liver where the compound is conjugated to create water soluble metabolites for urinary excretion. As this medication is recirculated by the body, both the parent drug and its metabolites can be detected for up to 3 weeks in urine. Common forensic drug testing methods include gas chromatography-mass spectrometry (GC- MS) and liquid chromatography-tandem mass spectrometry (LC-MS/MS). Since this medication has a narrow
therapeutic index, the dosage needs to be carefully determined. Overdosing can easily occur, causing depressed CNS activity which can slow both heart and breathing rates to the point of death. For example, a dose of 1 gram may cause poisoning in adults, with 2 to 10 grams resulting in death. Side effects from this drug include dizziness, drowsiness,
confusion, and problems with memory and concentration. Individuals using this Schedule IV drug are known to develop a tolerance to its effects, leading to addiction. Minor withdrawal symptoms can occur 8 to 12 hours after the last dose and include tremors of the hands, muscle twitches, progressive weakness, dizziness, orthostatic hypertension, visual distortion, anxiety, nausea, and vomiting. Major withdrawal symptoms including convulsions and delirium can start within 16 hours of the last dose and last days. In spite of the potential for addiction, the drug is sometimes used to help ease withdrawal symptoms from other medications. Our mystery drug is sold under the trade
names Luminal, Solfoton, and Tedral (in Canada). It is known by the street names
purple hearts, goofalls, and feenies. Tis month’s mystery drug is phenobarbital. ❚
Rebecca Heidker is a post- doctoral scientist at Quest Diagnostics in Lenexa, KS. She received her PhD in Cell and Molecular Biology from the University of Ne-
vada, Reno. Rebecca’s responsibilities at Quest include understanding the process of drugs-of-abuse testing in the different matrices, reviewing in-house technical pro- cesses and regulations, and providing con- tinuing education to laboratory staff. She recently published a peer-reviewed article, Intersections of Pathways Involving Biotin and Iron Relative to Therapeutic Mecha- nisms for Progressive Multiple Sclerosis, in Discovery Medicine.
www.datia.org
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