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PubMed1983

Efficacy of psychotherapeutic counselling during 21-day ambulatory heroin detoxification.

Structured, psychotherapeutic counselling during 21-day heroin detoxification was evaluated by randomly assigning a group of 25 heroin addicts to a detoxification treatment regimen with mandatory counselling by a therapist and 25 to a control group who received only standard detoxification without counselling. There was no significant difference between groups in the number who successfully detoxified as measured by conversion of morphine positive urine to morphine negative urine. The counselling intervention group did, however, improve the attendance of subjects while in detoxification treatment, and significantly more patients entered long-term treatment following detoxification. Maximal use of a counselor during 21-day heroin detoxification may best be realized by directing therapy toward engaging patients in long-term care.

Adolescent↗

PubMed1997

Glutaraldehyde detoxification of aortic wall tissue: a promising perspective for emerging bioprosthetic valve concepts.

BACKGROUND AND AIMS OF THE STUDY: Due to its superb crosslinking activity, glutaraldehyde (GA) is still the most widely used fixative for bioprosthetic heart valves. At the same time, however, GA is also believed to be partly responsible for tissue calcification and the lack of surface re-endothelialization, both of which may contribute to valve degeneration. Although excess GA has previously been extracted from thin leaflet tissue, this treatment proved insufficient for the detoxification of thick aortic wall tissue of stentless valves or root prostheses. METHODS: In order to establish a detoxification procedure which thoroughly extracts biologically active GA from aortic wall tissue, we used a highly sensitive bioassay where endothelial cells were seeded onto glutaraldehyde-fixed aortic wall discs following various detoxification procedures. Absolute cell numbers and morphologic shape were correlated with shrinkage temperature and shrinkage extent of the tissue to determine the potential of the treatments to reverse crosslinks. To optimize treatment conditions, pH (3.2 versus 4.5), temperature (22 degrees C versus 37 degrees C) and incubation time (48 h versus one week) were varied. In order to identify an optimal detoxification agent, 12 different amino-reagents from four chemical groups were compared: low pKa aromatic amines, amino acids, low pKa N-heterocyclic compounds and amino sugars. RESULTS: Amino-reagent treatment required warm temperature (37 degrees C), prolonged reaction time (one week) and a pH of 4.5 to achieve long-term cell growth on glutaraldehyde-fixed aortic wall. All 12 amino-reagents were able to detoxify aortic tissue satisfactorily; and all mildly reversed crosslinks, although there were differences between candidates. When summarized data were ranked correlating cell growth and quality with shrinkage temperature and shrinkage extent, seven reagents had a rank sum above the overall mean value, and five below with statistically significant differences between candidates. The additional stabilization of the detoxification reaction through borohydride-reduction had no further effect on tissue biocompatibility and crosslinks. CONCLUSIONS: Efficient detoxification of thick aortic wall tissue is possible if a one-week incubation in an acetic acid buffer-based amino-reagent is carried out at 37 degrees C.

Acetic Acid↗

PubMed2000

Methadone maintenance vs 180-day psychosocially enriched detoxification for treatment of opioid dependence: a randomized controlled trial.

