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O objetivo deste trabalho é avaliar os efeitos do napsilato de propoxifeno sobre a prenhez da rata albina. Para tanto utilizamos 50 ratas prenhes divididas ao acaso em cinco grupos iguais. Todas receberam diariamente, por gavagem, o volume de 1 ml, desde os dias 0 (zero) até o 20 de prenhez, com as seguintes características: grupo I - somente água destilada (controle); grupo II - solução aquosa de acácia 2% (veículo); grupos III, IV e V - respectivamente, 5, 15 e 45 mg/kg de peso de napsilato de propoxifeno dissolvido em solução de acácia a 2%. Os pesos maternos foram anotados nos dias 0 (zero), 7, 14 e 20 de prenhez; no 20º dia as matrizes foram sacrificadas. Nossos resultados mostraram que os animais tratados com 45 mg/kg do fármaco apresentaram redução dos pesos individuais dos fetos como também dos pesos das ninhadas e das placentas. Quanto às outras variáveis apreciadas: número de reabsorções, de implantações e de placentas não houve diferença significante entre os grupos tratados em relação ao grupo controle.The purpose of this study is to evaluate the effects of propoxyphene napsylate on the pregnancy of the rat. We used fifty pregnant rats divided into five groups. All the animals received daily 1 ml of the solution by gavage from day 0 to the 20th day of pregnancy. Group I - only distilled water (control); group II - aqueous solution of acacia 2% (vehicle); groups III, IV and V - respectively, 5, 15 and 45 mg/kg of weight of propoxyphene napsylate diluted in 2% acacia solution. The animals were weighed on days 0, 7, 14 and 20 of pregnancy. All animals were sacrificed on the 20th day of pregnancy. Our results showed that the animals treated with 45 mg/kg of propoxyphene napsylate presented reduction of the individual weights of the fetuses, as well as of the weights of the newborns and placentas. The difference betewwn number of resorptions, implantations and placentas of the treated groups was shown to be non significant cohen compered with the control groups.

The article presents a study on the detection of norpropoxyphene metabolite excretion in human urine with the use of liquid chromatography and tandem mass spectroscopy. It states that the study used electrospray ionization to collect all spectra and used chromatographic retention differences to validate metabolite observations. Moreover, the study concludes that dehydrated rearrangement and norpropoxyphene metabolites are excreted in the urine of propoxyphene-prescribed patients.

Abstract: Background:: Published guidelines have identified propoxyphene as an inappropriate medication for use in aged patients. It is no more effective than acetaminophen, yet has been associated with the same adverse effects (AEs) associated with other opioid drugs. In particular, its central nervous system-related AEs, dizziness and sedation, may increase the risk for fracture resulting from falls in older adults. Nonetheless, US studies have reported widespread use of propoxyphene in the elderly US population. Objective:: The aim of this study was to examine the risk for fracture associated with propoxyphene use in older adults. Methods:: This prospective cohort study used a large administrative claims data set from adults aged ≥65 years. A time-varying (lagged) covariate defined each person as a propoxyphene user or nonuser based on propoxyphene exposure in the 14 days before each fracture event in the cohort. Another time-varying measure stratified propoxyphene users based on their mean daily dose of propoxyphene (high dose = >260 mg; low dose = ≤260 mg of propoxyphene hydrochloride or equivalent napsylate salt). Time-dependent Cox regression models were used to estimate the association between propoxyphene exposure and occurrence of hip fracture (using International Classification of Diseases, Ninth Revision, Clinical Modification code 820.xx). Results:: A total of 362,503 patients were included in the analysis. During a mean follow-up of 464 days, ∼10% (37,569) of the sample had ≥1 propoxyphene prescription filled and ≈l% (5065) sustained a hip fracture. Propoxyphene users had a 2-fold higher risk for hip fracture (hazard ratio [HR] [95% CI], 2.05 [1.87–2.25]) compared with nonusers of analgesics. Multivariate analysis found a dose-response relationship between propoxyphene and hip fracture risk (low dose, HR [95% CI], 1.45 [1.26–1.67]; high dose, HR [95% CI], 2.05 [1.85–2.29]). Other opioid analgesics were associated with an increased risk for hip fractures. Conclusions:: The results of this cohort database study suggest that propoxyphene use among adults aged ≥65 years is associated with increased risk for hip fracture and suggest a need for interventions to reduce propoxyphene use in older adults. Clinicians should be aware of the risk for hip fracture with other opioids as well and weigh them against potential benefits when prescribing for older adults. [Copyright &y& Elsevier]

