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Δ 9-Tetrahydrocannabinol (THC) augments the locomotor activity produced by methamphetamine (0.5 mg/kg) in aggregated mice. THC-induced augmentation was dose related and lasted for a two-hour period. Maximal effective dosage of THC was 15 mg/kg with higher dosages of 30 and 60 mg/kg producing a decrease from maximum in locomotor activity. THC, 15 mg/kg, also increases locomotor activity among aggregated animals treated with saline. However, the increase was much less than the methamphetamine augmentation. In similar studies using isolated mice THC produced only a dose-related decrease in locomotor activity among both methamphetamine-treated and saline-treated animals. THC, 60 mg/kg, had no effect on methamphetamine-induced lethality in aggregated mice. However, at 15 mg/kg, THC significantly enhanced the lethality of methamphetamine. THC did not after methamphetamine lethality in isolated mice. Distribution studies using 14C-methamphetamine indicated that neither THC nor isolation of animals affected tissue concentration or disappearance of 14C material. Previously reported synergistic interaction between amphetamine and THC is related to aggregation of the animals rather than drug treatment. Since THC at low doses can stimulate motor activity in saline-treated animals, amphetamine may act only to amplify the behavioral activity produced by low doses of THC.

A double-blind, placebo-controlled study in eight healthy male volunteers was conducted to study possible disulfiram-type reactions and hypoprothrombinemia associated with cefotetan administration. Three doses of cefotetan (2 g) or of placebo were administered at 12-h intervals. Ethanol (0.5 g/kg of total body weight) was ingested 1 h after the third dose. Blood ethanol, serum acetaldehyde, and prothrombin times were measured throughout the study. Heart rate, blood pressure, and clinical signs as well as symptoms suggestive of a disulfiram-type reaction were also noted. Five of eight volunteers that received cefotetan showed significant flushing. A significant increase in heart rate also was noted. No change in mean arterial pressure was observed during the cefotetan phase, and no one experienced nausea or vomiting. No statistical differences were observed between phases with respect to ethanol area under the time-concentration curve, elimination rate, or serum acetaldehyde concentrations. A slight but statistically significant increase in prothrombin time also was observed with cefotetan. This study suggests that patients receiving cefotetan might be at risk to develop disulfiram-type reactions and hypoprothrombinemia.

The rate of disappearance of ethanol from the entire body is usually expressed as mg/kg per hr, which has been designated B sub 60. For humans the average B sub 60 is about 100. It is fairly constant for a given person but varies among individuals, with extremes of about 50 and 200. Essentially the same information may be obtained from the slope of the curve for blood ethanol concentration, which like B sub 60, is a straight line. This is the Widmark Beta factor. It is now expressed as mg percent per hr, and designated as Beta sub 60. For humans the average Beta sub 60 is about 15, with extremes of 10 to 20. This paper considers certain chemicals (drugs) which offer promise of altering B sub 60 and Beta sub 60, and two other procedures of perhaps dubious efficacy. Both live animal and human subject tests were performed.

Succinylcholine, a bis-quaternary ammonium compound, was extracted from embalmed tissues as an ion-pair with hexanitrodiphenylamine in methylene chloride. The evaporated ion-pair residue is demethylated with sodium benzenethiolate. The tertiary amine formed is identified and quantitated by gas chromatography/mass spectrometry (GC/MS) utilizing a 25 meter glass capillary column coated with SE 52. Identification is accomplished by retention time and mass spectrometry. Quantitation is performed after the addition of deuterated succinylcholine as an internal standard by focusing the mass spectrometer on m/z 58 (for demethylated succinylcholine) and m/z 62 (for the internal standard). The method is applied to the quantitation of succinylcholine from the embalmed kidney, liver, and muscle of rats injected i.m. with 10-200 mg/kg. After six months of storage, the succinylcholine can still be identified and quantitated with highest concentrations found in the muscle injection site. Concentrations as low as 5 ng/g are easily detected.

We investigated direct histamine release and its effects in edema formation following paraquat (PQ) injury in a blood-free, perfused rat lung preparation. Under control conditions, perfusate histamine levels from the lung averaged 9.5 +/- 1.4 ng/ml. Lungs perfused with paraquat (1 mM) showed marked increases in pulmonary arterial pressure (133%), airway pressure (74%), alveolarcapillary protein flux (200%), and lung weight (38%). Prior to any detectable lung weight or pressure changes, PQ caused a 300% increase in perfusate histamine. Diphenhydramine (1.0 X 10(-5) M), a specific H1-histamine receptor antagonist, blocked the increased protein flux that followed PQ administration and significantly delayed edema. Furthermore, diphenhydramine attenuated the rise in PGF2 alpha. Conversely, histamine release was partially attenuated by the cyclooxygenase inhibitor, ibuprofen, at 2.4 X 10(-5) M, the same level that we had previously shown to block an early rise in PGF2 alpha and the onset of edema after PQ. These data show that the increased alveolar-capillary protein flux that occurred with PQ injury was attenuated by an H1-receptor antagonist and suggest that histamine is a primary mediator in paraquat-induced injury and that histamine subsequently stimulates prostaglandin release.

