The diagnosis of fixed drug eruption is straightforward because of characteristic findings, including recurrence of similar lesions at the same site and healing with residual hyperpigmentation. However, generalized or multiple fixed drug eruption, a rare variant form, can be a diagnostic challenge. Acebrophylline is a widely prescribed oral bronchodilator with mucosecretolyic and anti-inflammatory activity and is known to be relatively safe. A 34-year-old woman presented with recurrent numerous erythematous patches after ingestion of cold medications containing clarithromycin, loxoprofen, acebrophylline, and pseudoephedrine. Skin biopsy results showed vacuolar degeneration of the basal cell layer, scattered necrotic keratinocytes in the epidermis, and perivascular lymphohistiocytic infiltration in the upper dermis. A patch test showed negative results. However, in an oral challenge with acebrophylline 3 hours later, lesions reappeared at the same sites. To the best of our knowledge, this is the first case report of acebrophylline-induced generalized fixed drug eruption.
Adult ; Biopsy ; Clarithromycin ; Dermis ; Diagnosis ; Drug Eruptions* ; Eating ; Epidermis ; Female ; Humans ; Hyperpigmentation ; Keratinocytes ; Patch Tests ; Pseudoephedrine ; Recurrence ; Skin

Ischemic colitis is the consequence of a sudden reduction in colon blood supply, which in turn results in ischemic injury. The splenic flexure and rectosigmoid junction are the areas most often affected. Ischemic colitis occurs with greater frequency in the elderly and is caused by various medications and procedures. Pseudoephedrine acts as a vasoconstrictor directly affecting adrenal receptors of nasal mucous membrane. Pseudoephedrine occasionally causes vascular insufficiency due to intense vasoconstriction, even at standard doses. Ischemic colitis associated with pseudoephedrine has been reported in other countries,, but it has never been reported in Korea. In this paper, we describe 3 cases of ischemic colitis that occurred after taking pseudoephedrine for nasal congestion.
Aged ; Colitis, Ischemic* ; Colon ; Colon, Transverse ; Estrogens, Conjugated (USP) ; Gastrointestinal Hemorrhage ; Humans ; Korea ; Mucous Membrane ; Pseudoephedrine* ; Vasoconstriction

OBJECTIVETo establish an HPLC method for the determination of ephedrine hydrochloride, D-pseudo-ephedrine and amygdalin in Xiao'er Pingchuan Qutan granule.

METHODPheny ether chromatographic column (4.6 mm x 250 mm, 5 microm) was adopted, with acetonitrile-0.1% phosphoric acid (containing 0.1% three ethylamine) (3:97) as the mobile phase. The UV detection wavelength was at 210 nm, with the flow rate of 1 mL x min(-1), and column temperature was at 35 degrees C.

RESULTThe linearity of ephedrine hydrochloride, D-pseudo-ephedrine and amygdalin ranged between 0.078 60-3.144 microg (r = 1.000 0), 0.103 4-2.068 microg (r = 0.999 7) and 0.430 5-3.157 microg (r = 0.999 8), respectively. Their average recoveries were 98.46% (RSD 1.1%), 103.0% (RSD 1.5%) and 97.15% (RSD 2.1%), respectively.

CONCLUSIONThe method is simple, stable and reliable that it can be used to determine the content of ephedrine hydrochloride, D-pseudo-ephedrine and amygdalin in Xiao'er Pingchuan Qutan granule.

Amygdalin ; analysis ; chemistry ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Ephedrine ; analysis ; chemistry ; Linear Models ; Pseudoephedrine ; analysis ; chemistry ; Reproducibility of Results ; Time Factors

OBJECTIVETo establish an HPLC method for determining the contents of scopolamine hydrobromide, atropine sulfate, ephedrine hydrochloride and pseudoephedrine hydrochloride in Zhichuanling oral liquid.

