1
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Kanji S, Williamson D, Hartwick M. Potential pharmacological confounders in the setting of death determined by neurologic criteria: a narrative review. Can J Anaesth 2023; 70:713-723. [PMID: 37131030 PMCID: PMC10202973 DOI: 10.1007/s12630-023-02415-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/11/2022] [Accepted: 10/18/2022] [Indexed: 05/04/2023] Open
Abstract
Guidelines for the determination of death by neurologic criteria (DNC) require an absence of confounding factors if clinical examination alone is to be used. Drugs that depress the central nervous system suppress neurologic responses and spontaneous breathing and must be excluded or reversed prior to proceeding. If these confounding factors cannot be eliminated, ancillary testing is required. These drugs may be present after being administered as part of the treatment of critically ill patients. While measurement of serum drug concentrations can help guide the timing of assessments for DNC, they are not always available or feasible. In this article, we review sedative and opioid drugs that may confound DNC, along with pharmacokinetic factors that govern the duration of drug action. Pharmacokinetic parameters including a context-sensitive half-life of sedatives and opioids are highly variable in critically ill patients because of the multitude of clinical variables and conditions that can affect drug distribution and clearance. Patient-, disease-, and treatment-related factors that influence the distribution and clearance of these drugs are discussed including end organ function, age, obesity, hyperdynamic states, augmented renal clearance, fluid balance, hypothermia, and the role of prolonged drug infusions in critically ill patients. In these contexts, it is often difficult to predict how long after drug discontinuation the confounding effects will take to dissipate. We propose a conservative framework for evaluating when or if DNC can be determined by clinical criteria alone. When pharmacologic confounders cannot be reversed, or doing so is not feasible, ancillary testing to confirm the absence of brain blood flow should be obtained.
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Affiliation(s)
- Salmaan Kanji
- Department of Pharmacy, The Ottawa Hospital, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada.
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
| | - David Williamson
- Faculté de pharmacie, Université de Montréal, Montreal, QC, Canada
- Pharmacy Department, Hôpital du Sacré-Cœur de Montréal and CIUSSS-Nord-de-l'ile-de-Montreal Research Center, Montreal, QC, Canada
| | - Michael Hartwick
- Department of Pharmacy, The Ottawa Hospital, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada
- Department of Critical Care, The Ottawa Hospital, Ottawa, Canada
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2
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Birabaharan J, West RE, Nolin TD, Traube C, Bell MJ, Empey PE. Simultaneous detection of a panel of nine sedatives and metabolites in plasma from critically ill pediatric patients via UPLC-MS/MS. J Pharm Biomed Anal 2022; 218:114853. [PMID: 35659658 PMCID: PMC9302904 DOI: 10.1016/j.jpba.2022.114853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/20/2022] [Accepted: 05/20/2022] [Indexed: 11/16/2022]
Abstract
Sedative use can result in adverse drug reactions. Intensive care unit patients are especially at risk and pharmacokinetic modeling of drug concentrations is an approach to develop precision dosing strategies. However, limited blood sampling availability in critically ill children and need for multiple assays to quantify a variety of commonly used sedatives creates logistical challenges. The goal of this project was to develop a sensitive and selective assay for the simultaneous quantification of a panel of sedatives comprised of midazolam (MDZ), alpha hydroxymidazolam (1- OH MDZ), dexmedetomidine (DEX), morphine (MOR), morphine-3-glucuronide (M3G), morphine-6-glucuronide (M6G), fentanyl (FEN), norfentanyl (NF), and hydromorphone (HM) in small volume pediatric plasma samples. A sensitive and efficient ultra-high performance liquid chromatography-mass spectrometry (UPLC-MS/MS) method was developed following FDA guidance for bioanalytical validation. Minimal sample preparation consisting of simple protein precipitation extraction using acetonitrile with internal standards was utilized. Analyte separation was achieved using a gradient mixture of (A: 0.15% formic acid in water and B: Acetonitrile) and a Waters Acquity C18, 1.7 µm (2.1 × 100 mm) column. Assays were linear over the clinical concentration ranges: MDZ, MOR, HM: 0.5-125 ng/mL; 1-OH MDZ, M3G, M6G: 5-500 ng/mL; and DEX, FEN, NF: 0.05-7.5 ng/mL (R2 > 0.99 for all). Assay run time was 10 min and required only 100 μL of plasma. Initial testing of samples from pediatric patients demonstrates adequacy of assay to measure sedatives and metabolites at clinical concentrations confidently in low volumes of plasma. This novel highly-sensitive and specific method to measure a total of nine different analytes (five sedatives, four metabolites) simultaneously enables comprehensive analysis of a panel of sedatives in small volumes such as in pediatric ICU patients.
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Affiliation(s)
- Jonathan Birabaharan
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA; Center for Clinical Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Raymond E West
- Department of Pharmacy & Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Thomas D Nolin
- Department of Pharmacy & Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA; Center for Clinical Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Chani Traube
- Division of Critical Care Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Michael J Bell
- Division of Critical Care Medicine, Children's National Hospital, Washington DC, USA
| | - Philip E Empey
- Department of Pharmacy & Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA; Center for Clinical Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA.
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3
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Zhao Q, Wang R, Liang C, Chen Y, Sheng Z, Xu Z, Zhang Y. Extension of the Temporal Window for the Determination of Alpha-Methylthiofentanyl and Thiofentanyl in Rat Urine by Monitoring the Metabolite Norfentanyl Using Online Solid-Phase Extraction (SPE) Coupled with Ultra-High Performance Liquid Chromatography–Tandem Mass Spectrometry (UHPLC–MS/MS). ANAL LETT 2022. [DOI: 10.1080/00032719.2022.2087229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Qingjia Zhao
- State Key Laboratory of New Drug and Pharmaceutical Process, China State Institute of Pharmaceutical Industry, Shanghai, China
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Institute of Forensic Science, Shanghai, China
| | - Rong Wang
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Institute of Forensic Science, Shanghai, China
| | - Chen Liang
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Institute of Forensic Science, Shanghai, China
| | - Yao Chen
- State Key Laboratory of New Drug and Pharmaceutical Process, China State Institute of Pharmaceutical Industry, Shanghai, China
- Shanghai Professional and Technical Service Center for Biological Material Drug-ability Evaluation, Shanghai, China
| | - Zhenhai Sheng
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Institute of Forensic Science, Shanghai, China
| | - Zhiru Xu
- State Key Laboratory of New Drug and Pharmaceutical Process, China State Institute of Pharmaceutical Industry, Shanghai, China
- Shanghai Professional and Technical Service Center for Biological Material Drug-ability Evaluation, Shanghai, China
| | - Yurong Zhang
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Institute of Forensic Science, Shanghai, China
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4
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Quantitation of seven sedative and analgesic drugs in whole blood from intensive care patients using liquid chromatography mass spectrometry. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2021. [DOI: 10.1016/j.toxac.2021.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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5
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Shum S, Shen DD, Isoherranen N. Predicting Maternal-Fetal Disposition of Fentanyl Following Intravenous and Epidural Administration Using Physiologically Based Pharmacokinetic Modeling. Drug Metab Dispos 2021; 49:1003-1015. [PMID: 34407992 PMCID: PMC11022861 DOI: 10.1124/dmd.121.000612] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/10/2021] [Indexed: 11/22/2022] Open
Abstract
Fentanyl is an opioid analgesic used to treat obstetrical pain in parturient women through epidural or intravenous route, and unfortunately can also be abused by pregnant women. Fentanyl is known to cross the placental barrier, but how the route of administration and time after dosing affects maternal-fetal disposition kinetics at different stages of pregnancy is not well characterized. To address this knowledge gap, we developed a maternal-fetal physiologically based pharmacokinetic (mf-PBPK) model for fentanyl to evaluate the feasibility to predict the maternal and fetal plasma concentration-time profiles of fentanyl after various dosing regimens. As fentanyl is typically given via the epidural route to control labor pain, an epidural dosing site was developed using alfentanil as a reference drug and extrapolated to fentanyl. Fetal hepatic clearance of fentanyl was predicted from CYP3A7-mediated norfentanyl formation in fetal liver microsomes (intrinsic clearance = 0.20 ± 0.05 µl/min/mg protein). The developed mf-PBPK model successfully captured fentanyl maternal and umbilical cord concentrations after epidural dosing and was used to simulate the concentrations after intravenous dosing (in a drug abuse situation). The distribution kinetics of fentanyl were found to have a considerable impact on the time course of maternal:umbilical cord concentration ratio and on interpretation of observed data. The data show that mf-PBPK modeling can be used successfully to predict maternal disposition, transplacental distribution, and fetal exposure to fentanyl. SIGNIFICANCE STATEMENT: This study establishes the modeling framework for predicting the time course of maternal and fetal exposures of fentanyl opioids from mf-PBPK modeling. The model was validated based on fentanyl exposure data collected during labor and delivery after intravenous or epidural dosing. The results show that mf-PBPK modeling is a useful predictive tool for assessing fetal exposures to fentanyl opioid therapeutic regimens and potentially can be extended to other drugs of abuse.
