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Thormann W. Capillary electrophoresis for the determination of drugs in biological fluids. HANDBOOK OF ANALYTICAL SEPARATIONS 2020. [DOI: 10.1016/b978-0-444-64066-6.00004-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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2
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Szarka M, Szigeti M, Guttman A. Imaging Laser-Induced Fluorescence Detection at the Taylor Cone of Electrospray Ionization Mass Spectrometry. Anal Chem 2019; 91:7738-7743. [DOI: 10.1021/acs.analchem.9b01028] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Máte Szarka
- Horváth Csaba Memorial Laboratory of Bioseparation Sciences, Research Center for Molecular Medicine, Faculty of Medicine, University of Debrecen, 98 Nagyerdei krt, Debrecen 4032, Hungary
| | - Márton Szigeti
- Horváth Csaba Memorial Laboratory of Bioseparation Sciences, Research Center for Molecular Medicine, Faculty of Medicine, University of Debrecen, 98 Nagyerdei krt, Debrecen 4032, Hungary
- Translational Glycomics Laboratory, Research Institute of Biomolecular and Chemical Engineering, University of Pannonia, 10 Egyetem Street, Veszprem 8200, Hungary
| | - András Guttman
- Horváth Csaba Memorial Laboratory of Bioseparation Sciences, Research Center for Molecular Medicine, Faculty of Medicine, University of Debrecen, 98 Nagyerdei krt, Debrecen 4032, Hungary
- Translational Glycomics Laboratory, Research Institute of Biomolecular and Chemical Engineering, University of Pannonia, 10 Egyetem Street, Veszprem 8200, Hungary
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Gao L, Liu G, Zhu J, Wang C, Liu J. Solid phase microextraction combined with gas chromatography-mass spectrometry for the determination of diquat residues in water. JOURNAL OF ANALYTICAL CHEMISTRY 2015. [DOI: 10.1134/s1061934815050081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Costa JL, Morrone AR, Resende RR, Chasin AADM, Tavares MFM. Development of a method for the analysis of drugs of abuse in vitreous humor by capillary electrophoresis with diode array detection (CE–DAD). J Chromatogr B Analyt Technol Biomed Life Sci 2014; 945-946:84-91. [DOI: 10.1016/j.jchromb.2013.10.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Revised: 10/03/2013] [Accepted: 10/12/2013] [Indexed: 11/28/2022]
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Capillary electrophoresis for the analysis of drugs of abuse in biological specimens of forensic interest. Trends Analyt Chem 2012. [DOI: 10.1016/j.trac.2011.06.019] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Huhn C, Pyell U. Diffusion as major source of band broadening in field-amplified sample stacking under negligible electroosmotic flow velocity conditions. J Chromatogr A 2010; 1217:4476-86. [DOI: 10.1016/j.chroma.2010.04.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2009] [Revised: 03/31/2010] [Accepted: 04/08/2010] [Indexed: 11/30/2022]
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Abstract
Forensic toxicology has developed as a forensic science in recent years and is now widely used to assist in death investigations, in civil and criminal matters involving drug use, in drugs of abuse testing in correctional settings and custodial medicine, in road and workplace safety, in matters involving environmental pollution, as well as in sports doping. Drugs most commonly targeted include amphetamines, benzodiazepines, cannabis, cocaine and the opiates, but can be any other illicit substance or almost any over-the-counter or prescribed drug, as well as poisons available to the community. The discipline requires high level skills in analytical techniques with a solid knowledge of pharmacology and pharmacokinetics. Modern techniques rely heavily on immunoassay screening analyses and mass spectrometry (MS) for confirmatory analyses using either high-performance liquid chromatography or gas chromatography as the separation technique. Tandem MS has become more and more popular compared to single-stage MS. It is essential that analytical systems are fully validated and fit for the purpose and the assay batches are monitored with quality controls. External proficiency programs monitor both the assay and the personnel performing the work. For a laboratory to perform optimally, it is vital that the circumstances and context of the case are known and the laboratory understands the limitations of the analytical systems used, including drug stability. Drugs and poisons can change concentration postmortem due to poor or unequal quality of blood and other specimens, anaerobic metabolism and redistribution. The latter provides the largest handicap in the interpretation of postmortem results.
