Effects of common antiepileptic drugs on teleost fishes.

Diazepam and lorazepam are two benzodiazepine drugs widely prescribed as antidepressants and antiepileptics. A straightforward and time-save dispersive micro solid phase extraction method as a sample preparation strategy was developed to extract these drugs in human urine and real water samples prior to their determination by HPLC-UV. A novel sorbent based on growing Co-MOF on Fe-MOF was synthesized and then magnetized using magnetic Fe3O4 nanoparticles and a sol–gel strategy. The sorbent (Fe3O4@SiO2@Co-MOF@Fe-MOF composite) showed the highest extraction efficiency toward diazepam and lorazepam compared to Fe-MOF and Co-MOF@Fe-MOF as sorbents. The effects of various factors on diazepam and lorazepam determination were studied by experimental design, in which a Plackett-Burman design and Box-Behnken design were used for screening the factors and optimizing the significant factors, respectively. Under optimum conditions, the method linearity for the diazepam and lorazepam determination was 0.3–450 and 0.2–400 ng mL−1 with an R2 of 0.9926 and 0.9943, respectively. Proper detection limits of 0.09 and 0.06 ng mL−1 were obtained for the diazepam and lorazepam determination. Also, intra-day and inter-day RSDs (n = 3) were in the range of 3.42–3.75 % and 4.76–5.39 % for the diazepam and lorazepam determination, respectively. The method exhibits a high preconcentration factor of 654.3 and 719.1 for the diazepam and lorazepam determination. Besides, the recoveries and RSDs were evaluated by analysis of tap, river, and well water, and two human urine samples using the method. RSDs were in the range of 3.09–6.80 %, with recoveries between 88.2 and 97.5 % for analysis of spiked real water and urine samples. 

Synthesis of novel MOF-on-MOF composite as a magnetic sorbent to dispersive micro solid phase extraction of benzodiazepine drugs prior to determination with HPLC-UV

Alcohol consumption is a global phenomenon and a major contributor to alcohol-associated liver disease (ALD). Detecting individuals at risk of ALD has been challenging, with only a small fraction of patients being identified at early stages compared to other chronic liver diseases. In response to this challenge, non-invasive tests (NITs) have become essential tools for the detection of ALD, offering opportunities for early identification and intervention to mitigate the disease burden. Non-invasive alcohol consumption biomarkers are crucial in estimating individuals' recent alcohol intake, providing valuable insights into their drinking patterns. Various NITs have been investigated for the initial screening of asymptomatic individuals at risk of ALD, as well as for identifying specific stages of the disease. These NITs are applied in two main clinical scenarios: population-based stratification for identifying and predicting liver-related symptoms, and diagnosing and prognosticating compensated cirrhosis or advanced chronic liver disease in secondary or tertiary care settings. Moreover, NITs play a significant role in the prognostic assessment of patients with various manifestations of ALD, including alcohol-associated hepatitis, decompensated cirrhosis, and metabolic and alcohol-associated liver disease. These tests guide appropriate treatment decisions and predict outcomes. In this review, various NITs for the early detection and monitoring of alcohol consumption were discussed. Additionally, the evaluation of NITs for screening and predicting ALD and liver complications was addressed comprehensively. Future perspectives of NITs for ALD were explored, alongside a thorough discussion of the opportunities and challenges associated with NITs for ALD screening.

Non-invasive tests for alcohol-associated liver disease.

Background: Diazepam, one of the benzodiazepines, is widely used clinically to treat anxiety, for termination of epilepsy, and for sedation. However, the reports of its adverse events (AEs) have been numerous, and even fatal complications have been reported. In this study, we investigated the AEs of diazepam based on real data from the U.S. Food and Drug Administration (FDA) adverse event reporting system (FAERS).Methods: Disproportionality in diazepam-associated AEs was assessed through the calculation of reporting odds ratios (RORs), proportional reporting ratios (PRRs), Bayesian confidence–propagation neural networks (BCPNNs), and gamma-Poisson shrinkage (GPS).Results: Among the 19,514,140 case reports in the FAERS database, 15,546 reports with diazepam as the “principal suspect (PS)" AEs were identified. Diazepam-induced AEs occurred targeting 27 system organ categories (SOCs). Based on four algorithms, a total of 391 major disproportionate preferred terms (PTs) were filtered out. Unexpectedly significant AEs such as congenital nystagmus, developmental delays, and rhabdomyolysis were noted, which were not mentioned in the drug insert.Conclusion: Our study identified potential signals of new AEs that could provide strong support for clinical monitoring and risk identification of diazepam.