CONTEXT: Despite evidence that methadone maintenance treatment (MMT) is effective for opioid dependence, it remains a controversial therapy because of its indefinite provision of a dependence-producing medication. OBJECTIVE: To compare outcomes of patients with opioid dependence treated with MMT vs an alternative treatment, psychosocially enriched 180-day methadone-assisted detoxification. DESIGN: Randomized controlled trial conducted from May 1995 to April 1999. SETTING: Research clinic in an established drug treatment service. PATIENTS: Of 858 volunteers screened, 179 adults with diagnosed opioid dependence were randomized into the study; 154 completed 12 weeks of follow-up. INTERVENTIONS: Patients were randomized to MMT (n = 91), which required 2 hours of psychosocial therapy per week during the first 6 months; or detoxification (n = 88), which required 3 hours of psychosocial therapy per week, 14 education sessions, and 1 hour of cocaine group therapy, if appropriate, for 6 months, and 6 months of (nonmethadone) aftercare services. MAIN OUTCOME MEASURES: Treatment retention, heroin and cocaine abstinence (by self-report and monthly urinalysis), human immunodeficiency virus (HIV) risk behaviors (Risk of AIDS Behavior scale score), and function in 5 problem areas: employment, family, psychiatric, legal, and alcohol use (Addiction Severity Index), compared by intervention group. RESULTS: Methadone maintenance therapy resulted in greater treatment retention (median, 438.5 vs 174.0 days) and lower heroin use rates than did detoxification. Cocaine use was more closely related to study dropout in detoxification than in MMT. Methadone maintenance therapy resulted in a lower rate of drug-related (mean [SD] at 12 months, 2.17 [3.88] vs 3.73 [6.86]) but not sex-related HIV risk behaviors and in a lower severity score for legal status (mean [SD] at 12 months, 0.05 [0.13] vs 0.13 [0.19]). There were no differences between groups in employment or family functioning or alcohol use. In both groups, monthly heroin use rates were 50% or greater, but days of use per month dropped markedly from baseline. CONCLUSIONS: Our results confirm the usefulness of MMT in reducing heroin use and HIV risk behaviors. Illicit opioid use continued in both groups, but frequency was reduced. Results do not provide support for diverting resources from MMT into long-term detoxification.

Adult↗

PubMed2004

Noninvasive assessment of liver detoxification capacity of children, observed in children from heavily polluted industrial and clean control areas, together with assessments of air pollution and chloro-organic body burden.

The liver is an important target organ in exposure to foreign substances or their metabolites. Early changes in the metabolic capacity of the liver may be a first sign of the effect of an exposure and an indication of an early (pre)pathological process. For the noninvasive testing of this metabolic capacity, a special diagnostic tool has been developed and demonstrated under real exposure conditions. The main questions investigated were (1) whether the liver detoxification capacity of children is affected by long-term low exposure in a highly polluted area and (2) to what extent redevelopment in once heavily polluted industrial areas contributes to improvement in the health measured in the children from the changed detoxification capacity. Kindergarten children from a heavily polluted industrial area and a control area were observed over a prolonged period during redevelopment of the industrial area. The liver's detoxification capacity was assessed with a stable-isotope-based diagnostic test, the [(15)N]methacetin test. In addition, the region-specific external exposure (indicator components were chlorinated compounds) and internal load were measured. The difference in the children's internal load between the exposed and control groups reflected the differences in exposure (exposed children had an internal load 2.3 times greater than that of the control children). The exposed children showed a 6% lower liver detoxification capacity. A reduction in pollution by about 70% as a result of remediation was reflected in improved liver detoxification capacity, and the difference between the polluted and control areas was no longer significant. Prolonged exposure to low concentrations of xenobiotics can disturb hepatic functioning. The proposed test can be used as a tool to determine the effects of multicomponent exposure and is well suited for bioeffect monitoring.

Acetamides↗

PubMedDate not supplied

Ultrarapid opiate detoxification: a review.

PURPOSE: This review on ultrarapid detoxification examines the pharmacology, techniques, and efficacy of this potentially promising technique and contrasts it with conventional treatment modalities. SOURCE: The information found here is derived from experiences at the Texas Tech University, government reports, and peer reviewed journals. PRINCIPLE FINDINGS: Incidence and prevalence of heroin use is on the rise. Social and treatment costs suggest that this problem is staggering. Approximately 400,000 patients are enrolled in or are actively seeking methadone therapy. While many of these individuals want to undergo detoxification, traditional techniques, including methadone tapering are usually unsuccessful. The withdrawal syndrome is extremely unpleasant, may be fatal, and deters patients from completing the detoxification process. Ultrarapid detoxification entails general anesthesia in conjunction with large boluses of narcotic antagonists. This combination allows the individual to completely withdraw from the opiate without suffering the discomfort of the withdrawal syndrome. Unless performed properly, this procedure can be dangerous due to the sympathetic outflow. However, with proper support, this danger can be mitigated. CONCLUSION: Ultrarapid opiate detoxification, performed under the proper circumstances, is associated with few adverse events and is relatively comfortable for patients who seek treatment for their addition.

