Drug level monitoring: cardiovascular drugs

Mass spectrometric behavior of thiazide-based diuretics after electrospray ionization and collision-induced dissociation

The mass spectrometric behavior of 21 thiazide-based compounds after electrospray ionization in the negative ion mode and collision-induced dissociation was investigated on a triple-stage quadrupole mass spectrometer. The mass spectra show individual and common fragmentation patterns, the generations of which are discussed based on comparable molecular structures of commercially available substances and the synthesis of unlabeled, deuterated, and 15N-labeled analogues. The synthesis of deuterated thiazides is perfomed by condensation of 4-amino-6-chloro-1,3-benzenedisulfonamide with appropriately labeled aldehydes, while the introduction of 15N into the sulfonamide groups of thiazides was achieved by the synthesis of 4-amino-6-chloro-1,3-benzenedisulfonamide(15N2) from 3-chloroaniline via 4-amino-6-chloro-1,3-benzenedisulfonyl chloride. The most common fragments determined are m/z 269, 205, and 126 for 6-chloro-7-sulfamoyl-3-alkyl-3,4-dihydro-1,2,4-benzothiadiazine-1,1-dioxides and m/z 303, 239, and 160 for 6-trifluoromethyl-7-sulfamoyl-3-alkyl-3,4-dihydro-1,2,4-benzothiadiazine-1,1-dioxides. Individual fragmentation behaviors were found that mainly depended on the C-3-linked side chain.

Simultaneous determination of eight beta-blockers by gradient high-performance liquid chromatography with combined ultraviolet and fluorescence detection in corneal permeability studies in vitro

A gradient HPLC method with combined ultraviolet and fluorescence detection was developed for the simultaneous determination of eight beta-blockers (alprenolol, atenolol, metoprolol, nadolol, pindolol, propranolol, sotalol and timolol) in corneal permeability studies in vitro. Fluorescence detection with excitation wavelength at 230 nm and emission at 302 nm was selective for six of the compounds, whereas UV detection at 205 nm was able to detect all the compounds. Calibration was performed with fluorescence detection for six compounds from 50 or 200 nM to 3 microM, and with UV detection for all the eight compounds from 100 or 200 nM to 30 microM. With optimized fluorescence detection, detection limits between 0.7 and 1.3 nM (0.035-0.065 pmol per 50 microl injection) were obtained for atenolol, metoprolol, nadolol and sotalol. A mixture of eight beta-blockers was used in cassette dosing permeability studies with a cultured corneal epithelium. The HPLC method revealed marked differences in the permeation between hydrophilic and lipophilic beta-blockers through the corneal epithelial cell culture model.

Enantioselective determination of oxprenolol in human plasma using dialysis coupled on-line to reversed-phase chiral liquid chromatography

A fully automated method for the determination of the enantiomers of oxprenolol in human plasma was developed, involving dialysis through a cellulose acetate membrane, clean-up and enrichment of the dialysate on a short precolumn and subsequent chiral liquid chromatographic (LC) analysis. All sample handling operations were executed automatically by a sample processor equipped with a robotic arm (ASTED system). The trace enrichment column (TEC) was packed with octadecylsilica. After conditioning of the TEC with the LC mobile phase and pH 3.0 acetate buffer. After the enrichment step, the analyte was transferred by the LC mobile phase to the analytical column by means of a switching valve. The influence of different parameters of the dialysis process on the recovery of oxprenolol was first investigated using achiral LC conditions. The volume as well as the aspirating and dispensing flow rates of the acceptor solution were the main parameters studied. Oxprenolol was separated on a C18 stationary phase used for the enantioseparation of oxprenolol was a Chiralcel OD-R column which contained cellulose tris (3,5-dimethylphenylcarbamate) coated on silica as chiral selector. The corresponding mobile phase consisted of a mixture of pH 6.0 phosphate buffer containing NaClO4 at 0.45 M concentration and acetonitrile (70:30 v/v). UV detection was performed at 273 nm. The method developed was validated. Recoveries for each enantiomer of oxprenolol were about 80%. The method was found to be linear in the 50-2500 ng ml-1 concentration range (r2 = 0.999 for both enantiomers) and good results with respect to intra- and inter-day reproducibility as well as accuracy were obtained.

