The respiratory and circulatory effects and other side effect liability 0/ intravenous doses 0/30 and 60 f.Lg/kg butorphanol, 150 to 300 f.Lg/kg norphine, and a placebo were investigated in a crossover double-blind study.Butorphanol (L-N -eyclobutymethyl-3-14ßdihydroxymorphinan) is a synthetie morphinan derivative. Like pentazoeine, it is an agonistantagonist with relatively potent analgesie and weak antagonistie aetivity. In earlier elinieal pharmaeologieal studies its analgesie aetivity by weight was estimated to be about 5 to 7 times as great as that of morphine 2 , 4 and about 20 times as great as that of pentazoeine. 3 We eompared the respiratory and eireulatory effeets and the side effeet liabilities of intravenously administered 30 and 60 p.,g/kg (about 2 and 4 mg/70 kg) butorphanol and 150 and 300 p.,g/kg (about 10 and 20 mg/70 kg) morphine sulfate. MethodsThis investigation was earried out on 10 healthy male volunteers, age ranging from 26 to 38 yr (mean, 30.4). In a double-blind, 5-way, eomplete erossover experiment, eaeh subjeet Supported by a grant from Bristol Laboratories.

Two patients are reported in whom diphenylhydantoin (Dilantin) neurotoxicity developed as a result of inadvertent overdosage. The clinical features indicative of such toxicity are emphasized. Prompt recognition of the condition can forestall permanent sequelae and spare the patient unnecessary or hazardous diagnostic procedures.