Rapid resolution liquid chromatography for monitoring the quality of stockpiled atropine preparations for injection

LC-MS/MS determination of atropine toxicity: Pre-analytical effect of blood collection tube and analytical matrix

Atropine (ATR) intoxication is a recurrent case in emergency departments. The diagnosis is dependent on clinical evaluation and is supported by analytical assessment. The assay is limited by the rapid degradation/metabolism of ATR into TRP as well as the preanalytical factors impairing correct detection and diagnosis. In this study, an HPLC-MS/MS method was optimized for the simultaneous determination of ATR and TRP. The effect of analytical matrix and the impact of blood-collection tube type on the ATR analytical signal were investigated. Separation was achieved using water: 0.01% formic acid acidified methanol (40: 60, v/v) as a mobile phase and Inertsil® C18 column (5 µm; 4.6*150 mm) as a stationary phase. The retention-times were 2.6 and 6.5 min for ATR and TRP, respectively. A chromatographic shift (0.4 min) in ATR peak, but not TRP, was observed in biological samples from neat ones. The best analytical signal was observed when heparinized blood collection tubes were employed. The method was linear, accurate and precise in the ATR toxicity range enabling the detection of ATR intoxication down to a concentration of 0.1 ng/mL by applying a simple sample clean-up procedure. In conclusion, an HPLC-MS/MS method for the simultaneous determination of ATR and TRP is presented. The method highlights the chromatographic shift of ATR peak in biological samples that may induce false-negative detection and poses TRP as an alternative toxicological marker for ATR toxicity. Meanwhile the study recommends heparin tubes for blood-sample collection.

Corneal Penetration of Low-Dose Atropine Eye Drops

Major studies demonstrating the inhibition of myopia in children and juveniles by low-dose atropine eye drops provide little information on the manufacturing process and the exact composition of the atropine dilutions. However, corneal penetration might significantly vary depending on preservatives, such as benzalkonium chloride (BAC), and the atropine concentration. Since there is a trade-off between side effects, stability, and optimal effects of atropine on myopia, it is important to gain better knowledge about intraocular atropine concentrations. We performed an ex vivo study to determine corneal penetration for different formulations. Atropine drops (0.01%) of different formulations were obtained from pharmacies and applied to the cornea of freshly enucleated pig eyes. After 10 min, a sample of aqueous humor was taken and atropine concentrations were determined after liquid–liquid extraction followed by high-performance liquid chromatography–tandem mass spectrometry (LC-MS/MS). The variability that originated from variations in applied drop size exceeded the differences between preserved and preservative-free formulations. The atropine concentration in the anterior chamber measured after 10 min was only 3.8 × 10⁻⁸ of its concentration in the applied eye drops, corresponding to 502.4 pM. Obviously, the preservative did not facilitate corneal penetration, at least ex vivo. In the aqueous humor of children’s eyes, similar concentrations, including higher variability, may be expected in the lower therapeutic window of pharmacodynamic action.