中有效成分的含量。     

Safety assessment of poloxamers 101, 105, 108, 122, 123, 124, 181, 182, 183, 184, 185, 188, 212, 215, 217, 231, 234, 235, 237, 238, 282, 284, 288, 331, 333, 334, 335, 338, 401, 402, 403, and 407, poloxamer 105 benzoate, and poloxamer 182 dibenzoate as used in cosmetics

Poloxamers are polyoxyethlyene, polyoxypropylene block polymers. The impurities of commercial grade Poloxamer 188, as an example, include low-molecular-weight substances (aldehydes and both formic and acetic acids), as well as 1,4-dioxane and residual ethylene oxide and propylene oxide. Most Poloxamers function in cosmetics as surfactants, emulsifying agents, cleansing agents, and/or solubilizing agents, and are used in 141 cosmetic products at concentrations from 0.005% to 20%. Poloxamers injected intravenously in animals are rapidly excreted in the urine, with some accumulation in lung, liver, brain, and kidney tissue. In humans, the plasma concentration of Poloxamer 188 (given intravenously) reached a maximum at 1 h, then reached a steady state. Poloxamers generally were ineffective in wound healing, but were effective in reducing postsurgical adhesions in several test systems. Poloxamers can cause hypercholesterolemia and hypertriglyceridemia in animals, but overall, they are relatively nontoxic to animals, with LD(50) values reported from 5 to 34.6 g/kg. Short-term intravenous doses up to 4 g/kg of Poloxamer 108 produced no change in body weights, but did result in diffuse hepatocellular vacuolization, renal tubular dilation in kidneys, and dose-dependent vacuolization of epithelial cells in the proximal convoluted tubules. A short-term inhalation toxicity study of Poloxamer 101 at 97 mg/m(3) identified slight alveolitis after 2 weeks of exposure, which subsided in the 2-week postexposure observation period. A short-term dermal toxicity study of Poloxamer 184 in rabbits at doses up to 1000 mg/kg produced slight erythema and slight intradermal inflammatory response on histological examination, but no dose-dependent body weight, hematology, blood chemistry, or organ weight changes. A 6-month feeding study in rats and dogs of Poloxamer 188 at exposures up to 5% in the diet produced no adverse effects. Likewise, Poloxamer 331 (tested up to 0.5 g/kg day(-1)), Poloxamer 235 (tested up to 1.0 g/kg day(-1)), and Poloxamer 338 (at 0.2 or 1.0 g/kg day(-1)) produced no adverse effects in dogs. Poloxamer 338 (at 5.0 g/kg day(-1)) produced slight transient diarrhea in dogs. Poloxamer 188 at levels up to 7.5% in diet given to rats in a 2-year feeding study produced diarrhea at 5% and 7.5% levels, a small decrease in growth at the 7.5% level, but no change in survival. Doses up to 0.5 mg/kg day(-1) for 2 years using rats produced yellow discoloration of the serum, high serum alkaline phosphatase activity, and elevated serum glutamicpyruvic transaminase and glutamic-oxalacetic transaminase activities. Poloxamers are minimal ocular irritants, but are not dermal irritants or sensitizers in animals. Data on reproductive and developmental toxicity of Poloxamers were not found. An Ames test did not identify any mutagenic activity of Poloxamer 407, with or without metabolic activation. Several studies have suggested anticarcinogenic effects of Poloxamers. Poloxamers appear to increase the sensitivity to anticancer drugs of multidrug-resistant cancer cells. In clinical testing, Poloxamer 188 increased the hydration of feces when used in combination with a bulk laxative treatment. Compared to controls, one study of angioplasty patients receiving Poloxamer 188 found a reduced myocardial infarct size and a reduced incidence of reinfarction, with no evidence of toxicity, but two other studies found no effect. Poloxamer 188 given to patients suffering from sickle cell disease had decreased pain and decreased hospitilization, compared to controls. Clinical tests of dermal irritation and sensitization were uniformly negative. The Cosmetic Ingredient Review (CIR) Expert Panel stressed that the cosmetic industry should continue to use the necessary purification procedures to keep the levels below established limits for ethylene oxide, propylene oxide, and 1,4-dioxane. The Panel did note the absence of reproductive and developmental toxicity data, but, based on molecular weight and solubility, there should be little skin penetration and any penetration of the skin should be slow. Also, the available data demonstrate that Poloxamers that are introduced into the body via routes other than dermal exposure have a rapid clearance from the body, suggesting that there would be no risk of reproductive and/or developmental toxicity. Overall, the available data do not suggest any concern about carcinogenesis. Although there are gaps in knowledge about product use, the overall information available on the types of products in which these ingredients are used, and at what concentration, indicates a pattern of use. Based on these safety test data and the information that the manufacturing process can be controlled to limit unwanted impurities, the Panel concluded that these Poloxamers are safe as used.     