Detection of beta-blockers in urine by solid-phase extraction-supercritical fluid extraction and gas chromatography-mass spectrometry

The most convenient way to perform supercritical fluid extraction (SFE) of liquid sample matrices is to combine it with solid-phase extraction (SPE). beta-Blockers from urine were collected on an Empore disc, which was then placed into an extraction cell for derivatization and SFE. SPE recovery was best at pH 10. Effects of temperature, pressure and volume of pyridine on the acetylation and SFE processes were studied. Without acetylation the beta-blockers were not significantly soluble in CO2. SFE temperatures of 70 degree C and 150 degree C together with 200 microliters of acetic anhydride and 400 microliters pyridine gave the best results. With the SPE-SFE-GC-MS method developed here, beta-blockers like oxprenolol, metoprolol and propranolol could easily be detected in urine samples, and the limit of detection (LOD) for these compounds was found to be 20 ng/ml, 30 ng/ml and 40 ng/ml, respectively.

Ion-pair chromatography and micellar electrokinetic capillary chromatography in analyzing beta-adrenergic blocking agents from human biological fluids

Ion-pair chromatography (IPC) and micellar electrokinetic capillary chromatography (MECC) were used for the separation and determination of parent beta-blockers from human biological fluids. In both these techniques, N-cetyl-N,N,N-trimethylammonium bromide (CTAB) was used as a buffer additive. In IPC, CTAB was an ion-pair former, and in MECC it was a micelle-forming surfactant. The effectiveness of the IPC method using methanol-gradient elution and that of MECC were compared for drug-spiked serum and urine samples. Detection was performed with a diode-array detector in the IPC method and with a 214-nm filter in the MECC technique. In both methods a phosphate buffer (pH 7.0) was used. In MECC the buffer solution contained 10 mM CTAB, while in IPC the CTAB concentration was decreased from 7 to 4 mM during the separation when a methanol gradient was used. The study showed that the IPC technique performed better for bioanalyses than the high-performance MECC technique, since in MECC UV detection presented a problem because of the low sample concentration. However, in MECC sample preparation was less time-consuming, using hydrolyzation and protein precipitation and, unlike the IPC technique, it did not require any liquid-liquid extraction step.

Determination of nine beta-blockers in serum by micellar electrokinetic capillary chromatography

beta-Adrenergic blocking agents are used for the treatment of angina pectoris, cardiac arrhythmia, hypertension, anxiety attacks, thyrotoxicosis, migraine and glaucoma. Owing to their sedative effect, they are also used as doping agents in sport. All beta-blockers have an alkanol amine side chain terminating in a secondary amino group in their structure. The pKa values vary from 9.2 to 9.8. Because some beta-blockers are hydrophilic and some lipophilic, simultaneous determination is difficult. In this work, a method based on micellar electrokinetic capillary chromatography (MECC) was developed for the separation and determination of beta-blockers in serum. The phosphate buffer 0.08 M (pH 6.7) solution contained 15 mM N-cetyl-N,N,N-trimethylammonium bromide. Nine parent beta-blockers could be separated in a single run and the concentrations determined by internal standard (ephedrine) method. The simple clean-up procedure consisted of enzyme hydrolysis (Helix pomatia), protein precipitation, and filtration through 0.5-microns PTFE membranes. The MECC method exhibited good repeatability and a linear range of 75-300 micrograms/ml. The method was successfully applied after concentration to the determination of propranolol in real samples.

