PubMed · 7619595
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R M Wylie. 1995. Reducing benzodiazepine usage.. https://pubmed.ncbi.nlm.nih.gov/7619595/
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An approach to determine the stability of benzodiazepines and some of their metabolites (n = 13) by means of a routinely applied gas chromatographic method using electron capture detection was made in this preliminary study. Validation data of the method are given. Spiked blood and plasma samples were stored at 4 degrees C and analysed at selected times up to 240 days. The concentrations of all analytes had decreased to at least 60% of the original levels at the end of the observation period. A clear pattern of breakdown could not be established. The data obtained suggest that results from long-term stored samples should be interpreted cautiously. Further investigations concerning the stability of drugs in blood and plasma samples, additional methods of identification and determination as well as the establishment of optimal storage conditions seem necessary.
Studies were undertaken to determine the stability of nitrobenzodiazepines and their 7-amino metabolites in water and blood. At 22 degrees C nitrazepam and clonazepam were stable in sterile fresh blood containing preservative over 28 days, whereas 25% of flunitrazepam was degraded. At 37 degrees C all three drugs were substantially lost over 9 h (29-51%). There was only a small loss observed for the 7-amino metabolites and no substantial amounts of parent drug and 7-amino metabolite were degraded in water under these conditions. In the absence of preservative substantial amounts (25-50%) of parent drugs were lost in fresh blood over 10 days at 22 degrees C. In bacterially-contaminated postmortem blood all three drugs were completely degraded over 8 h at 22 degrees C with almost all drug completely converted to the respective 7-amino metabolite. These metabolites were also partially degraded (10-20%) over 45 h at 22 degrees C. All 3 nitrobenzodiazepines were stable in blood stored for up to 24 months at -20 degrees C, or 4 degrees C over 10 months. Their respective 7-amino metabolites were, however, relatively unstable at -20 degrees C with a significant loss (29%) after 2 months. At 4 degrees C a 21% loss occurred after 1 month. Freeze/thawing was found not to affect the concentration of nitrobenzodiazepine and 7-amino metabolites. These results show that the nitrobenzodiazepines and their metabolites are unstable chemically and metabolically in blood. We advise that blood collected for the purpose of nitrobenzodiazepine determinations should be preserved with sodium fluoride, stored at -20 degrees C and assayed as soon as practicable, preferably within a week of collection.
In Nova Scotia Canada, governmental authorities expressed concern in the late 1980s about the adverse effects of drug use by parents on the welfare of their children. Since 1991, parents with a history of drug abuse may be required to submit to urine drug and alcohol testing when ordered by the Family Courts of this province. The objective of this paper is to present this drug testing program and the results of drug testing on 125 clients from 1994-1996. Urine specimens were collected in the parents' residence by a nurse and transferred directly to the laboratory by the collector or a courier. Specimens were screened by immunoassay and TLC followed by GC-MS confirmation. Results were sent directly to the social worker. In the 3,613 urine specimens analyzed, 50.2% of specimens were negative, 45.6% were positive for one or more drug/metabolite and 4.2% of specimens were dilute (creatinine < 25 mg/dL). The distribution of positive results were: cannabinoids (11.5%), cocaine metabolite (5.0%), benzodiazepines (14.5%), codeine/morphine (7.1%), codeine (6.6%), diphenhydramine (2.2%) and ethyl alcohol (1.6%). Drug testing has been considered a success by these agencies since testing provides an objective indication of recent drug use and the overall prevalence of drug use in this drug abusing population has reduced from 100% to < 50%.