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Yoshiaki Hashimoto - One of the best experts on this subject based on the ideXlab platform.

  • tissue distribution of Nitrazepam and 7 aminoNitrazepam in a case of Nitrazepam intoxication
    Forensic Science International, 2003
    Co-Authors: Fumio Moriya, Yoshiaki Hashimoto
    Abstract:

    Abstract We report a case of Nitrazepam poisoning in which the distribution of Nitrazepam and 7-aminoNitrazepam was determined in body fluids and tissues. A 52-year-old woman was found dead in a shallow ditch (approximately 5 cm in depth), in the winter. Ambient temperature was 2–8 °C. The postmortem interval was estimated to be approximately 1 day and no putrefaction was observed. The cause of death was thought to be drowning due to Nitrazepam overdose and cold exposure. Blood concentrations of Nitrazepam and 7-aminoNitrazepam were very site dependent (0.400–0.973 μg/ml and 0.418–1.82 μg/ml). In addition, the concentration of the same analytes in the bile were 4.08 and 1.67 μg/ml, respectively, and in the urine: 0.580 and 1.09 μg/ml, respectively. A high accumulation of both substances was observed in various types of brain tissue (2.17–6.22 μg/g and 2.49–5.11 μg/g). Only small amounts of Nitrazepam and 7-aminoNitrazepam were detected in the liver (0.059 and 0.113 μg/g, respectively). Large differences in the observed concentrations of Nitrazepam and 7-aminoNitrazepam among arterial and venous blood samples were thought to be mainly due to dilution of arterial blood by water entering the circulation through lungs at the time of death. Bacterial metabolism of Nitrazepam may also have contributed to the observed differences.

  • Tissue distribution of Nitrazepam and 7-aminoNitrazepam in a case of Nitrazepam intoxication.
    Forensic science international, 2003
    Co-Authors: Fumio Moriya, Yoshiaki Hashimoto
    Abstract:

    We report a case of Nitrazepam poisoning in which the distribution of Nitrazepam and 7-aminoNitrazepam was determined in body fluids and tissues. A 52-year-old woman was found dead in a shallow ditch (approximately 5 cm in depth), in the winter. Ambient temperature was 2-8 degrees C. The postmortem interval was estimated to be approximately 1 day and no putrefaction was observed. The cause of death was thought to be drowning due to Nitrazepam overdose and cold exposure. Blood concentrations of Nitrazepam and 7-aminoNitrazepam were very site dependent (0.400-0.973 microg/ml and 0.418-1.82 microg/ml). In addition, the concentration of the same analytes in the bile were 4.08 and 1.67 microg/ml, respectively, and in the urine: 0.580 and 1.09 microg/ml, respectively. A high accumulation of both substances was observed in various types of brain tissue (2.17-6.22 microg/g and 2.49-5.11 microg/g). Only small amounts of Nitrazepam and 7-aminoNitrazepam were detected in the liver (0.059 and 0.113 microg/g, respectively). Large differences in the observed concentrations of Nitrazepam and 7-aminoNitrazepam among arterial and venous blood samples were thought to be mainly due to dilution of arterial blood by water entering the circulation through lungs at the time of death. Bacterial metabolism of Nitrazepam may also have contributed to the observed differences.

David J Greenblatt - One of the best experts on this subject based on the ideXlab platform.

  • toxicity of Nitrazepam in the elderly a report from the boston collaborative drug surveillance program commentary author s reply
    British Journal of Clinical Pharmacology, 2004
    Co-Authors: David J Greenblatt, Marcia D Allen, Arduino A Mangoni
    Abstract:

    1 To assess the potential hazards of Nitrazepam therapy of insomnia in the elderly, adverse reactions to Nitrazepam were studied in 2111 hospitalized medical patients who received the drug. 2 Manifestations of unwanted central nervous system (CNS) depression (such as drowsiness or 'hangover') were reported in 49 Nitrazepam recipients (2.3%), and signs of unwanted CNS stimulation (such as nightmares, insomnia, agitation, etc.) in 15 (0.7%). None of the adverse reactions were considered serious. 3 Physician-rated clinical efficacy of Nitrazepam was not related to dose, but the frequency of both types of adverse reactions increased significantly at higher daily doses. CNS depression also was significantly more frequent in the elderly, being reported in 11% of those aged 80 years or older, whereas the frequency of CNS stimulation was not correlated with age. 4 The effect of age on the reported rate of unwanted CNS depression was most striking at high doses. Among patients aged 80 years or over whose daily dose averaged 10 mg or more, 55% experienced unwanted CNS depression attributed to Nitrazepam. 5 Low doses of Nitrazepam are safe for elderly individuals, but the elderly are readily susceptible to excessive CNS depression at high doses. The findings suggest that there is little reason to exceed 5 mg doses of Nitrazepam for most patients, particularly those who are elderly.

