This case series documents the use of triple drip, a combination of IV guaifenesin, ketamine, and xylazine (GKX) to extend the length of anesthesia in zoo-owned Przewalski horses (Equus ferus przewalskii). In three separate procedures involving two different animals, GKX was used to prolong and deepen the plane of anesthesia for 90 to 120 min beyond an initial induction dart containing ketamine, butorphanol, azaperone, and medetomidine. The depth of anesthesia was sufficient to permit surgical excision of SC abscesses and other procedures. Throughout the anesthetic events, the horses breathed spontaneously and maintained normal cardiorespiratory parameters, demonstrated no response to noxious stimuli, and had excellent muscle relaxation. Recoveries were smooth in all cases. Development of anesthetic protocols without ultrapotent opioids has become a priority in zoological medicine due to decreased drug availability as well as safety considerations. This is the first report of an entirely ultrapotent narcotic-free anesthetic protocol for intermediate to extended length procedures in Przewalski horses.

Dextromethorphan is a drug used in many over-the-counter cough and cold medicines for its antitussive effects.[1] It comes in oral strips, lozenges, liquids, or liquid-filled capsules and formulations often combine the drug with guaifenesin, acetaminophen, and pseudoephedrine.[1] Dextromethorphan is also a commonly abused drug because of its euphoric, hallucinogenic, and dissociative properties.[2] Some street names for dextromethorphan are “Triple C,” “Dex,” “Orange Crush,” “Red Devils,” and “Poor Man’s PCP.”[2] Depending on the amount ingested, dextromethorphan toxicity can have a wide range of cardiovascular, neurological, metabolic, and musculoskeletal adverse effects.[3]  Emergency department providers should become familiar with how to manage patients with dextromethorphan toxicity since hypertension, seizures, tachycardia, psychosis, and rhabdomyolysis are several of the complications that can arise.[3]

Neither the excretion of guaifenesin in milk nor its effect on breastfed infants have been studied. It is unlikely that with usual maternal doses amounts in breastmilk would harm the nursing infant, especially in infants over 2 months of age. It is best to avoid the use of products with a high alcohol content while nursing.

Upper respiratory tract disorders are seriously prevalent disorders that impact people daily all over the world. Antipyretics, analgesics, bronchodilators, antitussives, expectorants, mucolytics, antihistamines, and antibiotics are among the pharmacological classes that are often administered either alone or in combination to treat and manage the symptoms attributed to upper respiratory tract disorders. In the rising era of green analytical chemistry, the development of broad, multi-analyte analytical techniques that can separate and quantify numerous pharmacologically related substances simultaneously is becoming of increasing significance. This work introduces a new, concise, accurate, and robust high performance liquid chromatography method with diode array detection approach for the simultaneous assay of eight substances, namely; Albuterol, Erdosteine, Paracetamol, Amoxicillin, Chlorpheniramine, Guaifenesin and two of the most frequently encountered preservatives that are incorporated in upper respiratory tract medications; Methyl and Propyl Parabens in their bulk and pharmaceutical formulations. An Inertsil octadecyl silane-3 (4.6 × 250 mm, 5 μm) column and a gradient mobile phase system consisting of methanol and 0.025 M potassium dihydrogen orthophosphate buffer (pH 4) were employed to achieve the separation. Chromatograms were detected at 225 nm for Albuterol and Chlorpheniramine, 230 nm for Guaifenesin and Amoxicillin, 236 nm for Erdosteine, 250 nm for Paracetamol, and 256 nm for Methyl and Propyl Parabens using the diode array detector. The suggested approach was successfully verified in compliance with the International Council for Harmonization guidelines with low values of percentage relative error and percentage relative standard deviation (< 2%) and strong correlation coefficients (> 0.9991), demonstrating its good accuracy, precision and linearity. Additionally, an in-depth five-sided examination was conducted to demonstrate the suggested method’s greenness, blueness, violet innovation and sustainability profiles using the analytical GREEnness metric, analytical eco-scale, blue applicability grade index, click analytical chemistry index, violet innovation grade index and white analytical chemistry assessment metrics. This work represents the establishment of a broad spectrum, multianalyte, versatile methodology that would provide an indispensable asset for quality control laboratories in terms of its affordability, speed, sensitivity, and sustainability.

