Determination of benzodiazepines in pericardial fluid by gas chromatography-mass spectrometry

Comparative Study of Postmortem Concentrations of Benzodiazepines and Z-Hypnotics in Several Different Matrices

Benzodiazepines and z-hypnotics are detected in the majority of fatal overdose cases in Norway, often in combination with other drugs of abuse, and their concentrations in peripheral blood (PB) might be important to elucidate the cause of death. In some forensic autopsies, PB is however not available. The aim of the present study was to compare concentrations of benzodiazepines and z-hypnotics in five alternative matrices to assess whether these concentrations are comparable to concentrations in PB. A total of 109 forensic autopsy cases were included. PB, cardiac blood (CB), pericardial fluid (PF), psoas muscle (PM), lateral vastus muscle (LVM) and vitreous humor (VH) from each case were analyzed using ultra high performance liquid chromatography--tandem mass spectrometry. We were able to detect clonazepam, 7-aminoclonazepam, flunitrazepam, 7-aminoflunitrazepam, nitrazepam, 7-aminonitrazepam, diazepam, nordiazepam, oxazepam, alprazolam, midazolam, zopiclone and zolpidem in all the analyzed matrices. Concentrations measured in VH were generally much lower than those of PB for all compounds except zopiclone. 7-Amino metabolite concentrations were high compared to the parent compounds, although less so for the muscle samples. Concentrations of the parent nitrobenzodiazepines in muscles were higher than those in PB, but for the other compounds, concentrations in muscle showed good correspondence with PB. Both CB and PF were viable alternative matrices for PB, although a larger variation and a tendency for higher concentrations in PF were observed. This study shows that CB, PM, LVM and PF can give comparable concentrations to PB for benzodiazepines and z-hypnotics, while VH was less suitable. The concentrations in alternative matrices must, however, be interpreted carefully.

Polystyrene nanofibers as an effective sorbent for the adsorption of clonazepam: kinetic and thermodynamic studies

Polystyrene (PS) electrospun nanofibers were prepared via electrospinning for the adsorption of clonazepam from aqueous solution. The adsorption conditions such as adsorption time, solution pH and the amount of adsorbent were optimized. The adsorption kinetics and thermodynamic properties of clonazepam on PS nanofibers were studied under optimized conditions. The pseudo-second-order kinetic model can fit well the adsorption process of clonazepam on polystyrene nanofibers, indicating that the diffusion process in the fiber is the rate-limiting step of the adsorption process. The adsorption equilibrium data are in accordance with the Freundlich isotherm model, and the maximum adsorption capacity is 3.2 mg g⁻¹. Thermodynamic studies revealed that the adsorption process is endothermic and spontaneous in nature. It was suggested that PS electrospun nanofibers have good potential for the separation and purification of clonazepam from a water-soluble matrix as a novel effective adsorbent material.

Polystyrene (PS) electrospun nanofibers were prepared via electrospinning for the adsorption of clonazepam from aqueous solution.

Sulfolane as a novel stationary phase for analytical separations by gas chromatography

Sulfolane is explored as a novel stationary phase for use in analytical separations by capillary column gas chromatography with flame ionization detection (GC-FID). Stainless steel capillaries were found to provide a good substrate for coating and retaining a sulfolane phase, whereas fused silica tubing did not perform well for this. In general, the phase was found to be stable for several hours of use when using elevated carrier gas pressures (90 psi) and a small restriction (25 μm I.D. tubing) at the outlet. This normally provided good performance at temperatures up to about 200 °C with very little background interference in the FID. Given its separation properties, a short 2 m × 100 μm I.D. column was found to be preferable for most separations in this study. Measurements indicated the coating procedure yielded a sulfolane film near 4 μm thick on this column, which produced 4400 plates for benzene with a sample capacity near 30 μg. The sulfolane phase yielded good retention and peak shape for many analytes including alkanes, aromatics, alcohols, bases, sulfides, phosphites, thiols, and others. Compared to longer conventional GC columns, the relatively short sulfolane column was found to offer improved selectivity in the separation of unsaturated, aromatic, and alkane test analytes. As such the method was successfully applied to the analysis of aromatics in gasoline headspace. Results suggest that sulfolane could be a potentially useful stationary phase to further explore in GC separations.

