Tablet seizures

Figure 6.2 Combined tablet seizures by United States Customs and the Drug Enforcement Administration have increased dramatically in the past decade. The number has increased from just several hundred in the early 1990s to more than 12 million in 2000. This does not include tablets seized in other countries.

The proportion of West and Central Europe would fall further if the ATS tablet seizures of Saudi Arabia (111.5 million tablets reported by ICPO/INTERPOL) were included on the basis that such tablets typically contain amphetamine.9... 

MISSELLANEOUS ANTICONVULSANTS. Valproic acid (Depakene) is unrelated chemically to the other anticonvulsants. This drug is absorbed rapidly when taken orally Tablets should not be chewed but swallowed whole to avoid irritation to the mouth and throat. The capsules may be opened and the drug sprinkled on a small amount of food, such as pudding or applesauce This mixture must be swallowed whole immediately and not chewed. Zonisamide is administered orally once a day or in divided doses. The dose may be increased by 100 mg day every 1 to 2 weeks until control of the seizures is obtained or the patient reaches the maximum dosage of 600 mg/d. 

Mefloquine (oral) 228 mg (base) (250 mg salt) weekly Less than or equal to 15 kg 4.6 mg/kg base (5 mg/kg salt) once weekly 1 5-19 kg 1/4 tablet 20-30 kg 1/f tablet 31-45 kg 3A tablet Greater than or equal to 45 kg 1 tablet Start 1 -2 wk before departure and continue for 4 wk after leaving endemic area may start 3—4 wk earlier to assess tolerance Contraindications History of seizure, psychiatric disorders (including depression and anxiety), or arrhythmias... 

The year 1995 produced the largest number of Rohypnol seizures by the DEA thus far, with more than 160,000 illegal pills confiscated. In one instance, over 52,000 Rohypnol pills, concealed in plastic bags located inside a car door, were seized by the Louisiana State Police. Also in 1995, the U.S. Border Patrol seized over 57,000 Rohypnol tablets (along with 53 pounds of marijuana) en route from Mexico to Florida. 

The volume of 3,4-MDP-2-P seizures for 2003 was the lowest reported since 1998 other than the Netherlands, only Estonia reported seizures of the substance during 2003. The latter case is particularly noteworthy as the seizure of 3,4-MDP-2-P was made at an MDMA (Ecstasy) laboratory and, in addition to the precursor, 26,000 MDMA tablets and 60 litres of liquid MDMA were also seized. More importantly, the authorities of Estonia, in cooperation with their counterparts from the Russian Federation, launched backtracking investigations to identify the source of the seized 3,4-MDP-2-P. That investigation led to the identification and dismantling of a laboratory illicitly manufacturing 3,4-MDP-2-P in the Russian Federation... 

Tablets and injection only - For adjunctive treatment of edema due to CHF, drug-induced edema, and centrencephalic epilepsy (petit mal, unlocalized seizures). 

SSRI selective sCTotonin reuptake inhibitor (class of drugs used to treat d ression, e.g., sCTtraline) SSS sick sinus s5mdrome stat immediately (Latin statim ) supl supplement or supplied supp suppository Susp suspension SVT supraventricular tachycardia Sx s5mptom S5md syndrome Sz seizure tab/tabs tablet/tablets tach tachycardia TB tubCTCulosis TBI traumatic brain injury TCA tricyclic antidqjressant (class of drugs commonly used to treat d ression, e.g., amitriptyline) TCP transcutaneous pacing TD transdermal TFT thyroid function test TEA transient ischemic attack tid three times a day (Latin ter in die ) tine tincture TMP trimethoprim (type of antibiotic)... 

More than half (57 %) of all seizure cases involved cannabis (herb, resin, oil, plants and seeds). Opiates (opium, morphine, heroin, synthetic opiates and poppy seeds), accounted for 17 per cent, with heroin alone accounting for 14 per cent of the total. This is followed by seizures of the amphetamine-type stimulants (12 %). About half of these seizures (or 5.5 % of the total) is accounted for by methamphetamine, followed by amphetamine (2.5 %) and ecstasy (2%) the rest (2 %) includes Captagon tablets (Near East) and Maxiton Forte (Egypt), ephedrone (methcathinone) and various undefined amphetamines. Coca products account for 9 percent of global seizure cases the bulk of coca related seizure cases concern cocaine (8 % of total). 

