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Alshogran OY, Dodeja P, Albukhaytan H, Laffey T, Chaphekar N, Caritis S, Shaik IH, Venkataramanan R. Drugs in Human Milk Part 1: Practical and Analytical Considerations in Measuring Drugs and Metabolites in Human Milk. Clin Pharmacokinet 2024; 63:561-588. [PMID: 38748090 DOI: 10.1007/s40262-024-01374-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2024] [Indexed: 05/22/2024]
Abstract
Human milk is a remarkable biofluid that provides essential nutrients and immune protection to newborns. Breastfeeding women consuming medications could pass the drug through their milk to neonates. Drugs can be transferred to human milk by passive diffusion or active transport. The physicochemical properties of the drug largely impact the extent of drug transfer into human milk. A comprehensive understanding of the physiology of human milk formation, composition of milk, mechanisms of drug transfer, and factors influencing drug transfer into human milk is critical for appropriate selection and use of medications in lactating women. Quantification of drugs in the milk is essential for assessing the safety of pharmacotherapy during lactation. This can be achieved by developing specific, sensitive, and reproducible analytical methods using techniques such as liquid chromatography coupled with mass spectrometry. The present review briefly discusses the physiology of human milk formation, composition of human milk, mechanisms of drug transfer into human milk, and factors influencing transfer of drugs from blood to milk. We further expand upon and critically evaluate the existing analytical approaches/assays used for the quantification of drugs in human milk.
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Affiliation(s)
- Osama Y Alshogran
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Prerna Dodeja
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Hamdan Albukhaytan
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Taylor Laffey
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nupur Chaphekar
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Steve Caritis
- Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, UPMC Magee-Women's Hospital, Pittsburgh, PA, USA
| | - Imam H Shaik
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA.
- Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, 3501 Terrace Street, Room 7406, Salk Hall, Pittsburgh, PA, 15261, USA.
| | - Raman Venkataramanan
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA.
- Department of Pathology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
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Ojara FW, Kawuma AN, Waitt C. A systematic review on maternal-to-infant transfer of drugs through breast milk during the treatment of malaria, tuberculosis, and neglected tropical diseases. PLoS Negl Trop Dis 2023; 17:e0011449. [PMID: 37440491 DOI: 10.1371/journal.pntd.0011449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Exclusive breastfeeding of infants under 6 months of age is recommended by the World Health Organization. In 2021, over 300 million combined incident cases of malaria, tuberculosis, and neglected tropical diseases (NTDs) were reported, predominantly in low-income countries. For many of the drugs used as first-line treatments for these conditions, there is limited knowledge on infant exposure through breastfeeding with poorly understood consequences. This review summarized available knowledge on mother-to-infant transfer of these drugs to inform future lactation pharmacokinetic studies. METHODOLOGY A list of first-line drugs was generated from the latest WHO treatment guidelines. Using standard online databases, 2 independent reviewers searched for eligible articles reporting lactation pharmacokinetics studies and extracted information on study design, participant characteristics, and the mathematical approach used for parameter estimation. A third reviewer settled any disagreements between the 2 reviewers. All studies were scored against the standardized "ClinPK" checklist for conformity to best practices for reporting clinical pharmacokinetic studies. Simple proportions were used to summarize different study characteristics. FINDINGS The most remarkable finding was the scarcity of lactation pharmacokinetic data. Only 15 of the 69 drugs we listed had lactation pharmacokinetics fully characterized. Most studies enrolled few mothers, and only one evaluated infant drug concentrations. Up to 66% of the studies used non-compartmental analysis to estimate pharmacokinetic parameters rather than model-based compartmental analysis. Unlike non-compartmental approaches, model-based compartmental analysis provides for dynamic characterization of individual plasma and breast milk concentration-time profiles and adequately characterizes variability within and between individuals, using sparsely sampled data. The "ClinPK" checklist inadequately appraised the studies with variability in the number of relevant criteria across different studies. CONCLUSIONS/SIGNIFICANCE A consensus is required on best practices for conducting and reporting lactation pharmacokinetic studies, especially in neglected diseases such as malaria, tuberculosis, and NTDs, to optimize treatment of mother-infant pairs.