  • Nitrazepam clearance unimpaired in patients with renal insufficiency
    Journal of Clinical Psychopharmacology, 1992
    Co-Authors: Hermann R Ochs, Udo Oberem, David J Greenblatt
    Abstract:

    : Eight patients with mild to moderate renal insufficiency (mean serum creatinine: 2.4 mg/100 ml) and 9 matched control subjects with normal renal function received a single 5-mg oral dose of Nitrazepam, cleared mainly by hepatic nitroreduction. Serum Nitrazepam levels were determined by gas chromatography during the 72 hours after dosage. Renal patients and controls were well-matched for age (74 vs. 63 years), height (165 vs. 164 cm), and weight (68 vs. 64 kg). Patients and control subjects did not differ significantly in Nitrazepam elimination half-life (32 vs. 24 hour) or volume of distribution (4.2 vs. 3.6 liters/kg). Clearance was higher in patients than in controls (4.2 vs. 1.7 ml/min/kg), but the difference was not significant. Nitrazepam free fraction in serum was increased in renal patients (16.8 vs. 15.0% unbound, p = 0.08). After correction for individual values of free fraction, the two groups still did not differ in kinetic variables for Nitrazepam. Thus, mild to moderate renal insufficiency does not alter the kinetics of Nitrazepam.

M Elam - One of the best experts on this subject based on the ideXlab platform.

  • Nitrazepam in patients with sleep apnoea a double blind placebo controlled study
    European Respiratory Journal, 1994
    Co-Authors: U Hoijer, Jan Hedner, H Ejnell, Ronald R Grunstein, E Odelberg, M Elam
    Abstract:

    We wanted to assess whether benzodiazepines worsen sleep apnoea, since their use in such patients has been controversial. Fourteen male patients with mild to moderate obstructive sleep apnoea were investigated in a placebo-controlled, double-blind study evaluating the influence of Nitrazepam (NIT) on apnoea frequency and severity. Each patient was given oral Nitrazepam 5 or 10 mg, or corresponding placebo, in a randomized order on three separate nights. Wash-out time was one week. A complete sleep study was undertaken at each study night. Eleven patients completed the study. Although there were individuals with marked variability in apnoea index between the three study nights, there was no significant change in apnoea index or minimum arterial oxygen saturation with any of the two Nitrazepam dosages studied. Only 3 out of 11 patients had a higher apnoea index after both Nitrazepam doses compared to placebo, and in these patients the increase in sleep-disordered breathing was of marginal clinical significance. Nitrazepam caused a modest increase in total sleep time and a decrease in rapid eye movement (REM) sleep. These results demonstrate that Nitrazepam does not worsen sleep apnoea in patients with mild to moderate sleep apnoea. The previously reported sleep apnoea promoting effects of benzodiazepines may be restricted to a small subgroup of patients with sleep-disordered breathing.

Fumio Moriya - One of the best experts on this subject based on the ideXlab platform.

  • tissue distribution of Nitrazepam and 7 aminoNitrazepam in a case of Nitrazepam intoxication
    Forensic Science International, 2003
    Co-Authors: Fumio Moriya, Yoshiaki Hashimoto
    Abstract:

    Abstract We report a case of Nitrazepam poisoning in which the distribution of Nitrazepam and 7-aminoNitrazepam was determined in body fluids and tissues. A 52-year-old woman was found dead in a shallow ditch (approximately 5 cm in depth), in the winter. Ambient temperature was 2–8 °C. The postmortem interval was estimated to be approximately 1 day and no putrefaction was observed. The cause of death was thought to be drowning due to Nitrazepam overdose and cold exposure. Blood concentrations of Nitrazepam and 7-aminoNitrazepam were very site dependent (0.400–0.973 μg/ml and 0.418–1.82 μg/ml). In addition, the concentration of the same analytes in the bile were 4.08 and 1.67 μg/ml, respectively, and in the urine: 0.580 and 1.09 μg/ml, respectively. A high accumulation of both substances was observed in various types of brain tissue (2.17–6.22 μg/g and 2.49–5.11 μg/g). Only small amounts of Nitrazepam and 7-aminoNitrazepam were detected in the liver (0.059 and 0.113 μg/g, respectively). Large differences in the observed concentrations of Nitrazepam and 7-aminoNitrazepam among arterial and venous blood samples were thought to be mainly due to dilution of arterial blood by water entering the circulation through lungs at the time of death. Bacterial metabolism of Nitrazepam may also have contributed to the observed differences.