Arformoterol: (R,R)-eformoterol, (R,R)-formoterol, arformoterol tartrate, eformoterol-sepracor, formoterol-sepracor, R,R-eformoterol, R,R-formoterol

Sepracor in the US is developing arformoterol [R,R-formoterol], a single isomer form of the beta(2)-adrenoceptor agonist formoterol [eformoterol]. This isomer contains two chiral centres and is being developed as an inhaled preparation for the treatment of respiratory disorders. Sepracor believes that arformoterol has the potential to be a once-daily therapy with a rapid onset of action and a duration of effect exceeding 12 hours. In 1995, Sepracor acquired New England Pharmaceuticals, a manufacturer of metered-dose and dry powder inhalers, for the purpose of preparing formulations of levosalbutamol and arformoterol. Phase II dose-ranging clinical studies of arformoterol as a longer-acting, complementary bronchodilator were completed successfully in the fourth quarter of 2000. Phase III trials of arformoterol began in September 2001. The indications for the drug appeared to be asthma and chronic obstructive pulmonary disease (COPD). However, an update of the pharmaceutical product information on the Sepracor website in September 2003 listed COPD maintenance therapy as the only indication for arformoterol. In October 2002, Sepracor stated that two pivotal phase III studies were ongoing in 1600 patients. Sepracor estimates that its NDA submission for arformoterol, which is projected for the first half of 2004, will include approximately 3000 adult subjects. Sepracor stated in July 2003 that it had completed more than 100 preclinical studies and initiated or completed 15 clinical studies for arformoterol inhalation solution for the treatment of bronchospasm in patients with COPD. In addition, Sepracor stated that the two pivotal phase III studies in 1600 patients were still progressing. In 1995, European patents were granted to Sepracor for the use of arformoterol in the treatment of asthma, and the US patent application was pending.     

Oral Presentations (LDD, LPES, LNM, LPAT, LNT, LPPT, LPM)

Probiotic microorganisms have been shown to provide specific health benefits when consumed as food supplements or as food components. The main problem of such products is the poor survival of the probiotic bacteria in the low pH of gastric fluid. However the use of synthetic excipients for enteric coating to prevent the exposure of microorganisms to gastric fluid is limited in food supplementary industry. Therefore the aim of this study was to develop an enteric coating formulation containing shellac as a natural polymer. Shellac possesses good resistance to gastric juice; the major disadvantage of this polymer is its low solubility in the intestinal fluid [1, 2]. Thus films containing different ratios of shellac and water-soluble polymers (sodium alginate, hydroxypropyl methylcellulose (HPMC) and polyvinylpyrrolidon (PVP)) or plasticizers (glycerol and glyceryl triacetate (GTA)) were prepared in order to analyse the films’ melting temperatures (T_m), the changes in enthalpy (ΔH), their capability of taking up water, and their solubility in different media. The release characteristics of the films were studied by loading pellets with Enterococcus faecium M74 and coating them with formulations containing different amounts of shellac and polymer or plasticized shellac. Using dissolution tests, performed according to USP XXXI paddle method, the resistance of the coatings to simulated gastric fluid (SGF, pH 1.2) and the release of cells in simulated intestinal fluid (SIF, pH 6.8) was investigated.The trials showed that an increasing amount of plasticizer results in a decrease of T_m and ΔH of the films whereat glycerol had a superior plasticization effect to GTA. The compatibility of films made of water-soluble polymers and shellac was also concentration dependent. HPMC and PVP showed superior compatibility with shellac compared to sodium alginate, since films containing shellac and more than 10% [w/w] sodium alginate tended to separate into two phases. In the end five formulations containing shellac and either 5% [w/w] glycerol, 10% [w/w] PVP, 20% [w/w] PVP, 10% [w/w] HPMC, or 5% [w/w] sodium alginate emerged as feasible for enteric coating purposes.     