For treatment of muscle spasms associated pain, combination of nonsteroidal anti-inflammatory drugs like diclofenac (DIC) and muscle relaxants as methocarbamol (MET) is usually utilized. This work represents a novel, rapid, facile, sensitive, and selective first derivative synchronous fluorescence spectroscopy (FDSFS) for the simultaneous determination of DIC and MET in their combined tablets. Factors influencing method's sensitivity were investigated, and the best findings were accomplished applying Δ λ = 60 nm and using water as a diluting solvent. Through applying the optimized experimental conditions, DIC showed a lower detection limit of 0.15 µg/mL and a quantitation limit of 0.30 µg/mL, while MET corresponding values were 0.03 µg/mL and 0.05 µg/mL. Diclofenac was measured at 288 nm, while methocarbamol was measured at 346 nm, exhibiting linearity over the concentration ranges of 0.3-2.5 and 0.05-5.0 µg/mL, respectively. Through application to several laboratory-prepared mixtures and commercial formulation, the suggested method's applicability was determined. When comparing the proposed method to the reported HPLC method using the student's t-test and F-ratio test, no discernible differences were found. Due to simplicity and economical advantage of the method, it can be applied in quality control laboratories for analysis of the studied drugs. The evaluation of the method's eco-friendliness and greenness was also performed using Analytical GREEnness (AGREE), Green Analytical Procedure Index (GAPI) and Analytical Green Star Area (AGSA) metrics. Complete validation procedures were applied to the suggested approach in compliance with the International Conference on Harmonization's criteria.

Methocarbamol (MT), a centrally acting muscle relaxant, presents significant analytical challenges due to its low ultraviolet (UV) absorptivity, rapid metabolism, and pronounced pH-dependent instability. The presence of guaifenesin-related impurities and interference from co-formulated analgesics further complicate its detection in pharmaceutical, biological, and environmental matrices. This review compiles peer-reviewed English-language studies indexed in Scopus, Web of Science, PubMed, ScienceDirect, and Google Scholar and provides a critical assessment of MT quantification methods developed over the past 25 years. Evidence shows that optimized high-performance liquid chromatography (HPLC), particularly fluorescence-based systems, provides the highest sensitivity and selectivity, achieving sub-ng/mL detection and overcoming limitations of UV assays, such as signal suppression and narrow linear ranges. Electrochemical approaches using CNT-, graphene-, MOF-, and magnetic-nanocomposite-modified electrodes enhance redox discrimination and enable nM-μM detection. Chemometric-assisted spectroscopic techniques offer rapid, low-cost analysis suitable for simple formulations but lack reliability in complex matrices. Across all platforms, strict pH control, rapid processing, and selective extraction methods-such as solid-phase extraction (SPE), molecularly imprinted polymer (MIP), and dispersive liquid-liquid microextraction (DLLME) remain essential to reduce degradation and matrix interference. Future progress will rely on miniaturized microfluidic systems, improved stability-indicating chromatography, and intelligent electrochemical sensors capable of multiplex quantification in challenging samples.

A viral infection can cause colds and coughs, which are common respiratory ailments. A robust and efficient RP-HPLC method was proposed for the concurrent determination of guaifenesin (GUF), ephedrine (EPD), diphenhydramine (DPH), and dextromethorphan (DEX) in pharmaceutical formulations. The study attempted to design seven ecologically friendly tools using green and white measures to assess the environmental effects of inventive and forthright RP-HPLC strategies for analyzing and separating the quaternary mixture under its marketed form. The method employed an Inertsil ODS-3 V column (150 mm × 4.6 mm, 5 μm) with a mobile phase consisting of methanol, water, and dioctyl sodium sulfosuccinate. The optimal wavelength for detection was set at 250 nm, and the flow rate was maintained at 2.0 mL/min. As a result, the limits of detection (LOD) and quantification (LOQ) were calculated to be satisfactory. The calibration curves were established in the 3–80 µg/mL range to investigate the linearity with R2 > 0.999. Recovery studies confirmed the method’s trueness and significant results were demonstrated within the acceptable range of 98–102%. The study was assured according to ICH parameters, demonstrating excellent linearity and robustness.

