Diphenhydramine Hydrochloride/Naproxen Sodium

We report on the investigation of sodium coordination environments with solid-state ²³Na nuclear magnetic resonance (NMR) spectroscopy of various hydrates and solvates of sodium naproxen (SN), a commercially available anti-inflammatory drug sold over the counter as Aleve®, among other names. The ²³Na quadrupolar coupling constant is found to change significantly depending on the hydration state, and subtle changes in oxygen coordination environment about the sodium cations were apparent in the NMR spectra. High-resolution double-rotation NMR experiments are also performed on powdered samples to obtain solution-like ²³Na NMR spectra. Our attempts at crystallizing various solvates of SN have led to the characterization of the first crystal structure for the heminonahydrated form. The composition of commercial SN is also investigated and it is shown that Aleve® is composed of approximately 80% monohydrate solvate. Density-functional theory calculations, using the gauge-including projector-augmented-wave formalism, allow for the assignment of ²³Na NMR peaks to specific sodium sites in the reported X-ray crystal structure.

A 40-year-old woman with history of hypertension and migraines presents with a complaint of headache. Two days prior to presentation she began to experience a left-sided, throbbing headache that radiated to the right and was accompanied by blurring of left eye vision and nausea. The blurred vision and headache were exacerbated by bright light, consistent with prior migraine attacks. She took her usual dose of naproxen with resolution of her nausea but still had a mild headache and blurred left eye vision. Two hours prior to presentation she walked outside and experienced worsening of her headache upon exposure to the sunlight, but without concomitant change in her vision or nausea. Aleve did not improve her symptoms, so she decided to present to the emergency department. Her vital signs were normal. 1. Which features are consistent with migraine in this patient? 2. What other important aetiologies of headache should be considered in this patient? …