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D N Bailey

Publications and source records attributed to D N Bailey.

At least 55 records · Page 3Linked to original sources
PubMed1980

Gas-chromatographic analysis for phencyclidine in plasma, with use of a nitrogen detector.

We describe a reliable gas-chromatographic analysis for unchanged phencyclidine in human plasma, with use of a nitrogen detector. The assay is sufficiently sensitive to permit measurement of as little as 5 microgram of the drug per liter, in 2 mL of plasma. Phencyclidine is extracted from plasma at pH 10.5 into hexane/iso-amyl alcohol containing meperidine as the internal standard, back-extracted into dilute HCl, and re-extracted into hexane/iso-amyl alcohol after alkalinization of the HCl. The coefficients of variation for the analysis at respective concentrations of 100 and 200 microgram/L are: within-run 4.0% and 3.4%; between-run, 2.8% and 5.2%. This procedure, used in our laboratory for more than one year, has been applied to plasma from numerous individuals with nonfatal phencyclidine intoxication. Some representative examples are given.

Chromatography, Gas↗
PubMed1979

Phencyclidine abuse. Clinical findings and concentrations in biological fluids after nonfatal intoxication.

Phencyclidine concentrations were measured in the plasmas of 22 patients with nonfatal phencyclidine intoxication using gas-liquid chromatography with a nitrogen detector. Concentrations found ranged from less than 10 to 812 micrograms/l, and except for the systolic blood pressure (r = 0.60, P less than 0.05), showed no significant correlation with the physical findings. The most common physical findings were combativeness-agitation (64%), depressed level of consciousness (50%), hypertension (43%), moiosis (43%), and tachycardia (43%). Phencyclidine concentrations measured in the erythrocytes of seven of the patients were generally higher than concentrations in the corresponding plasmas (erythrocyte:plasma concentration ratios ranged from 3.1 to 37.9), suggesting that the binding of phencyclidine to plasma proteins is low. Erythrocytic concentrations also showed no significant correlation with either the physical findings or the plasma concentrations of phencyclidine. For 15 unselected urines the concentrations of phencyclidine showed no significant correlation with urinary pH.

Adolescent↗
PubMed1979

Gas-chromatographic analysis for chlorpromazine and some of its metabolites in human serum, with use of a nitrogen detector.

We describe a gas-chromatographic method for measuring chlorpromazine and its metabolites chlorpromazine sulfoxide, mono-N-desmethylchlorpromazine, and di-N-desmethylchlorpromazine at therapeutic concentrations in human serum, with use of a nitrogen detector. The compounds are extracted from serum at pH 10.5 into hexane/isoamyl alcohol, re-extracted into dilute HCl, and then extracted into hexane after alkalinization of the HCl. The N-desmethylated metabolites are measured as their respective N-trifuloracetyl derivatives; the parent drug and its sulfoxide are measured as the unchanged bases. Promazine is the internal standard. As little as 5 micrograms of chlorpromazine, 20 micrograms of chlorpromazine sulfoxide, 20 micrograms of mono-N-desmethylchlorpromazine, and 10 micrograms of di-N-desmethylchlorpromazine per liter can be measured in 2-mL samples of serum. The within-run coefficients of variation for assays of these drugs at 100 micrograms/L are 2.7%, 5.6%, 5.1%, and 5.3%, respectively. The procedure was applied to patients receiving therapeutic doses of chlorpromazine and to patients who had ingested an overdose of chlorpromazine.

Chlorpromazine↗
PubMed1978

Tricyclic antidepressants: plasma levels and clinical findings in overdose.

Following amitriptyline or imipramine overdose by 30 patients, total plasma concentrations ranged from 29 to 1732 ng/ml but did not correlate well with physical findings or most electrocardiographic changes. Only those patients with a QRS interval greater than 0.1 second had significantly elevated plasma levels. However, a plasma level ratio of the parent drug (amitriptyline, imipramine) to its respective N-desmethyl metabolite (nortriptyline, desmethylimipramine) greater than or equal to 2.0 was associated with an acute overdose. This ratio was more useful than total plasma levels in differentiating an overdose from a therapeutic dose with associated toxicity and an elevated steady-state plasma level.

Adolescent↗
PubMed1976

Gas-chromatographic analysis for therapeutic concentrations of amitriptyline and nortriptyline in plasma, with use of a nitrogen detector.