METHODAgela Durashell RP-C18 (4. 6 mm x250 mm, 5 microm) was adopted, with acetonitrile-sodium phosphate buffer solution (0. 07 mol L-1 sodium phosphate solution with 17.5 mmol L-1 sodium dodecylsulfate adjusted to pH 6.0 with phosphoric acid solution) (30:70) as the mobile phase. The flow rate was 0. 9 mL min -1, the detection wavelength was 207 nm, and the column temperature was 25 degree C.

RESULTScopolamine hydrobromide, atropine sulfate, ephedrine hlvdrochloride and pseudoephedrine hydrochloride showed good linear relations with peak areas within the concentration range of 0. 021 21-1. 060 5 pg (r =0. 999 3) , 0. 011 14-0. 557 microg (r = 0. 999 6) , 0. 200 56-10. 028 microg (r =0. 999 7) and 0.070 33-3. 516 5 gg (r =0. 999 6), respectively, with the average recoveries of 101.9% , 99. 80%, 100. 3%, 100. 2% (n=6).

CONCLUSIONThe method was so quick, simple, highly reproducible and specific that it could be used as one of quality control methods of Zhichuanling oral liquid.

Atropine ; analysis ; Chromatography, High Pressure Liquid ; methods ; Ephedrine ; analysis ; Pseudoephedrine ; analysis ; Scopolamine Hydrobromide ; analysis

This paper reports the establishment of a method for rapid identification 15 effective components of anti common cold medicine (paracetamol, aminophenazone, pseudoephedrine hydrochloride, methylephedrine hydrochloride, caffeine, amantadine hydrochloride, phenazone, guaifenesin, chlorphenamine maleate, dextromethorphen hydrobromide, diphenhydramine hydrochloride, promethazine hydrochloride, propyphenazone, benorilate and diclofenac sodium) with MRM by LC-MS/MS. The samples were extracted by methanol and were separated from a Altantis T3 column within 15 min with a gradient of acetonitrile-ammonium acetate (containing 0.25% glacial acetic acid), a tandem quadrupole mass spectrometer equipped with electrospray ionization source (ESI) was used in positive ion mode, and multiple reaction monitoring (MRM) was performed for qualitative analysis of these compounds. The minimum detectable quantity were 0.33-2.5 microg x kg(-1) of the 15 compounds. The method is simple, accurate and with good reproducibility for rapid identification many components in the same chromatographic condition, and provides a reference for qualitative analysis illegally added chemicals in anti common cold medicine.
Acetaminophen ; analysis ; Acetanilides ; analysis ; Amantadine ; analysis ; Aminopyrine ; analysis ; Anti-Inflammatory Agents, Non-Steroidal ; analysis ; Antipyretics ; analysis ; Antipyrine ; analogs & derivatives ; analysis ; Caffeine ; analysis ; Chlorpheniramine ; analysis ; Chromatography, Liquid ; Diclofenac ; analysis ; Diphenhydramine ; analysis ; Drug Contamination ; Drug Stability ; Ephedrine ; analogs & derivatives ; analysis ; Guaifenesin ; analysis ; Promethazine ; analysis ; Pseudoephedrine ; analysis ; Reproducibility of Results ; Salicylates ; analysis ; Spectrometry, Mass, Electrospray Ionization ; Tandem Mass Spectrometry