The extent of [14]C-warfarin binding to plasma proteins was evaluated in a group of normal, healthy volunteers and in two groups of individuals occupationally exposed to toluene diisocyanate (TDI). Plasma binding was assessed by ultrafiltration after the addition of racemic [14]C-warfarin to a final concentration of 0.8 microgram/ml. Chronic occupational exposure to TDI did not affect the extent of warfarin binding since warfarin free fractions (normalized to an albumin concentration of 4.5 g/dl) were 1.09 +/- 0.23 (mean +/- SD), 0.98 +/- 0.19, and 0.97 +/- 0.15 for controls and the two groups of TDI-exposed individuals, respectively.

The neuromuscular blocking agent succinylcholine (SCh) has been identified and quantitated in biological material using gas chromatography-mass spectrometry. The bisquaternary ammonium compound SCh is extracted from tissue homogenates or body fluids into dichloromethane as an ion pair with hexanitrodiphenylamine (DPA). The evaporated ion pair residue is demethylated with sodium benzenethiolate to form the corresponding tertiary amine which is identified and quantitated by gas chromatography-mass spectrometry using a glass capillary column coated with SE 52. In the quantitative analysis deuterated SCh is used as internal standard. The instrument is focussed on m/z 58 for demethylated SCh and m/z 62 or 64 for the internal standard. Concentrations as low as 5 ng SCh iodide/g tissue or body fluid are easily detected.

A procedure has been developed for the simultaneous determination of heroin, morphine, and hydromorphone from postmortem tissues by reversed phase high performance liquid chromatography (HPLC) using electrochemical detection. This method permits the direct determination of unmetabolized heroin from antemortem or postmortem urine as evidence of illegal drug use. Presumptive confirmation of heroin was based on the ability to hydrolyze the HPLC heroin fraction to morphine. Heroin was also confirmed in urine by gas chromatographic/mass spectroscopic (GC/MS) analysis of the HPLC fraction. Analysis of postmortem blood, gastric contents, urine, and injection site tissues have revealed the presence of morphine and hydromorphone, while heroin has only been identified in urine.

delta9-Tetrahydrocannabinol (THC) augments the locomotor activity produced by methamphetamine (0.5 mg/kg) in aggregated mice. THC-induced augmentation was dose related and lasted for a two-hour period. Maximal effective dosage of THC was 15 mg/kg with higer dosages of 30 and 60 mg/kg producing a decrease from maximum in locomotor activity. THC, 15 mg/kg, also increases locomotor activity among aggregated animals treated with saline. However, the increase was much less than the methamphetamine augmentation. In similar studies using isolated mice THC produced only a dose-related decrease in locomtor activity among both methamphetamine-treated and saline-treated animals. THC, 60 mg/kg, had no effect on methamphetamine-induced lethality in aggregated mice. However, at 15 mg/kg, THC significantly enhanced the lethality of methamphetamine. THC did not alter methamphetamine lethality in isolated mice. Distribution studies using 14C-methamphetamine indicated that neither THC nor isolation of animals affected tissue concentration or disappearance of 14C material. Previously reported synergistic interaction between amphetamine and THC is related to aggregation of the animals rather than drug treatment. Since THC at low doses can stimulate motor activity in saline-treated animals, amphetamine may act only to amplify the behavioral activity produced by low doses of THC.

The effects of erythromycin on the single dose kinetics of phenytoin (PHT) were studied in eight healthy, male volunteers in a crossover study. PHT was administered in a single, oral 300 mg dose either alone or after 5 days of a 7 day erythromycin regimen. Erythromycin base (333 mg) was taken orally every 8 hr. PHT concentrations were measured in plasma collected at 0, 2, 4, 8, 12, 24, 36, and 48 hr after PHT administration and in saliva at 48 hr. PHT was assayed by a polarized immunofluorescent technique. Mean (+/- SD) control values for PHT intrinsic clearance, CLint/F; volume of distribution, V/F; and half-life, t 1/2 were 0.028 (+/- 0.009) 1 X hr-1 X kg-1, 0.97, (+/- 0.33) l/kg, and 27.3 (+/- 12.4) hr, respectively. During erythromycin treatment CLint/F was 0.026 (+/- 0.011) 1 X hr-1 X kg-1, V/F was 0.87 (+/- 0.23) l/kg, and t 1/2 was 31.2 (+/- 26.1) hr. None of the mean values changed significantly due to erythromycin treatment (p greater than 0.05). Estimates of intrinsic unbound PHT clearance, CL'int/F, based upon the 48 hr salivary PHT values were 0.403 (+/- 0.170) 1 X hr-1 X kg-1 and 0.352 (+/- 0.152) 1 X hr-1 X kg-1 for the control and erythromycin phases, respectively (p greater than 0.05). When intrinsic unbound PHT clearance, CL'int/F, was calculated from CLint/F using a mean free PHT fraction, fu, of 0.069 a good correlation between CL'int/F and CL'int/F could be shown. Evaluation of the interaction on the basis of multiple plasma sample data and single salivary sample data led to the same conclusion. Even though erythromycin failed to significantly decrease mean PHT clearance, occasionally large changes in PHT clearance accompanying erythromycin treatment provide sufficient incentive to closely monitor patients taking both drugs.