Anesthesia, General↗

PubMed1997

[Dependency outcome of alcohol-dependent patients after inpatient detoxification and motivation treatment].

In addition to psychiatric outpatient treatment, the detoxification of alcoholics in psychiatric hospitals is an important link between medical detoxification and psychosocial inpatient treatment aiming at abstinence. Integrated models of inpatient detoxification and motivation therapy focus on improvement of the motivation of patients towards further treatment of their alcoholism and towards abstinence. In our study 529 alcoholics underwent such treatment lasting between 2 to 3 weeks. A total of 469 patients (89%) were followed up after 8 months; 242 alcoholics (52% of the follow-up sample; 46% of the whole sample) achieved the treatment goal and started further treatment, mainly as inpatients. Fifty-four of these patients relapsed before they started further alcoholism treatment, but achieved abstinence afterwards; 60 (25%) of these 242 patients relapsed after the specific alcoholism therapy; 227 alcoholics did not start further treatment after the initial detoxification and motivation therapy. In this subpopulation, 113 (50%) relapsed during the follow-up period. Although this is not a controlled study, it can be concluded that integrated inpatient detoxification and motivation therapy has positive effects on the treatment behavior of alcoholic patients and enhances the probability of further abstinence.

Adult↗

PubMed2000

[Antagonist-induced opiate detoxification. Report on clinical experience as well as on short and intermediate range course].

In a special inpatient unit for detoxification treatment of illicit drugs, antagonist-induced opiate detoxification was studied in five nonselected inpatients with polytoxicomanic abuse. The purpose was to evaluate the feasibility of this detoxification method and its impact on further reaction to treatment. During rapid detoxification under general anesthesia in an intensive care unit, no complications occurred. Withdrawal symptoms were observed in all patients over several days. During the inpatient period, no patient could be motivated to take part in a longer rehabilitation therapy. Most patients were discharged prematurely on their own demand and none made use of the rehabilitation program offered to them. All patients relapsed after relatively short times and three out of five presented for a new detoxification treatment.

Adult↗

PubMed1978

Ambulatory detoxification of heroin addicts: a follow-up study.

The present study was devised to investigate whether or not 18 psychosocial characteristics of 141 male and 43 female heroin addicts who entered a 21-day ambulatory detoxification program were correlated with (1) length of stay, (2) completing the full course of detoxification, (3) being successfully transferred to aftercare treatment, and (4) being locatable for follow-up one month later. The study also described the status of the patients who were locatable one month after receiving their last dose of methadone in the detoxification program. Only 74 persons were contacted one month after receiving their last dose of methadone, and they were all in treatment. Eighty-three addicts were transferred to other programs before leaving the detoxification program. There were only two significant relationships between the 18 psychosocial characteristics and the four dependent variables. Number of arrests was inversely related to length of stay, and whites were more likely to be transferred to an aftercare program than blacks. The implications of the results for evaluating other ambulatory detoxification programs and for improving retention rates were discussed.

Adolescent↗

PubMedDate not supplied

Methadone combined with clonidine versus clonidine alone in opiate detoxification.