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MESH Headings
- Administration, Intravenous
- Adult
- Analgesia, Epidural
- Analgesics, Opioid/administration & dosage
- Analgesics, Opioid/pharmacokinetics
- Anesthesia, Epidural
- Anesthesia, Obstetrical
- Aryl Hydrocarbon Hydroxylases/metabolism
- Cytochrome P450 Family 2/metabolism
- Female
- Fentanyl/administration & dosage
- Fentanyl/pharmacokinetics
- Fetus
- Humans
- Infant, Newborn
- Injections, Epidural
- Liver/metabolism
- Maternal-Fetal Exchange
- Microsomes, Liver/metabolism
- Models, Statistical
- Predictive Value of Tests
- Pregnancy
- Tissue Distribution
- Umbilical Cord/chemistry
- Umbilical Cord/metabolism
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Affiliation(s)
- Sara Shum
- Department of Pharmaceutics, University of Washington, Seattle, Washington
| | - Danny D Shen
- Department of Pharmaceutics, University of Washington, Seattle, Washington
| | - Nina Isoherranen
- Department of Pharmaceutics, University of Washington, Seattle, Washington
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6
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Venkatapura Chandrashekar D, DuBois B, Mehvar R. UPLC-MS/MS analysis of the Michaelis-Menten kinetics of CYP3A-mediated midazolam 1'- and 4-hydroxylation in rat brain microsomes. J Chromatogr B Analyt Technol Biomed Life Sci 2021; 1180:122892. [PMID: 34388602 DOI: 10.1016/j.jchromb.2021.122892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/29/2021] [Accepted: 08/01/2021] [Indexed: 11/17/2022]
Abstract
Midazolam (MDZ) is a short-acting benzodiazepine with rapid onset of action, which is metabolized by CYP3A isoenzymes to two hydroxylated metabolites, 1'-hydroxymidazolam and 4-hydroxymidazolam. The drug is also commonly used as a marker of CYP3A activity in the liver microsomes. However, the kinetics of CYP3A-mediated hydroxylation of MDZ in the brain, which contains much lower CYP content than the liver, have not been reported. In this study, UPLC-MS/MS and metabolic incubation methods were developed and validated for simultaneous measurement of low concentrations of both hydroxylated metabolites of MDZ in brain microsomes. Different concentrations of MDZ (1-500 µM) were incubated with rat brain microsomes (6.25 µg) and NADPH over a period of 10 min. After precipitation of the microsomal proteins with acetonitrile, which contained individual isotope-labeled internal standards for each metabolite, the analytes were separated on a C18 UPLC column and detected by a tandem mass spectrometer. Accurate quantitation of MDZ metabolism in the brain microsomes presented several challenges unique to this tissue, which were resolved. The optimized method showed validation results in accordance with the FDA acceptance criteria, with a linearity ranging from 1 to 100 nM and a lower limit of quantitation of 0.4 pg on the column for each of the two metabolites. The method was successfully used to determine the Michaelis-Menten (MM) kinetics of MDZ 1'- and 4-hydroxylase activities in rat brain microsomes (n = 5) for the first time. The 4-hydroxylated metabolite had 2.4 fold higher maximum velocity (p < 0.01) and 1.9 fold higher (p < 0.05) MM constant values than the 1'-hydroxylated metabolite. However, intrinsic clearance values of the two metabolites were similar. The optimized analytical and metabolic incubation methods reported here may be used to study the effects of various pathophysiological and pharmacological factors on the CYP3A-mediated metabolism of MDZ in the brain.
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Affiliation(s)
| | - Barent DuBois
- Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Irvine, USA
| | - Reza Mehvar
- Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Irvine, USA.
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7
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Boivin PN, Legendre P, Bonnaure AC, Lester MA. Physicochemical stability of compounded midazolam capsules over a one-year storage period. PHARMACEUTICAL TECHNOLOGY IN HOSPITAL PHARMACY 2020. [DOI: 10.1515/pthp-2020-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Objectives
In patients suffering from chronic liver disease, the hepatic metabolism of drugs is perturbed and the metabolic capacity is difficult to assess. Midazolam could be used as a phenotypical probe to predict the metabolic capacity of CYP3A to adjust dosages of drug substrates of this cytochrome. In this context, a prospective clinical trial is going to be conducted in our institution and a hospital preparation of midazolam capsules suitable for the clinical trial was developed. The objective of the present work was to assess the physicochemical stability of the formulation over 12 months to set shelf life.
Methods
Three batches of 1 mg capsules were prepared using midazolam hydrochloride and microcrystalline cellulose as a diluent. The capsules were stored at ambient temperature and protected from light. To measure the evolution of the capsules content, a stability-indicating high-performance liquid chromatography (HPLC) method was developed with ultraviolet (UV) detection at 254 nm. Data were confirmed using a liquid chromatography-tandem mass spectrometry (LC-MS/MS) analytical method.
Results
After one year, midazolam hydrochloride content remained higher than 95% of the initial concentration in capsules.
Conclusions
The results show that 1 mg midazolam capsules are stable for 12 months at room temperature and under dark conditions.
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Affiliation(s)
- Pierre-Nicolas Boivin
- Pharmacy Department , Pharmaceutical Technology Unit, Rennes University Hospital , Rennes , France
| | - Pauline Legendre
- Pharmacy Department , Pharmaceutical Technology Unit, Rennes University Hospital , Rennes , France
| | - Anne-Claire Bonnaure
- Pharmacy Department , Pharmaceutical Technology Unit, Rennes University Hospital , Rennes , France
| | - Marie-Antoinette Lester
- Pharmacy Department , Pharmaceutical Technology Unit, Rennes University Hospital , Rennes , France
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8
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Belal F, Omar MA, Derayea SM, Zayed S, Hammad MA, Saleh SF, Alhazmi HA, Al Bratty M. Direct Injection Microemulsion HPLC Method for Simultaneous Determination of Morphine, Tramadol and Lornoxicam in Biological Fluids Using Monolithic Column. CURR PHARM ANAL 2020. [DOI: 10.2174/1573412915666190617172144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
<P>Objective: A rapid and environmental friendly microemulsion liquid chromatographic method
was developed for simultaneous quantification of morphine (MOR), tramadol (TRA) and lornoxicam
(LOR) in biological fluids.
</P><P>
Methods: Microemulsion used in this study was an aqueous solution containing sodium dodecyl sulfate
(0.12 M), n-propanol (10%), ethyl acetate (0.75%), tri-ethyl amine (0.3%), orthophosphoric acid (0.15
%) and the pH was adjusted to 3.0 with orthophosphoric acid. Chromatographic separation was carried
out on a monolithic C18 column and a mobile phase flow rate of 1.0 mL min−1 was applied throughout
the analysis. The data was monitored using UV-detection mode at a wavelength of 220 nm.
</P><P>
Results: Under the optimized conditions, all the studied drugs were well resolved and completely eluted
within 6 min. The proposed method was linear over the concentration ranges of 0.5−100, 0.75−125 and
0.25−50 μg mL−1; limits of detection of 0.074, 0.086 and 0.056 μgmL−1 and limits of quantification of
0.21, 0.28 and 0.12 were recorded for TRA, LOR, and MOR, respectively. The developed method was
fully validated according to the ICH guidelines. The method was successfully utilized to estimate the
tested analytes in plasma and urine samples, which were directly injected into the chromatographic
system after suitable dilution with the microemulsion.
</P><P>
Conclusion: The developed method is considered to be very efficient to analyze the cited drugs in different
biological fluids with low running costs and short analysis time.</P>
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Affiliation(s)
- Fathalla Belal
- Department of Analytical Chemistry, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
| | - Mahmoud A. Omar
- Department of Analytical Chemistry, Faculty of Pharmacy, Minia University, Minia, Egypt
| | - Sayed M. Derayea
- Department of Analytical Chemistry, Faculty of Pharmacy, Minia University, Minia, Egypt
| | - Sahar Zayed
- Unit of Drug Analysis, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
| | - Mohamed A. Hammad
- Department of Analytical Chemistry, Faculty of Pharmacy, Sadat city University, Sadat City, Egypt
| | - Safaa F. Saleh
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Jazan University, Jazan, Postcode 45142, Saudi Arabia
| | - Hassan A. Alhazmi
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Jazan University, Jazan, Postcode 45142, Saudi Arabia
| | - Mohammed Al Bratty
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Jazan University, Jazan, Postcode 45142, Saudi Arabia
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9
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Feliu C, Konecki C, Binet L, Vautier D, Haudecoeur C, Oget O, Fouley A, Marty H, Gozalo C, Cazaubon Y, Djerada Z. Quantification of methadone, buprenorphine, naloxone, opioids, and their derivates in whole blood by liquid chromatography-high-resolution mass spectrometry: Analysis of their involvement in fatal forensic cases. J Chromatogr B Analyt Technol Biomed Life Sci 2020; 1152:122226. [PMID: 32540719 DOI: 10.1016/j.jchromb.2020.122226] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 06/02/2020] [Accepted: 06/04/2020] [Indexed: 11/25/2022]
Abstract
Opioids represent a broad family of compounds that can be used in several indications: analgesics, antitussives, opioid substitution therapy (e.g. methadone, buprenorphine…). When these products are misused, they are often addictive. Thus, we aimed to develop an analytical method able to rapidly quantify several opiates and opioids (6-monoacetylmorphine, buprenorphine, codeine, dihydrocodeine, 2-ethyl-1,5-dimethyl-3,3-diphenylpyrrolidine, ethylmorphine, heroin, methadone, morphine, nalbuphine, naloxone, norbuprenorphine, norcodeine, norpropoxyphene, oxycodone and propoxyphene) in whole blood by ultra-high performance liquid chromatography combined with high resolution mass spectrometry (UHPLC-HRMS). The validated assay requires only 100 µL of the blood sample. The sample is prepared by a rapid liquid-liquid extraction using 5% zinc sulfate (W/V), methanol and acetonitrile. Calibration curves range from 0.98 to 1000 µg/L, except for buprenorphine (0.39-100 µg/L) and norbuprenorphine (0.20-100 µg/L). Inter- and intra-analytical accuracy was less than 15%. Therefore, we describe the development and full validation of an accurate, sensitive and precise assay using UHPLC-HRMS for the analysis of opioids in whole blood. After validation, this new assay is successfully applied on a routine laboratory application basis.
