[Pharmacologic dependence on nefopam (Acupan): a case report].
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Biomedical subjects
Publications and source records attributed to J Arditti.
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The authors report on a case of vegetating bromoderma observed after therapy with bromocalcic speciality (Calcibronat). Repeated bromine determinations in body fluids enabled, while reconsidering the metabolism of this halogen, to monitor its elimination.
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Local anesthesia for ambulatory phlebectomy makes it necessary to inject a considerable quantity of lidocaine. This study involved 50 operations. The doses of lidocaine containing 1% adrenaline and injected after cooling (between 2 and 5 degrees C) ranged from 200 mg to nearly 900 mg in a single administration. The assays of lidocaine in the peripheral venous blood were carried out by means of F.P.I.A. (Fluorescence Polarization Immuno Assay) at times 0, 30 min 60 min, 90 min., 24 hours and 48 hours. The peak concentration obtained (1.8 micrograms/ml) for a dose of 700 mg in a subject weighting 65 kg, i.e. 10.9 mg/kg, was only one-half the concentration considered to be neurologically toxic (4 to 12 micrograms/ml) or one-twelfth of the toxic levels with regard to the cardiovascular system (24 micrograms/ml). The performance of local anesthesia in the physician's office is devoid of major risks, even though the doses used during AP are much higher than those usually administered in routine dematological surgery.
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A study of benzodiazepine impregnation of 234 drivers involved in road accidents showed a higher level of impregnation than that usually observed in the general population and a different frequency of this impregnation in the two populations. Although a significant correlation was found between responsibility of the driver and positivity of benzodiazepine assays, this result must be interpreted with caution and does not permit to attribute the responsibility for the accident to the presence of benzodiazepine in blood.
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Following the setting up by the Government of their project for the management of drug addicts, and under the guidance of the CEIP (Centre d'Evaluation et d'Information sur les Pharmacodépendances [Centre for Evaluation and Information on Drug Addiction]) in Marseille, a survey of prescriptions written on controlled-drug prescription pads was performed. The aims were threefold: to study the medicines prescribed, to follow up the legislation and to inform doctors and pharmacists. Copies of the prescriptions, dated between 1 January 1996 and 30 June 1996, which were sent by 81 per cent of the 216 pharmacies contacted in 15 towns in the Provence-Alpes-Côte d'Azur (PACA) region were studied. Various criteria, relating to writing of the prescriptions and distribution of the medicines to the patients, were coded and analysed. This survey showed that of 4 prescriptions, 3 were prescribed for maintenance and one for analgesic therapy. The patients receiving maintenance therapy were male in three-quarters of the cases, and were around 30 years old. Analgesics were prescribed in equal proportions for patients of both sexes, who were around 65 years old. Since it was put on the market, Subutex has been quickly prescribed.