Determination of ten beta-blockers in urine by micellar electrokinetic capillary chromatography

beta-Adrenergic blocking agents are of therapeutic value in the treatment of migraine and various cardiovascular disorders (angina pectoris, cardiac arrhythmia, hypertension). Owing to their sedative effect, they are also used as doping agents in sport. A characteristic feature of beta-blockers is the alkanolamine side-chain terminating in a secondary amino group. The pKa values vary from 9.2 to 9.8. Because some beta-blockers are hydrophilic and some lipophilic, simultaneous determination is difficult. In this work, a method based on micellar electrokinetic capillary chromatography (MECC) was developed for the separation and determination of beta-blockers. The 0.08 M phosphate buffer (pH 7.0) solution contained 10 mM N-cetyl-N,N,N-trimethylammonium bromide (CTAB). Ten parent beta-blockers in human urine could be separated in a single run and determined quantitatively by the internal standard (2,6-dimethylphenol) method. Neither endogenous compounds in urine nor caffeine and its metabolites interfered with the analysis. The clean-up procedure for urine consisted of a simple filtration through 0.5-microns PTFE membranes. The MECC method exhibited good repeatability and a linear range of 25-150 micrograms/ml. The method was applied to determination of oxprenolol in real samples.

Screening of beta-blockers in human serum by ion-pair chromatography and their identification as methyl or acetyl derivatives by gas chromatography-mass spectrometry

A simultaneous screening method for atenolol, acebutolol, metoprolol, oxprenolol, alprenolol and propranolol by ion-pair chromatography with a column-switching technique was developed. The serum samples were purified using either liquid-liquid extraction or solid-phase extraction methods. The pretreatment of the samples consisted of hydrolysis and protein precipitation. The drug separation was on either octadecylsilica or polymer-based alkyl column material. Binary eluent mixtures containing methanol and a buffer solution with a quaternary ammonium salt as an ion-pair former were used. Detection of the compounds in liquid chromatographic analysis was based on ultraviolet spectra. The effects of methanol, two buffers and the ion-pair former on the retention of the compounds were studied. The determination limits ranged from nanograms to micrograms in the ion-pair chromatographic method, depending on the drug studied. Identification was based on the mass spectra or, if necessary, on selected-ion monitoring spectra of either the methylated or the acetylated compounds obtained by means of gas chromatography-electron impact or negative chemical ionization mass spectrometry. The detection limits for the identified compounds were in the picogram range. The matrix effect was strong, and this resulted in determination limits in the nanogram range with the scan method.

Gas chromatographic analysis of isomeric organic mononitrates in plasma

A specific, sensitive and precise capillary gas chromatographic method using electron-capture detection was developed for the determination of four isomeric vasodilating organic mononitrates, viz. L-isoidide mononitrate (L-IIMN), isosorbide-2-mononitrate (IS-2-MN), isomannide mononitrate (IMMN) and isosorbide-5-mononitrate (IS-5-MN), in rat plasma. With a sample size of 100 microliters of rat plasma, the detection limits were found to be between 0.5 and 2 ng/ml for these mononitrates, and the absolute recovery was found to range from 83 to 90%. The within-day coefficients of variation for the assay of the four isomers were less than 5%, while the between-day coefficients of variation were less than 10%. Because of the short retention times of these isomers in this assay, routine analyses of about sixty plasma samples per day can be carried out. The possibility of in vivo interconversion among these four isomers in rats was investigated after individual administration of each isomer. No interconversion was found based on examination of plasma samples. The gas chromatographic method was applied to the pharmacokinetic studies of these four isomers in rats; at an intravenous dose of 2 mg/kg, the biological half-lives of L-IIMN, IMMN, IS-2-MN and IS-5-MN were found to be 13.2, 25.2, 54.6 and 112 min, respectively.

Analysis of diuretic doping agents by HPLC screening and GC-MSD confirmation

The simultaneous analysis of 14 diuretics in human urine (belonging to five different pharmacological groups) by reversed-phase high-performance liquid chromatography (HPLC) with a diode-array detector was developed by using a gradient elution with acetonitrile and phosphate buffer containing propylamine hydrochloride on a Bondclone-ODS (10 microns) column. The method was applied to the screening test of several diuretics abused by athletes. The confirmation analysis was performed by gas chromatography-mass spectrometry with ion-selective detection (GC-MSD). The characteristic mass fragment ions obtained by electron-impact (EI) ionization (70 eV) provided sufficient identification of these diuretic agents. During the 1990 weight-lifting contest of Asia in Kao-Hsiung, Republic of China, one urine sample was found positive for the diuretic hydrochlorothiazide.