Fixed drug eruption is an uncommon adverse drug reaction caused by delayed cell-mediated hypersensitivity. Levocetirizine is an active (R)-enatiomer of cetirizine and there have been a few reports of fixed drug eruption related to these antihistamines. We experienced a case of levocetirizine-induced fixed drug eruption and cross-reaction with other piperazine derivatives confirmed by patch test. A 73-year-old female patient presented with recurrent generalized itching, cutaneous bullae formation, rash and multiple pigmentation at fixed sites after taking drugs for common cold. She took bepotastine besilate (Talion®) and levocetirizine (Xyzal®) as antihistamine. She took acetaminophen, pseudoephedrine 60 mg / triprolidine 2.5 mg (Actifed®), dihydrocodeinebitartrate 5 mg / di-methylephedrine hydrochloride 17.5 mg / chlorpheniramine maleate 1.5 mg / guaifenesin 50 mg (Codening®) and aluminium hydroxide 200 mg / magnesium carbonate 120 mg (Antad®) at the same time. Patch test was done with suspected drugs and the result was positive with levocetirizine. We additionally performed patch test for other antihistamines such as cetirizine, hydroxyzine, fexofenadine and loratadine. Piperazine derivatives (cetirizine and hydroxyzine) were positive, but piperidine derivatives (fexofenadine and loratadine) were negative to patch test. There was no adverse drug reaction when she was challenged with fexofenadine. We report a case of levocetirizine-induced fixed drug eruption confirmed by patch test. Cross-reactions were only observed in the piperazine derivatives and piperidine antihistamine was tolerant to the patient.
Acetaminophen ; Aged ; Carbon ; Cetirizine ; Chlorpheniramine ; Common Cold ; Drug Eruptions ; Drug-Related Side Effects and Adverse Reactions ; Exanthema ; Female ; Guaifenesin ; Histamine Antagonists ; Humans ; Hydroxyzine ; Hypersensitivity ; Loratadine ; Magnesium ; Patch Tests ; Pigmentation ; Pruritus ; Pseudoephedrine ; Triprolidine

The paper is to establish a method for simultaneous determination of 5 kinds of alkaloids in ephedra and poppy which are in Kechuanning tablets. Solid-phase extraction (SPE) was adopted in pretreatment, and a UPLC method with 2 different wavelengths had been developed: 210 nm for the detection of morphine, codeine phosphate, ephedrine hydrochloride and pseudoephedrine hydrochloride, and 251 nm for papaverine hydrochloride. The column used was Acquity UPLC BEH C18 (100 mm x 2.1 mm ID, 1.7 microm) with linear gradient elution using acetonitrile and 0.1% phosphoric acid. The flow rate was 0.4 mL.min-1, and the column temperature was 30 degrees C. The linear response range was 0.375 0 - 12.50 microg.mL-1 for morphine, 0.064 32 - 2.144 microg.mL-1 for codeine phosphate, 0.030 06 - 1.002 microg.mL-1 for papaverine hydrochloride, 1.126 - 37.52 microg.mL-1 for ephedrine hydrochloride, 0.287 8 - 9.592 microg.mL-1 for pseudoephedrine hydrochloride (r = 0.999 7). The average recoveries of these compounds were 99.26%, 100.6%, 95.29%, 100.1% and 97.48%, respectively. This is a more reasonable and credible method of quality control for Kechuanning tablets.
Alkaloids ; analysis ; Chromatography, High Pressure Liquid ; Codeine ; analysis ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; isolation & purification ; Ephedra ; chemistry ; Ephedrine ; analysis ; Morphine ; analysis ; Papaver ; chemistry ; Papaverine ; analysis ; Plants, Medicinal ; chemistry ; Pseudoephedrine ; analysis ; Quality Control ; Solid Phase Extraction ; Tablets

In order to successfully express the carbonyl reductase gene mldh in Bacillus subtilis and complete coenzyme regeneration by B. subtilis glucose dehydrogenase, the promoter PrpsD and the terminator TrpsD from B. subtilis rpsD gene were used as the expression cassette to be a recombinant plasmid pHY300plk-PrpsD-TrpsD. After that, the carbonyl reductase gene mldh was inserted into the previous plasmid and a plasmid pHY300plk-PrpsD-mldh-TrpsD was achieved, followed by transformed into B. subtilis Wb600 to obtain a recombinant B. subtilis Wb600 (pHY300plk-PrpsD-mldh-TrpsD). Subsequently, the results for whole-cell biotransformation from recombinant B. subtilis showed that it could be used to catalyze MAK (1-phenyl- 1-keto-2-methylaminopropane) to d-pseudoephedrine in the presence of glucose. The yield of d-pseudoephedrine could be up to 97.5 mg/L and the conversion rate of MAK was 24.1%. This study indicates the possibility of biotransformation production of d-pseudoephedrine from recombinant B. subtilis.
Alcohol Oxidoreductases ; genetics ; Bacillus subtilis ; genetics ; metabolism ; Glucose 1-Dehydrogenase ; chemistry ; metabolism ; Mutagenesis, Insertional ; Pseudoephedrine ; metabolism ; Recombinant Proteins ; biosynthesis ; genetics ; Recombination, Genetic

