Validation of direct injection electrospray LC-MS/MS for confirmation of opiates in urine drug testing

LC-MS/MS-Based Method for the Multiplex Detection of 24 Fentanyl Analogues and Metabolites in Whole Blood at Sub ng mL-1 Concentrations

The United States and numerous other countries worldwide are currently experiencing a public health crisis due to the abuse of illicitly manufactured fentanyl (IMF) and its analogues. This manuscript describes the development of a liquid chromatography-tandem mass spectrometry-based method for the multiplex detection of N = 24 IMF analogues and metabolites in whole blood at concentrations as low as 0.1-0.5 ng mL^-1. These available IMFs were fentanyl, norfentanyl, furanyl norfentanyl, remifentanil acid, butyryl norfentanyl, remifentanil, acetyl fentanyl, alfentanil, AH-7921, U-47700, acetyl fentanyl 4-methylphenethyl, acrylfentanyl, para-methoxyfentanyl, despropionyl fentanyl (4-ANPP), furanyl fentanyl, despropionyl para-fluorofentanyl, carfentanil, (±)-cis-3-methyl fentanyl, butyryl fentanyl, isobutyryl fentanyl, sufentanil, valeryl fentanyl, para-fluorobutyryl fentanyl, and para-fluoroisobutyryl fentanyl. Most IMF analogues (N = 22) could be easily distinguished from one another; the isomeric forms butyryl/isobutyryl fentanyl and para-fluorobutyryl/para-fluoroisobutyryl fentanyl could not be differentiated. N = 13 of these IMF analogues were quantified for illustrative purposes, and their forensic quality control standards were also validated for limit of detection (0.017-0.056 ng mL^-1), limit of quantitation (0.100-0.500 ng mL^-1), selectivity/sensitivity, ionization suppression/enhancement (87-118%), process efficiency (60-95%), recovery (64-97%), bias (<20%), and precision (>80%). This flexible, time- and cost-efficient method was successfully implemented at the Montgomery County Coroner's Office/Miami Valley Regional Crime Laboratory in Dayton, Ohio, where it aided in the analysis of N = 725 postmortem blood samples collected from February 2015 to November 2016.

Spray-inlet microwave plasma torch ionization tandem mass spectrometry for the direct detection of drug samples in liquid solutions

RATIONALE

Drug abuse or dependence results in a series of social problems, including crime and traffic accidents. Spray-inlet microwave plasma torch tandem mass spectrometry (MPT-MS/MS) was developed and used for the direct detection of such drugs in liquid solutions.

METHODS

Drug sample solutions were directly sprayed into the flame of an MPT by a sampling pump and the ions produced by Penning ionization and ion-molecule reactions were guided into a quadrupole time-of-flight (QTOF) tandem mass spectrometer for mass analysis. The MPT was operated at 40 W and 2.45 GHz in a 700 mL/min argon flow both for the inner and middle plasma.

RESULTS

Intact quasi-molecular and molecular ions of various drugs were successfully characterized by spray-inlet MPT-MS/MS. The analysis of one sample was finished within 30 s. Furthermore, the method exhibited excellent efficiency, precision and sensitivity, and the limits of detection and limits of quantification of the samples in methanol were in the range of 5.25-60.0 and 17.5-200 ng g^-1 , respectively. Excellent linearities with coefficients of determination (R² ) of 0.9627-0.9980 were verified in the range 0.05-50 μg g^-1 . Four different beverages purchased locally were also analyzed with spray-inlet MPT-MS/MS, and caffeine was directly determined in two of the beverages. By adding six standard drug samples to sport drinks (each drug was 1 μg g^-1 ) and Chinese spirit (each drug was 0.1 μg g^-1 ), all the drugs except for caffeine were detected successfully.

CONCLUSIONS

This study indicates that spay-inlet MPT-MS/MS is an effective method for direct and rapid identification of drug solutions, and it has substantial potential for fast and sensitive drug residue detection.