Chromatography of cardiac glycosides

Most of the recently reported methods for the quantitation of cardiac glycosides have been for digoxin and its metabolites. Recent procedures using high-performance liquid chromatography-radioimmunoassay (HPLC-RIA) and HPLC following derivatization show appreciable improvements in accuracy and specificity for quantitating digoxin in the low nanogram range. Gas chromatographic procedures have been explored to a very limited extent and further advances in the quantitation of cardiac glycosides are anticipated to arise from the use of laser desorption-Fourier transform mass spectrometry. However, currently, HPLC with derivatization and HPLC-RIA techniques remain the techniques of choice for quantitation of digoxin and/or its metabolites based on considerations of ease of use, sensitivity, specificity, accuracy and reproducibility.

Chromatography of beta-adrenergic blocking agents

The determination of beta-blockers has posed pharmaceutical analysts with a variety of problems arising from the essential characteristics of these compounds as bases and the variability of physicochemical properties of individual drugs. Liquid chromatography has become the favoured method of analysis and to a certain extent there is a standardised approach to analysis based on either solvent or solid-phase extraction and reversed-phase high-performance liquid chromatography coupled to fluorescence detection. The analyst must be aware of interactions occurring during extraction stages. All manipulations should be fully evaluated for individual drugs and metabolites prior to use. Other analytical options are chosen for specific or more demanding applications. The use of unmodified silicas for the liquid chromatography of beta-blockers (and other basic drugs) is an example of a potential alternative mode of chromatography. The stereoselectivity of the pharmacology of beta-blockers has spawned a great deal of literature describing the resolution of enantiomers by chromatographic methods. It is envisaged that this area will achieve greater prominence in the future as drug development pursues optical purity. The demand for the availability of enantiomerically pure pharmaceutical preparations will certainly see developments for preparative-scale separations as well as analytical methods and will surely promote developments in new and established methods of chromatography.

Identification of antiarrhythmic drugs and their metabolites in urine

Identification of the antiarrhythmic drugs ajmaline, aprindine, diltiazem, disopyramide, flecainide, gallopamil, lidocaine, lorcainide, mexiletine, phenytoin, prajmaline, propafenone, quinidine, sparteine, tocainide and verapamil and their metabolites in urine is described. After acid hydrolysis of the conjugates, extraction and acetylation, the urine samples were analysed by computerized gas chromatography-mass spectrometry. Using ion chromatography with the selective ions m/z 58, 72, 84, 86, 136, 224, 266, and 426, the possible presence of antiarrhythmic drugs and/or their metabolites was indicated. The identity of positive signals in the reconstructed ion chromatograms was confirmed by a visual or computerized comparison of the stored full mass spectra with the reference spectra. The ion chromatograms, reference mass spectra and gas chromatographic retention indices (OV-101) are documented. The method presented is integrated in a general screening procedure (general unknown analysis) for several groups of drugs.

Acid-base equilibria of beta-blockers in acetonitrile

The acid-base equilibria of a series of beta-adrenoceptor blocking drugs in acetonitrile have been studied, and pKHB+ values determined. The theory of such titrations is discussed and simple potentiometric and visual methods in acetonitrile media are proposed for the assay of beta-adrenoceptor blocking drugs.

High-performance liquid chromatographic determination of beta-adrenoceptor blocking agents in body fluids

Several reports have been published reviewing high-performance liquid chromatographic (HPLC) methods for the determination of beta-adrenoceptor blocking agents (beta-blockers) in biological materials (Flouvat et al., 1981; Mehta, 1983; Marko and Soltés, 1984; Ahnoff et al., 1985; Tkaczyková and Safarík, 1987). Of these, the paper by Mehta (1983) briefly summarizes the interrelationship between physiocochemical properties of beta-blockers with prechromatographic treatment of biological samples, as well as with the HPLC methods used for the determination of 12 beta-adrenoceptor blocking drugs. The work by Ahnoff et al. (1985) concerning the monitoring of cardiovascular drugs also deals with HPLC assays of 18 beta-blockers in plasma. The Appendix to this report presents the great majority of HPLC methods for determining 30 beta-blockers in various body fluids. HPLC methods providing resolution and determination of individual beta-blocker enantiomers have not been included since this topic is being covered by Walle and Walle (1989). The Appendix is just a guide to the methods reviewed for the HPLC determination of parent beta-blockers as well as some of their metabolites co-assayed in various body fluids. It does not include details such as the internal standard, recovery, setting of the detector, limit of determination, etc., given in the individual methods listed. The isolation technique of the drug(s) from the given body fluid represents the main step in the sample work-up procedure. Along with this information, only the type of the HPLC column packing and the detection principle used by each method's developers are given.

