PubMed · 15550406
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Anne M Holbrook. 2004-11-20. Treating insomnia.. https://doi.org/10.1136/bmj.329.7476.1198
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An anti-diazepam, molecularly imprinted polymer (MIP) has been synthesized and used to extract diazepam and other benzodiazepines from hair samples via a molecularly imprinted solid-phase extraction (MISPE) protocol. Optimum retention of diazepam on the MIP columns was achieved using an apolar solvent, and the binding capacity of the polymer toward diazepam was found to be 110 ng of diazepam/mg of polymer. The recovery of a 50 ng diazepam standard spiked into blank hair was 93%, with good precision (RSD = 1.5%). The LOD and LOQ of diazepam in spiked hair samples were 0.09 and 0.14 ng/mg, respectively. The MISPE method was demonstrated to be applicable to the analysis of diazepam metabolites and other benzodiazepine drugs, in addition to diazepam itself. The application of the extraction method to postmortem hair samples yielded results that were in good agreement with the corresponding ELISA data (from blood samples) and data arising from the analysis of the same blood samples using a validated in-house SPE-LC-MS-MS method.
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INTRODUCTION: Platelets have a central role in the development of arterial thrombosis and subsequent cardiovascular events. An appreciation of this has made antiplatelet therapy the cornerstone of cardiovascular disease management. Recent studies have described the phenomenon of clopidogrel resistance but the possible mechanisms are still unclear. PATIENTS AND METHODS: The aim of this study was to compare the characteristics (risk profile, previous diseases, medications, hemorheological variables and plasma von Willebrand factor and soluble P-selectin levels) of patients in whom clopidogrel provided effective platelet inhibition with those in whom clopidogrel was not effective in providing platelet inhibition. 157 patients with chronic cardio- and cerebrovascular diseases (83 males, mean age 61+/-11 yrs, 74 females, 63+/-13 yrs) taking 75 mg clopidogrel daily (not combined with aspirin) were included in the study. RESULTS: Compared with clopidogrel-resistant patients (35 patients (22%), patients who demonstrated effective clopidogrel inhibition had a significantly lower BMI (26.1 vs. 28.8 kg/m2, p<0.05). Patients with ineffective platelet aggregation were significantly more likely to be taking benzodiazepines (25% vs. 10%) and selective serotonin reuptake inhibitors (28% vs. 12%) (p<0.05). After an adjustment to the risk factors and medications BMI (OR 2.62; 95% CI: 1.71 to 3.6; p<0.01), benzodiazepines (OR 5.83; 95% CI: 2.53 to 7.1; p<0.05) and SSRIs (OR 5.22; 95% CI: 2.46 to 6.83; p<0.05) remained independently associated with CLP resistance. There was no significant difference in the rheological parameters and in the plasma levels of adhesive molecules between the two examined groups. CONCLUSION: The background of ineffective clopidogrel medication is complex. Drug interactions may play a role on clopidogrel bioavailability, on the other hand, the significant difference in BMI between the two examined groups suggests that clopidogrel therapy should be weight-adjusted.