Alcohol case histories

Since 2000, atorvastatin (1) has been the world s top selling prescription drug, with sales in the 12 months to June 2008 of 13.8 billion [4]. The conversion of the chloro alcohol 2 to the key atorvastatin intermediate hydroxy nitrile 3 (Scheme 11.1) provides a good case history for the development of a continuous process, as it demonstrates... 

One case history has suggested that the use of alcohol with mefloquine can precipitate a neuropsychiatric reaction (18). 

Pancreatitis has been reported in various individual case histories (SEDA-15, 298), but there is reason to think that some of these cases at least were due to other factors, such as alcohol use (SEDA-13, 832). 

The following factors have been suggested as alternatives to consider when presented with a potential case of exposure to bicyclophosphates history of epilepsy exposure to alcohol, cocaine, lead, camphor, strychnine, and/or carbon monoxide medicinals such as phenothiazines head trauma, heatstroke encephalitis, meningitis, and tetanus. 

Two studies were located that reported the occurrence of liver cancer in humans exposed to carbon tetrachloride fumes, both acutely (Tracey and Sherlock 1968) and for longer periods (Johnstone 1948). In the former case, a male died of hepatocellular carcinoma 7 years after acute intoxication with carbon tetrachloride at an age of 59, although he had a history of moderate alcohol consumption (without demonstrable liver cirrhosis). In the second case, a 30- year-old female died of "liver cancer" after 2-3 years of occupational exposure to carbon tetrachloride that was sufficient to produce signs of intoxication. However, this evidence is much too sparse to establish a cause-and-effect relationship. 

Death Many cases of human fatalities have occurred as the result of carbon tetrachloride exposure, both by ingestion and inhalation (Norwood et al. 1950 Umiker and Pearce 1953 von Oettingen 1964). Most fatal cases of carbon tetrachloride toxicity involve individuals with a history of alcohol consumption, while nondrinkers are considerably less susceptible. 

Propoxyphene (dextropropoxyphene Darvon) is structurally related to methadone but is much less potent as an analgesic. Compared with codeine, propoxyphene is approximately half as potent and is indicated for the treatment of mild pain. It is not antipyretic or antiinflammatory like aspirin and is less useful than aspirin in most cases of mild pain. Toxicity from propoxyphene, especially in combination with other sedatives, such as alcohol, has led to a decrease in its use. Death following ingestion of alcohol in combination with propoxyphene can occur rapidly (within 20 minutes to 1 hour). The drug is not indicated for those with histories of suicide or depressive illnesses. 

Codeine, also known as methylmorpliine, C H2 NOt H20, is a colorless white crystalline substance, mp 154.9 C, slightly soluble in water, soluble in alcohol and chloroform, effloresces slowly in dry air. Codeine is derived from opium by extraction or by the methylation of morphine. For medical use, codeine is usually offered as the dichlotide, phosphate, or sulfate. Codeine is habit forming. Codeine is known to exacerbate urticaria (familiarly known as hives). Since codeine is incorporated in numerous prescription medicines for headache, heartburn, fatigue, coughing, and relief of aches and pains, persons with a history of urticaria should make this fact known to their physician. Codeine is sometimes used ill cases of acute pericarditis to relieve severe chest pains in early phases of disease. Codeine is sometimes used in drug therapy of renal (kidney) diseases. 

Hall and Cassel describe a complete, commercially available experimental system for detailed studies of the thermal history and other characteristics of fibers, a common form of evidence material. The Bureau of Alcohol, Tobacco, and Firearms has developed a large library of inks of known manufacture dates and reports excellent cooperation from industry in its tagging project (Brunelle and Cantu). Again, the application of a well established technique (in this case thin-layer chromatography, which is sensitive enough to allow concurrent handwriting and other supportive analysis) proves its value not only operationally but also from the viewpoint of legal admissibility (Brunelle and Cantu). 

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