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Affiliation(s)
- Catherine Feliu
- Department of Pharmacology, E.A.3801, SFR CAP-santé, Reims University Hospital, 51, rue Cognacq-Jay, 51095 Reims Cedex, France
| | - Celine Konecki
- Department of Pharmacology, E.A.3801, SFR CAP-santé, Reims University Hospital, 51, rue Cognacq-Jay, 51095 Reims Cedex, France
| | - Laurent Binet
- Department of Pharmacology, E.A.3801, SFR CAP-santé, Reims University Hospital, 51, rue Cognacq-Jay, 51095 Reims Cedex, France
| | - Damien Vautier
- Department of Pharmacology, E.A.3801, SFR CAP-santé, Reims University Hospital, 51, rue Cognacq-Jay, 51095 Reims Cedex, France
| | - Cyril Haudecoeur
- Department of Pharmacology, E.A.3801, SFR CAP-santé, Reims University Hospital, 51, rue Cognacq-Jay, 51095 Reims Cedex, France
| | - Olivier Oget
- Department of Pharmacology, E.A.3801, SFR CAP-santé, Reims University Hospital, 51, rue Cognacq-Jay, 51095 Reims Cedex, France
| | - Aurelie Fouley
- Department of Pharmacology, E.A.3801, SFR CAP-santé, Reims University Hospital, 51, rue Cognacq-Jay, 51095 Reims Cedex, France
| | - Hélène Marty
- Department of Pharmacology, E.A.3801, SFR CAP-santé, Reims University Hospital, 51, rue Cognacq-Jay, 51095 Reims Cedex, France
| | - Claire Gozalo
- Department of Pharmacology, E.A.3801, SFR CAP-santé, Reims University Hospital, 51, rue Cognacq-Jay, 51095 Reims Cedex, France
| | - Yoann Cazaubon
- Department of Pharmacology, E.A.3801, SFR CAP-santé, Reims University Hospital, 51, rue Cognacq-Jay, 51095 Reims Cedex, France
| | - Zoubir Djerada
- Department of Pharmacology, E.A.3801, SFR CAP-santé, Reims University Hospital, 51, rue Cognacq-Jay, 51095 Reims Cedex, France.
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10
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Jutras M, Williamson D, Chassé M, Leclair G. Development and validation of a liquid chromatography coupled to tandem mass spectrometry method for the simultaneous quantification of five analgesics and sedatives, and six of their active metabolites in human plasma: Application to a clinical study on the determination of neurological death in the intensive care unit. J Pharm Biomed Anal 2020; 190:113521. [PMID: 32861167 DOI: 10.1016/j.jpba.2020.113521] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/13/2020] [Accepted: 07/28/2020] [Indexed: 11/29/2022]
Abstract
A sensitive and selective high-performance liquid chromatographic method coupled to tandem mass spectrometry was developed and validated for the quantification of morphine, hydromorphone, fentanyl, midazolam and propofol and their metabolites morphine-3-β-d-glucuronide, morphine-6-β-d-glucuronide, hydromorphone-3-β-d-glucuronide, 1'-hydroxymidazolam-β-d-glucuronide, α-hydroxymidazolam and 4-hydroxymidazolam in human plasma using potassium oxalate/sodium fluoride mixture as anticoagulant. Human plasma samples (0.4 mL) to which were added a mixture of eleven deuterated internal standards were subjected to solid phase extraction using a mixed-mode polymeric Oasis PRiME MCX in 96-well format. Propofol was selectively eluted and further derivatized using 2-Fluoro-1-methylpyridinium p-toluenesulfonate, whereas the remaining 10 analytes were eluted separately and further concentrated. The derivatized propofol was analyzed separately in a second injection. The analytes were chromatographically separated on a Kinetex phenyl-hexyl analytical column in gradient elution mode, using a mobile phase consisting of aqueous ammonium formate/formic acid buffer and methanol. The overall run time was 8 min. Detection was performed using an AB/SCIEX 4000 QTRAP instrument with positive electrospray ionization employing scheduled multiple reaction monitoring mode. The lower limits of quantification ranged from 0.02 to 5 ng/mL depending on the analyte. Calibration curves covered a concentration range of 1000× in all cases but 1'-hydroxymidazolam-β-d-glucuronide where it covered a range of 500 × . The validated method was accurate and precise, the intra-day accuracy and precision of quality control samples (4 concentration levels, n = 6 each) being within 91.5-112 % and 1.3-13.2 % (coefficient of variation), respectively, and inter-day (n = 24; 4 days) accuracy and precision of quality control samples (3 concentration levels) being within 94.8-103.5 % and 3.2-11.2 % (coefficient of variation). Mean absolute extraction recoveries were above 60 % for all compounds, except for hydromorphone-3-β-d-glucuronide (44 %) and for 1'-hydroxymidazolam-β-d-glucuronide (33 %). Internal standard corrected matrix effect ranged from -4.8 to 3.8 % in normal plasma and in plasma containing 1 % hemolyzed blood. Analytes were stable (above 90 %) in plasma and blood for 19 h at 22 °C, in blood for 90 h at 5 °C, in plasma for 60 days at -20 °C, for 4 months at -70 °C and after three freeze-thaw cycles, and in the injection solvent for at least 3 days in the autosampler. The present method is successfully being applied in a multicenter clinical study for the analysis of plasma samples from patients in intensive care units from a number of Canadian hospitals.
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Affiliation(s)
- Martin Jutras
- Platform of Biopharmacy, Faculty of Pharmacy, Université de Montréal, H3T 1J4, Canada.
| | - David Williamson
- Platform of Biopharmacy, Faculty of Pharmacy, Université de Montréal, H3T 1J4, Canada; Research Center and Pharmacy Department, Hôpital du Sacré-Coeur de Montréal, H4J 1C5, Canada.
| | - Michaël Chassé
- Faculty of Medecine, Université de Montréal, H3T 1J4, Canada; Research Center and Department of Medicine (Critical Care), Centre Hospitalier de l'Université de Montréal, H2X 0A9, Canada.
| | - Grégoire Leclair
- Platform of Biopharmacy, Faculty of Pharmacy, Université de Montréal, H3T 1J4, Canada.
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11
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Wang L, Ni C, Shen H, Sheng Z, Liang C, Wang R, Zhang Y. Comparison of the Detection Windows of Heroin Metabolites in Human Urine Using Online SPE and LC-MS/MS: Importance of Morphine-3-Glucuronide. J Anal Toxicol 2020; 44:22-28. [PMID: 31095707 DOI: 10.1093/jat/bkz040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 02/21/2019] [Accepted: 04/24/2019] [Indexed: 11/12/2022] Open
Abstract
Heroin abuse is a serious problem that endangers human health and affects social stability. Though often being used as confirmation of heroin use, 6-monoacetylmorphine (6-MAM) has limitations due to its short detection window. To compare the detection windows of heroin metabolites (morphine (MOR), 6-MAM, morphine-3-glucuronide (M3G) and morphine-6-glucuronide (M6G)) in human urine, an automated online solid phase extraction (SPE) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and fully validated. The limits of detections (LODs) of the four metabolites were in the range of 1.25-5 ng/mL. Intra and inter-day precision for all the metabolites was 0.4-6.7% and 1.8-7.3%, respectively. Accuracy ranged from 92.9 to 101.7%. This method was then applied to the analysis of urine samples of 20 male heroin abusers. M3G was detected 9-11 days after admission to the drug rehabilitation institute in 40% of heroin users while MOR or M6G was not always detected. The detection window of M3G was thus the longest. Furthermore, M3G had a much higher concentration than MOR and M6G. Therefore, M3G could provide diagnostic information with regard to heroin exposure in the combination with other clues (e.g., heroin seizures at the scene).
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Affiliation(s)
- Luying Wang
- State Key Laboratory of New Drug and Pharmaceutical Process, China State Institute of Pharmaceutical Industry, Shanghai, China.,Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Institute of Forensic Science, Shanghai, China
| | - Chunfang Ni
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Institute of Forensic Science, Shanghai, China
| | | | - Zhenhai Sheng
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Institute of Forensic Science, Shanghai, China
| | - Chen Liang
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Institute of Forensic Science, Shanghai, China
| | - Rong Wang
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Institute of Forensic Science, Shanghai, China
| | - Yurong Zhang
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Institute of Forensic Science, Shanghai, China
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12
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Development of Carbon Quantum Dot–Labeled Antibody Fluorescence Immunoassays for the Detection of Morphine in Hot Pot Soup Base. FOOD ANAL METHOD 2020. [DOI: 10.1007/s12161-020-01700-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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13
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Krauss ST, Ross D, Forbes TP. Separation and Detection of Trace Fentanyl from Complex Mixtures Using Gradient Elution Moving Boundary Electrophoresis. Anal Chem 2019; 91:13014-13021. [PMID: 31560514 PMCID: PMC7164688 DOI: 10.1021/acs.analchem.9b03083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The current opioid epidemic remains an ongoing challenge, exacerbated by the extreme potency of synthetic opioids (e.g., fentanyl and fentanyl analogues), leading to an increase in adulterated heroin-related deaths. The increasing prevalence of fentanyl and fentanyl analogues in mixtures with heroin and other adulterants, excipients, and bulking agents has placed an emphasis on trace analysis methods for their detection from complex drug mixtures. Here, gradient elution moving boundary electrophoresis (GEMBE), a robust and miniaturized electrophoretic separation technique, was employed for the separation and detection of fentanyl and nine (9) fentanyl analogues from mixtures. GEMBE incorporated a short capillary (5 cm × 15 μm i.d.) for the electrophoretic separation of analytes with an opposing bulk counterflow. As the velocity of the counterflow was varied, analytes with differing electrophoretic mobilities entered the separation channel at different times and were analyzed as moving boundaries by contactless conductivity detection. The continuous injection of sample, driven by a controlled and variable pressure, both provided selectivity of the analytes and prevented contaminants or particulate within the sample from entering the separation capillary. Fentanyl was successfully separated and detected down to 2.5 μmol/L and demonstrated only 50% to 60% signal suppression in dilute binary mixtures with heroin and other common adulterants and excipients at 30:1 (compound/fentanyl) concentration ratios. In addition, GEMBE was successfully applied to a few adjudicated case samples of fentanyl-related mixtures exhibiting dyes and visible particulate. The short capillaries, contactless detection format utilized here, and continuous injection of sample allow for a small footprint platform that is easy-to-use for forensic analyses.
