Experiences - Cold Water Extractions Should Be Performed Very Carefully

[HorseBucket]

SWIM just learned first hand how dangerous CWE's are. SWIM tried out 3 CWE's last week and the past couple of days he had been having abdominal pain and diahrrea. Today he spotted some black stuff in his stool. Black stuff in stool is usually old blood. It turns black as it passes through the lower gastrointestinal tract. SWIM believes it was ibuprofen which caused the gastrointestinal bleeding. SWIM ignored the warnings on the leaflets that come with ibuprofen medications which advise against taking ibuprofen if you have any gastrointestinal problems. SWIM has had a peptic hernia for about a year.

SWIM will go to the doctor tomorrow and get himself checked.

Reputation Comments on this post:

	good thread....this is a point that warrants attention
	glad you shared this experience
	Made SWIM more careful :)

[DopinDan]

Originally Posted by MercuryDrinker

SWIM just learned first hand how dangerous CWE's are. SWIM tried out 3 CWE's last week and the past couple of days he had been having abdominal pain and diahrrea. Today he spotted some black stuff in his stool. Black stuff in stool is usually old blood. It turns black as it passes through the lower gastrointestinal tract. SWIM believes it was ibuprofen which caused the gastrointestinal bleeding. SWIM ignored the warnings on the leaflets that come with ibuprofen medications which advise against taking ibuprofen if you have any gastrointestinal problems. SWIM has had a peptic hernia for about a year.

SWIM will go to the doctor tomorrow and get himself checked.

SWIM is sorry to hear that.

How did SWIY filter the solution?

SWIM got perfectly clear solution by using a morter and pestle to crush the pills to a powder, dissolving in warm distilled water, putting in the freezer and removing at 4 degrees C measured with a lab thermometer, and using a buchner funnel, with the correct size filter paper, and a vacuum filter flask under light vacuum from a hand vacuum pump. A lot of APAP came out.

SWIM doesn't use alot of pills though, maybe 14 15/500 codiene pills were used. In SWIMs opinion its a waste of pills anyhow, as he doesn't get that much of a buzz off drinking the liquid.

Reputation Comments on this post:

nice suggestion re: technique. swim will have to try it.

[TheNewLeft]

one word...ASPIRIN.

aspirin filters better than acetaminophen and ibuprofen.

it's less water soluble, safer and quicker.

[trannyboy]

I am sorry to hear about your situation and I hope everyone reads it and perhaps learns more about the serious dangers of CWE. As crappy as it is that this has happened at least you were aware and caught it early on. Ibeprofen or any of the NSAIDs are absolutely not safe for anyone with your condition and neither is aspirin so please don't consider using these drugs in the future especially in large amount required of CWE. CWE can't remove enough for your condition, I would be hesitant to suggest it even with proper laboratory equiptment. I hope for your sake that the doctor clears you of any ill health.

To anyone reading this, please remember that the information in the leaflet is important and does apply to you. If you have gastro issues don't touch the NSAIDs. If you have liver issues don't touch either acetaminophen or the NSAIDs it just isn't worth your life, the time in the hospital or your liver/ GI tract.

The original poster is correct that it takes a lot of care to preform a CWE correctly and even then it might not be correct or safe. It often worries me that the instructions available for CWE make it appear so simple a trained monkey could do it when I know that it isn't that easy and the results of screwing up are so serious.

trannyboy

Reputation Comments on this post:

good points

[Ilsa]

swi-Dan's use of a Buchner funnel and vacuum filtration is probably the best way....coffe filters work, but take forever and allow particulates through. when kitten used to do these she'd either do it that way at the lab (at night of course....'oh hi Dr. so and so.. this? oh, it's, uh..... carbonate! really!) or the coffee filter method, but the latter is messy and takes forever, so she'd usually say fuck it and just drink the stuff. NOT safe.

[malsat]

Just take large amounts of antacids. This seems to prevent any GI damage from NSAID's in your CWE.

--------------------------

With relation to the rep comment for this post, I didn't say antacids prevent all NSAID overdose symptoms, I merely stated that taking antacids will prevent any GI disturbances associated with such overdose; NSAID's both reduce prostaglandin formation and have an acidic effect in the stomach. Antacids prevent damage from stomach acid and the NSAID's themselves to the unprotected gastric cells. From wikipedia:

"NSAIDs cause a dual insult on the GIT: the acidic molecules directly irritate the gastric mucosa, and inhibition of COX-1 reduces the levels of protective prostaglandins."

"Commonly, gastrointestinal adverse effects can be reduced through suppressing acid production"

I'd recommend you do some reading before criticising someone's facts.

Reputation Comments on this post:

Terrible advice. Antacids will not save you from ODing on NSAIDS!