OBJECTIVES: To examine the effect of replacing drug-specific computerized prescribing alerts with age-specific alerts on rates of dispensing potentially inappropriate medications in older people and to determine whether group academic detailing enhances the effectiveness of these alerts. DESIGN: Cluster-randomized trial of group academic detailing and interrupted time-series analysis. SETTING: Fifteen clinics of a staff-model health maintenance organization. PARTICIPANTS: Seven practices (113 clinicians, 24,119 patients) were randomly assigned to receive age-specific prescribing alerts plus the academic detailing intervention; eight practices (126 clinicians, 26,805 patients) received alerts alone. Prior implementation of drug-specific alerts established a downward trend in use of target medications that served as the baseline trend for the present study. INTERVENTION: The computerized age-specific alerts occurred at the time of prescribing a targeted potentially inappropriate medication (e.g., tertiary tricyclic amine antidepressants, long-acting benzodiazepines, propoxyphene) and suggested an alternative medication. Clinicians at seven sites were randomized to group academic detailing, an interactive educational program delivering evidence-based information. MEASUREMENTS: Number of target medications dispensed per 10,000 patients per quarter, 2 years before and 1.5 years after the replacement of drug-specific with age-specific alerts. RESULTS: Age-specific alerts resulted in a continuation of the effects of the drug-specific alerts without measurable additional effect ( P=.75 for level change), but the age-specific alerts led to fewer false-positive alerts for clinicians. Group academic detailing did not enhance the effect of the alerts. CONCLUSION: Age-specific alerts sustained the effectiveness of drug-specific alerts to reduce potentially inappropriate prescribing in older people and resulted in a considerably decreased burden of the alerts. [ABSTRACT FROM AUTHOR]

Aqueous 2-chloronapthalene was contacted with cast iron in batch systems, resulting in an initial rapid increase in the sorbed 2-chloronapthalene concentration ( C s ) followed by a slow decline, and an initial rapid decline in the aqueous 2-chloronapthalene concentration ( C a ) followed by a slower decline. The initial rapid partitioning of 2-chloronapthalene to the solid phase was due to its adsorption on elemental carbon present on the cast iron surface, while the residual aqueous phase 2-chloronapthalene underwent reductive dehalogenation at a slower rate through interaction with the metallic iron surface. The overall rate of change of total 2-chloronapthalene concentration ( C T = C s + C a ) with time, i.e., (d/ C T }{{d} t}) could be described by the expression,− k 1 ⋅ M⋅ ( C a ) n , where M is the concentration of cast iron. The values of k 1 and n were determined to be 1.576 × 10−5 hr−1 g−1 iron L and 1.945 respectively. Equilibrium partitioning of 2-chloronapthalene between solid and aqueous phases could be described by a Freundlich isotherm, C s = K⋅ [ C a ] m , where m and K were determined to be 0.55 and 4.92 × 10−3 L g−1. Considering K to be the ratio of the adsorption ( k 2) and desorption ( k 3) rate constants, expressions were developed for describing the evolution of C s and C a with time. Putting k 3 = 1 hr−1 in these expressions resulted in adequate model fit to the experimental data. Napthalene was identified as the major dehalogenation by-product, with greater than 99 percent of the naphthalene produced partitioning to carbon present on the cast iron surface. No competition between 2-chloronapthalene and naphthalene for adsorption on the carbon surface was observed, suggesting non-specific adsorption of these compounds restricted only by the physical size of the molecules and the available carbon surface area. [ABSTRACT FROM AUTHOR]