Gas chromatographic determination of gallopamil and norgallopamil in human plasma

A highly sensitive gas chromatographic assay is described for the simultaneous determination of gallopamil, a calcium channel blocking agent, and its major metabolite, norgallopamil. A multi-step extraction procedure is employed followed by on-column capillary gas chromatographic analysis using nitrogen-selective detection. Acetylation of norgallopamil is performed to enable accurate quantification of the metabolite. Linearity was achieved over the range 1-50 ng/ml for both analytes. Assay specificity, precision and accuracy were investigated.

Assay of isradipine and of its major metabolites in biological fluids by capillary gas chromatography and chemical ionization mass spectrometry

A method is described for the determination of isradipine, a dihydropyridine calcium antagonist, and five of its metabolites in plasma and urine. The neutral compounds were extracted in toluene and analysed in a wide-bore silica capillary column. The acidic compounds were extracted in two steps, then esterified with diazomethane and assayed separately using the same column. Detection was performed by negative-ion mass spectrometry with chemical ionization. The limit of detection of isradipine was 0.04 ng/ml when the compound was determined alone and 0.7 ng/ml when its oxidized metabolite was determined simultaneously. The limits of detection of the metabolites in plasma ranged from 0.15 to 2 ng/ml. The method was successfully used in conventional pharmacokinetic studies and in a multicentre study of population pharmacokinetics.

Phosgene as a derivatizing reagent prior to gas and liquid chromatography

The use of phosgene as a derivatizing agent for bifunctional compounds prior to gas and liquid chromatographic analysis is reviewed. Applications include gas chromatographic determinations of metoprolol and its metabolites in biological fluids, enantiomeric separations of beta-blocking drugs and sympathomimetic agents on a chiral stationary phase and liquid chromatographic enantiomer separations.

Reversed-phase liquid chromatography method for measurement of procainamide and three metabolites in serum and urine: percent of dose excreted as deethyl metabolites

We report a reversed-phase high-performance liquid chromatography method for the determination of procainamide (PA) and three of its metabolites, n-acetylprocainamide (NAPA), deethylprocainamide (DEPA), and deethyl-n-acetylprocainamide (DENAPA), in serum and urine. (p-Amino)-n-(2-dipropylaminoethyl)-benzamide was the internal standard. A phenyl column (1.0-mL/min flow rate) and a mobile phase consisting of 0.075 M acetate buffer (pH 4.3):acetonitrile (20:3) resulted in a total chromatography time of 21.6 min. The optimum detector wavelength was 270 nm. Maximum linear concentrations were 37.8, 34.2, 20.0, and 16.3 mg/L for DEPA, DENAPA, PA, and NAPA, respectively. Minimum detectable concentrations were 0.05 mg/L or less for all four compounds. One-tenth milliliter of sample was extracted into methylene chloride:2-propyl alcohol (9:1). Extraction efficiencies were independent of concentration or biological fluid for each compound. Standard curves were linear and best-fit by dividing the curve into two portions and/or using weighted linear regression. Within-day and day-to-day precison were excellent. No interfering substances were observed in the serum or urine of normal subjects with the exception of caffeine, which was resolved by alteration of the mobile phase. Advantages of this method include a small sample volume, low minimum detectable concentrations, and an order of elution which enhances the detectability of the deethyl metabolites. Urinary excretion of DEPA and DENAPA accounted for an average of only 0.58 and 0.53%, respectively, of PA doses administered intravenously to six normal volunteers.