[Ilsa]

^^^ this does not in any way help mitigate the hepatotoxic effects of ingesting high doses of tylenol, etc that can be left behind in a poorly executed CWE. admittedly, acetylsalicylic acid would in theory be neutralized by antacids, but since stomach pH is 1-2, this type of acid would not add much in terms of acidity, as HCl is a strong acid, while aspirin's is a much weaker acid, so i don't see how an antacid would be very helpful in preventing GI damage. if ibuprofen did indeed cause GI bleeding, it would not be the result of increased acidity.

Reputation Comments on this post:

	Great informative post!
	Informative post, poster made important harm reduction points throughout thread

[malsat]

Originally Posted by Ilsa

^^^ this does not in any way help mitigate the hepatotoxic effects of ingesting high doses of tylenol, etc that can be left behind in a poorly executed CWE

The OP was not about tylenol containing formulations, it was about ibuprofen.

if ibuprofen did indeed cause GI bleeding, it would not be the result of increased acidity.

Ibuprofen definitely can produce gastric bleeds.

Ibuprofen inhibits COX-1 and thus reduces the secretion of prostaglandins that normally protect the stomach from the acid and digestive enzymes it produces. If you administer antacids or proton pump inhibitors, you reduce the levels of acid and thus deactivate the digestive enzymes that would damage the unprotected stomach lining. Therefore taking large amounts of antacids is effective in reducing GI disturbances from any NSAID's left in a CWE.

malsat added 6 Minutes and 21 Seconds later...

Originally Posted by trannyboy

The damage that those drugs do is not related to PH of the drug it is related to the acutual drug. The use of antiacids is just to aid absorption of opiates it in no way negates the damage to liver or GI tract.

As I've said several times now, yes it does attenuate potential damage to the stomach.

I hope that you do some more research before you make blanket statement like this again.

I'm a health sciences student; everything I say has been researched.

[Ilsa]

Originally Posted by malsat

The OP was not about tylenol containing formulations, it was about ibuprofen.

Ibuprofen definitely can produce gastric bleeds.

Ibuprofen inhibits COX-1 and thus reduces the secretion of prostaglandins that normally protect the stomach from the acid and digestive enzymes it produces. If you administer antacids or proton pump inhibitors, you reduce the levels of acid and thus deactivate the digestive enzymes that would damage the unprotected stomach lining. Therefore taking large amounts of antacids is effective in reducing GI disturbances from any NSAID's left in a CWE.

ok that makes sense, thanks for clarifying and in detail. this is the type of info we need here, as we all have different areas of knowledge which together is more than the sum of its parts. don't take a disgreement over something personally: it's a chance to clarify and provide correct information, not a personal attack.

is there a reference for this? i am not contesting the validity of you statements on the protective effects of antacids co-administered with ibuprofen-- good medical references are valuable ( and much welcome in the file archive), and i'd like to read more about the mechanism you mentioned. it's common to provide a reference of some sort. there are doctors, researchers, and other experts in various areas that post here, so posting a ref is common practice and it benefits the quality of info here as a whole..

[trannyboy]

Malsat that advice is absolutely reckless and poorly informed. The damage that those drugs do is not related to PH of the drug it is related to the acutual drug. The use of antiacids is just to aid absorption of opiates it in no way negates the damage to liver or GI tract. I hope that you do some more research before you make blanket statement like this again. Please don't take this too hard, I am sure you have alot to offer on these forums but when you make medical statements you need to know what you are talking about or people might assume you are correct and be seriously injured or killed based on your advice. Take care.

trannyboy

P.S. Also on further thought I am worried that you might be following your own advice. Even in those without pre-existing liver and GI tract problems, medications like ibeprofen, aspirin, acetaminophen and other NAIDs can cause extensive damage to the vital organs if abused. If you have been using your method along with any of these drugs, I would encourage you to seek out assessment by your doctor to ensure you haven't harmed yourself in any way. It is better to be safe, healthy and evaulated then sick or dead because you didn't seek out assessment early on. So please see your family doctor, a walk-in clinic or emergency room and tell them the truth. If you experience any unusual abdomeninal pain, fever, yellowing of the skin, general feeling of ill health, fatigue, vommitting or other unusual or unexpected symptoms please seek out medical treatment immediately. I hope you are alright from this experience and continue to learn and be a valued member of this community.

[RoboCodeine7610]

one word...ASPIRIN.

aspirin filters better than acetaminophen and ibuprofen.

it's less water soluble, safer and quicker.

That's true, but aspirin would cause the same gastrointestinal problems as Ibuprofen and would probably even worsen it by increasing the bleeding rate.

[Ilsa]

the GI effects caused by different nsaid's are different, although aspirin is definitely one of the more infamous re: irritability.


malsat has knowedge of some of these differential effects, and i'd also like to see some of the references i mentioned earlier, any luck on those?

[Hamburglar]

Originally Posted by RoboCodeine7610

That's true, but aspirin would cause the same gastrointestinal problems as Ibuprofen and would probably even worsen it by increasing the bleeding rate.

