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The use of GC/MS for the analysis of drugs
Sýkora, Richard ; Opatřilová, Radka (referee) ; Vávrová, Milada (advisor)
This diploma thesis is based on the current issue of the presence of pharmaceuticals in various components of the environment. Concerning the contamination by residues of pharmaceuticals the most affected environment is the aquatic environment where these substances leaks especially from wastewater treatment plants, which eliminate them during the cleaning process only partially. This work is focused on the selected group of pharmaceuticals, non-steroidal anti-inflammatory drugs (salicylic acid, ibuprofen, caffeine, naproxen, ketoprofen, diclofenac) in waste water. For analysis purposes two types of sampling were used and compared: the conventional spot sampling of wastewater and the sampling using passive samplers POCIS. The sampling took place at the inflow and outflow of the wastewater treatment plant in Brno Modřice. The solid phase extraction (SPE) using Oasis HLB columns was used as the extraction method. Extracted sample was derivatized then. Derivatization agents were: MSTFA (N-methyl-N-(trimethylsilyl)trifluoroacetamid) and BSTFA (N, O-bis(trimethylsilyl) trifluoroacetamid). The final analysis was performed using gas chromatography with mass spectrometric detection Time-of-Flight (GC/TOF-MS).
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Aplication of gas chromatography for determination of drug residuals in waters
Lacina, Petr ; Stoupalová, Michaela (referee) ; Vávrová, Milada (advisor)
Diploma thesis is focused on the choose of methods and optimalisation analysis procedure of selected pharmaceuticals (salicylic acid, ibuprofene, naproxene, ketoprofene and diclofenac) in surface and waste water by using gas chromatography with mass spectrometer (GC-MS). Solid-phase extraction (SPE) with Oasis HLB cartridges was used as an extraction method in this analysis. Extraction is followed by derivatization and their optimalization of selected pharmaceuticals. Derivatization and its optimalization were performed by two silylation reagens N-methyl-N-(trimethylsilyl)trifluoroacetamide (MSTFA) and N,O-bis(trimethylsilyl)trifluoroacetamide (BSTFA). Different volumes of derivatization reagents, different temperatures and different times were used during the procedure. The best combination is then used for analysis of real samples. Real samples of waste water were collected in sewage treatment plants in Brno – Modřice and real samples of surface water were collected from several rivers and one pond in region Moravia. This thesis also presents and tests SPE methods for extraction and concentration selected sulfonamide residues (sulfamethazine, sulfamethoxazole, sulfapyridine and sulfathiazole) from the aquatic environment.
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Question of determination of analgetics in waters
Benešová, Markéta ; Lisá, Hana (referee) ; Vávrová, Milada (advisor)
The bachelor thesis is focused on the optimization of the method for the determination of analgetics in waters. The aim of this work is to work up the methodical procedure for determination of chosen pharmaceuticals i.e. salicylic acid and naproxen in model water samples. Analytes were isolated by solid phase extraction (SPE); they were identified by high performance liquid chromatography with UV-VIS detection of diode – array type (HPLC – DAD). The optimal method was selected from several verified procedures on the basis of practical experience.
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The role of the paramedic in the treatment of pain in the prehospital emergency care
ŠKOLKOVÁ, Aneta
The Bachelor thesis deals with a very current and spread topic in the sphere of the pre-hospital urgent care, it concerns the issue of pain and the role of the paramedic at its treatment in the pre-hospital urgent care. Pain is one of the most frequent indications initiating the medical ambulance service intervention. It is an affiliated and really essential stressor. The task for the paramedic is to help the patient suffering from pain and to use all ways of treatment which are possible to be applied in the sphere of the pre-hospital care. Therefore it is very important for the paramedics to be well informed on the issue of analgesia and to have good theoretical knowledge and to be able to apply it in practice. The theoretical part deals with the complex issue which is related to pain and with the role of the paramedic. At the beginning of the work there are defined basic concepts concerning the wide issue of pain, i.e. its types and categories form the localization point of view. Further, there is described the basic examination and getting information from the patient which form the integral part of information and data for consequent diagnosing and its possible therapies in the pre-hospital care. Therefore there is also a detailed elaboration of evaluating scales including the children´s ones. In order to get a sight into the issue of pain treatment there is integrated the subchapter concerning the invasive and non-invasive methods in the work. Next, the attention of the work is mostly focused on defining concepts of the pre-hospital urgent care and on the competences of the paramedic which form an integral part of the knowledge of this profession. It is related to possibilities of non-pharmacology and pharmacology treatment in the pre-hospital urgent care, which the specialist can use. The practical part was focused on recording of knowledge and procedures of paramedics in the process of pain treatment in the pre-hospital urgent care. There was carried out the whole republic inquiry using the quantitative method of anonymous questionnaire form. It was designed for the medical care workers working as paramedics. All regions in the Czech Republic were contacted; however, only eleven joined the research. Upon agreement with the managers of non-medical workers the questionnaires were delivered to paramedics. There were sent out 210 questionnaires while their return was 71.43% (150). All questionnaires were included in the consequent resultant inquiry. Responding paramedics were informed on the character of the research and assured that the anonymity of their person and the provided information will be preserved. The questionnaire involved 17 questions in total and the first five questions were statistical ones. The questions were focused on knowledge of analgesia and on procedure used by paramedics in the fieldwork. Questions 2, 4, 4a, 4b, 5, 8, 8a, 10, 10a, 11 were selected in order to get information whether the responding paramedics have knowledge on the issue of analgesia an in order to get base for answering the research question. The obtained information was consequently evaluated. Each question was answered individually and then transferred into diagrams (sometimes only into charts), which show their absolute and (mostly) relative frequency of obtained answers. The stated research question was (on the basis of the above mentioned 10 questions) evaluated by means of chi quadrate test. The obtained level of significance refused the stated ideal statement and confirmed results of the research which says that the knowledge of the paramedics is insufficient. The goal of the work was to record possibilities of pain treatment in the pre-hospital urgent care by the paramedic and it was fulfilled. Statistically evaluated questionnaire inquiry and answer to the research question show that further education of paramedics as well as their accepting the complex view of the issue is absolutely necessary.