Opiates,catecholamines, behavior,and mood

Indirect evidence has linked opioid reinforcement with changes in noradrenergic metabolism secondary to drug administration. Methodological precedents for biobehavioral correlations in depressive illness have suggested an important association between changes in mood and biogenic amine excretion patterns in the urines of patients during depression and recovery. This paper presents preliminary data on the possible relationship between changes in catecholamine excretion that were observed and the changes in behavior, mood, psychiatric status, and cardiorespiratory physiology secondary to heroin administration and methadone-assisted withdrawal. This study focuses on the urinary excretion of MHPG, since an appreciable fraction of this metabolite is probably derived from norepinephrine originating in the brain. The subjective changes in mood associated with heroin use, the decrease in respiratory rate, and the behavioral and mental status effects associated with opiate intoxication were observed only in the individuals whose MHPG excretion increased during the period of opiate administration.     

Temperature,pH, salinity,hardness, and particulates mediate nickel toxicity to eubacteria,an actinomycete,and yeasts in lake,simulated estuarine,and sea waters

The survival of some eubacteria, an actinomycete, and yeasts after acute and chronic exposures to nickel (Ni) in lake, simulated estuarine, and sea waters and the influence of environmental factors on Ni toxicity were determined. Nickel toxicity to microbes in marine systems was reduced by increasing the salinity, by decreasing the temperature, and by the incorporation of simulated sediment. The toxicity of Ni to microbes in fresh water was reduced by increasing the pH, by increasing the hardness, and by the incorporation of suspended particulates. Chronic toxicity studies indicated that fresh waters are more sensitive than marine waters to Ni pollution, as microbial survival was greater in marine than in fresh waters stressed with equivalent concentrations of Ni.     

Final report on the safety assessment of sodium p-chloro-m-cresol, p-chloro-m-cresol, chlorothymol, mixed cresols, m-cresol, o-cresol, p-cresol, isopropyl cresols, thymol, o-cymen-5-ol, and carvacrol