  • Tissue distribution of Nitrazepam and 7-aminoNitrazepam in a case of Nitrazepam intoxication.
    Forensic science international, 2003
    Co-Authors: Fumio Moriya, Yoshiaki Hashimoto
    Abstract:

    We report a case of Nitrazepam poisoning in which the distribution of Nitrazepam and 7-aminoNitrazepam was determined in body fluids and tissues. A 52-year-old woman was found dead in a shallow ditch (approximately 5 cm in depth), in the winter. Ambient temperature was 2-8 degrees C. The postmortem interval was estimated to be approximately 1 day and no putrefaction was observed. The cause of death was thought to be drowning due to Nitrazepam overdose and cold exposure. Blood concentrations of Nitrazepam and 7-aminoNitrazepam were very site dependent (0.400-0.973 microg/ml and 0.418-1.82 microg/ml). In addition, the concentration of the same analytes in the bile were 4.08 and 1.67 microg/ml, respectively, and in the urine: 0.580 and 1.09 microg/ml, respectively. A high accumulation of both substances was observed in various types of brain tissue (2.17-6.22 microg/g and 2.49-5.11 microg/g). Only small amounts of Nitrazepam and 7-aminoNitrazepam were detected in the liver (0.059 and 0.113 microg/g, respectively). Large differences in the observed concentrations of Nitrazepam and 7-aminoNitrazepam among arterial and venous blood samples were thought to be mainly due to dilution of arterial blood by water entering the circulation through lungs at the time of death. Bacterial metabolism of Nitrazepam may also have contributed to the observed differences.

Akira Okada - One of the best experts on this subject based on the ideXlab platform.

  • triazolam and Nitrazepam use in elderly outpatients
    Annals of Pharmacotherapy, 1993
    Co-Authors: Naoko Takami, Akira Okada
    Abstract:

    OBJECTIVE:To determine adverse reactions and effects on sleep among three groups of patients: those taking triazolam, those taking Nitrazepam, and a control group.DESIGN:Telephone interviews.PATIENTS:Forty-seven patients taking triazolam, 36 taking Nitrazepam, and 40 control patients. All study participants were outpatients over 60 years of age.RESULTS:The rate of awakening in the middle of sleep was not significantly different among patients taking triazolam (61.7 percent) and those taking Nitrazepam (69.4 percent). Incidence of nocturia, the primary reason for awakening, was not significantly different between triazolam- (36.2 percent) and Nitrazepam-taking patients (41.7 percent). The rate of having difficulty falling back to sleep was significantly different among triazolam (62.1 percent) and Nitrazepam (8 percent), and triazolam and control (11.1 percent) groups (p<0.01). No difference was evident, however, between Nitrazepam and control groups.CONCLUSIONS:Patients taking Nitrazepam have less difficu...

  • Triazolam and Nitrazepam Use in Elderly Outpatients
    Annals of Pharmacotherapy, 1993
    Co-Authors: Naoko Takami, Akira Okada
    Abstract:

    OBJECTIVE:To determine adverse reactions and effects on sleep among three groups of patients: those taking triazolam, those taking Nitrazepam, and a control group.DESIGN:Telephone interviews.PATIENTS:Forty-seven patients taking triazolam, 36 taking Nitrazepam, and 40 control patients. All study participants were outpatients over 60 years of age.RESULTS:The rate of awakening in the middle of sleep was not significantly different among patients taking triazolam (61.7 percent) and those taking Nitrazepam (69.4 percent). Incidence of nocturia, the primary reason for awakening, was not significantly different between triazolam- (36.2 percent) and Nitrazepam-taking patients (41.7 percent). The rate of having difficulty falling back to sleep was significantly different among triazolam (62.1 percent) and Nitrazepam (8 percent), and triazolam and control (11.1 percent) groups (p