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Toxicity of freely available analgesics in relation to human health
VODVÁŘKA, Stanislav
Analgesics represent a large group of medicines which is used for suppresing subjectively perceived pain. Analgesics can be divided into two large groups, opioids and non-opioids. Some of the non-opioids can be used as anti-inflammatory and/or antipyretics as well. All non-opioids influence metabolism of prostaglandins. Diverse group of non-opioid analgesics is available in Czech pharmacies as prescription medicines or for sale over the counter. The aim of this work is mainly to assess the toxicity of over-the-counter analgesics and to find out the frequency of fatal intoxications caused by these analgesics in the Czech Republic and abroad. A list of peroral over-the-counter analgesics was created. A partial analysis of data from medical judicial departments of regional hospitals in the Czech Republic was performed in order to obtain total number of deaths caused by overdosing with these drugs. Using ÚZIS the number of deaths was extracted from information system Deceased. These logged deaths were caused only by acute intoxication with analgesics and were chosen on basis of precisely defined combinations of diagnostic codes (MKN10). Results were then expanded by similar enumeration from the National register of hospitalized, by which we specified the amount of intoxications where patients survived. Overall case report was evaluated from processed information. The number of deaths caused by analgesics and commonly misused addictive substances were compared by which the second hypothesis was clarified. The data was obtained from Annual reports about substance misuse and 6 years were compared in total. Identified risk of analgesic in Czech Republic was compared with registered cases of overdosing in world. Data used for comparing were gained from analysis of world literature. During the years 2006 ? 2011, 53 deaths and 2024 hospitalizations in the Czech Republic were caused by acute intoxication as a result of overdosing with mentioned medication. Our first hypotesis can be confirmed on the basis of these numbers, and therefor it can be said that over-the-counter medicines used for suppressing pain can cause death. On the basis of analysis of world literature a certain risk is seen in fact that these analgesics ? mainly paracetamol ? are often linked with suicides. For instance in United Kingdom thousands of cases of self-harm are caused by overdosing with paracetamol. In USA 16 500 deaths are thought to be caused by NSAIDS and 1600 acute liver failure incidents are caused by overdosing with paracetamol annualy. Illegal drugs caused 253 intoxications during the years 2006 -2011 compared to 53 cases of deaths caused by overdosing by analgesics. Annual reports about substance misuse report that deaths caused by illegal drugs are more common than deaths caused by over-the-counter analgesics in the Czech Republic. There remains a question: What percentage of analgesics intoxications, where patient survived or not, is caused only by over-the-counter analgesics without any other cause.
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The application of opioids in crews of medical rescue service
MATOUŠEK, Jan
The aim set by this bachelor thesis is to survey the application of opioids in the emergency crews. To meet this objective, I posed two research questions. Research question Nr. 1: Are patients informed about the application of opioids? Research question Nr. 2: Do paramedics find out the effects of opioids administered to patients? Patients are entitled by law to information about administering any medicaments, according to Health Care of the Population Act. The back check of effects of medicaments administered is important for the check-up of the efficiency of the dose administered as well as the danger of undesired effects. Opioid substances are derived from morphine. Morphine, which is found in the juice of opium poppy, has been used throughout history to produce euphoric effects and especially as an analgesic. The reason for using analgesics is pain, and for that reason I explain here what pain is, how it is classified, measured and especially how it is soothed. Opioids are substances used for soothing severe pains for which non-opioid analgesics are insufficient. However, using these substances may result in addiction, and therefore manipulation with them is strictly controlled by law. To achieve the objective I conducted quantitative research, and data were collected by a secondary data analysis, the method of questioning and interview technique. Drawing on the research results that were obtained by observing paramedics and from interviews with their patients, it appears that it is necessary to inform patients that they are being administered an opioid substance. There are exceptional states when patients are not able to perceive such information and their consent to administering the medicine can be supposed. It was observed that paramedics make a back proof of the effects of the medicaments administered, and it was also found out that there are paramedics who, in the event that the dose of medicament is inefficient, do nothing more.
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