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Affiliation(s)
- Shannon T. Krauss
- National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, Maryland 20899, USA
| | - David Ross
- National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, Maryland 20899, USA
| | - Thomas P. Forbes
- National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, Maryland 20899, USA
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14
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Tang F, Bada H, Ng CM, Leggas M. Validation of a HPLC/MS method for simultaneous quantification of clonidine, morphine and its metabolites in human plasma. Biomed Chromatogr 2019; 33:e4527. [PMID: 30830964 DOI: 10.1002/bmc.4527] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/20/2019] [Accepted: 02/26/2019] [Indexed: 11/08/2022]
Abstract
A high-performance liquid chromatography-tandem mass spectrometry method was developed and validated for the simultaneous quantification of morphine, morphine's major metabolites morphine-3-glucuronide and morphine-6-glucuronide, and clonidine, to support the pharmacokinetic analysis of an ongoing double-blinded randomized clinical trial that compares the use of morphine and clonidine in infants diagnosed with neonatal abstinence syndrome. Plasma samples were processed by solid-phase extraction and separated on an Inertsil ODS-3 (4 μm) column using an 0.1% formic acid in water-0.1% formic acid in methanol gradient. Detection of the analytes was conducted in the positive multiple reaction monitoring mode. The range of quantitation was 1-1000 ng/mL for morphine, morphine-3-glucuronide and morphine-6-glucuronide, and 0.25-100 ng/mL for clonidine. Intra-day and inter-day accuracy and precision were ≤15% for all analytes across the quantitation range. Extraction recovery rates were ≥94% for morphine, ≥90% for M3G, ≥87% for M6G and ≥ 79% for clonidine. Matrix effect ranged from 85-94% for clonidine to 101-106% for M3G. The method fulfilled all predetermined acceptance criteria and required only 100 μL of starting plasma volume. Furthermore, it was successfully applied to 30 clinical trial plasma samples.
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Affiliation(s)
- Fei Tang
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, KY, USA.,Center for Pharmaceutical Research and Innovation, College of Pharmacy, University of Kentucky, Lexington, KY, USA
| | - Henrietta Bada
- Department of Pediatrics, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Chee M Ng
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, KY, USA
| | - Markos Leggas
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, KY, USA.,Center for Pharmaceutical Research and Innovation, College of Pharmacy, University of Kentucky, Lexington, KY, USA
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15
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Wang K, Xu B, Wu J, Zhu Y, Guo L, Xie J. Elucidating fentanyls differentiation from morphines in chemical and biological samples with surface‐enhanced Raman spectroscopy. Electrophoresis 2019; 40:2193-2203. [DOI: 10.1002/elps.201900004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 02/13/2019] [Accepted: 02/14/2019] [Indexed: 01/06/2023]
Affiliation(s)
- Kai Wang
- State Key Laboratory of Toxicology and Medical Countermeasures and Laboratory of Toxicant Analysis Institute of Pharmacology and Toxicology Academy of Military Medical Sciences Beijing P. R. China
| | - Bin Xu
- State Key Laboratory of Toxicology and Medical Countermeasures and Laboratory of Toxicant Analysis Institute of Pharmacology and Toxicology Academy of Military Medical Sciences Beijing P. R. China
| | - Jianfeng Wu
- State Key Laboratory of Toxicology and Medical Countermeasures and Laboratory of Toxicant Analysis Institute of Pharmacology and Toxicology Academy of Military Medical Sciences Beijing P. R. China
| | - Yingjie Zhu
- State Key Laboratory of Toxicology and Medical Countermeasures and Laboratory of Toxicant Analysis Institute of Pharmacology and Toxicology Academy of Military Medical Sciences Beijing P. R. China
| | - Lei Guo
- State Key Laboratory of Toxicology and Medical Countermeasures and Laboratory of Toxicant Analysis Institute of Pharmacology and Toxicology Academy of Military Medical Sciences Beijing P. R. China
| | - Jianwei Xie
- State Key Laboratory of Toxicology and Medical Countermeasures and Laboratory of Toxicant Analysis Institute of Pharmacology and Toxicology Academy of Military Medical Sciences Beijing P. R. China
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16
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Roda G, Faggiani F, Bolchi C, Pallavicini M, Dei Cas M. Ten Years of Fentanyl-like Drugs: a Technical-analytical Review. ANAL SCI 2019; 35:479-491. [PMID: 30686797 DOI: 10.2116/analsci.18r004] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Synthetic opioids, such as fentanyl and its analogues, are a new public health warning. Clandestine laboratories produce drug analogues at a faster rate than these compounds can be controlled or scheduled by drug agencies. Detection requires specific testing and clinicians may be confronted with a sequence of severe issues concerning the diagnosis and management of these contemporary opioid overdoses. This paper deals with methods for biological sample treatment, as well as the methodologies of analysis that have been reported, in the last decade, in the field of fentanyl-like compounds. From this analysis, it emerges that the gold standard for the identification and quantification of 4-anilinopiperidines is LC-MS/MS, coupled with liquid-liquid or solid-phase extraction. In the end, the return to the scene of illicit fentanyls can be considered as a critical problem that can be tackled only with a global multidisciplinary approach.
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Affiliation(s)
- Gabriella Roda
- Department of Pharmaceutical Sciences, University of Milan
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17
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Swaminathan SK, Fisher J, Kandimalla KK. Sensitive Determination of Fentanyl in Low-Volume Serum Samples by LC-MS/MS. AAPS PharmSciTech 2018; 19:2812-2817. [PMID: 30191378 DOI: 10.1208/s12249-018-1103-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 06/08/2018] [Indexed: 01/01/2023] Open
Abstract
Fentanyl is a widely used drug in the management of pain. Present LC-MS/MS methods for analysis of fentanyl require a large volume of serum, but yet the sensitivity was at about 50 pg/mL. Here, we report a modified liquid-liquid extraction method for the analysis of fentanyl in serum. The method is very sensitive with a LLOQ of 5 pg/mL while using only 0.175 mL of serum for analysis. The separation was performed on a Zorbax XDB-C18 column (4.6 × 50 mm, 1.8 μm, 600 bar) using a mobile phase of water: acetonitrile (70:30 v/v) with 0.1% formic acid that was pumped isocratically at a flow rate of 0.5 mL per minute. The calibration curve was found to be linear over a range of 5-10,000 pg/mL. The inter-day and intra-day accuracy and precision were tested using low (20 pg/mL), medium (1000 pg/mL), and high (5000 pg/mL) quality control samples of fentanyl prepared in blank human serum and were within ± 15% of the nominal value. Fentanyl was also found to be stable in various storage and sample preparation conditions, including short-term bench-top storage (for 5 h), freeze-thaw cycling (three cycles), long-term frozen condition (4.5 months at - 70°C), and post-preparative storage (for 48 h).
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18
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Hassib ST, Hashem HMA, Mahrouse MA, Mostafa EA. Determination of four antiepileptic drugs in plasma using ultra-performance liquid chromatography with mass detection technique. Biomed Chromatogr 2018; 32:e4253. [PMID: 29637570 DOI: 10.1002/bmc.4253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 03/13/2018] [Accepted: 03/26/2018] [Indexed: 11/07/2022]
Abstract
Status epilepticus (SE) is considered the second most frequent neurological emergency. Its therapeutic management is performed using sequential antiepileptic drug regimens. Diazepam (DIA), midazolam (MID), phenytoin (PHT) and phenobarbital (PB) are four drugs of different classes used sequentially in the management of SE. A sensitive, selective, accurate and precise method was developed and validated for simultaneous determination of the four antiepileptic drugs in human plasma. Their separation and quantification were achieved using ultra-performance liquid chromatography (UPLC) with mass detection using carbamazepine as internal standard (IS). For the first three drugs and the IS, UPLC-MS/MS with electrospray ionization working in multiple reaction monitoring mode was used at the following transitions: m/z 285 → 193 for DIA; m/z 326 → 291 for MID; m/z 253 → 182 for PHT; and m/z 237 → 194, 237 → 192 for IS. For the fourth drug (PB), a molecular ion peak of PB [M + H] + at m/z 233 was used for its quantitation. The method was linear over concentration ranges 5-500 ng/mL for DIA and MID and 0.25-20 μg/mL for PHT and PB. Bioanalytical validation of the developed method was carried out according to European Medicines Agency guidelines. The developed method can be applied for routine drug analysis, therapeutic drug monitoring and bioequivalence studies.