Economical synthesis of 13C-labeled opiates, cocaine derivatives and selected urinary metabolites by derivatization of the natural products

The illegal use of opiates and cocaine is a challenge world-wide, but some derivatives are also valuable pharmaceuticals. Reference samples of the active ingredients and their metabolites are needed both for controlling administration in the clinic and to detect drugs of abuse. Especially, ¹³C-labeled compounds are useful for identification and quantification purposes by mass spectroscopic techniques, potentially increasing accuracy by minimizing ion alteration/suppression effects. Thus, the synthesis of [acetyl-¹³C₄]heroin, [acetyl-¹³C₄-methyl-¹³C]heroin, [acetyl-¹³C₂-methyl-¹³C]6-acetylmorphine, [N-methyl-¹³C-O-metyl-¹³C]codeine and phenyl-¹³C₆-labeled derivatives of cocaine, benzoylecgonine, norcocaine and cocaethylene was undertaken to provide such reference materials. The synthetic work has focused on identifying ¹³C atom-efficient routes towards these derivatives. Therefore, the ¹³C-labeled opiates and cocaine derivatives were made from the corresponding natural products.

Development of quantitative method for determination of γ-glutamyl peptides by capillary electrophoresis tandem mass spectrometry: an efficient approach avoiding matrix effect

Serum γ-glutamyl di- and tripeptides have proven to be useful biomarkers to accurately predict nine different forms of liver disease. Using liquid chromatography-tandem mass spectrometry (LC-MS/MS) with multiple reaction monitoring (MRM), serum and liver samples spiked with γ-glutamyl peptide standards were analyzed to estimate accuracy. Unexpectedly, the recovery rates for several γ-glutamyl peptides in the serum samples were quite low, whereas values for some γ-glutamyl peptides in the liver samples were highly elevated. Most of these peptides were barely retained on the reverse-phase column, resulting in significant ion suppression or enhancement. In contrast, a capillary electrophoresis tandem mass spectrometry (CE-MS/MS) method with MRM was minimally affected by matrix effects. Of the 39 tested compounds, most of γ-glutamyl peptides that did not contain a thiol substituent in its structure gave acceptable recoveries (70-120%), and limits of detection for the analytes were between 3.6 and 800 nmol/l with pressure injection at 5 kPa for 10 s (ca. 10 nl). The CE-MS/MS method provided high resolution and proved to be highly selective and sensitive, its utility being demonstrated by the determination of γ-glutamyl di- and tripeptides in serum and liver samples.

Methods for urine drug testing using one-step dilution and direct injection in combination with LC–MS/MS and LC–HRMS

The advent of LC combined with MS made it possible to design analytical methods for urine drug testing based on the very simple concept of diluting urine with an internal standard as the sole preparation procedure prior to instrumental analysis. The number of publications using this method design increased after the development of high-efficiency LC based on sub-2 μm particles. The success of this method design for drug testing, doping control and toxicological investigations of urine is now well documented and comprise both screening and confirmation methods. The nondiscriminating nature of this method design makes it even more attractive in combination with high-resolution MS for multicomponent target and general unknown analysis applications.

Methylphenidate for attention deficit hyperactivity disorder and drug relapse in criminal offenders with substance dependence: a 24-week randomized placebo-controlled trial

AIM

To test the efficacy and safety of osmotic release oral system (OROS) methylphenidate (MPH) in doses up to 180 mg/day to treat attention deficit hyperactivity disorder (ADHD) and prevent any drug relapse in individuals with a co-diagnosis of ADHD and amphetamine dependence.

DESIGN

Randomized placebo-controlled 24-week double-blind trial with parallel groups design.

SETTING

Participants were recruited from medium security prisons in Sweden. The medication started within 2 weeks before release from prison and continued in out-patient care with twice-weekly visits, including once-weekly cognitive behavioural therapy.

PARTICIPANTS

Fifty-four men with a mean age of 42 years, currently incarcerated, meeting DSM-IV criteria for ADHD and amphetamine dependence.