Designer Benzodiazepines: A Review of Toxicology and Public Health Risks

The rising use of designer benzodiazepines (DBZD) is a cat-and-mouse game between organized crime and law enforcement. Non-prohibited benzodiazepines are introduced onto the global drug market and scheduled as rapidly as possible by international authorities. In response, DBZD are continuously modified to avoid legal sanctions and drug seizures and generally to increase the abuse potential of the DBZD. This results in an unpredictable fluctuation between the appearance and disappearance of DBZD in the illicit market. Thirty-one DBZD were considered for review after consulting the international early warning database, but only 3-hydroxyphenazepam, adinazolam, clonazolam, etizolam, deschloroetizolam, diclazepam, flualprazolam, flubromazepam, flubromazolam, meclonazepam, phenazepam and pyrazolam had sufficient data to contribute to this scoping review. A total of 49 reports describing 1 drug offense, 2 self-administration studies, 3 outpatient department admissions, 44 emergency department (ED) admissions, 63 driving under the influence of drugs (DUID) and 141 deaths reported between 2008 and 2021 are included in this study. Etizolam, flualprazolam flubromazolam and phenazepam were implicated in the majority of adverse-events, drug offenses and deaths. However, due to a general lack of knowledge of DBZD pharmacokinetics and toxicity, and due to a lack of validated analytical methods, total cases are much likely higher. Between 2019 and April 2020, DBZD were identified in 48% and 83% of postmortem and DUID cases reported to the UNODC, respectively, with flualprazolam, flubromazolam and etizolam as the most frequently detected substances. DBZD toxicology, public health risks and adverse events are reported.

Calcium/Copper Alginate Framework Doped with CuO Nanoparticles as a Novel Adsorbent for Micro-extraction of Benzodiazepines from Human Serum

Background:

Sample preparation is one of the most challenging phases in pharmaceutical analysis, especially in biological matrices, affecting the whole analytical methodology.

Objective:

In this study, a new Ca(II)/Cu(II)/alginate/CuO Nanoparticles Hydrogel Fiber (CCACHF) was synthesized through a simple, green procedure and applied for fiber micro solid-phase extraction (FMSPE) of diazepam (DIZ) and oxazepam (OXZ) as model drugs prior to high-performance liquid chromatography-UV detection (HPLC-UV).

Methods:

Composition and morphology of the prepared fiber were characterized and the effect of main parameters on the fiber fabrication and extraction efficiency have been studied and optimized.

Results:

In optimal conditions, calibration curves were linear, ranging between 0.1–500 μg L−1 with regression coefficients of 0.9938 and 0.9968. Limit of Detection (LOD) (S/N=3) and Limit of Quantification (LOQ) (S/N=10) of the technique for DIZ and OXZ were 0.03 to 0.1 μg L−1. Within-day and between-day Relative Standard Deviations (RSDs) for DIZ and OXZ were 6.0–12.5% and 3.3–9.4%, respectively.

Conclusion:

The fabricated adsorbent has been substantially employed to the extraction of selected benzo-diazepines (BZDs) from human serum real specimens and the obtained recoveries were also satisfactory (82.1-109.7%).

Quantification of 54 Benzodiazepines and Z-Drugs, Including 20 Designer Ones, in Plasma

Benzodiazepines are widely used in the treatment of sleep and anxiety disorders, as well as epileptic seizures and alcohol withdrawal because of their broad therapeutic index and low cost. Due to their central nervous system depressant effects they are also often implicated in traffic accidents and drug-related intoxications. With an increasing number of designer benzodiazepines used in a recreational setting, there is a need for analytical methods to be able to quantify both the prescribed and designer benzodiazepines. A liquid chromatography-triple quadrupole mass spectrometry method was developed for the quantification of 34 prescribed and 20 designer benzodiazepines in plasma. Different sample preparation strategies, including protein precipitation, liquid-liquid extraction, solid-phase extraction and mini-QuEChERS, were tested. The best recoveries for all compounds of interest were obtained with a liquid-liquid extraction using methyl-tertiary-butyl-ether and 500 μL plasma. The method was fully validated according to the European Medicines Agency guidelines for all compounds, except pivoxazepam, which is included for qualitative purposes only. In-sample stability issues were observed for cloxazolam, both at ambient temperature and during long-term storage at -20°C. Due to the large number of compounds included, the simple and time-efficient sample preparation and the relatively inexpensive instrumentation used, the presented method can be readily implemented in both therapeutic drug monitoring and forensic analyses.