PURPOSE: In Korea, pregnancy termination is frequently reported among women who took medications for an acute or chronic disease during pregnancy, for fear of teratogenic risk. We have previously shown that a service providing evidence-based information is helpful for women who week counseling to make a rational decision regarding their pregnancies. This study aimed to evaluate whether termination of pregnancy based on such perceptions, is justified using the 'DRug Exposure and risk Assessment in Moms' (DREAM) registry. METHODS: The study included 5,032 consenting pregnant women from the clinic and call center at the Korean Motherisk Program, from November 1999 to October 2008. The DREAM registry recorded the pregnancy outcomes (preterm birth, low birth weight, intrauterine fetal death, and congenital anomaly) of 3,328 women. RESULTS: Among women exposed to medications, time of exposure ranged from 3.5-4.6 weeks of gestation. There were 1,308 different drugs prescribed to these women. The drug most frequently prescribed was acetaminophen followed by chlorpheniramine maleate, and pseudoephedrine. There were 4.7% (n=156/3,328) women who underwent a voluntary abortion for fear of birth defects. We compared frequency of birth defects between exposed women and unexposed pregnant women in our institution during gestation. The frequency of major congenital malformations was 2.5% (n=74/2,977) in exposed group and 2.9% (n=75/2,573) in unexposed group (P=0.32). There was no statistically significant difference between exposed and control group in the rate of preterm births, intrauterine fetal death and low-birth weight babies. CONCLUSION: We did not observe increased risk of congenital malformations and adverse pregnancy outcomes in a population of pregnant women exposed to a variety of medications. Therefore these medications are not considered teratogen.
Acetaminophen ; Chlorpheniramine ; Chronic Disease ; Congenital Abnormalities ; Counseling ; Female ; Fetal Death ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Maleates ; Parturition ; Pregnancy ; Pregnancy Outcome ; Pregnant Women ; Premature Birth ; Pseudoephedrine ; Risk Assessment

OBJECTIVEAn HPLC method was developed to determinate Ibuprofen and Pseudoephedrine Hydrochloride and Chlorpheniramine Maleate in Compound BuluoWeimaNamin Tablets.

METHODSUsing HPLC with Kromasil C18 column, and acetonitrile -0.5% SDS- phosphate (580:420:1) as the mobile phase. The wavelength for detection was 262 nm.

RESULTSBetter linearities and good correlation coefficients were obtained: the concentration ranges of ibuprofen, pseudoephedrine hydrochloride and chlorpheniramine maleate were over 2.062-14.434 microg (r=0.9999), 0.296-2.072l microg (r=0.9999), and 0.0204~0.1428 microg (r=0.9998), respectively. The recoveries of ibuprofen, pseudoephedrine hydrochloride and chlorpheniramine maleate were 99.98% (RSD=0.52%), 99.72 (RSD=0.82%) and 99.545 (RSD=0.76%), respectively.

CONCLUSIONThe method was convenient, accurate and specific. It can be used as a method to control quality of Compound Buluoweimanamin Tablets.

Chlorpheniramine ; analysis ; Chromatography, High Pressure Liquid ; methods ; Ibuprofen ; analysis ; Pseudoephedrine ; analysis ; Tablets ; chemistry