MEASUREMENTS

Change in self-reported ADHD symptoms, relapse to any drug use (amphetamine and other drugs) measured by urine toxicology, retention to treatment, craving and time to relapse.

FINDINGS

The MPH-treated group reduced their ADHD symptoms during the trial (P = 0.011) and had a significantly higher proportion of drug-negative urines compared with the placebo group (P = 0.047), including more amphetamine-negative urines (P = 0.019) and better retention to treatment (P=0.032).

CONCLUSIONS

Methylphenidate treatment reduces attention deficit hyperactivity disorder symptoms and the risk for relapse to substance use in criminal offenders with attention deficit hyperactivity disorder and substance dependence.

The challenges of LC–MS/MS analysis of opiates and opioids in urine

Opioids are some of the most commonly prescribed and abused drugs around the world. Primarily used for anesthesia or pain management, other opioids can also be used in the treatment of opioid addiction. Given these facts, clinicians often randomly test or monitor their patients to determine compliance or abstinence from these drugs via immunoassay methods. When a positive screen is obtained, a confirmatory assay is carried out and although the gold standard has been GC–MS, LC–MS/MS is fast becoming a valid and popular alternative. This review will discuss opioids, the complex metabolic pathways, the measurement of these drugs, the challenges involved and, finally, will describe some LC–MS/MS methods published from 2003 until 2013.

A new platform for sensing urinary morphine based on carrier assisted electromembrane extraction followed by adsorptive stripping voltammetric detection on screen-printed electrode

Electromembrane extraction (EME) coupled with electrochemical detection on screen-printed carbon electrode has been developed for the quantification of morphine in urine samples. Charged morphine molecules were extracted from an aqueous sample by applying an electrical potential through a thin supported liquid membrane (SLM) into an acidic aqueous acceptor solution (20 µL) placed inside the lumen of a hollow fiber. Then, the acceptor solution was mixed with 20 µL of NaOH solution (0.1 M) and analyzed using screen printed electrochemical strip. Differential pulse voltammetry (DPV) peak current at 0.18 V was selected as the signal and the influences of experimental parameters were investigated and optimized using Box-behnken design and also one-variable-at-a-time methodology as follows: adsorptive accumulation time, 40 s; SLM, 2-nitrophenyl octyl ether+10% tris-(2-ethylhexyl) phosphate+10% di-(2-ethylhexyl) phosphate; pH of the sample solution, 6.0; pH of the acceptor solution, 1.0; EME time, 24 min; EME potential, 90 V and stirring rate, 1000 rpm. The calibration curve which was plotted by the variation of DPV currents as a function of morphine concentration was linear within the range of 0.005-2.0 µg mL(-1). The limit of detection and the limit of quantification were 0.0015 (S/N=3) and 0.005 µg mL(-1), respectively. Finally, the proposed method was able to determine morphine simply and effectively at concentration levels encountered in toxicology and doping.

Determination of morphine, codeine, and paclitaxel in human serum and plasma by micellar electrokinetic chromatography

A micellar electrokinetic chromatography method is proposed for the determination of morphine, codeine, and paclitaxel at clinical relevant levels in human serum and plasma, which are employed in the treatment of patients with cancer. Optimal conditions for the separation were investigated. A background electrolyte solutions consisting of 20 mM borate buffer adjusted to pH 8.5, sodium dodecyl sulphate 60 mM and 15% methanol, hydrodynamic injection, and 25 kV as separation voltage were used. Detection wavelength was 212 nm for morphine and codeine and 200 nm for paclitaxel. Aspects such as stability of the solutions, linearity, accuracy, precision, and robust and ruggedness were examined in order to validate the proposed method. Detection limits obtained for all the studied compounds ranged between 26 and 52 ng/mL. Before micellar electrokinetic chromatography determination, the samples were purified and enriched by means of an extraction-preconcentration step with a preconditioned C(18) cartridge. This method was applied to the analysis of serum and plasma samples from different cancer patients undergoing treatment with paclitaxel or/and codeine.