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Affiliation(s)
- Francis Williams Ojara
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Pharmacology and Therapeutics, Gulu University, Gulu, Uganda
| | - Aida N Kawuma
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Catriona Waitt
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool, United Kingdom
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3
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Moroni AB, Calvo NL, Kaufman TS. Selected Aspects of the Analytical and Pharmaceutical Profiles of Nifurtimox. J Pharm Sci 2023; 112:1523-1538. [PMID: 36822273 DOI: 10.1016/j.xphs.2023.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/16/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023]
Abstract
Nifurtimox is a nitroheterocyclic drug employed for treatment of trypanosomiases (Chagas disease and West African sleeping sickness); its use for certain cancers has also been assessed. Despite having been in the market for over 50 years, knowledge of nifurtimox is still fragmentary and incomplete. Relevant aspects of the chemistry and biology of nifurtimox are reviewed to summarize the current knowledge of this drug. These comprise its chemical synthesis and the preparation of some analogues, as well as its chemical degradation. Selected physical data and physicochemical properties are also listed, along with different approaches toward the analytical characterization of the drug, including electrochemical (polarography, cyclic voltammetry), spectroscopic (ultraviolet-visible, nuclear magnetic resonance, electron spin resonance), and single crystal X-ray diffractometry. The array of polarographic, ultraviolet-visible spectroscopic, and chromatographic methods available for the analytical determination of nifurtimox (in bulk drug, pharmaceutical formulations, and biological samples), are also presented and discussed, along with chiral chromatographic and electrophoretic alternatives for the separation of the enantiomers of the drug. Aspects of the drug likeliness of nifurtimox, its classification in the Biopharmaceutical Classification System, and available pharmaceutical formulations are detailed, whereas pharmacological, chemical, and biological aspects of its metabolism and disposition are discussed.
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Affiliation(s)
- Aldana B Moroni
- Área de Análisis de Medicamentos, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario e Instituto de Química Rosario (IQUIR, CONICET-UNR), Suipacha 531, Rosario S2002LRK, Argentina
| | - Natalia L Calvo
- Área de Análisis de Medicamentos, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario e Instituto de Química Rosario (IQUIR, CONICET-UNR), Suipacha 531, Rosario S2002LRK, Argentina
| | - Teodoro S Kaufman
- Área de Análisis de Medicamentos, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario e Instituto de Química Rosario (IQUIR, CONICET-UNR), Suipacha 531, Rosario S2002LRK, Argentina.
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Treder N, Bączek T, Wychodnik K, Rogowska J, Wolska L, Plenis A. The Influence of Ionic Liquids on the Effectiveness of Analytical Methods Used in the Monitoring of Human and Veterinary Pharmaceuticals in Biological and Environmental Samples-Trends and Perspectives. Molecules 2020; 25:E286. [PMID: 31936806 PMCID: PMC7024248 DOI: 10.3390/molecules25020286] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 12/27/2019] [Accepted: 01/08/2020] [Indexed: 02/06/2023] Open
Abstract
Recent years have seen the increased utilization of ionic liquids (ILs) in the development and optimization of analytical methods. Their unique and eco-friendly properties and the ability to modify their structure allows them to be useful both at the sample preparation stage and at the separation stage of the analytes. The use of ILs for the analysis of pharmaceuticals seems particularly interesting because of their systematic delivery to the environment. Nowadays, they are commonly detected in many countries at very low concentration levels. However, due to their specific physiological activity, pharmaceuticals are responsible for bioaccumulation and toxic effects in aquatic and terrestrial ecosystems as well as possibly upsetting the body's equilibrium, leading to the dangerous phenomenon of drug resistance. This review will provide a comprehensive summary of the use of ILs in various sample preparation procedures and separation methods for the determination of pharmaceuticals in environmental and biological matrices based on liquid-based chromatography (LC, SFC, TLC), gas chromatography (GC) and electromigration techniques (e.g., capillary electrophoresis (CE)). Moreover, the advantages and disadvantages of ILs, which can appear during extraction and separation, will be presented and attention will be given to the criteria to be followed during the selection of ILs for specific applications.
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Affiliation(s)
- Natalia Treder
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, Hallera 107, 80-416 Gdańsk, Poland; (N.T.); (T.B.)
| | - Tomasz Bączek
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, Hallera 107, 80-416 Gdańsk, Poland; (N.T.); (T.B.)
| | - Katarzyna Wychodnik
- Department of Environmental Toxicology, Faculty of Health Sciences with Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Dębowa 23 A, 80-204 Gdańsk, Poland; (K.W.); (J.R.); (L.W.)
| | - Justyna Rogowska
- Department of Environmental Toxicology, Faculty of Health Sciences with Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Dębowa 23 A, 80-204 Gdańsk, Poland; (K.W.); (J.R.); (L.W.)
| | - Lidia Wolska
- Department of Environmental Toxicology, Faculty of Health Sciences with Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Dębowa 23 A, 80-204 Gdańsk, Poland; (K.W.); (J.R.); (L.W.)
| | - Alina Plenis
- Department of Pharmaceutical Chemistry, Medical University of Gdańsk, Hallera 107, 80-416 Gdańsk, Poland; (N.T.); (T.B.)