Abstract Background:: Several pain management guidelines and explicit medication-use criteria identify propoxyphene as an inappropriate medication for use in older adults. Objective:: This study was conducted to estimate trends in propoxyphene use among community-dwelling elderly (age ≥65 years) Medicare beneficiaries from 1993 through 1999 and to determine whether beneficiaries'' drug coverage and specific characteristics of their physicians were associated with receipt of propoxyphene in 1999. Methods:: Data from the Medicare Current Beneficiary Survey (MCBS) were used to examine the prevalence of propoxyphene use in cross-sections of nationally representative samples of community-dwelling elderly Medicare beneficiaries from 1993 through 1999. The 1999 MCBS was linked with the 1999 Area Resource File to examine patient and physician factors associated with propoxyphene use in the community-dwelling elderly at the county level. Results:: Rates of propoxyphene use were generally stable over the 7-year period, from an annual prevalence of 6.8% in 1993 to the slightly decreased prevalence of 6.6% in 1999. No protective effects against propoxyphene use were observed based on beneficiaries'' drug coverage or type of drug coverage. Rather, Medicaid beneficiaries were more likely to receive propoxyphene than those without drug coverage (odds ratio [OR] = 1.40; 95% CI, 1.02–1.92). Among physician characteristics, male sex (OR = 1.34; 95% CI, 1.02–1.75) and medical specialty (OR = 0.81; 95% CI, 0.65–1.00) were strongly correlated with prescribing of propoxyphene. Conclusion:: This study found a continuing high prevalence of propoxyphene use in the community-dwelling elderly Medicare population from 1993 through 1999, with >2 million beneficiaries receiving the drug in 1999. [Copyright &y& Elsevier]

Drugs and alcohol often occur together in fatal poisonings, complicating the process of determining the cause of death. Especially when found in concentrations generally regarded as toxic but not lethal, the question arises whether the combination of sublethal amounts was the likely cause of death. In this study, we examined poisoning deaths involving amitriptyline, propoxyphene and promazine, which are, after benzodiazepines, the most frequently occurring drugs in Finnish alcohol-related poisonings. From the forensic toxicology database, covering the years 1995–2002, we extracted 332 fatal poisonings, calculated median blood alcohol and drug concentrations, constructed concentration-concentration and concentration-response curves and evaluated the significance of the presence of therapeutic amounts of benzodiazepines. Median amitriptyline and propoxyphene concentrations were lower in alcohol-related cases than in clean drug poisonings. Correspondingly, the median blood alcohol concentrations in all drug-related poisonings were 1.5–2.2 mg/g lower than that found in clean alcohol poisonings. Alcohol concentration proved to be a more sensitive indicator of alcohol-drug interaction than drug concentration. This result suggests that when alcohol is present, relatively small overdoses of the studied drugs may result in fatal poisoning. In this context, fatal drug and alcohol concentrations and the issue of determining the most important agent in fatal drug-alcohol intoxications are discussed. [ABSTRACT FROM AUTHOR]

Abstract: A novel series of cis-fused 2-N,N-dimethylaminomethyl-2,3,3a,12b-tetrahydrodibenzo[b,f]furo[2,3-d]oxepin derivatives modified at position C-11 was prepared and evaluated for its potential antidepressant/anxiolytic properties. In vitro affinities for the norepinephrine transporter and for 5-HT2A and 5-HT2C receptors, as well as the ED50 values obtained in some in vivo assays predictive for antidepressant and anxiolytic potential are reported. [Copyright &y& Elsevier]

In this work, sludge was submitted to aerobic dynamic substrate feeding. Two sequencing batch reactors were operated, with acetate or propionate as carbon substrates. When acetate was used the system only produced a homopolymer of polyhydroxybutyrate (PHB). In order to maximize the PHB production, tests with different concentrations of acetate and ammonia were preformed. The best results (67.2% of PHB by cell dry weight) were obtained for 0.7 Nmmol/l of ammonia and 180 Cmmol/l of acetate. The PHB cell content was further improved by pulse addition of substrate, three times 60 Cmmol/l of acetate, reaching a value of 78.5%. Propionate can be used as a precursor for hydroxyvalerate. In conjunction with other substrates, it allows for the formation of copolymers, which present better processing properties on commercial applications. Tests with different concentrations of propionate and ammonia were performed. Under the operating conditions used, the maximum PHA accumulated inside cells was 34.8%, with 30 Cmmol/l of propionate and no ammonia. [ABSTRACT FROM AUTHOR]

To estimate the scope of potentially inappropriate medication prescriptions (PIRx) among elderly residents in U.S. nursing homes (NHs), and to examine associated resident and facility characteristics. The 1996 Medical Expenditure Panel Survey Nursing Home Component (MEPS NHC), a survey of a nationally representative sample of NHs and residents. The PIRx, defined by Beers's consensus criteria (1991, 1997), was identified using up to a year's worth of NH prescribed medicine data for each resident. The study sample represented 1.6 million NH residents ( n=3,372). At a minimum, 50 percent of all residents aged 65 or older, with an NH stay of three months or longer received at least one PIRx in 1996. The most common PIRx involved propoxyphene, diphenhydramine, hydroxyzine, oxybutynin, amitriptyline, cyproheptadine, iron supplements, and ranitidine. Resident factors associated with greater odds of PIRx were Medicaid coverage, no high school diploma, and nondementia mental disorders. Facility factors were more beds and lower RN-to-resident ratio. Factors associated with lower odds of PIRx were fewer medications, residents with communication problems, and being in an accredited NH. Onsite availability of pharmacists or mental health providers was not related. With quality of care and patient safety as major public health concerns, effective policies are needed to avoid PIRx occurrences and improve the quality of prescribing among elderly residents in NHs. Additional studies are needed to determine the impact of PIRx on this NH population. [ABSTRACT FROM AUTHOR]