The neuromuscular blocking agent succinylcholine (SCh) has been identified and quantitated in biological material using gas chromatography-mass spectrometry. The bisquaternary ammonium compound SCh is extracted from tissue homogenates or body fluids into dichloromethane as an ion pair with hexanitrodiphenylamine (DPA). The evaporated ion pair residue is demethylated with sodium benzenethiolate to form the corresponding tertiary amine which is identified and quantitated by gas chromatography-mass spectrometry using a glass capillary column coated with SE 52. In the quantitative analysis deuterated SCh is used as internal standard. The instrument is focussed on m/z 58 for demethylated SCh and m/z 62 or 64 for the internal standard. Concentrations as low as 5 ng SCh iodide/g tissue or body fluid are easily detected.

A statistical evaluation of the relationship between elevated concentrations of lead and cadmium in human urine is presented. The importance of the 24-hour continuously collected urine sample is confirmed.

Extravascular liver/blood and brain/blood ratios were found to be an average of 6% and 1% higher, respectively, in all experiments than total liver/blood and brain/blood ratios. This difference may be informative in establishing true tissue levels. There was a significant time effect (P less than 0.05) with the extravascular liver/blood ratios but not with the extravscular brain/blood ratios. Extravascular liver/blood ratios were slightly higher in phenobarbital-pretreated animals than in non-pretreated animals. Tissue secobarbital levels in pretreated and non-pretreated animals are not different at 1/4 or 1 h, even though pretreated animals received higher doses than non-pretreated animals. Tissue levels are significantly higher (P less than 0.01) in pretreated animals than in non-pretreated animals at 4 h. It is possible that, at this time period, the barbiturate-metabolizing enzymes have become saturated or exhausted.

Experiments were conducted to investigate the bronchodilating action of delta-9-tetrahydrocannabinol (THC) using normal human lung tissue obtained post mortem. Isolated rings of human bronchioles contracted to histamine, carbachol, and prostaglandin F(2a)(PGF(2a)) and relaxed to isoproterenol. THC (5 X 10(-4)M) did not alter the responses of the bronchial rings to histamine, whereas methapyrilene (10(-6)M) antagonized these responses. Atropine (2 X 10(-6)M) had a highly significant effect on the responses of the bronchioles to carbachol: there was also a significant effect of THC (5 X 10(-4)M), but to a much lesser extent than atropine. Propranolol (10(-6)M) pretreatment significantly antagonized the relaxant responses of the bronchioles to isoproternol: THC antagonized these responses to a smaller degree. Incubation with THC did not cause relaxation of resting tissues or tissues in which a spasm had been induced. These data suggest that THC does not have significant direct effects in human bronchial smooth muscle and that bronchoactivity observed in vivo is likely to be of a nondirect or central origin.

The appropriateness of all serum phenytoin concentrations measured at this 294-bed, tertiary care institution over a 7-week period were evaluated. Each serum level was determined to be justified or unjustified based on either pharmacokinetic or clinical criteria. A total of 234 serum levels were measured in 58 patients. Thirty-eight (16%) of the levels were justified on a pharmacokinetic basis, whereas 70 (30%) were justified for clinical assessment of the patient. One hundred thirty (56%) of the serum levels could not be justified on any grounds. Also identified were distinct clinical situations for 13 patients for which monitoring of serum levels was warranted but not performed. Most phenytoin serum level measurements at this institution were not reasonably justified and may have been unnecessary. A yearly reduction in laboratory costs in excess of $9,000 was predicted if such serum levels had been ordered only when clearly indicated.

Twelve male medical and graduate students received dextroamphetamine sulfate in doses of 0, 5, 10, and 15 mg/70 kg body weight. The study was conducted in a double-blind manner, and treatments were assigned according to randomized, complete block design. The drug was given orally and subjects were instructed not to eat 3 1/2 h prior to administration. After administration, total urine output was collected for 12 h; no attempt was made to control urinary pH to more realistically approach the general clinical usage of amphetamines. The urine was pooled into two 6-h segments and analyzed for amphetamine concentration. Subjective impressions of the treatments were also evaluated by means of the Cornell Medical Index Questionnaire. Results showed that approximately 30% of the total dose was excreted unchanged within 12 h after administration. The amount excreted agreed very closely with the doses given and paralleled the scores for subjective impressions by the subjects. None of the subjects felt that their driving would be impaired for any of the doses administered. This study indicates that under ordinary conditions (in which pH is not artificially controlled), therapeutic doses of dextroamphetamine can be detected in urine for up to 12 h after oral administration.