30 research outputs found
How resistant to tampering are codeine containing analgesics on the market? Assessing the potential for opioid extraction
INTRODUCTION: Misuse of opioid analgesics, in combination with diversion, dependence, and fatal overdoses, presents a serious problem for public health, which affects many countries worldwide. Within this context, tampering with opioids has been associated with serious harm. The aim of the present study was to assess the tampering potential of codeine combination analgesics on the market (containing codeine/non-opioid analgesics) by the extraction of codeine. METHODS: Codeine was extracted from three combination formulations sold lawfully from licensed pharmacies without a medical prescription in Denmark and the UK. Extraction of codeine followed tampering procedures available on the Internet. The amounts of codeine and accompanying non-opioid analgesics in tampering products were analysed with liquid chromatography and tandem mass spectrometry (LC–MS/MS). RESULTS: LC–MS/MS showed recoveries of the total amounts of codeine in tampering products of 81–84% from Product 1 (codeine/acetylsalicylic acid); 61–67% from Product 2 (codeine/ibuprofen); and 42–71% from Product 3 (codeine/paracetamol). Recoveries of non-opioid analgesics ranged between: 57–73% acetylsalicylic acid; 5.5–8.5% ibuprofen, and 5.0–9.2% paracetamol. CONCLUSION: With the tampering procedures used, high amounts of codeine were separated from the accompanying analgesics in some, but not in all of the codeine containing formulations. Evidence-based medicine regulation, treatment for opioid dependence, and information to minimise risks to the public are essential components of an effective public health strategy to address the harms of tampering and misuse. FUNDING: Marie Pedersen and Jensine Heiberg Foundation
Gamma-hydroxybutyrate and cocaine intoxication in a Danish child
GHB intoxication must be considered in children with coma and a suspicion of drug intoxication. Furthermore, mixed intoxication with several substances and the possibility of unpredictable symptom profiles should be anticipated to ensure optimal symptomatic treatment of patients
Ethylene glycol:Evidence of glucuronidation in vivo shown by analysis of clinical toxicology samples
Can protein and energy enriched soups be a tool in the nourishment of hospitalised patients in Denmark? A quality-development study
Baggrund: Patienters fødevare- og smagspræferencer ændres ofte med stigende alder og sygdom. Dette studie har till formål at undersøge proteinberigede supper som et alternativ eller supplement til standard protein drikke hos svært syge danske patienter.
Metode: Forbedringsmodellen (Plan-Do-Study-Act cycle) er anvendt til at evaluere de berigede supper og inkluderede tre sessioner (session 1-3). Session 1) 18 svært syge patienter indlagt mere end 24 timer på Regions Hospital Nordjylland fik i vilkårlig rækkefølge serveret 6 forskellige proteinberigede supper (0,1-0,2 dl) med og uden topping og skulle efterfølgende bedømme supperne på en VAS-skala. Session 2) Borgere med kronisk obstruktive lungelidelse (KOL) deltog i et gruppeinterview om fødevarepræferencer ved svær sygdom i hjemmet eller under indlæggelse. Session 3) Supperne blev modificeret ud fra erfaringer fra session 1-2 og testet igen på en tilsvarende patientgruppe som i session 1, som evaluerede supperne ud fra en 5-punkts Likert skala med ansigter.
Resultater: Session 1: I session 1 kunne størstedelen af data ikke indhentes på grund af at patienter 1) faldt i søvn, 2) ikke kunne anvende VAS skalaen, 3) oplevede manglende smags- og lugtesans, 4) ikke kunne tygge eller anvende ske. I session 2 foretrak deltagerne i gruppeinterviewene varme måltider, tyk konsistens og at det krævede begrænset energi at spise måltidet samt at der ikke indgik nødder. I session 3 var det muligt at indhente pålidelige resultater. Gennemsnitsscoren for kærnemælks-, tomat- og kartoffelsuppe var henholdsvis 4,7, 3,8 og 4,2 ud af 5. Tyk og sød suppe var det foretrukne valg.
Konklusion: Studiet viste, at svært syge patienter oplevede det var vanskeligt at holde sig vågne under måltiderne, føre maden til munden, de var stakåndede, udmattede af at tygge og manglede smags- og lugtesans. Protein- og energiberigede supper er tilfredsstillende og blev rangeret højt på smagsoplevelse. Fremadrettet virker proteinberigede supper i små portioner som en god mulighed for at imødekomme mange af de problemer disse patienter oplever