The availability and use of a methadone/clonidine combination versus clonidine alone in opiate detoxification were studied. In Phase I of the study, a sequential combination of methadone followed by clonidine was utilized in those patients presenting with a primary diagnosis of opiate dependence. During the Phase II of the study, only clonidine was available. Medications were administered only if the history and clinical findings indicated impending or acute opiate withdrawal syndrome. Overall, there was no difference between the Phase I and Phase II groups when the number of opiate dependent admissions, patients completing detoxification, and the patients completing a follow-up rehabilitation program were compared. However, the patients in Phase I whose clinical symptomatology warranted the use of methadone were more likely to complete the detoxification program when compared to the patients in Phase II who received clonidine only. There was no difference between the two groups in completion of a follow-up rehabilitation. Detoxification with clonidine alone was more likely to be successful if the patient has had prior detoxification experience with methadone or if there was a secondary dependence of alcohol, sedative, or tranquilizer present coexisting with the primary opiate dependence diagnosis.

Adolescent↗

PubMed2006

Structural and functional characterization of microcystin detoxification-related liver genes in a phytoplanktivorous fish, Nile tilapia (Oreochromis niloticus).

Liver genes related to phase I and phase II detoxification, as well as inhibition of reactive oxygen species (ROS) production, were cloned, and their response to microcystin-LR (MC-LR) and lipopolysaccharide (LPS) exposure via intraperitoneal injection, was determined in a phytoplanktivorous fish, Nile tilapia (Oreochromis niloticus). The cloned full-length cDNA of tilapia soluble glutathione S-transferase (sGST) was classified as alpha-class GST based on their amino acid sequence identity with other species. The tilapia sGST clone was 861 bp in length, and contained a 25 bp 5'-UTR, a 167 bp 3'-UTR and an open reading frame of 669 bp, encoding a polypeptide of 222 amino acids. Using genome walker method, a 366 bp 5'-flanking sequence of tilapia sGST gene was further obtained, and the possible regulatory elements were identified. Partial cDNA sequences of glutathione peroxidase (GPX) and uncoupling protein 2 (UCP2) were also obtained by PCR using degenerate primers from tilapia liver. To study the transcriptional response of liver genes to microcystin treatment, tilapia were respectively exposed to a single 50 microg kg(-1) body weight (bwt) dose of pure MC-LR, a single 2 mg kg(-1) bwt dose of LPS and a co-exposure MC-LR and LPS (50 microg kg(-1) bwt+2 mg kg(-1) bwt), and were then sacrificed at 24 h post-exposure. Using beta-actin as external control, a significant increase (about 80%) in sGST mRNA expression was found in response to the MC-LR exposure after 24 h (P < 0.05), indicating the importance of sGST in microcystin detoxification. A slight decrease of sGST mRNA expression was observed in the liver of tilapia, exposed to LPS and MC-LR+LPS. It seems that the LPS response element (LPSRE), identified in the promoter region of tilapia sGST gene, may be functional at a rather low level. In contrast, the levels of cytochrome P450 1A (CYP1A) mRNA expression were found to keep unchanged to either MC-LR, or LPS, or MC-LR+LPS treatment, indicating that unlike the phase II enzyme (sGST), the phase I enzyme (CYP1A) might not play an important role in the detoxification process of microcystins. Although not significant, the mRNA expression level of GPX tended to increase in the liver of tilapia exposed to both MC-LR and LPS (P > 0.05). In addition, a significant increase in UCP2 mRNA expression was observed in the liver of tilapia exposed to LPS (P < 0.05), as well as an obvious but not significant increase in MC-LR exposure group. We suggest that phase II detoxification enzyme, instead of phase I detoxification enzyme, might be responsible for the strong tolerance of the phytoplanktivorous fish to microcystins, and hepatocyte proteins coping with oxidative stress (GPX and UCP2), might also have some auxiliary effect. In addition, the rather low and insignificant response of tilapia sGST gene to the inhibitory effect of LPS exposure, might possibly be critical to the phytoplanktivorous fish to utilize toxic blue-green algae.

5' Flanking Region↗

PubMed2006

Detoxification of chromium slag by chromate resistant bacteria.

