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Detection of pentazocine and tripelennamine in urine.

Pentazocine and tripelennamine can be identified in urine as a part of routine screening for drug abuse. Pentazocine, pentazocine hydrate, and tripelennamine can be detected by thin-layer chromatography of chloroform/isopropanol extracts of heat- and acid-hydrolyzed urine. Gas chromatography is used for confirmation. Gas chromatographic/mass spectrometric studies (chemical ionization mode) show that such extracts contain major molecular (M+) ions of m/e 256, 286, and 304, indicating the presence of tripelennamine, pentazocine, and pentazocine hydrate, respectively.

Chromatography, Gas↗

Metabolism of tripelennamine in man.

Four polar metabolites were isolated from the urine of human subjects orally treated with tripelennamine, and their structures elucidated by various chemical and physical methods. One of the metabolites, which is a minor one, was identified as an N-oxide of tripelennamine, and the other three as glucuronide conjugates. One of the conjugates, which is a major metabolite, has been assigned a unique quaternary ammonium N-glucuronide structure, since it gave tripelennamine and D-glucuronic acid on incubation with beta-glucuronidase. The N-oxide, which has also been prepared synthetically, remained unchanged on similar treatment. The other two conjugates were O-glucuronides of hydroxylated derivatives, the glucuronide of hydroxytripelennamine being the principal metabolite. No desmethyltripelennamine was found in the urine, however. Hydroxylation in both cases had occurred in the pyridine ring.

Chromatography, Gas↗

Tripelennamine enhances buprenorphine-, but not pentazocine-induced hyperactivity in mice.

The opioid agonist-antagonist pentazocine (1-30 mg/kg) and the partial agonist buprenorphine (0.05-0.25 mg/kg) were tested, alone or in combination with the histamine H1-receptor antagonist tripelennamine (1, 2.5, 5 or 10 mg/kg), on locomotor activity in mice of the CD-1 strain. When given alone, pentazocine produced slight and non-dose-related activity increments, while buprenorphine induced strong and dose-related locomotor stimulation. Tripelennamine slightly increased activity by itself and enhanced buprenorphine-, but not pentazocine-induced hyperactivity. The results are discussed in relation to the hypothesis that antihistaminic agents specifically interfere with locomotor effects of opioids.

Animals↗

Tripelennamine: enhancement of brain-stimulation reward.

Thresholds for reinforcing electrical stimulation to the medial forebrain bundle were determined in rats by means of a rate-free psychophysical method. The acute administration of tripelennamine lowered the threshold for rewarding brain stimulation in a dose-dependent manner. These results suggest that the abuse liability of tripelennamine may be related to its ability to sensitize the central neural pathway that mediates reward.

Animals↗

DNA-damaging activity of tripelennamine in primary cultures of human hepatocytes.

The genotoxicity of tripelennamine, an antihistamine used in the treatment of allergic disorders, was examined in human hepatocyte primary cultures derived from 3 different donors, after exposure to non-toxic concentrations ranging from 10 to 100 microM. A modest but statistically significant and dose-related amount of autoradiographic DNA repair was present in cultures from two donors. DNA fragmentation, as measured by alkaline elution, was found to occur in dose-dependent amounts in cultures of all the 3 donors. These findings, which agree with the previously observed capability of tripelennamine to induce DNA repair and fragmentation in rat hepatocytes, strengthen the suspicion of a potential genotoxic risk of this drug to humans.

Aged↗

Association of infection caused by Pseudomonas aeruginosa serotype O11 with intravenous abuse of pentazocine mixed with tripelennamine.

From July 1979 to June 1983, 25 of 40 intravenous drug addicts with systemic infections had Pseudomonas aeruginosa as the etiological agent; by 1982, P. aeruginosa had replaced Staphylococcus aureus as the most common pathogen. At least 21 of the 25 addicts with P. aeruginosa infection abused pentazocine mixed with tripelennamine (commonly known as T's and blues) compared with 6 of 15 addicts infected with other pathogens (P = 0.006). Of the 25 P. aeruginosa isolates, 23 were of serotype O11. Phenotypic patterns in isolates from addicts and in 22 serotype O11 control isolates from nonaddicts were determined by pyocin and electrophoretic enzyme typing, as well as by susceptibility to heavy metals and antibiotics. Of 25 isolates from addicts, 20 were identical or differed by only one marker, whereas the 22 nonaddict serotype O11 isolates were distributed among 17 distinct phenotypic patterns. We postulate that the emergence of P. aeruginosa as the major cause of deep infection in addicts is a consequence of contamination of their paraphernalia during preparation of pentazocine and tripelennamine for self-injection. The phenotypic similarity among isolates from addicts may reflect acquisition from related environmental sources and an unusual ability of certain serotype O11 strains to survive preparation of the drugs or to be invasive.