Liquid chromatographic screening of diuretics in urine

We describe a liquid chromatographic screening procedure for the detection, in urine, of twelve of the fifteen potassium-depleting diuretics available in Australia. A 2-ml urine sample was acidified with NaH2PO4 (pH 4.1) and extracted with 4 ml ethyl acetate. The sample was cleaned up further by washing with 5 ml Na2HPO4 (pH 7.5). The ethyl acetate was then evaporated to dryness, the residue reconstituted in 100 microliters mobile phase and 5 microliter were injected onto a Merck LiChrosorb RP-18 (5 microns) column. The ultraviolet absorbance of the eluent was monitored at 271 nm for 10 min. The screen was evaluated by giving each of thirty volunteers the lowest recommended dose of one of the diuretics in the study and obtaining urine samples 4, 8 and 24 h after having taken the dose. Twelve diuretics, chlorothiazide, hydrochlorothiazide, quinethazone, chlorthalidone, methyclothiazide, clopamide, frusemide, metolazone, mefruside, bendrofluazide, cyclopenthiazide and bumetanide, were all detectable up to 24 h after a dose. We therefore conclude that the screen would be reliable for the detection of these diuretics in urine.

High-performance liquid chromatographic assay of a new non-steroidal anti-inflammatory agent, 2-(10,11-dihydro-10-oxodibenzo[b,f]thiepin-2-yl)propionic acid, in human plasma and urine

A high-performance liquid chromatographic method for the quantitation of a new anti-inflammatory agent, 2-(10,11-dihydro-10-oxodibenzo[b,f]thiepin-2-yl)propionic acid (CN-100; I), has been developed. The assay consists in extracting samples containing I and mefenamic acid, the internal standard, under acidic conditions and analysis by reversed-phase chromatography using ultraviolet detection at 330 nm. Preliminary plasma concentration-time and cumulative urinary excretion profiles from a healthy subject following oral administration of the tablet formulation are presented. This method is simple, sensitive and reproducible and is applicable to studies of the pharmacokinetic behaviour of I in humans.

Determination of nicainoprol, a new antiarrhythmic agent, in human plasma and urine by high-performance liquid chromatography

A new method for the determination of nicainoprol in human plasma and urine has been developed. Nicainoprol and p-chlorodisopyramide as the internal standard are extracted into dichloromethane under basic conditions, and then evaporated to dryness. A reconstituted aliquot is injected onto a cyanopropyl column with an automatic high-performance liquid chromatographic system and quantitated using ultraviolet detection at 250 nm. The whole system-elapsed time to analyse a sample is ca. 10 min, and the detection limit using 1 ml of plasma is 15 ng/ml. Preliminary plasma and urinary concentration-time data from a healthy subject following an oral nicainoprol administration are reported. The assay method presented appears to be selective, and is of sufficient sensitivity, precision and accuracy to be applicable to the study of the pharmacokinetic behaviour of nicainoprol in humans.

Determination of the new beta-blocker bisoprolol and of metoprolol, atenolol and propranolol in plasma and urine by high-performance liquid chromatography

High-performance liquid chromatographic methods using fluorimetric detection have been developed for the determination in plasma and urine of bisoprolol, atenolol, metoprolol and propranolol. Bisoprolol, metoprolol and propranolol were extracted at alkaline pH with dichloromethane, atenolol with n-butanol-dichloromethane (25:75). After evaporation of the organic solvent the compounds were chromatographed on silica gel Si-60 columns (normal phase) using aqueous ammonium phosphate buffer (pH 4) containing 3-7% acetonitrile as eluent (method 1). Alternatively, the compounds were acetylated prior to chromatography on reversed-phase columns (RP-8), using acetonitrile-water mixtures as eluents (method 2). The detection limit was 1-2 ng/ml in plasma and 10 ng/ml in urine for bisoprolol and metoprolol with either method. For atenolol the detection limit was 5 ng/ml in plasma or 50 ng/ml in urine (method 1), for propranolol 1 ng/ml in plasma (method 2).