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Affiliation(s)
- Sonia T Hassib
- Pharmaceutical Chemistry Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Hanaa M A Hashem
- Pharmaceutical Chemistry Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Marianne A Mahrouse
- Pharmaceutical Chemistry Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Eman A Mostafa
- Pharmaceutical Chemistry Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt
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19
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LC–MS determination of fentanyl in human serum and application to a fentanyl transdermal delivery pharmacokinetic study. Bioanalysis 2017; 9:1551-1560. [DOI: 10.4155/bio-2017-0174] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Aim: Fentanyl is an opioid agonist used for acute and chronic pain management. In this report, a highly sensitive and simple LC–MS/MS method using Hydrophilic Interaction Chromatography (HILIC) column was validated and used for fentanyl quantification in human serum. Results: The isocratic mobile phase was composed of acetonitrile: 10 mM ammonium formate buffer (pH = 3.2; 90:10, v/v). The assay was linear over a concentration range of 10–10,000 pg/ml. The accuracy of the validation method ranged from 93.2 to 107%, and the precision was within 6.4%. Fentanyl was stable during short- and long-term storage. Conclusion: The assay has been successfully applied to serum samples obtained from healthy subjects of a fentanyl transdermal pharmacokinetic study.
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20
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Veigure R, Aro R, Metsvaht T, Standing JF, Lutsar I, Herodes K, Kipper K. A highly sensitive method for the simultaneous UHPLC-MS/MS analysis of clonidine, morphine, midazolam and their metabolites in blood plasma using HFIP as the eluent additive. J Chromatogr B Analyt Technol Biomed Life Sci 2017; 1052:150-157. [PMID: 28388512 DOI: 10.1016/j.jchromb.2017.03.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 03/01/2017] [Accepted: 03/09/2017] [Indexed: 10/20/2022]
Abstract
In intensive care units, the precise administration of sedatives and analgesics is crucial in order to avoid under- or over sedation and for appropriate pain control. Both can be harmful to the patient, causing side effects or pain and suffering. This is especially important in the case of pediatric patients, and dose-response relationships require studies using pharmacokinetic-pharmacodynamic modeling. The aim of this work was to develop and validate a rapid ultra-high performance liquid chromatographic-tandem mass spectrometric method for the analysis of three common sedative and analgesic agents: morphine, clonidine and midazolam, and their metabolites (morphine-3-glucuronide, morphine-6-glucuronide and 1'-hydroxymidazolam) in blood plasma at trace level concentrations. Low concentrations and low sampling volumes may be expected in pediatric patients; we report the lowest limit of quantification for all analytes as 0.05ng/mL using only 100μL of blood plasma. The analytes were separated chromatographically using the C18 column with the weak ion-pairing additive 1,1,1,3,3,3-hexafluoro-2-propanol and methanol. The method was fully validated and a matrix matched calibration range of 0.05-250ng/mL was attained for all analytes In addition, between-day accuracy for all analytes remained within 93-108%, and precision remained within 1.5-9.6% for all analytes at all concentration levels over the calibration range.
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Affiliation(s)
- Rūta Veigure
- University of Tartu, Institute of Chemistry, 14a Ravila Street, 50411 Tartu, Estonia
| | - Rudolf Aro
- University of Tartu, Institute of Chemistry, 14a Ravila Street, 50411 Tartu, Estonia
| | - Tuuli Metsvaht
- Tartu University Hospital, Lunini 6, 51014 Tartu Estonia
| | - Joseph F Standing
- Inflammation, Infection and Rheumatology Section, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, United Kingdom; Paediatric Infectious Diseases Research Group, Institute for Infection and Immunity, St. George's, University of London, Cranmer Terrace, London, SW17 0RE, United Kingdom
| | - Irja Lutsar
- University of Tartu, Institute of Microbiology, 19 Ravila Street, 50411 Tartu, Estonia
| | - Koit Herodes
- University of Tartu, Institute of Chemistry, 14a Ravila Street, 50411 Tartu, Estonia
| | - Karin Kipper
- University of Tartu, Institute of Chemistry, 14a Ravila Street, 50411 Tartu, Estonia; Paediatric Infectious Diseases Research Group, Institute for Infection and Immunity, St. George's, University of London, Cranmer Terrace, London, SW17 0RE, United Kingdom.
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21
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Zhang C, Han Y, Lin L, Deng N, Chen B, Liu Y. Development of Quantum Dots-Labeled Antibody Fluorescence Immunoassays for the Detection of Morphine. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2017; 65:1290-1295. [PMID: 28132500 DOI: 10.1021/acs.jafc.6b05305] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Quantum dots (QDs)-labeled antibody fluorescence immunoassays (FLISA) for the detection of morphine were developed. Quantum dots (CdSe/ZnS), which contained carboxyl, were used to label antimorphine antibody by 1-ethyl-3-(3-dimethylaminoprophyl) carbodiimide hydrochloride/N-hydroxysulfosuccinimide, which were used as coupling reagents. The CdSe/ZnS QDs labeled antimorphine antibody (QDs labeled Ab) was characterized by fluorescence spectrum and gel electrophoresis. Plate-based FLISA and nitrocellulose membrane-based flow-through FLISA were developed and applied to quantitative and qualitative detection of morphine. Under the optimal conditions for plate-based FLISA, the linear range spanned from 3.2 × 10-4 to 1 mg/L (R2 = 0.9905), and the detection limit was 2.7 × 10-4 mg/L. The visual detection limit for morphine by membrane-based flow-through FLISA was 0.01 mg/L. These results demonstrated that the developed fluorescence immunoassays could be applied as highly sensitive and convenient tools for rapid detection of morphine, which make it ideally suited for on-site screening of poppy shell added illegally in hot pot soup base.
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Affiliation(s)
- Can Zhang
- School of Food & Biological Engineering, Jiangsu University , Zhenjiang 212013, P. R. China
| | - Yufeng Han
- School of Food & Biological Engineering, Jiangsu University , Zhenjiang 212013, P. R. China
| | - Li Lin
- School of Food & Biological Engineering, Jiangsu University , Zhenjiang 212013, P. R. China
| | - Nannan Deng
- School of Food & Biological Engineering, Jiangsu University , Zhenjiang 212013, P. R. China
| | - Bo Chen
- Zhenjiang Institute for Drug Control, Zhenjiang 212000, P. R. China
| | - Yuan Liu
- Zhenjiang Institute for Drug Control, Zhenjiang 212000, P. R. China
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22
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Moosavi SM, Shekar K, Fraser J, Smith MT, Ghassabian S. High-throughput assay for quantification of the plasma concentrations of thiopental using automated solid phase extraction (SPE) directly coupled to LC-MS/MS instrumentation. J Chromatogr B Analyt Technol Biomed Life Sci 2016; 1038:80-87. [PMID: 27802918 DOI: 10.1016/j.jchromb.2016.10.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 10/24/2016] [Accepted: 10/26/2016] [Indexed: 10/20/2022]
Abstract
Most previous assays for thiopental are time-consuming due to laborious sample extraction steps prior to analysis using gas chromatography or high pressure liquid chromatography. Here, we describe the first high-throughput liquid chromatography - tandem mass spectrometry (LC-MS/MS) method for quantification of thiopental concentrations in samples of human plasma. Robotic on-line solid phase extraction (SPE) was used to elute the analytes of interest from samples of human plasma (50μL) loaded onto C18 SPE cartridges to which were added aliquots (50μL) of internal standard solution (thiopental-d5 100ng/mL) and 0.5% formic acid in water (100μL). Cartridges were washed using 10% methanol in ammonium acetate buffer (50mM, pH 7) before elution with mobile phase comprising 0.1% formic acid in water and acetonitrile with a flow rate of 0.55mL/min using a 7.2min run time. The analytes were separated on a C18 XTerra® analytical column. Mass spectrometry detection was performed using a QTrap 5500 mass spectrometer (AB Sciex) with negative ionisation. The multiple reaction monitoring (MRM) transitions for thiopental and the internal standard were 241→58, and 246→58, respectively. The calibration curve was linear over a range of 6-600ng/mL. Thiopental was stable in human plasma samples for at least 36h in the autosampler, as well as after three cycles of freeze and thaw, and after 3h storage at room temperature. The absolute recovery and matrix effect were 102% and 6.9%, respectively, and the within-run and between-run precision and accuracy were ≤15%. Our method is fully-validated and satisfies the requirements of the 2012 European Medicines Agency (EMEA) guideline for Bioanalytical Method Validation.
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Affiliation(s)
- Seyed Mojtaba Moosavi
- Centre for Integrated Preclinical Drug Development, University of Queensland, Brisbane, Queensland, Australia
| | - Kiran Shekar
- Critical Care Research Group, Adult Intensive Care Services, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - John Fraser
- Critical Care Research Group, Adult Intensive Care Services, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Maree T Smith
- Centre for Integrated Preclinical Drug Development, University of Queensland, Brisbane, Queensland, Australia; School of Pharmacy, University of Queensland, Brisbane, Queensland, Australia
| | - Sussan Ghassabian
- Centre for Integrated Preclinical Drug Development, University of Queensland, Brisbane, Queensland, Australia.
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23
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Viaene J, Lanckmans K, Dejaegher B, Mangelings D, Vander Heyden Y. Comparison of a triple-quadrupole and a quadrupole time-of-flight mass analyzer to quantify 16 opioids in human plasma. J Pharm Biomed Anal 2016; 127:49-59. [DOI: 10.1016/j.jpba.2015.12.055] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 12/27/2015] [Accepted: 12/29/2015] [Indexed: 10/22/2022]
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24
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Applications and challenges in using LC–MS/MS assays for quantitative doping analysis. Bioanalysis 2016; 8:1307-22. [DOI: 10.4155/bio-2016-0030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
LC–MS/MS is useful for qualitative and quantitative analysis of ‘doped’ biological samples from athletes. LC–MS/MS-based assays at low-mass resolution allow fast and sensitive screening and quantification of targeted analytes that are based on preselected diagnostic precursor–product ion pairs. Whereas LC coupled with high-resolution/high-accuracy MS can be used for identification and quantification, both have advantages and challenges for routine analysis. Here, we review the literature regarding various quantification methods for measuring prohibited substances in athletes as they pertain to World Anti-Doping Agency regulations.