Efficiency of a miniaturized silica monolithic cartridge in reducing matrix ions as demonstrated in the simultaneous extraction of morphine and codeine from urine samples for quantification with liquid chromatography-tandem mass spectrometry (LC-MS/MS)

Presence of matrix ions could negatively affect the sensitivity and selectivity of liquid chromatography-tandem mass spectrometer (LC-MS/MS). In this study, the efficiency of a miniaturized silica monolithic cartridge in reducing matrix ions was demonstrated in the simultaneous extraction of morphine and codeine from urine samples for quantification with LC-MS. The miniaturized silica monolith with hydroxyl groups present on the largely exposed surface area function as a weak cation exchanger for solid phase extraction (SPE). The miniaturized silica cartridge in 1 cm diameter and 0.5 cm length was housed in a 2-ml syringe fixed over a SPE vacuum manifold for extraction. The cleaning effectiveness of the cartridge was confirmed by osmometer, atomic absorption spectrometer, LC-MS and GC-TOFMS. The drugs were efficiently extracted from urine samples with recoveries ranging from 86% to 114%. The extracted analytes, after concentration and reconstitution, were quantified using LC-MS/MS. The limits of detection for morphine and codeine were 2 ng/ml and 1 ng/mL, respectively. The relative standard deviations of measurements ranged from 3% to 12%. The monolithic sorbent offered good linearity with correlation coefficients > 0.99, over a concentration range of 50-500 ng/ml. The silica monolithic cartridge was found to be more robust than the particle-based packed sorbent and also the commercial cartridge with regards to its recyclability and repeated usage with minimal loss in efficiency. Our study demonstrated the efficiency of the miniaturized silica monolith for removal of matrix ions and extraction of drugs of abuse in urinary screening.

Pitfalls Associated with the Use of Liquid Chromatography–Tandem Mass Spectrometry in the Clinical Laboratory

BACKGROUND

Novel mass spectrometric techniques such as atmospheric pressure ionization and tandem mass spectrometry have substantially extended the spectrum of clinical chemistry methods during the past decade. In particular, liquid chromatography tandem–mass spectrometry (LC-MS/MS) has become a standard tool in research laboratories as well as in many clinical laboratories. Although LC-MS/MS has features that suggest it has a very high analytical accuracy, potential sources of inaccuracy have recently been identified.

CONTENT

The sources of inaccuracy in LC-MS/MS methods used in the routine quantification of small molecules are described and discussed. Inaccuracy of LC-MS/MS methods can be related to the process of ionization through the insource transformation of conjugate metabolites or target analytes and may also be attributable to ionization matrix effects that have a differential impact on target analytes and internal-standard compounds. Inaccuracy can also be associated with the process of ion selection, which mainly occurs when compounds from the sample matrix share mass transitions with a target analyte. In individual assays, most potential sources of inaccuracy can be controlled by sufficient LC separation–based sample workup before MS analysis.

SUMMARY

LC-MS/MS methods should undergo rigorous and systematic validation before introduction into patient care.

Micro-solid phase extraction coupled with high-performance liquid chromatography-tandem mass spectrometry for the determination of stimulants, hallucinogens, ketamine and phencyclidine in oral fluids

A confirmatory method for the determination of illicit drugs based on micro-solid phase extraction with modified tips, made of a functionalized fiberglass with apolar chains of octadecylsilane into monolithic structure, has been developed in this study. Drugs belonging to different chemical classes, such as amphetamine, methamphetamine, methylenedioxyamphetamine, methylenedioxyethylamphetamine, methylenedioxymethylamphetamine, cocaine, benzoylecgonine, ketamine, mescaline, phencyclidine and psilocybine were analyzed. The quantitation was performed by liquid chromatography-tandem mass spectrometry and the analytes were detected in positive ionization by means of an electrospray source. The limits of quantification ranged between 0.3 ng mL(-1) for cocaine and 4.9 ng mL(-1) for psilocybine, with coefficients of determination (r(2)) >0.99 for all the analytes as recommended in the guidelines of Society of Forensic Toxicologists-American Association Forensic Sciences.

