Selegiline Pseudoephedrine

Clinically important, potentially hazardous interactions with alprazolam, amphetamines, astemizole, clarithromycin, clozapine, desipramine, dexibuprofen, dextroamphetamine, diethylpropion, droperidol, duloxetine, erythromycin, haloperidol, imipramine, isocarboxazid, linezolid, lithium, MAO inhibitors, mazindol, meperidine, methamphetamine, midazolam, moclobemide, nortriptyline, phendimetrazine, phenelzine, phentermine, phenylpropanolamine, phenytoin, pimozide, pseudoephedrine, selegiline, serotonin agonists, sibutramine, St John s wort, sumatriptan, sympathomimetics, tramadol, tranylcypromine, trazodone, tricyclic antidepressants, troleandomycin, tryptophan, zolmitriptan... 

A positive screening test result for amphetamines may be due to use of amphetamine or methamphetamine-containing prescription or over-the-counter drugs. For example, the drug Selegiline, which is used to treat Parkinson s disease, is metabolized to amphetamine and methamphetamine. The nasal decongestant pseudoephedrine can cross-react in the test and result in a false positive. In the latter case, the confirmatory test is for amphetamine. 

Amphetamines 2-5 days Up to 2 weeks with prolonged or heavy use Many sympathomimetic amines such as pseudoephedrine, ephedra, phenylephrine, fenfluramine, and phentermine may cause positive results. Other drugs such as selegiline, chlorpromazine, trazodone, bupropion, and amantadine may cause false-positive results depending on the assay. 

These compounds have been used therapeutically for many years in the treatment of hyperactivity disorders and to facilitate weight loss. Additionally, other therapeutic uses of some of the ATSs exist, e.g., selegiline for Parkinson s disease and dementia (3) or pseudoephedrine for nasal congestion. Not all of the amphetamines have therapeutic uses. In this respect, both licit and illicit amphetamines are subject to abuse, which can lead to addiction. Based on their abuse and addiction properties as well as a lack of, or limited, medical use, many of the amphetamines are classified in the United States as schedule I and II controlled substances (4). 

Stock solutions. The following are available as 1 mg/mL methanolic stocks (Cerilliant, Round Rock, TX) ephedrine, methylephedrine, pseudoephedrine, phenylpropanolamine, amphetamine, phentermine, methamphetamine, 3,4-methyl-enedioxyamphetamine (MDA), 3,4-methylenedioxymethamphetamine (MDMA), 3,4-methylenedioxyethylamphetamine (MDEA), selegiline, dj-ephedrine, dj-phenylpropanolamine, dj-amphetamine, dj-methamphetamine, d -MDA, d -MDMA, dj-MDEA. Norpseudoephedrine, dg-selegiline, and dj-pseudoephedrine are available as 0.1 mg/mL methanolic stocks (Cerilliant, Round Rock, TX). Phendimetrazine (Alltech Associates, Lancaster, PA) and phenmetrazine (USP, Rockville, MD) are available as powders to create the stock standards, dissolve the powders in methanol to a concentration of 1 mg/ mL. 

Mixed amphetamines panel substock standard A. Add 5 mL of deionized water to a 10 mL volumetric flask. Add 10 J.L of concentrated hydrochloric acid and mix well. Quantitatively add the stock standards as follows 100 pL each ephedrine, methylephedrine, pseudoephedrine, phenylpropanolamine, amphetamine, phentermine, methamphetamine, MDA, MDMA, phendimetrazine, phenmetrazine 200 i,L MDEA 50 pL selegiline 1,000 pL norpseudoephedrine. Dilute to volume with deionized water cap and mix by inversion. Store between 2 and 8°C in an amber bottle with Teflon -lined cap. Final concentration for all compounds is 10 pg/mL except MDEA (20 pg/mL) and selegiline (5 pg/mL). 

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