The synthesis, radiolabeling, and in vitro and in vivo evaluation of a new positron emission tomography (PET) radioligand for the serotonin transporter (SERT), [11C]2-[2-(dimethylaminomethyl)phenylthio]-5-fluoromethylphenylamine ([11C]AFM) is reported. AFM was prepared from 4-chloro-3-nitrobenzyl acetate and thiosalicylic acid in a five-step synthetic sequence. In binding studies in vitro with cloned human transporters, AFM displayed high binding affinity (Ki 1.04 nmol/L for hSERT) and good selectivity (Ki 664 nmol/L for hNET and >10,000 nmol/L for hDAT) for SERT. The radiolabled compound [11C]AFM was prepared in 30-37 minutes from its monomethylamine precursor by reaction with high specific activity [11C]iodomethane. Radiochemical yield was 12.3 ± 8.1% based on [11C]iodomethane and specific activity was 1733 ± 428 Ci/mmol at end of synthesis (EOS, n = 14). Radiochemical and chemical purity of the final product was >97%. Biodistribution studies in rats indicated that [11C]AFM entered the brain readily and localized in regions known to contain high concentrations of SERT, with high specific to nonspecific binding ratios. Furthermore, binding of [11C]AFM in SERT-rich regions was blocked by the cold compound AFM and the selective serotonin reuptake inhibitor citalopram but not by the selective norepinephrine reuptake inhibitor nisoxetine or the selective dopamine reuptake inhibitor GBR 12935. At 30 minutes after injection, >95% of the brain activity corresponded to the parent compound, indicating the absence of radiolabeled metabolites in the rat brain. PET imaging experiments in baboons showed a brain distribution pattern of [11C]AFM consistent with the regional concentrations of SERT, with the highest levels of radioactivity detected in the midbrain and thalamus, moderate levels in the hippocampus and striatum, and the low levels in the cortical regions. Pretreatment of the baboons with citalopram (4 and 6 mg/kg, intravenously) reduced regional brain distribution volumes to low and homogeneous levels, thus underlining the binding specificity of [11C]AFM for SERT in vivo. Analysis of blood samples indicated a fast metabolism of the radioligand into more hydrophilic components, as well as the absence of radiolabeled lipophilic metabolites. Regional time–activity curves were analyzed with kinetic and graphical analysis methods using the arterial concentrations as input function. Both methods returned similar kinetic parameters and documented high specific to nonspecific equilibrium coefficients (V3″) for [11C]AFM. Identical V3″ values were also derived with the simple reference tissue method, indicating that quantification of SERT with [11C]AFM can be achieved without arterial blood sampling. In summary, [11C]AFM appears to be an excellent PET radioligand for the visualization and reliable quantification of SERT in vivo. [Copyright &y& Elsevier]

OBJECTIVES: To provide the first comparable national prevalence estimates on use of propoxyphene, a potentially inappropriate drug, by elderly Medicare beneficiaries living in the community and institutions and to determine whether institutionalized beneficiaries are at a greater risk for receiving propoxyphene than community-dwelling beneficiaries. DESIGN: Cross-sectional study. SETTING: U.S. representative sample of elderly using Medicare database. PARTICIPANTS: Nationally representative sample of community-dwelling (n = 9,851, weighted n = 32.5 million) and institutionalized (n = 1,099, weighted n = 2.3 million) Medicare beneficiaries aged 65 and older. MEASUREMENTS: National estimates on prevalence of propoxyphene use and the odds of receiving propoxyphene were the two main outcome measures. RESULTS: Annual prevalence of propoxyphene use in 1998 was 6.8% by all community-dwelling elderly beneficiaries and 15.5% by institutionalized elderly beneficiaries. Beneficiaries in long-term care facilities had almost 40% higher odds of receiving propoxyphene (odds ratio = 1.38, 95% confidence interval = 1.1–1.8) than beneficiaries in the community even after controlling for other factors in a logistic regression. Other risk factors include female, rural residence, poor health, and history of osteoporosis or hip fracture. Beneficiaries residing in regions in the midwest and south were more than twice as likely to receive propoxyphene as those in the mid-Atlantic area. CONCLUSION: These results show that propoxyphene use by U.S. community-dwelling seniors is high but is much higher in the institutionalized population. These findings suggest that prescribing for older adults with pain could be improved, especially for vulnerable long-term care residents. [ABSTRACT FROM AUTHOR]