This paper presented direct detoxification of chromium slag by using microorganisms. Our work showed that a bacterial consortium isolated from chromium slag can efficiently accelerate Cr(VI) leaching rate and remove it. The chromate resistant bacterial consortium consists of three strains. The detoxification efficiencies of the three respective strains follow the sequence: strain I > strain III > strain II. The detoxification capability of the bacterial consortium is far stronger than that of the respective strain, showing an excellent synergistic effect. The specific growth rates in pure and chromium-containing medium are 0.1475 and 0.1573 h(-1), respectively. The presence of Cr(VI) has little effect on growth rate of the bacterial consortium. Cr(VI) removal takes place in exponential growth period of the bacterial consortium; the detoxification time should be controlled in this phase for every run. The kinetics of detoxification process was studied and can be described as eta = 0.0615e(0.1573t), which can be used to predict Cr(VI) removal efficiency.

Bacteria↗

PubMed2004

Use of gabapentin for attenuation of symptoms following rapid opiate detoxification (ROD)--correlation with neurophysiological parameters--.

Rapid opiate detoxification (ROD) is a technique whereby the opiate-dependent patient is withdrawn acutely, under anesthesia, from the opioid. Following detoxification, patients experience severe back pain and restlessness often accompanied by a restless-leg-syndrome. We evaluated gabapentin given immediately following detoxification to attenuate these symptoms. In addition, we evaluated the use of the somatosensory-evoked potential (SEP) as a parameter to quantitate pain responses. Patients (n=21; mean age 32.5 +/- 7 SD; 12 males, 9 females) underwent ROD with naltrexone (2 x 50 mg) during propofol anesthesia and artificial ventilation (IPPV). Sympathetic overshoot was attenuated by clonidine, and increased bowl movement was managed by continuous i.v. somatostatin. Back pain, restlessness, and restless-leg-syndrome were treated with gabapentin (1200 mg) in the ICU. Efficacy was assessed by the patient's subjective ratings of restlessness (0-4). In addition, measurements of amplitude (microV), latency (ms) of late N100-peak of the somatosensory evoked potential (SEP), and tolerance to an increased electrical nociceptive stimulus (mA) to the forearm were performed. Data were compared to pre-treatment control and to the period shortly after detoxification. From a mean of 8.4 +/- 2.5 microV, N100-peak increased to a mean of 12.3 microV +/- 3.3 (p < 0.005) following opioid detoxification. Gabapentin reduced amplitude height to a mean of 3.5 +/- 1.5 microV. Also, tolerance to nociceptive stimulus, which had dropped to 4.4 mA, increased to 12.5 mA (p < 0.01), while intensity for restlessness and thrashing of limbs dropped from 3.2 to 1.2 (p < 0.05). The sudden displacement of the opiate from its receptor site induced by naltrexone, resulted in a post inhibitory SEP overshoot with an increase in nociceptive afferent volleys, and a lowering in pain threshold. This was associated with back pain, limb thrashing and a restless-leg-syndrome, all of which could be attenuated by gabapentin. The amplitude of late N100-peak parameter appears to be a potential candidate to quantify the increase of nociception in such patients.

Acetates↗

PubMed2004

Mirtazapine and venlafaxine in the management of collateral psychopathology during alcohol detoxification.