Drug Contamination↗

Report of a fatal, acute tripelennamine intoxication.

A death resulting from tripelennamine overdose in a 19-year-old male Caucasian is reported. The patient died 7 h after ingesting approximately twenty 50-mg tripelennamine tablets. A concentration of 1.0 mg/100 ml was found in the blood. All tissue concentrations were measured by ultraviolet spectroscopy and verified by gas-liquid chromatography. Significant findings included pulmonary edema and multiple small petechial hemorrhages in the soft tissue of the scalp.

Adult↗

N-depyridination and N-dedimethylaminoethylation of tripelennamine and pyrilamine in the rat. New metabolic pathways.

N-(2-Dimethylaminoethyl)benzylamine and 2-benzylaminopyridine were identified as two new urinary metabolites of tripelennamine in the rat by GC/MS. 2-(4-Methoxybenzylamino)-pyridine and N-(dimethylaminoethyl)-4-hydroxybenzylamine were identified as new urinary metabolites of pyrilamine by GC/MS. Thus, in addition to N- and O-demethylation, hydroxylation, and glucuronidation, N-debenzylation, N-depyridination and N-dedimethylaminoethylation were shown to be novel pathways for metabolism of tripelennamine and pyrilamine. The mechanism for N-depyridination and N-dealkylation is discussed.

Aminopyridines↗

Current trends in the abuse of pentazocine and tripelennamine: the metropolitan St. Louis experience.

A discussion of the intravenous use by narcotic addicts in metropolitan St. Louis of a combination of pentazocine and tripelennamine, known as "T's and blues," is presented. The folklore and ritual of "T"'s and blues" use were gleaned from interviews with addicts. The cause of, possible adverse reactions to, and medical examiners' experience with this new mode of drug abuse are discussed. Pharmacology relative to the abuse of pentazocine and tripelennamine is reviewed.

Drug Combinations↗

T's and blues. Abuse of pentazocine and tripelennamine.

Pentazocine, long an abused drug among the medical community, has become popular among street addicts. The tablet form of pentazocine is combined with the antihistamine, tripelennamine, dissolved in water, and injected intravenously. This combination is known as "T's and Blues." Prescribing physicians should be aware of the abuse of these two drugs, particularly since pentazocine in tablet form is often considered of low abuse potential. Patterns of abuse, serious medical complications, and treatment considerations are discussed.

Humans↗

The effects of cocaine, chlorpheniramine and tripelennamine on the cardiac responses to sympathetic nerve stimulation.

The effects of cocaine (COC), chlorpheniramine (CHL), and tripelennamine (TRI) on the cardiac responses to sympathetic neural stimulation were compared in open-chest, anesthetized dogs. The amplitudes of the chronotropic responses were not significantly altered by any of these drugs. Similarly, the amplitudes of the inotropic responses were not affected significantly by either COC or TRI, but they were increased moderately by CHL. All three drugs prolonged the inotropic and especially the chronotropic responses. CHL and TRI, in addition to being antihistaminics, are inhibitors of the neuronal uptake of norepinephrine. Therefor, the similarity of the effects of CHL, TRI, and COC on the cardiac responses to sympathetic stimulation is probably ascribable to their inhibitory activities on the neuronal uptake mechanism.

Animals↗

The effect of tripelennamine alone and in combination with opiates to produce antinociception in mice.

Antinociception (ANTI) was assessed in male CD-1 mice by a modification of Haffner's tail clamp procedure. Studies revealed that tripelennamine (Tp) alone produced antinociception (ANTI) in mice and also caused potentiation when combined with morphine (M) or nalbuphene (NB). Naloxone (Nx) only partially blocked the effect of Tp, but fully blocked M. Although atropine (At) had no intrinsic ANTI activity, it enhanced that of Tp but not M. Histamine (Hm) had no intrinsic ANTI activity, nor did it interact with either Tp or M. The partial abolition of Tp ANTI, in contrast to complete blockade of M effects with Nx, appears to indicate that Tp can stimulate the opiate receptor as well as another receptor for ANTI at a different locus. The combination of Tp with various opiates may have considerable abuse potential.

Analgesia↗

Tripelennamine and pentazocine alone and in combination: effects on interresponse-time-greater-than-t responding of rats.

The effects of tripelennamine (3, 6, 12, 18, and 24 mg/kg) and pentazocine (5, 10, 20, 30, and 40 mg/kg), given alone and in selected combinations, were determined in rats performing under an interresponse-time-greater-than-15-sec schedule of food delivery. Each drug alone produced statistically insignificant increases in response rates and statistically significant decreases in reinforcement rates. Combinations produced effects identical in direction to, and significantly greater than, those predicted by a simple additive model.

Animals↗

Characterization of the interaction of pentazocine and tripelennamine: drug discrimination and mu-receptor binding assay.

