In case 1, plasma moclobemide was 2.8 mg/L with 1.8 mg/L clomipramide; in case 2, 18 mg/L; in case 3 60.9 mg/L and 4.6 mg/L 12 hours later. None of the patients showed serious effects during 24 hours of observation. Plasma moclobemide at 10 to 30 times therapeutic was not associated with major toxic effects. Moclobemide seems to be considerably less toxic than tricyclic antidepressants.
After intentional ingestion of the herbicide, 2-methyl-4-chlorophenoxyacetic acid, a young man suffered burning in his mouth, spasmodic pain in the extremities and a severe hypotensive crisis. Plasma 2-methyl-4-chlorophenoxyacetic acid concentration was 546 mg/L two hours after ingestion. Therapy by forced diuresis was ineffective until the urine was alkalinized (Day 4). This resulted in a rapid decline of the plasma 2-methyl-4-chlorophenoxyacetic acid level to 6 mg/L and recovery of the patient.
In order to determine the fetal-maternal distribution of heroin and its main metabolites (6-monoacetylmorphine and morphine) the drug concentrations were measured in autopsy material. The heroin-related death of a pregnant drug abuser (approximately the 32nd week of gestation) provided the fetal and maternal material. Fetal and maternal hair was analyzed in order to obtain long-term information on the transplacental opiate transfer. Morphine and 6-monoacetylmorphine were detected in toxic concentrations in maternal as well as in fetal tissues and body fluids. The drug concentrations in the fetal blood were significantly lower than in the maternal blood. The ratio of fetal-to-maternal (F/M) blood morphine concentration was found to be 0.39, whereas the F/M ratio of 6-monoacetylmorphine in blood was 0.15. In fetal hair analysis, morphine, heroin, and, for the first time, 6-monoacetylmorphine were measured. The resulting F/M ratios were 0.49, 0.36, and 0.6, respectively.
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