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Mazzarino M, de la Torre X, Mazzei F, Botrè F. Rapid screening of beta-adrenergic agents and related compounds in human urine for anti-doping purpose using capillary electrophoresis with dynamic coating. J Sep Sci 2009; 32:3562-70. [DOI: 10.1002/jssc.200900450] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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9
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Chemiluminescence detection of opium poppy (Papaver somniferum) alkaloids. J Pharm Biomed Anal 2008; 48:508-18. [DOI: 10.1016/j.jpba.2008.06.022] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2008] [Revised: 06/27/2008] [Accepted: 06/28/2008] [Indexed: 11/23/2022]
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Znaleziona J, Petr J, Maier V, Knob R, Horakova J, Smetanova D, Sevcik J. CAPILLARY ELECTROPHORESIS AS A VERIFICATION TOOL FOR IMMUNOCHEMICAL DRUG SCREENING. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2007; 151:31-6. [PMID: 17690736 DOI: 10.5507/bp.2007.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The aim of this work was to develop a simple capillary electrophoretic method as the verification and confirmation tool in the screening analysis for amphetamines, opiates, benzodiazepines and cocaine and their metabolites for toxicological applications. METHODS 50 mM phosphate Tris pH 2.0 with 30% (v/v) of methanol was used as a background electrolyte that enabled fast separation of drugs and their metabolites in saliva and urine. Verification of the data from the electrophoretic method was done by High Performance Thin Layer Chromatography (HPTLC) and the immunochemical screening test QuikScreen. RESULTS The experimental conditions of the Capillary Electrophoresis (CE) were partially optimized (mainly the influence of concentration and types of additives, e.g. cyclodextrines, organic solvents) and validated; the method was used for analysing samples from drug abusers. CONCLUSIONS The non-instrumental, immunoassay tests could only confirm qualitative addictions and are mainly employed when the emergency detection of drugs is needed. For quantitative analysis and verification of obtained results the confirmation step is strongly recommended. The simple screening capillary zone electrophoresis method allows recognition of the most abused drugs. The agreement of the results from CE, HPTLC and QuikScreen test was more than 95%.
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Affiliation(s)
- Joanna Znaleziona
- Department of Analytical Chemistry, Faculty of Science, Palacky University, tr. Svobody 8, CZ-771 46 Olomouc, Czech Republic
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Meng P, Fang N, Wang M, Liu H, Chen DDY. Analysis of amphetamine, methamphetamine and methylenedioxy-methamphetamine by micellar capillary electrophoresis using cation-selective exhaustive injection. Electrophoresis 2006; 27:3210-7. [PMID: 16858725 DOI: 10.1002/elps.200500886] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Cation-selective exhaustive injection (CSEI) is used as an on-line concentration method for the high-sensitivity analysis of illicit amphetamines using CE. Optimum conditions for the determination of amphetamine, methamphetamine and methylenedioxy-methamphetamine were investigated. Sodium dodecyl sulfate (25 mM) in 100 mM phosphate buffer (pH 2.9) with 20% methanol as organic additive was used as the background electrolyte for CE separation. The LOD, based on an S/N of 3:1, was about 0.01 microg/mL using normal capillary micellar electrokinetic chromatography, while by using CSEI in combination with micellar sweeping the sensitivity increased up to 1000-fold with the LOD lower than 50 pg/mL. The reproducibility of CSEI combined with micellar sweeping for analyzing amphetamines was satisfactory (relative standard deviation around 10% by using area ratios against an internal standard). This method is highly sensitive and can be used to analyze trace amount amphetamines in human hair.
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Affiliation(s)
- Pinjia Meng
- Department of Forensic Science, China Peoples Public Security University, Beijing, China
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Xu Y, Gao Y, Wei H, Du Y, Wang E. Field-amplified sample stacking capillary electrophoresis with electrochemiluminescence applied to the determination of illicit drugs on banknotes. J Chromatogr A 2006; 1115:260-6. [PMID: 16616928 DOI: 10.1016/j.chroma.2006.02.084] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2005] [Revised: 02/23/2006] [Accepted: 02/27/2006] [Indexed: 11/25/2022]
Abstract
Capillary electrophoresis (CE) with Ru(bpy)3(2+) electrochemiluminescence (ECL) detection system was established to the determination of contamination of banknotes with controlled drugs and a high efficiency on-column field-amplified sample stacking (FASS) technique was also optimized to increase the ECL intensity. The method was illustrated using heroin and cocaine, which are two typical and popular illicit drugs. Highest sample stacking was obtained when 0.01 mM acetic acid was chosen for sample dissolution with electrokinetical injection for 6 s at 17 kV. Under the optimized conditions: ECL detection at 1.2 V, separation voltage 10.0 kV, 20 mM phosphate-acetate (pH 7.2) as running buffer, 5 mM Ru(bpy)3(2+) with 50 mM phosphate-acetate (pH 7.2) in the detection cell, the standard curves were linear in the range of 7.50x10(-8) to 1.00x10(-5) M for heroin and 2.50x10(-7) to 1.00x10(-4) M for cocaine and detection limits of 50 nM for heroin and 60 nM for cocaine were achieved (S/N = 3), respectively. Relative standard derivations of the ECL intensity and the migration time were 3.50 and 0.51% for heroin and 4.44 and 0.12% for cocaine, respectively. The developed method was successfully applied to the determination of heroin and cocaine on illicit drug contaminated banknotes without any damage of the paper currency. A baseline resolution for heroin and cocaine was achieved within 6 min.