I believe his point is that less aspirin will be left over in the final solution, because of it's reduced water solubility.

I am a strong proponent of aspirin use; it filters extremely quickly and with a single coffee filter I get a completely clear solution. I have not measured but I am confident that my final results contain less than 1g of aspirin (when starting with 35 375mg pills).

[RoboCodeine7610]

believe his point is that less aspirin will be left over in the final solution, because of it's reduced water solubility.

I am a strong proponent of aspirin use; it filters extremely quickly and with a single coffee filter I get a completely clear solution. I have not measured but I am confident that my final results contain less than 1g of aspirin (when starting with 35 375mg pills).

Oh yeah, for sure.But right now, even therapeutic doses of aspirin would worsen his condition considerabily.So right now, paracetamol is your best option since it does not affect COX-1 nor is it a NSAID.

Reputation Comments on this post:

interesting point

[malsat]

http://general-medicine.jwatch.org/c...ion/2008/221/2

http://www.docguide.com/news/content...25719D004AD9D7

Here are your references.

Reputation Comments on this post:

Provides references for your previous points, you bring to attention something quite interesting

[Ilsa]

the former article requires a log-in, but the latter explains it quite well, thanks for posting them!

[smeghead]

Patience is a virtue. SWIM finds it's better to wait and let the filtering take place, even if it takes hours, rather than getting impatient with the stuff.
Don't squeeze the filter to try and get more out of it. SWIM just adds more water and waits a bit longer.
If you can't wait that long perhaps you're too addicted to the stuff?

[Hamburglar]

Originally Posted by smeghead

Patience is a virtue. SWIM finds it's better to wait and let the filtering take place, even if it takes hours, rather than getting impatient with the stuff.
Don't squeeze the filter to try and get more out of it. SWIM just adds more water and waits a bit longer.
If you can't wait that long perhaps you're too addicted to the stuff?

SWIM questions your advice that the filter should not be squeezed.

When SWIM squeezes the filter, nothing but crystal clear liquid comes out. The final solution is completely opaque, even after 5 minutes of filtering and then a firm squeeze.

One should be careful, granted, but SWIM does not think that squeezing the filter will have any harm.

[darkglobe]

SWIM recently came across a rather odd combination: Codeine Phosphate (30mg) + Naproxen (300mg).

How strange! The infamous Naproxen known for its gastrointestinal disturbances of a somewhat severe degree in a large percentage of patients.

SWIM is not a medical professional and makes no claims to know a great deal outside of his general interest area (neuroscience and neuropharmacology), but he is aware of Naproxen belonging to the NSAID group, he himself has been prescribed Naproxen in the past for pain due to his joint hypermobility syndrome (ribs "clicking" and shifting as SWIM walked), and has first hand experience of the stomach bleeding (his stools confirmed this).

Anybody know of the water-solubility of Naproxen, or even if it would theoretically be captured by a CWE?

[honourableone]

Originally Posted by darkglobe

Anybody know of the water-solubility of Naproxen, or even if it would theoretically be captured by a CWE?

My pharmacopeia (British Pharmacopeia 1999) claims that naproxen is "practically insoluble in water". It says the same thing about ibuprofen, but it says that paracetamol is "sparingly soluble in water" and that aspirin is "slightly soluble in water".

Searching the internet, I struggled to find any actual numerical data, but it is definitely insoluble (I was getting the impression that it was more so than ibuprofen, but nothing definite so don't hold me on that one). I'll keep looking, and I'll post an update if I find more.

[miggeth]

My friend filters it several times, sometimes up to 4. First with cotton to remove most of the apap fast, then with coffee filter, than again when all the subsequent passes are complete. Keeping at 3 degrees C all the time.

[smeghead]

SWIM's been on Naproxen too, for arthritic pains in a damaged joint. SWIM didn't have any sides from the drug. (SWIM was 16 at the time)

(note that SWIM is not a
chemist, SWIM barely has a science GSCE. )

I can't paste in any links as I less than 50 posts, but many pages on Google Search for "naproxen water soluble" linking to journals give back results stating it's poor water solubility. There seem to be some papers out there trying to find a method of increasing Naproxen's water solubulity/uptake. 'Tis worth waiting for someone who knows what they're on about to chip in (Hello Pharmacists? I know you're out there, reading these boards )

SWIM doesn't know anyone who's done CWE with naproxen products (didn't know any existed either!) but SWIM would avoid it precisely because of the gastro sides; especially in anything over 6 tablets. The last thing he wants is a stomach ulcer.

Cheers

Reputation Comments on this post:

Welcome =) Good attempt at answering a member's question.

[InTheCity]

Good post! SWIM read this earlier today and just finished doing another CWE this evening. Noticed it was pretty murky so SWIM sent it through another filter, and it came out still murky! This is where SWIM would have normally given up, but this thread jumped into SWIMs head and he double filtered it again and it came out crystal clear.

+rep for a healthy reminder