During the period 2004-05, the world s largest ATS seizures took place in East and South-East Asia (32 per cent), followed by West and Central Europe (25 per cent), and North America (18 per cent). Seizures in North Africa (6 per cent), mainly reflect Maxiton Forte in Egypt. Similarly seizures in the Near and Middle East Region (6 per cent), are Captagon tablets seized in Saudi Arabia and neighbouring countries. 

The largest national ATS seizures in 2005 were reported from China (23 per cent), followed by the United States of America (14 per cent) and Saudi Arabia (8 per cent). China and the USA seized primarily methampheta-mine, both produced locally or smuggled into the country from a direct neighbour (Myanmar and Mexico, respectively). Saudi Arabia seized primarily Captagon tablets which had been shipped across several borders from South-East Europe. Other large ATS seizures in 2005 were reported by Taiwan province of China (7 per cent), the Netherlands (6 per cent), Thailand (5 per... 

Waddell et al. [79] investigated the applicability of ICP-MS data obtained from the analysis of ecstasy tablets to provide linkage information from seizure to... 

In addition to sinus tachycardia and tremor, vomiting is common after overdose. Hypotension, tachycardia, hypokalemia, and hyperglycemia may occur, probably due to -adrenergic activation. The cause of this activation is not fully understood, but the effects can be ameliorated by the use of B-blockers (see below). Cardiac arrhythmias include atrial tachycardias, premature ventricular contractions, and ventricular tachycardia. In severe poisoning (eg, acute overdose with serum level > 100 mg/L), seizures often occur and are usually resistant to common anticonvulsants. Toxicity may be delayed in onset for many hours after ingestion of sustained-release tablet formulations. 

The government is currently in the process of attempting to regulate ephedrine use in pep pills and supplements. The proposal is the FDA s first regulatory major initiative under the 1994 Act. According to the FDA, more than 800 adverse reactions, including seizures, strokes, and heart attacks, have been linked to ephedrine capsules, tablets, and teas since 1994. The FDA puts the ephedrine-related death toll at 18 since then. 

Ukraine, each of which reported seizures of ephedrine larger than 10 kg. In the Czech Republic, over 400 kitchen laboratories used to manufacture methamphetamine were detected, although the quantities of ephedrine seized were lower than in previous years. A large part of the 65 kg seized in Hungary was made up of ephedrine tablets purportedly manufactured in Turkey by an established pharmaceutical company. No exports or diversion of pharmaceutical preparations originating in Europe were identified during Operation Crystal Flow. 

Even though Hoffmann-LaRoche has reformulated Rohypnol tablets to be more easily identified when placed into someone s drink, Rohypnol is still a very potent benzodiazepine and is subject to abuse. Chronic or daily Rohypnol use causes dependence in humans. Once dependence has developed, abstention induces withdrawal symptoms, including headache, muscle pain, extreme anxiety, tension, restlessness, confusion, and irritability. Numbness, tingling of the extremities, loss of identity, hallucinations, delirium, convulsions, shock, and cardiovascular collapse also may occur. Withdrawal seizures can occur in chronic abusers with abrupt cessation of Rohypnol use. 

Rohypnol tablets from a pharmaceutical distributor. This was one of the largest seizures of Rohypnol in history. The investigation revealed that the product had been manufactured in Belgium and was intended for distribution in Egypt. 

A 20-year-old man became unconscious and had generalized tonic-clonic seizures 2 hours after taking one ecstasy tablet. He had a rectal temperature of 40.6°C, a heart rate of 170/minute, and a blood pressure of 92/ 21 mmHg. He had roving eye movements and myoclonus. His blood pH was 6.92, the serum sodium was 144 mmol/1, and his urine was positive for ecstasy. He recovered with cooling. 

A 32-year-old HIV-positive man, who added ritonavir 600 mg bd to his antiretroviral regimen of zidovudine and lamivudine, became unwell within hours after having taken two and a half tablets of ecstasy, estimated to contain 180 mg of MDMA. He was hypertonic, sweating profusely, tachypneic, tachycardic, and cyanosed. Shortly after he had a tonic-clonic seizure and a cardiorespiratory arrest. Attempts at resuscitation were unsuccessful. Blood concentrations obtained post-mortem showed an MDMA concentration of 4.56 mg/1, in the range of that reported in a patient with a life-threatening illness and symptoms similar to this patient after an overdose of 18 tablets of MDMA. 

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