Symptoms of anxiety and depression are common in a large proportion of alcohol-abusing/dependent individuals during alcohol detoxification. The aim of this study was to examine the impact of a combined psychotherapeutic-psychopharmacological (either with mirtazapine or venlafaxine) treatment of these symptoms during the early withdrawal phase of alcohol compared to a group treated only with psychotherapy. A total of 60 alcohol-dependent/abusing subjects randomly assigned to three groups (psychotherapy, psychotherapy plus mirtazapine, psychotherapy plus venlafaxine) were studied. Assessment of psychopathology and global functioning throughout a 4-5-week detoxification period was done by the Hamilton Anxiety Rating Scale (HARS), the Hamilton Depression Rating Scale (HDRS), and the Global Assessment Scale (GAS). At baseline, high scores of anxiety and depression were recorded (HARS: controls: 33.1+/-7.8, mirtazapine: 33.2+/-12.6, venlafaxine: 36.6+/-5.4; HDRS: controls: 39.5+/-7.4, mirtazapine: 37.9+/-7.8, venlafaxine: 41.9+/-4.5). A marked improvement (p<0.000) was evidenced in all groups by the end of the detoxification period. However, patients on mirtazapine improved significantly more compared to the other two groups (HARS: controls: 9.6+/-7.6, mirtazapine: 4.3+/-4.4*, venlafaxine: 7.2+/-4.1, *p=0.011; HDRS: controls: 8.6+/-7.9, mirtazapine: 3.8+/-3.2*, venlafaxine: 8.2+/-3.5, *p=0.017; GAS: controls: 79.5+/-9.4, mirtazapine: 87.5+/-5.5**, venlafaxine: 83.0+/-8.0, **p=0.006). It is concluded that addition of mirtazapine, but not venlafaxine, to a standard psychotherapy-oriented alcohol detoxification treatment may facilitate the detoxification process by minimizing psychological discomfort. Consequently, it may prove to be a facilitator for the long-term abstinence from alcohol.

Adult↗

PubMed2001

Glycoside carbamates from benzoxazolin-2(3H)-one detoxification in extracts and exudates of corn roots.

Zea mays was incubated with the natural phytotoxin benzoxazolin-2(3H)-one (BOA) to investigate the detoxification process. A hitherto unknown detoxification product, 1-(2-hydroxyphenylamino)-1-deoxy-beta-gentiobioside 1,2-carbamate (3), was isolated and identified. A reinvestigation of known BOA detoxification products by NMR methods led to the finding that the structure of benzoxazolin-2(3H)-one-N-beta-glucoside (1) first reported from Avena sativa has to be revised. In fact, the correct structure is that of the isomeric 1-(2-hydroxyphenylamino)-1-deoxy-beta-glucoside 1,2-carbamate 2, which is structurally related to 3. It was now shown with a synthetic mixture of 1 and 2 that 1 underwent spontaneous isomerization to form 2 in solution. Thus, N-glucosylation of BOA in the plant led finally to the carbamate 2. In contrast to BOA-6-O-glucosylation, BOA-induced N-glucosylation appears first after 6-8 h of incubation. As soon as N-glucosylation is possible, BOA-6-O-glucoside is not further accumulated, whereas the amount of glucoside carbamate increases continuously during the next 40 h. Synthesis of gentiobioside carbamate seems to be a late event in BOA detoxification. All detoxification products are released into the environment via root exudation.

Benzoxazoles↗

PubMed2003

Alcohol detoxification and social anxiety symptoms: a preliminary study of the impact of mirtazapine administration.

BACKGROUND: Social anxiety disorder is fairly prevalent among alcohol abusing/dependent subjects. The objective of the present study was to investigate: (a) the incidence of social anxiety symptoms in inpatient alcoholics, (b) the effect of alcohol detoxification on these symptoms, and (c) whether a combined psychotherapeutic/mirtazapine treatment during the post-detoxification phase of alcoholism has a greater impact on the aforementioned symptoms than a non-pharmacological approach. METHOD: Social anxiety symptoms were assessed through the Liebowitz Social Anxiety Scale (LSAS) following a 4-5-week detoxification period in two groups: group A (n=21) that followed a detoxification protocol of cognitive-behavioral orientation and group B (n=33) that was assigned to mirtazapine in addition to the standard protocol. Concomitant psychopathology was monitored through the HARS and HDRS, and level of functioning through the GAS. RESULTS: A marked reduction of social anxiety symptoms was evidenced in both groups. However, patients on mirtazapine improved significantly more compared to controls. LIMITATIONS: A single measure of social anxiety, i.e., the LSAS was used. Also, a longer follow-up period is needed to ascertain remission of social anxiety symptoms. CONCLUSIONS: The present study found a rather high incidence of social anxiety symptoms in inpatient alcoholics which subsided following alcohol detoxification; moreover, it provides preliminary evidence that a combined psychotherapeutic/mirtazapine treatment (30-60 mg/daily) has a greater impact on the aforementioned symptoms than non-pharmacological treatment alone.