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Affiliation(s)
- Yuanhong Xu
- State Key Laboratory of Electroanalytical Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Graduate School of the Chinese Academy of Science, Changchun, Jilin 130022, China
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Gillette R, Doyle JM, Miller ML, Montgomery MA, Mushrush GW. Capillary electrophoresis screening of poisonous anions extracted from biological samples. J Chromatogr B Analyt Technol Biomed Life Sci 2006; 831:190-5. [PMID: 16406748 DOI: 10.1016/j.jchromb.2005.10.054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2004] [Revised: 12/22/2004] [Accepted: 12/05/2005] [Indexed: 11/20/2022]
Abstract
A method was developed for screening human biological samples for poisonous anions using capillary electrophoresis (CE) employing indirect UV detection. The run buffer consisted of 2.25 mM pyromellitic acid, 1.6 mM triethanolamine, 0.75 mM hexamethonium hydroxide and 6.5mM NaOH at pH 7.7. Biological samples were pretreated using solid phase extraction. The method was applied to the analysis of human blood, plasma, urine, and intestinal contents. Twenty-nine different anions were detectable at aqueous concentrations of 1 part per million (ppm) with a typical analysis time less than 20 min. Intraday migration time R.S.D. and peak area R.S.D. for blood samples were less than 1.1% and 6.3%, respectively. Interday migration time R.S.D. for plasma samples ranged from 7.5% to 10.4%. The new method produced efficient separations of various target anions extracted from complex biological matrices.
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Affiliation(s)
- Robert Gillette
- Department of Chemistry, George Mason University, Fairfax, VA 22030, USA
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Qi XH, Mi JQ, Zhang XX, Chang WB. Design and preparation of novel antibody system and application for the determination of heroin metabolites in urine by capillary electrophoresis. Anal Chim Acta 2005. [DOI: 10.1016/j.aca.2005.07.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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15
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16
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Bishop SC, Lerch M, McCord BR. Micellar electrokinetic chromatographic screening method for common sexual assault drugs administered in beverages. Forensic Sci Int 2004; 141:7-15. [PMID: 15066708 DOI: 10.1016/j.forsciint.2003.12.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2003] [Accepted: 12/12/2003] [Indexed: 10/26/2022]
Abstract
Recently, much attention has been given to benzodiazepines and gamma-hydroxybutyric acid (GHB) related compounds owing to their alleged widespread use as date-rape drugs. Toxicologists would greatly benefit from a screening method that allows for the simultaneous detection of both groups of substances. A new capillary electrophoresis (CE) method has been developed in the micellar mode to accomplish this separation in under 16 min using a sodium dodecyl sulfate (SDS)/sodium tetraborate/boric acid buffer with an acetonitrile organic modifier. Optimization of SDS and organic modifier concentration, along with pH, were performed on a set of standards containing eight benzodiazepines, GHB, gamma-butyrolactone, and the internal standard, sulfanilic acid. The method was shown to have a detection limit of less than 2 microg/ml for five out of eight benzodiazepines with a linear range of 2.5-100 microg/ml. The detection limit for GHB was 32 mg/ml with a linear range to 2500 microg/ml. This method was applied to the rapid analysis of spiked beverages. GHB spiked beverages were monitored after using a series of simple dilutions to determine the effects of time on the drug analysis. Possible interfering peaks from drugs of abuse and artifacts from a variety of different drink combinations were also studied in detail. A one-step liquid-liquid extraction was the only necessary sample pretreatment.