This work presents a selective, accurate, and highly sensitive differential pulse voltammetric (DPV) approach for the quantification of oxeladin citrate (OC). The electrochemical behavior of OC was investigated using several working electrodes, including carbon paste electrode (CPE), zeolite-modified carbon paste electrode (ZMCPE), iron oxide-modified carbon paste electrode (IOMCPE) and screen-printed multi-wall carbon nanotubes (SPMWCNTs), with operational parameters optimized through cyclic voltammetry. The results confirmed an irreversible, diffusion-controlled oxidation process for OC producing a peak between 0.7 and 0.8 V (vs. Ag/AgCl). The SPMWCNTs electrode outperformed the others, providing a linear calibration range from 0.35 to 3.9 μg/mL (R[2] = 0.998), a detection limit (LOD) of 0.114 μg/mL, and a quantification limit (LOQ) of 0.35 μg/mL. The practical utility of the method was confirmed by the successful determination of OC in pharmaceutical products, both alone and in combination with Guaifenesin (GU), as well as in spiked human serum, all yielding excellent recovery values. The procedure's environmental footprint was critically evaluated using the Analytical Greenness Calculator (AGREE) and the Complex Green Analytical Procedure Index (Complex GAPI), with the high scores obtained verifying its eco-friendly nature. Characterized by its sensitivity, operational simplicity, and sustainability. This voltammetric strategy offers a robust and viable alternative for the routine analysis of OC in pharmaceutical quality control and clinical settings.

Background: Methocarbamol is a central nervous system depressant with antispasmodic properties used as a skeletal muscle relaxant as part of a multimodal analgesia regimen in critically ill patients. Intravenous (IV) methocarbamol contains polyethylene glycol (PEG) 300 and propylene glycol (PG) which have been associated with acute kidney injury (AKI). To mitigate AKI risk, IV methocarbamol is limited to 72 consecutive hours, followed by a 48-hour drug-free interval (DFI). Objective: To characterize the incidence of AKI in intensive care unit (ICU) patients receiving IV methocarbamol. Methods: This is a single-center, retrospective evaluation of adult trauma or surgical ICU patients who received at least 3 consecutive doses of IV methocarbamol. The primary outcome was the difference in SCr from day 1 through day 7 after IV methocarbamol initiation. Results: A total of 68 patients met inclusion criteria. Four patients were classified in the non-DFI group. There was no difference in the median (IQR) SCr (mg/dL) measured at any time point from day 1 through day 7 after IV methocarbamol initiation in the entire cohort [0.83 (0.71, 1.08) vs 0.74 (0.62, 1.33), P = 0.55]. There was no difference between the median (IQR) SCr (mg/dL) from day 1 through day 7 in patients that had no DFI [1.04 (0.89, 2.56) vs 1.20 (0.79, 2.92), P = 0.84]. Conclusion: No statistically significant change in SCr was observed over time in critically ill patients receiving IV methocarbamol regardless of DFI use.

In this study, a novel low-pass/band-pass diplexer-based microwave sensor is introduced for the first time as a high-sensitivity platform for the detection and quantification of sucrose and sorbitol concentrations in pharmaceutical syrups. The proposed sensor features a compact footprint of 13.1 mm × 15.84 mm and integrates two distinct filtering paths, each optimized for specific spectral ranges. The band-pass and low-pass filters are constructed using a combination of M-notch-shaped and semicircular-shaped resonators, with the latter enhanced by integrated spiral lines to reduce both physical dimensions and resonant frequency. This geometric optimization enables stronger field confinement and improved sensitivity. An equivalent lumped-element LC circuit model is also presented to accurately predict the resonators' behavior and validate the electromagnetic performance. The sensor's functionality was experimentally verified using three commercially available pharmaceutical syrups-Diphenhydramine, Guaifenesin, and Salbutamol-each with varying concentrations of sweetening agents. The sensor achieved a maximum sensitivity of 9312.5 MHz/(g mL[-1]) and a minimum detection limit (DL) of 0.00037 (dB g)/(MHz mL), demonstrating exceptional accuracy in resolving small dielectric variations. The observed nonlinear correlation between sweetener concentration and resonant frequency shift enables precise quantification of both sucrose and sorbitol across diverse formulations. The combination of high sensitivity, excellent repeatability, and miniaturized design makes the proposed sensor highly suitable for real-time, non-invasive quality control of pharmaceutical syrups. This work represents a significant advancement in dielectric-based sensing and offers promising potential for implementation in both laboratory testing and point-of-care diagnostics within the pharmaceutical industry.