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25
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Yang Z, Wang L, Xu M, Gu J, Yu L, Zeng S. Simultaneous analysis of gemfibrozil, morphine, and its two active metabolites in different mouse brain structures using solid-phase extraction with ultra-high performance liquid chromatography and tandem mass spectrometry with a deuterated internal standard. J Sep Sci 2016; 39:2087-96. [PMID: 27060926 DOI: 10.1002/jssc.201600088] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 03/25/2016] [Accepted: 03/26/2016] [Indexed: 12/27/2022]
Abstract
A rapid and sensitive bioassay was established and validated to simultaneously determine gemfibrozil, morphine, morphine-3β-glucuronide, and morphine-6β-glucuronide in mouse cerebrum, epencephalon, and hippocampus based on ultra-high performance liquid chromatography and tandem mass spectrometry. The deuterated internal standard, M6G-d3, was mixed with the prepared samples at 10 ng/mL as the final concentration. The samples were transferred into the C18 solid-phase extraction columns with gradient elution for solid-phase extraction. The mobile phase consisted of methanol and 0.05% formic acid (pH 3.2). Multiple reaction monitoring has been applied to analyze gemfibrozil (m/z 249.0 → 121.0) in anion mode, and M6G-d3 (m/z 465.1 → 289.1), morphine (m/z 286.0 → 200.9), and M3G and M6G (m/z 462.1 → 286.1) in the positive ion mode. The method has a linear calibration range from 0.05 to 10 ng for gemfibrozil, morphine, and M3G and M6G with correlation coefficients >0.993. The lower limit of quantitation for all four analytes was 0.05 ng/mL, relative standard deviation of intra- and interday precision was less than 10.5%, and the relative error of accuracy was from -8.2 to 8.3% at low, medium, and high concentrations for all the analytes. In conclusion, gemfibrozil can influence the morphine antinociception after coronary heart disease induced chronic angina by the change in one of morphine metabolites', M3G, distribution in mouse brain.
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Affiliation(s)
- Zizhao Yang
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University Hangzhou, China
| | - Lu Wang
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University Hangzhou, China
| | - Mingcheng Xu
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University Hangzhou, China
| | - Jingkai Gu
- Research Center for Drug Metabolism, College of Life Science, Jilin University, Changchun, China
| | - Lushan Yu
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University Hangzhou, China
| | - Su Zeng
- Institute of Drug Metabolism and Pharmaceutical Analysis, Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University Hangzhou, China
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Kim TS, Jin SE, Sun B, Kim MS, Hwang SJ. Comparison of adhesion and dissolution of fentanyl patches: Fentadur® and Durogesic DTrans®. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2015. [DOI: 10.1007/s40005-015-0195-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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27
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Liao S, Ren Q, Yang C, Zhang T, Li J, Wang X, Qu X, Zhang X, Zhou Z, Zhang Z, Wang S. Liquid chromatography-tandem mass spectrometry determination and pharmacokinetic analysis of amentoflavone and its conjugated metabolites in rats. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2015; 63:1957-1966. [PMID: 25415840 DOI: 10.1021/jf5019615] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Amentoflavone (AMF) is a biflavone found in many herbal dietary supplements. To investigate the pharmacokinetic profile of AMF in rats, a sensitive, simple, and accurate liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and used to monitor AMF and its conjugated metabolites in plasma. AMF was administered to rats by oral gavage (po), or by intravenous (iv) or intraperitoneal (ip) injection. Plasma samples (with apiolin as an internal standard) were liquid/liquid extracted after hydrolysis with β-glucuronidase/sulfatase in vitro. Following chromatographic separation on a C18 column with a methanol:water:formic acid (70:30:0.1, v/v/v) mobile phase, AMF and internal standard were determined by electrospray ionization in negative ion mode and their precursor-product ion pairs (m/z 537.1 → 374.9 and m/z 269.2 → 224.9, respectively) were used for measurement. This bioanalytical method was fully validated and showed good linearity (r(2) > 0.99), wide dynamic range (0.93-930 nmol/L), and favorable accuracy and precision. After iv or ip AMF (10 mg/kg) injection, 73.2% ± 6.29% and 70.2% ± 5.18% of the total AMF detected in plasma was present as conjugated metabolites. Furthermore, AMF and AMF conjugates showed similar time courses with no significant differences in the time to reach the maximum plasma concentration (tmax) and terminal half-life (t1/2) (p > 0.05). Following po AMF administration (300 mg/kg), 90.7% ± 8.3% of the total AMF was circulating as conjugated metabolites. When compared with iv administration (with dose correction), the bioavailability of po AMF was very low (0.04% ± 0.01% for free AMF; 0.16% ± 0.04% for conjugated AMF). Collectively, these data provided a preliminary pharmacokinetic profile for AMF that should inform further evaluations of its biological efficacy and preclinical development.
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Affiliation(s)
- Sha Liao
- Beijing Institute of Pharmacology and Toxicology , 27 Taiping Road, Haidian District, Beijing, 100850 P. R. China
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Ma J, Wang S, Zhang M, Zhang Q, Zhou Y, Lin C, Lin G, Wang X. Simultaneous determination of bupropion, metroprolol, midazolam, phenacetin, omeprazole and tolbutamide in rat plasma by UPLC-MS/MS and its application to cytochrome P450 activity study in rats. Biomed Chromatogr 2015; 29:1203-12. [PMID: 25582505 DOI: 10.1002/bmc.3409] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Revised: 11/09/2014] [Accepted: 11/17/2014] [Indexed: 12/22/2022]
Abstract
A specific ultra-performance liquid chromatography tandem mass spectrometry method is described for the simultaneous determination of bupropion, metroprolol, midazolam, phenacetin, omeprazole and tolbutamide in rat plasma with diazepam as internal standard, which are the six probe drugs of the six cytochrome P450 isoforms CYP2B6, CYP2D6, CYP3A4, CYP1A2, CYP2C19 and CYP2C9. Plasma samples were protein precipitated with acetonitrile. The chromatographic separation was achieved using a UPLC® BEH C18 column (2.1 × 100 mm, 1.7 µm). The mobile phase consisted of acetonitrile and water (containing 0.1% formic acid) with gradient elution. The triple quadrupole mass spectrometric detection was operated by multiple reaction monitoring in positive electrospray ionization. The precisions were <13%, and the accuracy ranged from 93.3 to 110.4%. The extraction efficiency was >90.5%, and the matrix effects ranged from 84.3 to 114.2%. The calibration curves in plasma were linear in the range of 2-2000 ng/mL, with correlation coefficient (r(2) ) >0.995. The method was successfully applied to pharmacokinetic studies of the six probe drugs of the six CYP450 isoforms and used to evaluate the effects of erlotinib on the activities of CYP2B6, CYP2D6, CYP3A4, CYP1A2, CYP2C19 and CYP2C9 in rats. Erlotinib may inhibit the activity of CYP2B6 and CYP3A4, and may induce CYP2C9 of rats.
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Affiliation(s)
- Jianshe Ma
- Shanghai Key Laboratory of Forensic Medicine, Institute of Forensic Science, Ministry of Justice, Shanghai, 200063, China.,Analytical and Testing Center of Wenzhou Medical University, Wenzhou, 325035, China
| | - Shuanghu Wang
- The Laboratory of Clinical Pharmacy, The People's Hospital of Lishui, Lishui, 323000, China
| | - Meiling Zhang
- Shanghai Key Laboratory of Forensic Medicine, Institute of Forensic Science, Ministry of Justice, Shanghai, 200063, China.,Analytical and Testing Center of Wenzhou Medical University, Wenzhou, 325035, China
| | - Qingwei Zhang
- Shanghai Institute of Pharmaceutical Industry, Shanghai, 200437, China
| | - Yunfang Zhou
- The Laboratory of Clinical Pharmacy, The People's Hospital of Lishui, Lishui, 323000, China
| | - Chongliang Lin
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Guanyang Lin
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Xianqin Wang
- Shanghai Key Laboratory of Forensic Medicine, Institute of Forensic Science, Ministry of Justice, Shanghai, 200063, China.,Analytical and Testing Center of Wenzhou Medical University, Wenzhou, 325035, China
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INOUE K, OZAWA Y, TOYO'OKA T. Application of Liquid Chromatography Coupled with Electrospray Ionization Tandem Mass Spectrometry for Therapeutic Drug Monitoring of Sedative Medicine in Clinical Stage. CHROMATOGRAPHY 2015. [DOI: 10.15583/jpchrom.2015.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Koichi INOUE
- College of Pharmaceutical Sciences, Ritsumeikan University
| | - Yuta OZAWA
- School of Pharmaceutical Sciences, University of Shizuoka
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Application of Two-dimensional Liquid Chromatography in Bioanalysis of Drugs and Toxicants. CHINESE JOURNAL OF ANALYTICAL CHEMISTRY 2014. [DOI: 10.1016/s1872-2040(14)60790-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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31
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Shaner RL, Kaplan P, Hamelin EI, Bragg WA, Johnson RC. Comparison of two automated solid phase extractions for the detection of ten fentanyl analogs and metabolites in human urine using liquid chromatography tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2014; 962:52-58. [PMID: 24893271 DOI: 10.1016/j.jchromb.2014.05.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 03/26/2014] [Accepted: 05/08/2014] [Indexed: 11/25/2022]
Abstract
Two types of automated solid phase extraction (SPE) were assessed for the determination of human exposure to fentanyls in urine. High sensitivity is required to detect these compounds following exposure because of the low dose required for therapeutic effect and the rapid clearance from the body for these compounds. To achieve this sensitivity, two acceptable methods for the detection of human exposure to seven fentanyl analogs and three metabolites were developed using either off-line 96-well plate SPE or on-line SPE. Each system offers different advantages: off-line 96-well plate SPE allows for high throughput analysis of many samples, which is needed for large sample numbers, while on-line SPE removes almost all analyst manipulation of the samples, minimizing the analyst time needed for sample preparation. Both sample preparations were coupled with reversed phase liquid chromatography and isotope dilution tandem mass spectrometry (LC-MS/MS) for analyte detection. For both methods, the resulting precision was within 15%, the accuracy within 25%, and the sensitivity was comparable with the limits of detection ranging from 0.002ng/mL to 0.041ng/mL. Additionally, matrix effects were substantially decreased from previous reports for both extraction protocols. The results of this comparison showed that both methods were acceptable for the detection of exposures to fentanyl analogs and metabolites in urine.