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Carabajal M, Teglia CM, Cerutti S, Culzoni MJ, Goicoechea HC. Applications of liquid-phase microextraction procedures to complex samples assisted by response surface methodology for optimization. Microchem J 2020. [DOI: 10.1016/j.microc.2019.104436] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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6
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Applications and opportunities of experimental design for the dispersive liquid–liquid microextraction method – A review. Talanta 2018; 190:335-356. [DOI: 10.1016/j.talanta.2018.08.002] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 07/31/2018] [Accepted: 08/01/2018] [Indexed: 12/22/2022]
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7
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A Fast and Simple Method for Determination of Vitamin E in Infant Formula by Dispersive Liquid-Liquid Microextraction Combined with HPLC-UV. FOOD ANAL METHOD 2018. [DOI: 10.1007/s12161-018-1331-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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8
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Mansour FR, Khairy MA. Pharmaceutical and biomedical applications of dispersive liquid–liquid microextraction. J Chromatogr B Analyt Technol Biomed Life Sci 2017; 1061-1062:382-391. [DOI: 10.1016/j.jchromb.2017.07.055] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 07/09/2017] [Accepted: 07/29/2017] [Indexed: 01/18/2023]
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9
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Li S, Li S, Huang Y, Liu C, Chen L, Zhang Y. Ionic-liquid-based ultrasound-assisted extraction of isoflavones from Belamcanda chinensis
and subsequent screening and isolation of potential α-glucosidase inhibitors by ultrafiltration and semipreparative high-performance liquid chromatography. J Sep Sci 2017; 40:2565-2574. [DOI: 10.1002/jssc.201700258] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 04/09/2017] [Accepted: 04/18/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Senlin Li
- Central Laboratory; Changchun Normal University; Changchun China
| | - Sainan Li
- Central Laboratory; Changchun Normal University; Changchun China
| | - Yu Huang
- Central Laboratory; Changchun Normal University; Changchun China
| | - Chunming Liu
- Central Laboratory; Changchun Normal University; Changchun China
| | - Lina Chen
- Central Laboratory; Changchun Normal University; Changchun China
| | - Yuchi Zhang
- Central Laboratory; Changchun Normal University; Changchun China
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Sun J, Zhao XE, Dang J, Sun X, Zheng L, You J, Wang X. Rapid and sensitive determination of phytosterols in functional foods and medicinal herbs by using UHPLC-MS/MS with microwave-assisted derivatization combined with dual ultrasound-assisted dispersive liquid-liquid microextraction. J Sep Sci 2016; 40:725-732. [DOI: 10.1002/jssc.201600711] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 11/11/2016] [Accepted: 11/13/2016] [Indexed: 12/15/2022]
Affiliation(s)
- Jing Sun
- Key Laboratory of Tibetan Medicine Research and Qinghai Key Laboratory of Qinghai-Tibet Plateau Biological Resources, Northwest Institute of Plateau Biology; Chinese Academy of Science; Xining Qinghai P.R. China
| | - Xian-En Zhao
- Key Laboratory of Tibetan Medicine Research and Qinghai Key Laboratory of Qinghai-Tibet Plateau Biological Resources, Northwest Institute of Plateau Biology; Chinese Academy of Science; Xining Qinghai P.R. China
- Shandong Provincial Key Laboratory of Life-Organic Analysis and Key Laboratory of Pharmaceutical Intermediates and Analysis of Natural Medicine, College of Chemistry and Chemical Engineering; Qufu Normal University; Qufu Shandong P. R. China
| | - Jun Dang
- Key Laboratory of Tibetan Medicine Research and Qinghai Key Laboratory of Qinghai-Tibet Plateau Biological Resources, Northwest Institute of Plateau Biology; Chinese Academy of Science; Xining Qinghai P.R. China
| | - Xiaoyan Sun
- Shandong Provincial Key Laboratory of Life-Organic Analysis and Key Laboratory of Pharmaceutical Intermediates and Analysis of Natural Medicine, College of Chemistry and Chemical Engineering; Qufu Normal University; Qufu Shandong P. R. China
| | - Longfang Zheng
- Shandong Provincial Key Laboratory of Life-Organic Analysis and Key Laboratory of Pharmaceutical Intermediates and Analysis of Natural Medicine, College of Chemistry and Chemical Engineering; Qufu Normal University; Qufu Shandong P. R. China
| | - Jinmao You
- Shandong Provincial Key Laboratory of Life-Organic Analysis and Key Laboratory of Pharmaceutical Intermediates and Analysis of Natural Medicine, College of Chemistry and Chemical Engineering; Qufu Normal University; Qufu Shandong P. R. China
| | - Xiao Wang
- Key Laboratory of TCM Quality Control Technology, Shandong Analysis and Test Center; Shandong Academy of Sciences; Jinan Shandong China