A 23 min gradient HPLC assay has been developed to simultaneously measure related substances of dextro-propoxyphene salts (napsalate, hydrochloride) and other actives that are routinely found in combination in capsules or tablets: aspirin, acetaminophen, and caffeine. This method has shown the ability to resolve all known active ingredients, impurities, and degradation products from the propoxyphene and other active drug parent peaks. All the propoxyphene related substances are quantified against a 1-point propoxyphene external standard prepared at 2% of the typical sample concentration. Propoxyphene related substance measurements occur at 210 nm. For acetaminophen combinations, wavelength switching is used starting at 280 nm to measure acetaminophen related substances, then switching to 210 nm for propoxyphene related substance measurements. Two sample solvents can be used for propoxyphene related substance quantitation, the second of which is used to provide enhanced room temperature stability-about one month-for aspirin containing formulations. This method provides a simple, one-step solution for related substance analysis rather than numerous separate assay methods for each active's related substances. [ABSTRACT FROM AUTHOR]

Abstract: We analyzed trends in prescribing and overdose deaths related to propoxyphene (e.g,. Darvon) before and after a 1978-80 informational campaign carried out by the US Food and Drug Administration and the drug's manufacturer through mailed warnings, face-to-face education of prescribers, press releases, and labeling changes The goals included a reduction in propoxyphene use with alcohol or other CNS depressants, reduced prescribing of refills, and cessation of prescribing for patients at risk of abuse and misuse (suicide). We conducted time-series analyses of nationwide propoxyphene use data 1974-83 and analyzed data on drug overdose death rates covering a combined population of about 83 million. Segmented regression methods were used to determine if the informational program was associated with changes in trends of prescribing or overdose deaths. Comparison drug series were analyzed to control for other secular trends in prescribing. Nationwide propoxyphene use during the warnings continued a pre-existing decline of about 8 per ¢ per year. but this decline halted after the warnings. The no-refill recommendation had no impact on refill rates. The risk of overdose death per propoxyphene proscription filled has remained about constant since 1979. Sharper declines in misuse of such drugs will require stronger, more sustained regulatory or educational measures. (Am J Public Health 1987: 77: 1518-1523.) [ABSTRACT FROM AUTHOR]

Presents a case of a patient who developed a wide QRS complex due to propoxyphene overdose. Condition of the patient before the treatment; Treatment of the patient by sodium bicarbonate therapy; Other treatment procedures for propoxyphene overdose; Decline in the number of propoxyphene overdose cases in the United States.

Background Epoxy resin compounds (ERC) include a large number of sensitizing chemicals such as epoxy resins (ER), hardeners (curing agents), and reactive diluents Allergic contact dermatitis (ACD) caused by ERCS is often occupational. Materials and Methods. We report a patient, sensitized to a hardener of a two-component epoxy paint Three conventional patch test sessions were performed to diagnose the causative chemical We also review the literature on sensitizing epoxy-resin hardeners. Results. A 47-year-old nonatopic woman developed dermatitis from a two-component epoxy `paint. Patch testing with epoxy resin was negative, but 2,4,6-tris(dimethylaminomethyl) phenol (tris-DMP), used in the paint hardener,,' induced an allergic patch test reaction. We also review briefly other epoxy hardeners that have caused allergic dermatitis, including (1) aliphatic polyamines, e.g, ethylenediamine, diethylenetriamine, triethylenetetramine, 3-dimethylaminopropylamine, and trimethylhexamethylenediamine, (2) cycloaliphatic polyamines, e,g , isophoronediamine and 3,3'-dimethyI-4,4-diaminodicycIohexyImethane; (3) aromatic amines, such as 4,4-diaminodiphenylmethane, m-phenylene diamine, and 1,3-xylylene diamine, (4) dicyanodiamide, (5) triglycidyl isocyanurate, an epoxy compound that may be used as an epoxy-resin hardener, and (6) additives in epoxy accelerators, such as hexavalent chromate. Conclusions. No one chemical can be used to screen for sensitization to the many different epoxy hardeners Extensive patch testing may be required to reveal the hardener that has caused the allergy The hardener, 2,4,6-tris-(dimethyl-aminomethyl)phenol (tris-DMP), is a new sensitizer. To verify ACD caused by tris-DMP, patch-testing at 1% in petrolatum is suggested. [ABSTRACT FROM AUTHOR]