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Affiliation(s)
- Rebecca L Shaner
- Centers for Disease Control and Prevention, 4770 Buford Highway, MS F44, Atlanta, GA 30341, United States
| | - Pearl Kaplan
- ORISE Fellow, Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, Atlanta, GA 30341, United States
| | - Elizabeth I Hamelin
- Centers for Disease Control and Prevention, 4770 Buford Highway, MS F44, Atlanta, GA 30341, United States
| | - William A Bragg
- Centers for Disease Control and Prevention, 4770 Buford Highway, MS F44, Atlanta, GA 30341, United States
| | - Rudolph C Johnson
- Centers for Disease Control and Prevention, 4770 Buford Highway, MS F44, Atlanta, GA 30341, United States.
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Lin G, Ma J, Lin C, Hu L, Wang X. DETERMINATION OF NORDIHYDROCAPSAICIN IN RABBIT PLASMA BY LIQUID CHROMATOGRAPHY-ELECTROSPRAY MASS SPECTROMETRY. J LIQ CHROMATOGR R T 2014. [DOI: 10.1080/10826076.2013.850721] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Guanyang Lin
- a Function Experiment Teaching Center of Wenzhou Medical University , Wenzhou , China
| | - Jianshe Ma
- b The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China
| | - Chongliang Lin
- a Function Experiment Teaching Center of Wenzhou Medical University , Wenzhou , China
| | - Lufeng Hu
- a Function Experiment Teaching Center of Wenzhou Medical University , Wenzhou , China
| | - Xianqin Wang
- c Analytical and Testing Center of Wenzhou Medical University , Wenzhou , China
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González O, Blanco ME, Iriarte G, Bartolomé L, Maguregui MI, Alonso RM. Bioanalytical chromatographic method validation according to current regulations, with a special focus on the non-well defined parameters limit of quantification, robustness and matrix effect. J Chromatogr A 2014; 1353:10-27. [PMID: 24794936 DOI: 10.1016/j.chroma.2014.03.077] [Citation(s) in RCA: 162] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 03/21/2014] [Accepted: 03/27/2014] [Indexed: 02/04/2023]
Abstract
Method validation is a mandatory step in bioanalysis, to evaluate the ability of developed methods in providing reliable results for their routine application. Even if some organisations have developed guidelines to define the different parameters to be included in method validation (FDA, EMA); there are still some ambiguous concepts in validation criteria and methodology that need to be clarified. The methodology to calculate fundamental parameters such as the limit of quantification has been defined in several ways without reaching a harmonised definition, which can lead to very different values depending on the applied criterion. Other parameters such as robustness or ruggedness are usually omitted and when defined there is not an established approach to evaluate them. Especially significant is the case of the matrix effect evaluation which is one of the most critical points to be studied in LC-MS methods but has been traditionally overlooked. Due to the increasing importance of bioanalysis this scenario is no longer acceptable and harmonised criteria involving all the concerned parties should be arisen. The objective of this review is thus to discuss and highlight several essential aspects of method validation, focused in bioanalysis. The overall validation process including common validation parameters (selectivity, linearity range, precision, accuracy, stability…) will be reviewed. Furthermore, the most controversial parameters (limit of quantification, robustness and matrix effect) will be carefully studied and the definitions and methodology proposed by the different regulatory bodies will be compared. This review aims to clarify the methodology to be followed in bioanalytical method validation, facilitating this time consuming step.
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Affiliation(s)
- Oskar González
- Analytical Chemistry Department, Science and Technology Faculty, the Basque Country University/EHU, P.O. Box 644, Bilbao, Basque Country 48080, Spain; Analytical Bioscience Division, LACDR, Leiden University Einsteinsweg 55, CC Leiden 2333, Netherlands
| | - María Encarnación Blanco
- Analytical Chemistry Department, Science and Technology Faculty, the Basque Country University/EHU, P.O. Box 644, Bilbao, Basque Country 48080, Spain
| | - Gorka Iriarte
- Laboratory of Public Health of Alava, (Public Health and Addictions Directorate, Basque Government), Santiago 11, Vitoria-Gasteiz 01002, Basque Country
| | - Luis Bartolomé
- Central Analytical Service (SGIker), Science and Technology Faculty, the Basque Country University/EHU, P.O. Box 644, Bilbao, Basque Country 48080 Spain
| | - Miren Itxaso Maguregui
- Analytical Chemistry Department, Science and Technology Faculty, the Basque Country University/EHU, P.O. Box 644, Bilbao, Basque Country 48080, Spain
| | - Rosa M Alonso
- Analytical Chemistry Department, Science and Technology Faculty, the Basque Country University/EHU, P.O. Box 644, Bilbao, Basque Country 48080, Spain.
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Determination of bicuculline in rat plasma by liquid chromatography mass spectrometry and its application in a pharmacokinetic study. J Chromatogr B Analyt Technol Biomed Life Sci 2014; 953-954:143-6. [DOI: 10.1016/j.jchromb.2014.02.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 01/16/2014] [Accepted: 02/10/2014] [Indexed: 11/19/2022]
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Ostman M, Fick J, Näsström E, Lindberg RH. A snapshot of illicit drug use in Sweden acquired through sewage water analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 472:862-71. [PMID: 24342093 DOI: 10.1016/j.scitotenv.2013.11.081] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 11/16/2013] [Accepted: 11/16/2013] [Indexed: 05/24/2023]
Abstract
Analytical measurements of sewage water have been used many times to estimate the consumption of specific drugs in an area. This study measured a large number of illicit drugs and metabolites (>30) at a large number of sewage treatment plants (STPs) distributed across Sweden. Twenty-four illicit and prescription drugs, classified as narcotic substances in Sweden, and seven selected metabolites were included in the study. A 24 hour composite sample of incoming sewage water was collected from 33 different municipalities at various geographic locations across Sweden. Species were analyzed using an on-line solid-phase extraction-liquid chromatography electrospray tandem mass spectrometry method. The method proved to be rapid with minimum need for sample work up and was able to detect 13 compounds above their respective limits of quantification. The results for all compounds were presented as per capita loads. Multivariate data analysis was used to relate drug consumption to geographical location and/or population of cities. The results showed that geographical differences in drug consumption were apparent across the country. For the narcotic pharmaceuticals, the geographical differences suggested by the multivariate model were supported by prescription statistics.
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Affiliation(s)
- Marcus Ostman
- Department of Chemistry, Umeå University, SE-901 87 Umeå, Sweden.
| | - Jerker Fick
- Department of Chemistry, Umeå University, SE-901 87 Umeå, Sweden
| | - Elin Näsström
- Department of Chemistry, Umeå University, SE-901 87 Umeå, Sweden
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Johnston C, Hilmer SN, McLachlan AJ, Matthews ST, Carroll PR, Kirkpatrick CM. The impact of frailty on pharmacokinetics in older people: using gentamicin population pharmacokinetic modeling to investigate changes in renal drug clearance by glomerular filtration. Eur J Clin Pharmacol 2014; 70:549-55. [DOI: 10.1007/s00228-014-1652-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 01/20/2014] [Indexed: 01/10/2023]
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Wen C, Lin C, Cai X, Ma J, Wang X. Determination of sec-O-glucosylhamaudol in rat plasma by gradient elution liquid chromatography–mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2014; 944:35-8. [DOI: 10.1016/j.jchromb.2013.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Revised: 10/30/2013] [Accepted: 11/01/2013] [Indexed: 11/28/2022]
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Wang X, Chen M, Wen C, Zhang Q, Ma J. Determination of chidamide in rat plasma by LC-MS and its application to pharmacokinetics study. Biomed Chromatogr 2013; 27:1801-6. [DOI: 10.1002/bmc.3001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 06/09/2013] [Accepted: 06/19/2013] [Indexed: 11/11/2022]
Affiliation(s)
- Xianqin Wang
- Analytical and Testing Center of Wenzhou Medical University; Wenzhou 325035 China
| | - Mengchun Chen
- Analytical and Testing Center of Wenzhou Medical University; Wenzhou 325035 China
| | - Congcong Wen
- Analytical and Testing Center of Wenzhou Medical University; Wenzhou 325035 China
| | - Qingwei Zhang
- Shanghai Institute of Pharmaceutical Industry; Shanghai 200437 China
| | - Jianshe Ma
- Function Experiment Teaching Center; Wenzhou Medical University; Wenzhou 325035 China
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39
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Karch SB. Postmortem toxicology in the elderly. Forensic Sci Med Pathol 2013; 9:256-7. [DOI: 10.1007/s12024-013-9406-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2013] [Indexed: 10/27/2022]
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40
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Shekar K, Roberts JA, Smith MT, Fung YL, Fraser JF. The ECMO PK Project: an incremental research approach to advance understanding of the pharmacokinetic alterations and improve patient outcomes during extracorporeal membrane oxygenation. BMC Anesthesiol 2013; 13:7. [PMID: 23517311 PMCID: PMC3643838 DOI: 10.1186/1471-2253-13-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 02/21/2013] [Indexed: 01/20/2023] Open
Abstract
Background Extracorporeal membrane oxygenation (ECMO) is a supportive therapy and its success depends on optimal drug therapy along with other supportive care. Emerging evidence suggests significant interactions between the drug and the device resulting in altered pharmacokinetics (PK) of vital drugs which may be further complicated by the PK changes that occur in the context of critical illness. Such PK alterations are complex and challenging to investigate in critically ill patients on ECMO and necessitate mechanistic research. The aim of this project is to investigate each of circuit, drug and critical illness factors that affect drug PK during ECMO. Methods/design An incremental research plan that encompasses ex vivo experiments for drug stability testing in fresh human and ovine whole blood, ex vivo drug disposition studies in standard and modified adult ECMO circuits primed with fresh human or ovine whole blood, PK studies in healthy and critically ill ovine models of ECMO with appropriate non ECMO controls and an international mutli-centre clinical population PK study will be utilised to comprehensively define the PK alterations that occur in the presence of ECMO. Novel drug assays that will allow quantification of multiple drugs in small volumes of plasma will also be developed. Mixed-effects regression models will be used to estimate the drug loss over time in ex vivo studies. Data from animal and clinical studies will be analysed using non-linear mixed-effects models. This will lead to generation of PK data that enables the development evidence based guidelines for antibiotic, sedative and analgesic drug therapy during ECMO. Discussion Systematic research that integrates both mechanistic and clinical research is desirable when investigating the complex area of pharmacokinetic alterations during ECMO. The above research approach will provide an advanced mechanistic understanding of PK during ECMO. The clinical study when complete will result in development robust guidelines for prescription of 18 commonly used antibiotic, sedative and analgesic drugs used in ECMO patients. This research may also pave the way for further refinements in circuitry, drug chemistry and drug prescriptions during ECMO. Trial registration ACTRN12612000559819.