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11
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Development of a dispersive liquid-liquid microextraction technique for the analysis of aryloxyphenoxy-propionate herbicides in soy-based foods. Microchem J 2016. [DOI: 10.1016/j.microc.2016.06.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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12
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Bioanalytical challenge: A review of environmental and pharmaceuticals contaminants in human milk. J Pharm Biomed Anal 2016; 130:318-325. [PMID: 27372148 DOI: 10.1016/j.jpba.2016.06.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 06/08/2016] [Indexed: 12/31/2022]
Abstract
An overview of bioanalytical methods for the determination of environmental and pharmaceutical contaminants in human milk is presented. The exposure of children to these contaminants through lactation has been widely investigated. The human milk contains diverse proteins, lipids, and carbohydrates and the concentration of these components is drastically altered during the lactation period providing a high degree of an analytical challenge. Sample collection and pretreatment are still considered the Achilles' heel. This review presents liquid chromatographic methods developed in the last 10 years for this complex matrix with focuses in the extraction and quantification steps. Green sample preparation protocols have been emphasized.
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13
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Anderson PO, Sauberan JB. Modeling drug passage into human milk. Clin Pharmacol Ther 2016; 100:42-52. [PMID: 27060684 DOI: 10.1002/cpt.377] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 03/16/2016] [Accepted: 04/01/2016] [Indexed: 01/16/2023]
Abstract
Breastfeeding has positive health consequences for both the breastfed infant and the nursing mother.(1,2) Although information on drug use during lactation is available through sites such as LactMed,(3) available information is often incomplete. Unlike pregnancy, in which large numbers of pregnant women need to be studied to assure safety, measurement of drug concentrations in breastmilk in a relatively few subjects can provide valuable information to assess drug safety. This article reviews methods of measuring and predicting drug passage into breastmilk.
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Affiliation(s)
- P O Anderson
- Health Sciences Clinical Professor, University of California San Diego, Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, California, USA
| | - J B Sauberan
- Neonatal Research Institute, Sharp Mary Birch Hospital for Women and Newborns, San Diego, California, USA
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Ghorbani M, Chamsaz M, Rounaghi GH. Ultrasound-assisted magnetic dispersive solid-phase microextraction: A novel approach for the rapid and efficient microextraction of naproxen and ibuprofen employing experimental design with high-performance liquid chromatography. J Sep Sci 2016; 39:1082-9. [DOI: 10.1002/jssc.201501246] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 12/27/2015] [Accepted: 12/30/2015] [Indexed: 12/30/2022]
Affiliation(s)
- Mahdi Ghorbani
- Department of Chemistry, Faculty of Sciences; Ferdowsi University of Mashhad; Mashhad Iran
| | - Mahmoud Chamsaz
- Department of Chemistry, Faculty of Sciences; Ferdowsi University of Mashhad; Mashhad Iran
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15
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Dispersive Liquid-Liquid Microextraction in the Analysis of Milk and Dairy Products: A Review. J CHEM-NY 2016. [DOI: 10.1155/2016/4040165] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Dispersive liquid-liquid microextraction (DLLME) is an extraction technique developed within the last decade, which involves the dispersion of fine droplets of extraction solvent in an aqueous sample. Partitioning of analytes into the extraction phase is instantaneous due to the very high collective surface area of the droplets. This leads to very high enrichment factors and very low solvent consumption, relative to other liquid or solid phase extraction methods. A comprehensive review of the various modes of DLLME in the analysis of organic and inorganic analytes in dairy products (milk, cheese, infant formula, yogurt, and breast milk) is presented here. Dairy products present a complex sample matrix and the removal of interfering matrix components can prove troublesome. This review focuses on sample pretreatment prior to the appropriate DLLME procedure, the extraction and dispersive solvents chosen, derivatisation methods, and analytical figures of merit. Where possible, a critical comparison of DLLME methods has been undertaken. The overall suitability, and limitations, of DLLME as a sample preparation technique for dairy products has been assessed.
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