Sodium p-Chloro-m-Cresol, p-Chloro-m-Cresol (PCMC), Mixed Cresols, m-Cresol, o-Cresol, p-Cresol, Isopropyl Cresols, Thymol, Chlorothymol, o-Cymen-5-ol, and Carvacrol are substituted phenols used as cosmetic biocides/preservatives and/or fragrance ingredients. Only PCMC, Thymol, and o-Cymen-5-ol are reported to be in current use, with the highest concentration of use at 0.5% for o-Cymen-5-ol in perfumes. The use of PCMC in cosmetics is restricted in Europe and Japan. Cresols can be absorbed through skin, the respiratory tract, and the digestive tract; metabolized by the liver; and excreted by the kidney as glucuronide and sulfate metabolites. Several of these cresols increase the dermal penetration of other agents, including azidothymidine. In acute oral toxicity studies, LD50 values were in the 200 to 5000 mg/kg day-1 range across several species. In short-term studies in rats and mice, an o-Cresol, m-Cresol, p-Cresol or m-Cresol/p-Cresol mixture at 30,000 ppm in the diet produced increases in liver and kidney weights, deficits in liver function, bone marrow hypocellularity, irritation to the gastrointestinal tract and nasal epithelia, and atrophy of female reproductive organs. The no observed effect levels (NOEL) of o-Cresol was 240 mg/kg in mink and 778 mg/kg in ferrets in short-term feeding studies, with no significant dose-related toxicity (excluding body weight parameters). In mice, 0.5% p-Cresol, but neither m-Cresol nor o-Cresol, caused loss of pigmentation. Short-term and subchronic oral toxicity tests performed with various cresols using mice, rats, hamsters, and rabbits resulted in no observed adverse effect levels (NOAELs) for mice of 625 ppm and rats of 50 mg/kg day-1, although the NOEL was 2000 ppm in a chronic study using rats. In rabbits, < or =160 mg/kg PCMC was found to produce irritation and erythema, but no systemic effects. Hamsters dosed with 1.5% p-Cresol in diet for 20 weeks had a greater incidence of mild and moderate forestomach hyperplasia as compared to the control. Acute inhalation toxicity studies using rats yielded LC50 values ranging from >20 mg/m(3) for o-Cresol to >583 mg/m(3) for PCMC. No deaths were recorded in mice given o-Cresol at 50 mg/m(3). Cats exposed (short-term) to 9 to 50 mg/m(3) of o-Cresol developed inflammation and irritation of the upper respiratory tract, pulmonary edema, and hemorrhage and perivascular sclerosis in the lungs. Rats exposed (subchronic) to o-Cresol at 9 mg/m(3) had changes in leukocytes, spinal cord smears, nervous activity, liver function, blood effects, clinical signs, and neurological effects. In guinea pigs, exposure to 9 mg/m(3) produced changes in hemoglobin concentrations and electrocardiograms (EKGs). Rats exposed (subchronic) to 0.05 mg/m(3) Mixed Cresols by inhalation exhibited central nervous system (CNS) excitation, denaturation of lung protein, and decreased weight gain. All cresols appear to be ocular irritants. Numerous sensitization studies have been reported and most positive reactions were seen with higher concentrations of Cresol ingredients. Developmental toxicity is seen in studies of m-Cresol, o-Cresol, and p-Cresol, but only at maternally toxic levels. In a reproductive toxicity study of a mixture of m-Cresol and p-Cresol using mice under a continuous breeding protocol, 1.0% caused minimal adult reproductive and significant postnatal toxicity in the presence of systemic maternal toxicity. The o-Cresol NOAEL was 0.2% for both reproductive and general toxicity in both generations. Cresol ingredients were generally nongenotoxic in bacterial, fruit fly, and mammalian cell assays. Thymol did not induce primary lung tumors in mice. No skin tumors were found in mice exposed dermally to m-Cresol, o-Cresol, or p-Cresol for 12 weeks. In the trypthan blue exclusion assay, antitumor effects were observed for Thymol and Carvacrol. Clinical patch testing with 2% PCMC may produce irritant reactions, particularly in people with multiple patch test reactions, that are misinterpreted as allergic responses. o-Cresol, p-Cresol, Thymol, Carvacrol, and o-Cymen-5-ol caused no dermal irritation at or above use concentrations. In two predictive patch tests, PCMC did not produce a sensitization reaction. Overall, these ingredients are not significant sensitizing or photosensitizing agents. The Cosmetic Ingredient Review (CIR) Expert Panel noted some of these ingredients may increase the penetration of other cosmetic ingredients and advised cosmetic formulators to take this into consideration. The CIR Expert Panel concluded that the toxic effects of these ingredients are observed at doses higher than would be available from cosmetics. A concentration limitation of 0.5% was chosen to ensure the absence of a chemical leukoderma effect. For p-Cresol and Mixed Cresols (which contain p-Cresol), the Panel considered that the available data are insufficient to support the safety of these two ingredients in cosmetics. Studies that would demonstrate no chemical leukoderma at concentrations of use of p-Cresol and Mixed Cresols, or would demonstrate a dose response from which a safe concentration could be derived, are needed.     

Strength of drug habits: For heroin,morphine, methadone,alcohol, barbiturates,pentobarbital, benzedrine,cocaine, and marijuana

The drug habits for 78 confirmed opiate addicts were studied on eight scales from the Process Association Test of Addiction (PATA) for many drug names. Through cluster analysis eight stages of addiction were defined: “to be clean”, “to learn about drugs”, “to hustle”, “to chip” (also “to be high”), to be psychologically dependent or “to need a shot”, “to be hooked”, “to kick a habit” and “to be in treatment”. Associations stimulated by the words heroin and morphine were very similar over the eight stages of addiction in opiate addicts. The subjects were especially inclined to associate morphine and heroin with the most severe level of addiction, “to be hooked”. Associations to both methadone and cocaine were elevated at the “hooked” stage, but in other respects associations to these drugs were opposite. Thus, associations to cocaine were focused on the stage of psychological dependence and the lower intermediate stage of addiction, “to chip” and “to be high”, whereas associations to methadone suggested a turning away from addiction as indicated by avoidance associations (“to come down” and “to kick a habit”) as well as associations to “treatment” and “to be clean”. Marijuana, Benzedrine, “goofball” (barbiturates) and alcohol habits were prominent at an intermediate stage of addiction (“to chip” and “to be high”). Avoidance associations were common for Benzedrine and “goofballs” (also pentobarbital) but not for marijuana or alcohol. “Hustling” associations were frequent for marijuana but not for alcohol.     