We describe a gas-chromatographic procedure for the simultaneous determination of amitriptyline and its active metabolite, nortriptyline, in therapeutic concentrations in human plasma, with use of a nitrogen detector. Both drugs are extracted at pH 10.5 into hexane/isoamyl alcohol, back-extracted into dilute HCl, and re-extracted into hexane/isoamyl alcohol after alkalinization of the HCl. The solvent is evaporated and the residue gas-chromatographed. Protriptyline is used as the internal standard. As little as 5 mug of amitriptyline or nortriptyline can be detected per liter of plasma. The coefficients of variation, for a concentration of 200 mug/liter, are 4.6% and 4.3% within-day and 8.6% and 3.4% day-to-day for amitriptyline and nortriptyline, respectively. The procedure was applied to patients receiving therapeutic doses of both drugs and also to patients who had taken overdoses of amitriptyline.

Amitriptyline↗
PubMed1976

Gas-chromatographic analysis for therapeutic concentration of imipramine and disipramine in plasma, with use of a nitrogen detector.

We describe a method for the simultaneous gas-chromatographic analysis of imipramine and desipramine (the active N-desmethyl metabolite) at therapeutic concentrations in human plasma, with use of a nitrogen detector. Imipramine is measured as the unchanged base and desipramine as its N-tribluoroacetyl derivative. Promazine is the internal standard. The lower limit of sensitivity is 5 mug/liter for each drug, and the within-day coefficients of variation for the determination of imipramine and desipramine, respectively, are 6.0% and 3.3%. We measured concentrations of these drugs both in patients receiving therapeutic doses of imipramine and in those who had ingested an overdose.

Chromatography, Gas↗
PubMed1975

Barbital overdose and abuse.

Bailey, David N., and Jatlow, Peter I.: Barbital overdose and abuse. A new problem. Am J Clin Pathol 64:291-296, 1975. The unusual epidemiology and toxicology of barbital overdose and abuse are demonstrated by eight recent cases. Since barbital is used primarily in laboratory buffers and is not available as a prescription or over-the-counter drug in the United States, barbital overdose and abuse have until recently been rare. In several instances the barbital was stolen from a clinical or research laboratory. Serum concentrations were often "astronomically" high compared with those of other barbiturates, including phenobarbital. Concentrations severalfold greater than would be considered lethal for other barbiturates were consistent with survival, and all patients, including one with a serum concentration of 120.2 mg per dl. (higher than any previously reported), recovered with only conservative therapy (no peritoneal or hemodialysis). Patients could be awakened when the concentration was less than 16.0 mg per dl. Serum barbiturate concentrations greater than 20.0 mg. per dl. in a living patient should warrant serious consideration of barbital ingestion. In addition to the eight overdoses, 16 abusers of barbital were detected during 1974 by drug-abuse screening of urine.

Acute Disease↗
PubMed1975

Gas-chromatographic analysis for cocaine in human plasma, with use of a nitrogen detector.

We describe a procedure for measuring the concentration of cocaine in plasma by gas chromatography, with use of a nitrogen detector. The procedure was tested on patients receiving intranasal cocaine for topical anesthesia. The propyl ester of benzoylecgonine is used as an internal standard. The lower limit of sensitivity of the procedure is 5--10 mug of cocaine per liter of plasma. The coefficients of variation are 5.3% and 3.0% for concentrations of 50 and 100 mug/liter, respectively.

Chromatography, Gas↗
PubMedDate not supplied

Chemical and hematological changes in stored CPD blood.

Blood was drawn from ten healthy volunteer donors into citrate-phosphate-dextrose (CPD) anticoagulant and placed on the quarantine shelf of the blood bank refrigerator. Plasma dextrose, sodium, potassium, chloride, bicarbonate, GOT, LDH, and hemoglobin as well as WBC, hematocrit, MCV, MCHC, whole blood pH, and ammonia were measured on all samples initially and at one, two, seven, 14, 21, and 28 days of storage at 4 C. Whole blood lactate also was analyzed serially on five of the units. An additional 27 units of CPD bank blood (two to 21 days of age), routinely processed, handled, and stored by the blood bank, were submitted to the same analyses on the day of administration to the patient. Five of these processed units, 21 days old, were resampled at 28 days. Results of the analyses are presented and discussed. The most pronounced changes were seen for dextrose, potassium, bicarbonate, lactate, LDH, ammonia, and hemoglobin. Plasma dextrose and bicarbonate declined in concentration while potassium, lactate, LDH, ammonia, and hemoglobin rose with storage. In general, changes in the regularly processed, singly sampled bank units were greater than those observed in the specially processed, quarantined units sampled serially. This study indicates that routine transportation, processing, and handling of bank blood may lead to increased biochemical alteration.

Ammonia↗
PubMedDate not supplied

Comprehensive toxicology screening in patients admitted to a university trauma center.