Determination of Seven Antidepressants in Pericardial Fluid by Means of Dispersive Liquid-Liquid Microextraction (DLLME) and Gas Chromatography-Mass Spectrometry (GC/MS)

Although blood is often used to detect and quantify the presence of drugs, there are some instances where samples obtained from other biological matrices, like pericardial fluid (PF), are necessary since adequate blood samples may not be available. PF is an epicardial transudate, which contains plasma components that include toxicological substances making this sample useful when blood samples are not available. This fluid is a well preserved postmortem sample and can easily be collected in larger amounts without significant contamination, compared with other body fluids. Although studies involving PF began around the 1980's, the adequacy of such fluid as a biological matrix has been poorly investigated. Antidepressants are frequently detected in postmortem samples from forensic cases. Nowadays, they constitute some of the most commonly prescribed drugs worldwide. A total of seven antidepressants (venlafaxine, mirtazapine, olanzapine, paroxetine, sertraline, fluoxetine and citalopram) were evaluated in this study. A new extraction method involving dispersive liquid-liquid microextraction (DLLME) is presented in which chloroform and acetonitrile are determined to be the best extraction and dispersing solvents. The experimental design was achieved using StatGraphics 18. The Response Surface Methodology enabled us to know the optimal volume for the two solvents used in the DLLME. The detection technique used was gas chromatography-mass spectrometry (GC-MS) with electron impact ionization as ionization source. A temperature gradient has been used and the total chromatographic separation time was 19.43 min. Validation results met the international validation guidances (FDA). Under the optimal condition, the method offered good validation parameters showing a new efficient, simple, rapid, and sensitive method. The analytical method was applied to thirty-one pericardial fluid samples. Twenty-one samples were positive with concentrations between 0.19 and 8.48 µg/mL. Venlafaxine and olanzapine were the antidepressants most frequently found.

A poly(N,N-dimethylaminoethyl methacrylate-co-ethylene glycol dimethacrylate) monolith for direct solid-phase extraction of benzodiazepines from undiluted human urine

A novel polymeric monolith using N,N-dimethylaminoethyl methacrylate as the monomer and ethylene glycol dimethacrylate as the crosslinker was successfully synthesized in a syringe and applied for direct solid-phase extraction of four benzodiazepines (bromazepam, triazolam, midazolam and diazepam) from undiluted urine samples prior to high performance liquid chromatography. The monolith was characterized by scanning electron microscopy, Fourier transform infrared spectroscopy and nitrogen adsorption-desorption experiments. Moreover, extraction parameters, including loading, washing and eluting conditions were optimized. Under the optimized conditions, the proposed method obtained linear ranges of 2.0-500 ng mL^-1 with correlation coefficients (r) higher than 0.9997. The limits of detection (S/N = 3) and limits of quantification (S/N = 10) were 0.4-0.6 ng mL^-1 and 1.4-2.0 ng mL^-1, respectively. The recoveries at three spiked levels ranged from 83.7% to 103% with the intra- and inter-day precisions from 0.6-7.6% to 2.7-9.8%. The present monolith allowed direct loading of crude urine samples without any filtration or dilution step. Besides, the sorbent offered an enhancement factor of 16.7-20.6 and was stable enough for ten replicate cycles of extraction/desorption of urine samples. The developed method presented an alternative strategy for the accurate and convenient determination of benzodiazepines in urine samples.

A Novel Bioanalytical Method for the Determination of Opioids in Blood and Pericardial Fluid

Opioids are the drugs most commonly detected in overdose deaths and the second most consumed worldwide. An analytical methodology has been optimized and fully validated for the determination of codeine, morphine, 6-acetylmorphine, 6-acetylcodeine, oxycodone, oxymorphone and fentanyl in whole blood and pericardial fluid. The internal standards used were codeine-d3, morphine-d3, 6-acetylmorphine-d3 and fentanyl-d5. Before solid-phase extraction, volumes of 250 μL of blood and pericardial fluid were subjected to a protein precipitation (with 750 μL of ice-cold acetonitrile) and a microwave-induced oximation was performed using a solution of 1% aqueous hydroxylamine hydrochloride in phosphate-buffered saline (1:2, v/v). Finally, the dried extracts were further derivatized with a solution of n-methyl-n-(trimethylsilyl) trifluoroacetamide + 5% trimethylchlorosilane under microwave irradiation. The chromatographic analysis was carried out using gas chromatography–mass spectrometry operating in electron impact and selected ion monitoring mode. For all analytes, the method was linear between 5 and 1,000 ng/mL with determination coefficients (r2) >0.99. Depending on the analyte and matrix, the limit of detection varies between 3 and 4 ng/mL. Intra- and intermediate precision (<20%) and bias (±20%) were acceptable for all analytes in both matrices. The stability of the substances in the studied matrices was guaranteed, at least, 24 h in the autosampler, 4 h at room temperature and 30 days after three freeze/thaw cycles. This methodology was applied to real samples from the Laboratory of Chemistry and Forensic Toxicology, Centre Branch, of the National Institute of Legal Medicine and Forensic Sciences, Portugal.