A real-world pharmacovigilance study of FDA adverse event reporting system events for diazepam

RATIONALE
For the purpose of doping control, this is the first report of accurate quantification of four critical structural isomers of nicotine metabolites (trans-3'-hydroxycotinine, cis-3'-hydroxycotinine, 5'-hydroxycotinine, and N'-hydroxymethylnorcotinine) in equine plasma and urine for the establishment of their elimination profiles. Besides, the pharmacokinetic studies of trans-3'-hydroxycotinine and N'-hydroxymethylnorcotinine in equine plasma and urine are also presented for the first time.


METHODS
The accurate quantification methods of the aforementioned four structural isomers in horse plasma and urine were successfully developed and validated by using the solid-phase extractions followed by liquid chromatography/tandem mass spectrometry analysis. Baseline chromatographic separation was achieved in order to differentiate completely these isomers which shared the same selected reaction monitoring transition. Such methods were applied to post-administration samples obtained from the nicotine and tobacco leaf administration studies for the establishment of pharmacokinetic profiles.


RESULTS
N'-Hydroxymethylnorcotinine could be quantified for the longest period, ranging from 48 h to 72 h in plasma and 96 h in urine after a single administration of 250 mg of nicotine and an equivalent amount of nicotine in tobacco leaves. In terms of detection, both N'-hydroxymethylnorcotinine and trans-3'-hydroxycotinine could be detected up to the last sample collection time point (96 h), indicating that they are the most appropriate biomarkers for nicotine exposure.


CONCLUSIONS
N'-Hydroxymethylnorcotinine and trans-3'-hydroxycotinine were detected longest in plasma and urine samples after both nicotine and tobacco leaf administrations, and N'-hydroxymethylnorcotinine was deemed most appropriate as a monitoring target due to its relatively higher abundance and slower elimination rate. These two biomarkers could also be used to differentiate sample contamination by tobacco products and genuine nicotine exposure to horse regardless of intentionality.

Additional studies on nicotine exposure in horses: Accurate quantification and elimination profiles of potential biomarkers in plasma and urine.

Urine is conventionally used as a specimen to document diazepam-related crimes; however, few reports have described the pharmacokinetics of diazepam and its metabolites in urine. This study aimed to investigate the pharmacokinetics of diazepam and its metabolites, including glucuronide compounds, in the urine of Chinese participants. A total of 28 volunteers were recruited and each participant ingested 5 mg of diazepam orally. Ten milliliters of urine were collected from each participant at post-consumption timepoints of prior (zero), 1, 2, 4, 8, 12, and 24 h and 2, 3, 6, 12, and 15 days. All samples were extracted by solid-phase extraction and analyzed using high-performance liquid chromatography–tandem mass spectrometry. Diazepam and its main metabolites, except for temazepam, were detected in the urine of volunteers. Pharmacokinetic parameters were analyzed using the pharmacokinetic software DAS according to the non-compartment model. Urinary diazepam peaked at 2.38 ng/mL (Cmax) and 1.93 h (Tmax). The urinary metabolite nordiazepam peaked at 1.17 ng/mL and 100.21 h; temazepam glucuronide (TG) peaked at 145.61 ng/mL and 41.14 h; and oxazepam glucuronide (OG) peaked at 101.57 ng/mL and 165.86 h. The elimination half-life (t½z) and clearance (CLz/F) for diazepam were 119.58 h and 65.77 L/h, respectively. The t½z of the metabolites nordiazepam, TG, and OG was 310.58 h, 200.17 h, and 536.44 h, respectively. Finally, this study found that both diazepam and its main metabolites in urine were detectable for at least 15 days, although there were individual differences. The results regarding diazepam pharmacokinetics in urine would be of great help in forensic science and drug screening. 