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Affiliation(s)
- Kiran Shekar
- Critical Care Research Group, Adult Intensive Care Services, The Prince Charles, Hospital and The University of Queensland, Brisbane, QLD, 4032, Australia.
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Berg T, Jørgenrud B, Strand DH. Determination of buprenorphine, fentanyl and LSD in whole blood by UPLC-MS-MS. J Anal Toxicol 2013; 37:159-65. [PMID: 23423312 DOI: 10.1093/jat/bkt005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A sensitive ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS-MS) method has been developed and validated for the quantification of buprenorphine, fentanyl and lysergic acid diethylamide (LSD) in whole blood. Sample preparation was performed by liquid-liquid extraction (LLE) with methyl tert-butyl ether. UPLC-MS-MS analysis was performed with a mobile phase consisting of ammonium formate (pH 10.2) and methanol. Positive electrospray ionization MS-MS detection was performed with two multiple reaction monitoring transitions for each of the analytes and the deuterium labeled internal standards. Limit of detection values of buprenorphine, fentanyl and LSD were 0.28, 0.044 and 0.0097 ng/mL and limit of quantification values were 0.94, 0.14 and 0.036 ng/mL, respectively. Most phospholipids were removed during LLE. No or only minor matrix effects were observed. The method has been routinely used at the Norwegian Institute of Public Health since September 2011 for qualitative and quantitative detections of buprenorphine, fentanyl and/or LSD in more than 400 whole blood samples with two replicates per sample.
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Affiliation(s)
- Thomas Berg
- Division of Forensic Medicine and Drug Abuse Research, Norwegian Institute of Public Health, Oslo, Norway.
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42
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Ma B, Zhang Q, Liu Y, Li J, Xu Q, Li X, Yang X, Yao D, Sun J, Cui G, Ying H. Simultaneous determination of Eleutheroside B and Eleutheroside E in rat plasma by high performance liquid chromatography–electrospray ionization mass spectrometry and its application in a pharmacokinetic study. J Chromatogr B Analyt Technol Biomed Life Sci 2013; 917-918:84-92. [DOI: 10.1016/j.jchromb.2012.12.041] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 12/28/2012] [Accepted: 12/31/2012] [Indexed: 11/29/2022]
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Development and validation of a sensitive liquid chromatography/tandem mass spectrometry method for the determination of raddeanin A in rat plasma and its application to a pharmacokinetic study. J Chromatogr B Analyt Technol Biomed Life Sci 2013; 912:16-23. [DOI: 10.1016/j.jchromb.2012.09.038] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 09/13/2012] [Accepted: 09/22/2012] [Indexed: 11/23/2022]
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Shekar K, Roberts JA, Welch S, Buscher H, Rudham S, Burrows F, Ghassabian S, Wallis SC, Levkovich B, Pellegrino V, McGuinness S, Parke R, Gilder E, Barnett AG, Walsham J, Mullany DV, Fung YL, Smith MT, Fraser JF. ASAP ECMO: Antibiotic, Sedative and Analgesic Pharmacokinetics during Extracorporeal Membrane Oxygenation: a multi-centre study to optimise drug therapy during ECMO. BMC Anesthesiol 2012. [PMID: 23190792 PMCID: PMC3543712 DOI: 10.1186/1471-2253-12-29] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Given the expanding scope of extracorporeal membrane oxygenation (ECMO) and its variable impact on drug pharmacokinetics as observed in neonatal studies, it is imperative that the effects of the device on the drugs commonly prescribed in the intensive care unit (ICU) are further investigated. Currently, there are no data to confirm the appropriateness of standard drug dosing in adult patients on ECMO. Ineffective drug regimens in these critically ill patients can seriously worsen patient outcomes. This study was designed to describe the pharmacokinetics of the commonly used antibiotic, analgesic and sedative drugs in adult patients receiving ECMO. Methods/Design This is a multi-centre, open-label, descriptive pharmacokinetic (PK) study. Eligible patients will be adults treated with ECMO for severe cardiac and/or respiratory failure at five Intensive Care Units in Australia and New Zealand. Patients will receive the study drugs as part of their routine management. Blood samples will be taken from indwelling catheters to investigate plasma concentrations of several antibiotics (ceftriaxone, meropenem, vancomycin, ciprofloxacin, gentamicin, piperacillin-tazobactum, ticarcillin-clavulunate, linezolid, fluconazole, voriconazole, caspofungin, oseltamivir), sedatives and analgesics (midazolam, morphine, fentanyl, propofol, dexmedetomidine, thiopentone). The PK of each drug will be characterised to determine the variability of PK in these patients and to develop dosing guidelines for prescription during ECMO. Discussion The evidence-based dosing algorithms generated from this analysis can be evaluated in later clinical studies. This knowledge is vitally important for optimising pharmacotherapy in these most severely ill patients to maximise the opportunity for therapeutic success and minimise the risk of therapeutic failure. Trial registration ACTRN12612000559819
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Affiliation(s)
- Kiran Shekar
- Critical Care Research Group, Adult Intensive Care Services, The Prince Charles Hospital and The University of Queensland, Brisbane, Queensland, Australia.
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Shekar K, Roberts JA, Mcdonald CI, Fisquet S, Barnett AG, Mullany DV, Ghassabian S, Wallis SC, Fung YL, Smith MT, Fraser JF. Sequestration of drugs in the circuit may lead to therapeutic failure during extracorporeal membrane oxygenation. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2012; 16:R194. [PMID: 23068416 PMCID: PMC3682296 DOI: 10.1186/cc11679] [Citation(s) in RCA: 202] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 09/18/2012] [Indexed: 01/19/2023]
Abstract
Introduction Extracorporeal membrane oxygenation (ECMO) is a supportive therapy, with its success dependent on effective drug therapy that reverses the pathology and/or normalizes physiology. However, the circuit that sustains life can also sequester life-saving drugs, thereby compromising the role of ECMO as a temporary support device. This ex vivo study was designed to determine the degree of sequestration of commonly used antibiotics, sedatives and analgesics in ECMO circuits. Methods Four identical ECMO circuits were set up as per the standard protocol for adult patients on ECMO. The circuits were primed with crystalloid and albumin, followed by fresh human whole blood, and were maintained at a physiological pH and temperature for 24 hours. After baseline sampling, fentanyl, morphine, midazolam, meropenem and vancomycin were injected into the circuit at therapeutic concentrations. Equivalent doses of these drugs were also injected into four polyvinylchloride jars containing fresh human whole blood for drug stability testing. Serial blood samples were collected from the ECMO circuits and the controls over 24 hours and the concentrations of the study drugs were quantified using validated assays. Results Four hundred samples were analyzed. All study drugs, except meropenem, were chemically stable. The average drug recoveries from the ECMO circuits and the controls at 24 hours relative to baseline, respectively, were fentanyl 3% and 82%, morphine 103% and 97%, midazolam 13% and 100%, meropenem 20% and 42%, vancomycin 90% and 99%. There was a significant loss of fentanyl (p = 0.0005), midazolam (p = 0.01) and meropenem (p = 0.006) in the ECMO circuit at 24 hours. There was no significant circuit loss of vancomycin at 24 hours (p = 0.26). Conclusions Sequestration of drugs in the circuit has implications on both the choice and dosing of some drugs prescribed during ECMO. Sequestration of lipophilic drugs such as fentanyl and midazolam appears significant and may in part explain the increased dosing requirements of these drugs during ECMO. Meropenem sequestration is also problematic and these data support a more frequent administration during ECMO.
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