The utility of performing comprehensive toxicology screening in patients admitted to a university trauma center was evaluated by retrospective review of the results of such screening for a one-year period. Eighty-five percent of the screens were performed on males. Sixty-nine percent of the screens were positive for one or more drugs, and eighty-five percent of the positive screens occurred in males. More than half of the positives were in individuals 30 years of age or less. Ethanol was present in 81% of the positive screens, and of these it was the only drug found in 84% of the cases. Blood ethanol concentrations for the entire series ranged from 0.01 to 0.41% (mean, 0.15%; SD, 0.08%). Blood ethanol measurement alone is more cost effective than comprehensive toxicology screening and may be nearly as useful as the comprehensive screen in the majority of trauma cases.

Adolescent↗
PubMedDate not supplied

Effect of parenterally administered ethanol on the tissue distribution of phencyclidine following percutaneous absorption.

At 1, 2, 3, and 4 hr after percutaneous absorption of phencyclidine hydrochloride in the hairless mouse, concentrations of the drug in blood, brain, liver, lung, and heart were much lower in mice that had been pretreated with hypertonic ethanol by intraperitoneal injection than in control mice pretreated with water. These findings are consistent with the hypothesis that hypertonic ethanol inhibits the percutaneous absorption of phencyclidine. The relative pattern of tissue distribution of phencyclidine, however, appeared to be essentially the same for both groups. It appears that the magnitude of percutaneous absorption of phencyclidine does not alter its relative tissue distribution.

Animals↗
PubMedDate not supplied

Drug use in patients admitted to a university trauma center: results of limited (rather than comprehensive) toxicology screening.

The results of rapid toxicology screening of paired blood and urine samples from 936 patients admitted to a university trauma center during the calendar year 1988 were reviewed in order to determine the drugs detected by use of a relatively limited (rather than comprehensive) screening procedure and to define the demographic characteristics of the positive population. Of the 936 cases, 65% (610) were positive for one or more drugs: ethanol (436), cocaine and/or benzoylecgonine (164), sympathomimetic amines (142), phencyclidine (40), narcotic analgesics (36), salicylates (17), and barbiturates (9). Of the positive screens, 70% (426) demonstrated only one drug or parent drug/metabolite combination. Positives were obtained from 69% of men, 50% of women, 80% of American Indians, 75% of Blacks, 66% of Latins, 65% of Caucasians, 60% of undetermined race, and 38% of Orientals screened. The age group 21-40 years accounted for 69% of positives. Rapid, limited admission toxicology screening of trauma patients can still provide useful information.

Adult↗
PubMedDate not supplied

Percutaneous absorption of tricyclic antidepressants: amitriptyline, nortriptyline, imipramine, and desipramine.

The percutaneous absorption of amitriptyline, nortriptyline, imipramine, and desipramine as their hydrochloride salts in vivo was demonstrated without use of a vehicle using the hairless (hr-1/hr-1) mouse as an experimental model for human skin. After topical application of 2 mg of each compound in distilled water, followed by rapid evaporation of the water, concentrations were measured in heart, lung, brain, liver, and blood in 1-, 2-, 4-, and 6-hour study groups. Lung consistently demonstrated the highest concentrations for all four compounds while heart and liver had the lowest. Concentrations in heart remained essentially constant for all compounds during the 6-hour study period. The concentrations in solid tissues were much lower than those commonly seen in man after overdose, whereas the concentrations in blood resembled low therapeutic to toxic concentrations in humans. Percutaneous absorption may provide a feasible route of administration for the tricyclic antidepressants which may lead to improved compliance with fewer gastrointestinal side effects.

Amitriptyline↗
PubMedDate not supplied

Ethchlorvynol ingestion in San Diego County: a 14-year review of cases with blood concentrations and findings.

Cases of nonfatal (51) and fatal (38) ingestions involving ethchlorvynol over a 14-year period (1975 through 1988) were reviewed in order to evaluate the current status of ingestion of this drug. In both series of cases men and women were involved approximately equally. Sixty-three percent of cases in both series occurred during the period 1975 through 1980. Most (78% of nonfatal and 89% of fatal) ingestions involved other drugs in addition to ethchlorvynol. Physical findings for nonfatal ingestions and causes of death for fatal ingestions are presented. Blood ethchlorvynol concentrations are discussed, and a composite of the average patient for each series is presented. Although ethchlorvynol abuse appears to be decreasing with time, it still occurs, and a search for this sedative-hypnotic agent should be included in the so-called "toxicology screen."

Adolescent↗