Abuse of the combination of pentazocine (P) and tripelennamine (T) reputedly produces an opiate-like euphoria not obtainable from either drug alone. To determine if this effect is related to interactions at the behavioral or receptor levels we tested this combination in rats trained to discriminate morphine from saline and in mu-receptor binding assays. Displacement of 3H-DHM was compared in morphine-naive, dependent and withdrawn states to determine the importance of prior morphine exposure. The morphine training cue (3 mg/kg) generalized to P but not to T. Combinations of T (0.3 and 1.0 mg/kg) with "no effect" doses of P (1 and 3 mg/kg) resulted in greater than additive increases in morphine-like responding. 3H-DHM was displaced by P but not T in naive, dependent and withdrawn states. Specific dose combinations of T (1 nM) with P (1 nM, 10 nM, 100 nM) resulted in enhanced displacement of 3H-DHM and was not related to prior morphine exposure. We conclude that the addition of T to P increases the mu-like subjective effects of P and this effect may be due to enhanced affinity of P for the mu-receptor.

Animals↗

Comparative disposition of tripelennamine in horses and camels after intravenous administration.

The pharmacokinetics of tripelennamine (T) was compared in horses (n = 6) and camels (n = 5) following intravenous (i.v.) administration of a dose of 0.5 mg/kg body weight. Furthermore, the metabolism and urinary detection time was studied in camels. The data obtained (median and range in brackets) in camels and horses, respectively, were as follows: the terminal elimination half-lives were 2.39 (1.91-6.54) and 2.08 (1.31-5.65) h, total body clearances were 0.97 (0.82-1.42) and 0.84 (0.64-1.17)L/h/kg. The volumes of distribution at steady state were 2.87 (1.59-6.67) and 1.69 (1.18-3.50) L/kg, the volumes of the central compartment of the two compartment pharmacokinetic model were 1.75 (0.68-2.27) and 1.06 (0.91-2.20) L/kg. There was no significant difference (Mann-Whitney) in any parameter between camels and horses. The extent of protein binding (mean +/- SEM) 73.6 + 8.5 and 83.4 +/- 3.6% for horses and camels, respectively, was not significantly statistically different (t-test). Three metabolites of T were identified in urine samples of camels. The first one resulted from N-depyridination of T, with a molecular ion of m/z 178, and was exclusively eliminated in conjugate form. This metabolite was not detected after 6 h of T administration. The second metabolite, resulted from pyridine ring hydroxylation, had a molecular ion of m/z 271, and was also exclusively eliminated in conjugate form. This metabolite could be detected in urine sample for up to 12 h after T administration. The third metabolite has a suspected molecular ion of m/z 285, was eliminated exclusively in conjugate form and could be detected for up to 24 h following T administration. T itself could be detected for up to 27 h after i.v. administration, with about 90% of eliminated T being in the conjugated form.

Animals↗

Outbreak of endocarditis caused by Pseudomonas aeruginosa serotype O11 among pentazocine and tripelennamine abusers in Chicago.

At Cook County Hospital (Chicago), before 1977, the incidence of endocarditis caused by Pseudomonas aeruginosa was one or two cases per year. The frequency of P. aeruginosa as an etiologic agent of endocarditis among drug abusers increased steadily from five (23%) of 22 patients in 1977 to 15 (68%) of 22 in 1980. P. aeruginosa serotype O11 accounted for 34 (76%) of 42 of the strains serotyped. The total increase in incidence of P. aeruginosa endocarditis that we observed can be attributed to disease caused by serotype O11. We serotyped 152 strains of P. aeruginosa obtained from hospital inpatients without endocarditis. Serotype O11 was the most frequently isolated type, accounting for 27% of the total. Incidence of serotype O11 in drug addicts with endocarditis is significantly higher than the incidence in patients with nonendocarditis infections (chi 2 = 32.89; P less than .001). There was a high degree of correlation between pentazocine and tripelennamine ("T's and Blues") abuse and endocarditis caused by P. aeruginosa (chi 2 = 36.71; P less than .001).

Chicago↗

Characterization of the antihistamines tripelennamine, methapyrilene, and thenyldiamine and their N-oxides by thermospray mass spectrometry.

This study describes an investigation of the thermospray (TS) mass spectrometric analysis of tripelennamine, methapyrilene, thenyldiamine, and their N-oxide derivatives. These compounds were analyzed by direct injection TS mass spectrometry in the column bypass mode and with 0.1M ammonium acetate/methanol (80:20, v/v) as the mobile phase. Typically, the parent antihistamines produced only [MH]s ions under these conditions. The N-oxides provided strong [MH]s ions and multiple fragment ions. A scheme to explain the fragmentation patterns is proposed.

Aminopyridines↗