Adrenergic alpha-Antagonists↗

PubMedDate not supplied

Self-detoxification attempts among methadone maintenance patients: what methods and what success?

In a study of patients attending a methadone maintenance clinic in South London, 66 of 114 (58%) had previously attempted to detoxify themselves from opiates without medical assistance. The total number of self-detoxification attempts was 237, an average of 3.6 attempts per individual. Forty subjects (61%) reported attempting self-detoxification with the help of drugs or alcohol. The drugs most commonly used were diazepam, alcohol, and cannabis. The most commonly reported reasons for attempting self-detoxification were "fed-up with the lifestyle" (61%) and "for their family" (12%). The reasons given for why patients had decided to detoxify themselves rather than access treatment services included 23% who reported that "they could cope on their own and that they didn't need any help." The short-term success rate (abstinent for at least 24 hours) was moderate, at 41% (97/237). Patients who had been unsuccessful were asked why their last self-detoxification attempt had not resulted in abstinence, with 27% reporting that they were "tempted to use again" and 23% reported that they "didn't know why they started using again." The prevalence of both attempts and success suggests that, for some opiate users, self-detoxification may be a pathway to abstinence.

Adult↗

PubMed1995

CQI action team: responding to the detoxification patient.

BACKGROUND: The management of detoxification patients is a complex interdisciplinary effort requiring involvement, cooperation, and understanding from staff at all levels of the facility. In 1992-93, alcohol-related diagnoses were the highest admission diagnosis at the Royal C. Johnson Veterans Affairs Medical Center (VAMC). Yet only 44% of the detoxification patients admitted to the VAMC were placed in beds specifically designed for detoxification. Initially, the action team believed that the issues were apparent and that the problems were the result of uncooperative and noncompliant providers who were not following established policy. METHODS AND RESULTS: Data analysis of admission and discharge trends, laboratory results, and bed census revealed discrepancies with several widespread myths held by local health care workers. These misperceptions and attitudes often interfered with treatment. CONCLUSIONS: Recommended changes included the development of a clinical pathway for the detoxification patient, implementation of an alcohol withdrawal assessment tool to manage and treat the patient at risk for experiencing alcohol withdrawal, and hospitalwide education on management of the detoxification patient.

Alcoholism↗

PubMed2001

Detoxification in relation to toxin tolerance in desert woodrats eating creosote bush.

We studied the relationship between the use of three detoxification pathways and urine pH and the tolerance of desert woodrats from two populations to a mixture of naturally occurring plant secondary metabolites (mostly phenolics) in resin from creosote bush (Larrea tridentata). The two populations of desert woodrats came from the Mojave desert (Mojave woodrats), where woodrats consume creosote bush, and from the Great Basin desert (Great Basin woodrats), where the plant species is absent. We fed woodrats alfalfa pellets containing increasing levels of the phenolic resin and measured three detoxification pathways and urine pH that are related to detoxification of allelochemicals. We found that the excretion rate of two phase II detoxification conjugates, glucuronides and sulfides. increased with increasing resin intake, whereas excretion of hippuric acid was independent of resin intake, although it differed between populations. Urine pH declined with increasing resin ingestion. The molar proportion of glucuronides in urine was three times that of the other conjugates combined. Based on an evaluation of variation in the three detoxification pathways and urine pH in relation to resin intake, we rejected the hypotheses that woodrats' tolerance to resin intake is related to capacity for amination, sulfation, or pH regulation. However, Mojave woodrats had higher maximum glucuronide excretion rates, and we accepted the hypothesis that within and between populations woodrats tolerate more resin because they have a greater capacity for glucuronide excretion.

Adaptation, Physiological↗