When high single doses of propoxyphene napsylate (PN) were given to patients on a methadone maintenance program, results indicated that, to avoid undesirable side effects, the dose should not exceed 600 mg. However, when PN was given in divided doses (800 mg/day in two equal doses), no significant adverse reactions were noted. In the double-blind comparison of 800 mg PN in two divided doses versus 20 mg methadone, 10 mg methadone, or placebo methadone, it was found that PN (1) did not alleviate withdrawal symptoms in patients previously maintained on 20 mg methadone, (2) produced a slightly overmedicated effect in the detoxified group of ex-methadone patients, and (3) compared favorably to 10 mg methadone in suppressing withdrawal symptoms without producing evidence of overmedication in those patients previously stabilized on a methadone maintenance dose of 10 mg. It is concluded that on a mg for mg basis, PN at a dose of 80-times that of methadone will relieve withdrawal symptoms in the treatment of mildly addicted patients requiring 10 mg methadone or less per day. [ABSTRACT FROM AUTHOR]

Focuses on a study that investigated a patient who was addicted to propoxyphene. Case report; Medical history of the patient; Discussion.

There are various etiologies for hypoglycemia in patients with chronic renal failure, and its pathogenesis is complex. Concomitant use of medications is the most common cause. We report a rare case of an 82-year-old woman with type 2 diabetes mellitus in end-stage renal disease undergoing maintenance hemodialysis, who experienced recurrent symptomatic hypoglycemia during treatment with propoxyphene for pain relief. Hypoglycemia occurred simultaneously with elevated levels of serum immunoreactive insulin and C-peptide. After discontinuing propoxyphene, hypoglycemia mitigated and the level of insulin returned to normal range. Our case reminds us that propoxyphene-induced hypoglycemia should not be ignored, especially in hemodialysis patients with cold sweats, agitation and depressed consciousness. [Copyright &y& Elsevier]

The article focuses on the use of solid-phase extraction and gas chromatography-mass spectrometry in determining propoxyphene in oral fluid. The Quantisal device is used to collect oral fluid. The parameters including selectivity, linearity, accuracy, intra- and interday precision, extraction efficiency and limit of the quantitation were all within acceptable limits.

Propoxyphene napsylate differs from the hydrochloride salt in several ways. It is much less soluble and bitter and poses few stability problems when capsulated or tableted with aspirin. There is some evidence in several animal species that the pattern and severity of poisoning may be different with the two salts. Equimolar doses of the two salts are probably interchangeable in the relief of pain. The role of propoxyphene in clinical medicine and the questions of propoxyphene abuse and propoxyphene-related fatalities are discussed. [ABSTRACT FROM AUTHOR]

The article reports on the regulatory challenge faced by the U.S. Food and Drug Administrations (FDA) concerning analgesics. The public is critical of the agency's plan to stop the manufacture and distribution of concentrated morphine sulfate oral solution. In addition, the agency's advisers approve to put a boxed warning about liver toxicity in the labeling of all prescription products containing acetaminophen. Also, FDA officials have decided not to ban the pain reliever propoxyphene.

Reports on a thesis documenting some adverse effects of the use of dextropropoxyphene (DXP) on chronic pain patients in Sweden. Documentation of the addiction liability of DXP; Underestimation of accidental DXP fatalities; Limitation in the basis for classification of the manner of death.

Reports a clinical case of a patient infected with acute generalized exanthematous pustulosis. Treatment of the disease by dextropropoxyphene; Conduction of a patch testing with aspirin, tenoxam, dextropropoxyphene, paracetamol, spiramycin and aspirin; Causal relationship of AGEP with dextropropoxyphene.

Provides information on propoxyphene, an overprescribed but minimally effective opioid. Comparison with the potency of codeine; Availability for oral use; Production of norpropoxyphene; Ailments where propoxyphene is prescribed.

A 23-year-old addict accidentally administered propoxyphene into the femoral artery. He developed penile skin necrosis.