New antiretroviral drugs: a review of the efficacy,safety, pharmacokinetics,and resistance profile of tipranavir,darunavir, etravirine,rilpivirine, maraviroc,and raltegravir

Background: The introduction and approval of new antiretroviral agents in the US and Canada bring new opportunities and new challenges. Arguably, for the first time ever, clinicians have the drugs necessary to achieve the goal of suppressing HIV RNA to levels less than 50 copies/mL in even the most treatment-experienced patients and in those with extensive drug-limiting resistance mutations. However, the use of these new agents is complicated by many drug–drug interactions and – to some extent – pre-existing mutations. To derive maximum durability from the use of these newer drugs, a thorough understanding of their indications and limitations is critical. Objective: To thoroughly review the six most recently approved or soon-to-be-approved antiretroviral drugs in the US and Canada: tipranavir, darunavir, etravirine, rilpivirine, maraviroc, and raltegravir. Methods: Discussion of the indications for, and pharmacokinetics, resistance profile, activity, toxicity, and clinical trials results of, the six new agents. Results/conclusions: These six new agents have resulted in marked progress towards the goal of being able to provide HIV-infected individuals with the drugs necessary to achieve decades of durable suppression of HIV without substantial toxicity.     

Simultaneous determination of codeine, morphine, hydrocodone, hydromorphone, oxycodone, and 6-acetylmorphine in urine, serum, plasma, whole blood, and meconium by LC-MS-MS

A liquid chromatography-tandem mass spectrometry (LC-MS-MS) method for simultaneous analysis of six major opiates in urine, serum, plasma, whole blood, and meconium is described. The six opiates included are codeine, morphine, hydrocodone, hydromorphone, oxycodone, and 6-acetylmorphine (6-AM). The method was compared to an in-house gas chromatography (GC)-MS method and an LC-MS-MS method performed by another laboratory. The sample preparation time was decreased by eliminating the glucuronide hydrolysis and derivatization required for GC-MS analysis, as well as by adapting the solid-phase extraction to elute directly into autosampler vials. These improvements illustrate the advantages of an LC-MS-MS method over a GC-MS method for opiates. The structural similarity of these six opiates and others in the opiate class causes a high potential for interference and false-positive results. Twelve opiate analogues and metabolites were evaluated for interference. The potential for interference was reduced by altering the MRM transitions chosen for the six opiates. The increased specificity of LC-MS-MS decreased the interference rate in urine to 3.9% compared to 13.6% on the in-house GC-MS method. The rate of positivity for 6-AM in meconium is described for the first time. In urine, 11.0% of morphine positive specimens were also positive for 6-AM compared to 8.3% in serum/plasma and 0.9% in meconium. Although 6-AM is infrequent in meconium, it provides a definitive proof of illegal heroin abuse by the pregnant mother. This method has been routinely used in our laboratory over the last 6 months on more than 1500 patient specimens.     

Gradualism, identity, reinforcements, and change

This paper reflects the ongoing development of gradualism, a drug treatment perspective that seeks to make use of the full array of effective, creative, and innovative harm reduction and abstinence-oriented treatments available to help addicted individuals move along a continuum from active/chaotic use to abstinence or moderation, as appropriate. The essence of gradualism is an emphasis on positive change and transformation as therapeutic goals. The paper first looks at manifestations of gradualism in harm reduction treatment facilities. Following this is a discussion of the role of identity transformation in the change process. The final section explores how contingency management or motivational incentive interventions could be used in harm reduction settings to facilitate this kind of therapeutic movement.