Parents drug routines

The likelihood that drug routines would prevail over childcare routines was apt to result in unpredictable mealtimes, bedtimes, erratic school attendance and a general lack of supervision and parental care ... 

Immunoaffinity-based assays are routinely developed for new biologicals and products of the biotechnology industry as part of their characterization as new agents. In contrast, assays used for pharmacokinetic studies of new chemically synthesized entities are less likely to be immunoaffinity based because analysts are required to measure accurately the concentration of the administered parent drug. Metabolism of the parent drug can result in metabolites that are structurally very similar and that cross-react with antibodies to the parent drug, but exhibit different pharmacological activity. For this reason, determination of the structures of these metabolites and, commonly, the measurement of their concentrations... 

Clearly, high-resolution mass spectrometric data dramatically simplifies the problem of product ion assignment. The routine, automatic translation of product ion data into a maximally constrained oxidation (i.e., the substructure identified as containing the site of oxidation is the smallest possible set of atoms consistent with the observed product ions) remains an open problem at the moment, at least in the sense that no robust, generic, open-source, or commercially available solution exists. A small number of publications have presented proof-of-concept or company-internal approaches to the localization problem, either with or without high-resolution data as input. In the simplest situations, either (a) the product ion spectrum of the metabolite is identical to that of the parent drug, in which case the biotransformation is likely to be on the smallest possible neutral which is lost, or (b) the product ion spectrum of the metabolite is identical to that of the parent compound, with the exception of one, attributable, low m/z product ion shifted by the mass of... 

The QTRAP instrument has the standard MRM function that is identical to that of classical triple quadrupole instruments such as the API 4000 triple quadrupole mass spectrometer and can be used to routinely quantify parent drug and their metabolites in PK and TK bioanalytical quantitative work. In addition, pMRM can be used as a survey scan to trigger the information-dependent EPI to confirm the identity of the observed peaks. Studies have... 

Drawing on the interviews with parents I will first outline their views on the force of their dependency problems and then move to depict some of the routines associated with drug use as a means of showing how these necessarily impinge upon the care and wellbeing of children, even despite the efforts of the parent to protect them from exposure to drugs and the associated lifestyle. 

To illustrate something of the difficulty of grafting childcare routines onto the rhythms that drug dependence imposes it is worth considering some concrete examples. Start with the beginning of the day. Mornings were difficult times for many of the parents ... 

Even considering this very small window into the day, one can see the conflict that sets up between meeting the needs of the child and those of the parent s drug problem. Considered in terms of the day s routines it is clear that things do not get any easier, with these same tensions being played out all through the day. The following parent, for example, describes a dilemma often encountered at the end of her son s school day ... 

Clinicians should be aware that many of their patients may be taking alternative treatments either via self-care or prescribed by CAM practitioners. Inquiring about this should be routine because of potential side effects and drug interactions. A working knowledge of CAM treatments will allow child psychiatrists to give parents and patients advice about safety and effectiveness. Use of St. John s wort in children with unipolar depression may at times be appropriate, particularly in cases where more standard treatments are contraindicated or have failed. However, it should be used cautiously and with an appropriate explanation of its risks and benefits, as a competent clinician would do for any treatment. Use of St. John s wort for other conditions is not currently recommended given the lack of evidence for efficacy. Kava extracts may be used for anxiety, with similar provisos. There are much fewer data about the efficacy and safety of other dietary supplements and their use cannot be supported at this point. 

These few examples illustrate that C-silylation of drugs can also lead to interesting biological properties, which can be similar or different as compared to the parent compounds. C-silylation of bioactive organic compounds may become a routine method in the development of novel drugs. 

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