Comparison of analytical approaches for liquid chromatography/mass spectrometry determination of the alcohol biomarker ethyl glucuronide in urine

Official guidelines originating from a European Union directive regulate requirements for analytical methods used to identify chemical compounds in biological matrices. This study compared different liquid chromatography/electrospray ionization mass spectrometry (LC/ESI-MS) and tandem mass spectrometry (LC/ESI-MS/MS) procedures for accurate determination of the conjugated ethanol metabolite and alcohol biomarker ethyl glucuronide (EtG) in urine, and the value of combined EtG and ethyl sulfate (EtS) measurement. Analysis was carried out on 482 urines following solid-phase extraction (SPE) sample cleanup or using direct injection of a diluted sample. SPE combined with LC/MS/MS was demonstrated to be the most selective and sensitive method and was chosen as reference method. The EtG results by different methods showed good correlation (r = 0.96-0.98). When comparing five reporting limits for EtG in the range 0.10-1.00 mg/L, the overall agreement with the reference method (frequency of true positives plus true negatives) was 82-97% for direct-injection LC/MS/MS, 90-97% for SPE-LC/MS, 86-98% for direct-injection LC/MS, and 86-98% for direct-injection LC/MS analysis of EtG and EtS. Most deviations were attributable to uncertainty in quantitation, when the value was close to a cutoff but the respective results were slightly above and below, or vice versa, the critical limit. However, for direct-injection LC/MS/MS, despite earning 4 identification points, equally many negative results were due to a product ion ratio outside the +/-20% deviation accepted by the guidelines. These results indicate that the likelihood of different analytical methods to provide reliable analytical results depends on the reporting limit applied.

Direct quantification of 11-nor-Delta(9)-tetrahydrocannabinol-9-carboxylic acid in urine by liquid chromatography/tandem mass spectrometry in relation to doping control analysis

An accurate and precise method for the quantification of 11-nor-Delta(9)-tetrahydrocannabinol-9-carboxylic acid (THCA) in urine by liquid chromatography/tandem mass spectrometry (LC/MS/MS) for doping analysis purposes has been developed. The method involves the use of only 200 microL of urine and the use of D(9)-THCA as internal standard. No extraction procedure is used. The urine samples are hydrolysed using sodium hydroxide and diluted with a mixture of methanol/glacial acetic acid (1:1). Chromatographic separation is achieved using a C8 column with gradient elution. All MS and MS/MS parameters were optimised in both positive and negative electrospray ionisation modes. For the identification and the quantification of THCA three product ions are monitored in both ionisation modes. The method is linear over the studied range (5-40 ng/mL), with satisfactory intra-and inter-assay precision, and the relative standard deviations (RSDs) are lower than 15%. Good accuracy is achieved with bias less than 10% at all levels tested. No significant matrix effects are observed. The selectivity and specificity are satisfactory, and no interferences are detected. The LC/MS/MS method was applied for the analysis of 48 real urine samples previously analysed with a routine gas chromatography/mass spectrometry (GC/MS) method. A good correlation between the two methods was obtained (r(2) > 0.98) with a slope close to 1.

Sample preparation and separation techniques for bioanalysis of morphine and related substances

In present time the use or misuse of morphine and its derivatives are monitored by assaying the presence of the drug and its metabolites in biofluids. In the present review, focus is placed on the sample preparation and on the separation techniques used in the current best practices of bioanalysis of morphine and its major metabolites. However, as methods for testing the misuse of heroin, a morphine derivative, often involve bioanalytical methods that cover a number of other illicit drug substances, such methods are also included in the review. Furthermore, the review also includes bioanalysis in a broader perspective as analysis of plant materials, cell cultures and environmental samples. The review is not intended to cover all publications that include bioanalysis of morphine but is more to be considered a view into the current best practices of bioanalysis of morphine, its metabolites and other related substances.