/pdf/pharmacokinetics-of-diazepam-and-its-metabolites-in-urine-of-iojrcfvk.pdf

Pharmacokinetics of Diazepam and Its Metabolites in Urine of Chinese Participants

Combined diazepam-ethanol poisoning is common in forensic toxicology. Both diazepam and ethanol can inhibit the central nervous system via the γ-aminobutyric acid (GABA) ligand gated chloride ion channel, GABAA Receptor (GABAAR). As the common target of diazepam and ethanol, whether GABAAR is the key target of their combined action remains unclear. This study aimed to explore their interaction based on the synergistic mechanisms between diazepam and ethanol targeting the GABAAR. Four models were built in silico based on the crystal structure of GABAAR. Molecular dynamic processes of the four models were simulated by the GPU-accelerated pmemd.cuda program in the Amber18 package. Results showed that ethanol inclined to combine the adjacent GABA or diazepam sites, minimized fluctuations of the root-mean-square deviation (RMSD) in the molecular dynamic process of GABA or diazepam binding the GABAAR, and increased the release of binding energy of GABA or diazepam binding the GABAAR. Results also showed that diazepam had less effect on the RMSD fluctuation or the binding energy release of GABA binding GABAAR. The formation of complex of diazepam and GABAAR could minimize the RMSD fluctuation and increase binding energy release of ethanol binding GABAAR. Thus, ethanol, bridging GABA and diazepam, could strengthen the complex of GABA binding the GABAAR, as well as the complex of diazepam binding the GABAAR. However, whether diazepam binds GABAAR or not, it cannot affect GABA binding the GABAAR; and yet the complex of diazepam and GABAAR can stabilize the complex of ethanol and GABAAR. 

Simulating Dynamic Interaction Between Diazepam and Ethanol Targeting the GABAA Receptor via in Silico Model.

The determination of length of time from the last drinking is critical for cases like drunk driving, sexual assault victims, and also postmortem suspected poisoning cases. The study was aimed to established a method of estimating the time of last drinking through the pharmacokinetic study of conjugation metabolites of alcohol in blood after a single oral dose. Twenty-six volunteers (14 males) consumed alcohol with food at a fixed dose of 0.72 g/kg after fasting for 12 h. Five milliliters of blood were collected 120 h after the start of drinking, and all samples were analyzed with headspace-gas chromatography and high-performance liquid chromatography-tandem mass spectrometry. The time point of last drinking was estimated through the relationship between the concentration ratio of ethyl glucuronide to ethyl sulphate and the length of time after drinking. Pharmacokinetic parameters were analyzed by a pharmacokinetic software DAS according to the non-compartment model. A good correlation model was obtained from the relationship between concentration ratio of ethyl glucuronide to ethyl sulphate in blood and the time of alcohol use, and the margin of error was mostly lower than 10%. The time of maximum concentration, maximum concentration, and elimination half-life of ethyl glucuronide in blood were 4.12 ± 1.07 h, 0.31 ± 0.11 mg/L and 2.56 ± 0.89 h; the time of maximum concentration, maximum concentration, and elimination half-life of ethyl sulphate in blood were 3.02 ± 0.70 h, 0.17 ± 0.04 mg/L, and 2.04 ± 0.76 h. The study established a potential method to estimate the length of time after a moderate oral dose, and provided pharmacokinetic parameters of ethyl glucuronide and ethyl sulphate in Chinese population. 

/pdf/estimating-the-time-of-last-drinking-from-blood-ethyl-27cwq0y7.pdf

Estimating the time of last drinking from blood ethyl glucuronide and ethyl sulphate concentrations

Creation and Exploration of the "Organized Fill-in-the-Blank Format" Discipline Construction Model for Forensic Medicine in the New Era.

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Papers

Pharmacokinetics of Diazepam and Its Metabolites in Urine of Chinese Participants

Simulating Dynamic Interaction Between Diazepam and Ethanol Targeting the GABAA Receptor via in Silico Model.

Estimating the time of last drinking from blood ethyl glucuronide and ethyl sulphate concentrations

Creation and Exploration of the "Organized Fill-in-the-Blank Format" Discipline Construction Model for Forensic Medicine in the New Era.