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Affiliation(s)
- Sandra C Bishop
- Department of Chemistry and Biochemistry, 136 Clippinger Laboratories, Ohio University, Athens, OH 45701, USA
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Vanhoenacker G, de l'Escaille F, De Keukeleire D, Sandra P. Analysis of Benzodiazepines in Dynamically Coated Capillaries by CE-DAD, CE-MS and CE-MS2. J Pharm Biomed Anal 2004; 34:595-606. [PMID: 15127816 DOI: 10.1016/s0731-7085(03)00571-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The applicability of a low pH volatile electrolyte for fast analysis of benzodiazepines with CE-MS was investigated. The electrolyte is based on a commercially available CEofix buffer system that produces a substantial and highly reproducible electroosmotic flow through a dynamic double coating principle. The system was first evaluated with a mixture of benzodiazepine standards in CE-DAD and the electrolyte composition was further optimized for CE-MS. The LOD for the six selected benzodiazepines with CE-MS was ca. 100 ppb, except for diazepam, for which the LOD was lower than 50 ppb. RSDs varied from 0.51 to 1.02% (n = 7) for migration times and from 4.75 to 11.80% (n = 7) for peak areas. The method was successfully applied to the analysis of a spiked urine sample after solid-phase extraction (SPE). CE-MS2 was performed on a standard mixture.
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Affiliation(s)
- G Vanhoenacker
- Department of Organic Chemistry, Laboratory of Separation Sciences, Faculty of Sciences, Ghent University, Krijgslaan 281(S4), B-9000 Ghent, Belgium
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Vanhoenacker G, de l'Escaille F, De Keukeleire D, Sandra P. Dynamic coating for fast and reproducible determination of basic drugs by capillary electrophoresis with diode-array detection and mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2004; 799:323-30. [PMID: 14670751 DOI: 10.1016/j.jchromb.2003.10.065] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The double coating principle of CEofix buffers was evaluated for the analysis of some basic drugs by capillary electrophoresis-diode-array detection (CE-DAD) and capillary electrophoresis-mass spectrometry (CE-MS). The involatile phosphate present in original low pH CEofix, was replaced with formic acid for hyphenation of CE with MS. The double coating produces a substantial and highly reproducible electroosmotic flow (EOF), even at low pH. The rinsing procedure and electrolyte composition were optimized for both CE-DAD and CE-MS. The system was evaluated with the analysis of a mixture of basic drugs and a spiked urine sample enriched by solid-phase extraction (SPE). The R.S.D. values on the migration time and peak area measured for 28 analyses with CE-DAD were below 0.25 and 2.40%, respectively. For CE-MS, the R.S.D. on the migration time was 0.85% or less and the area precision ranged from 5.65 to 14.33% (for seven injections). The LOD with the developed CE-MS method was below 50 ppb for all five drug standards tested.
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Affiliation(s)
- Gerd Vanhoenacker
- Laboratory of Separation Sciences, Department of Organic Chemistry, Faculty of Sciences, Ghent University, Krijgslaan 281 (S4), B-9000 Gent, Belgium
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Piette V, Parmentier F. Analysis of illicit amphetamine seizures by capillary zone electrophoresis. J Chromatogr A 2002; 979:345-52. [PMID: 12498266 DOI: 10.1016/s0021-9673(02)01405-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Capillary zone electrophoresis was applied for the determination of amphetamine and related substances in seized drugs. A buffer made of 0.1 M phosphoric acid adjusted to pH 3.0 with triethanolamine was selected. With this background electrolyte, triethanolamine is adsorbed to the capillary wall and the electroosmotic flow is reversed. This gives rise to peaks with good symmetry, high efficiency and reproducible migration times. The separation of the different analytes was performed in a fused-silica capillary thermostatted at 25 degrees C and the applied voltage was 25 kV. Under these experimental conditions, amphetamine, methamphetamine, 3,4-methylenedioxyamphetamine, 3,4-methylenedioxymethamphetamine (MDMA), 3,4-methylenedioxyethamphetamine, N-methyl-1-(1,3-benzodioxol-5-yl)-2-butamine and ephedrine were resolved within 8 min and without interference from adulterants usually found in illicit powders. Their identification by the migration time was confirmed by their UV spectra recorded with a diode array UV detector (190-350 nm). The selected method was then applied to identify these substances in illicit tablets known as "Ecstasy" and the MDMA determined in these samples according to a laboratory validation procedure.
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Affiliation(s)
- Véronique Piette
- Laboratory of Drug Analysis, Scientific Institute of Public Health-Louis Pasteur, Rue Juliette Wytsman 14, B-1050 Brussels, Belgium.
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Thormann W. Progress of capillary electrophoresis in therapeutic drug monitoring and clinical and forensic toxicology. Ther Drug Monit 2002; 24:222-31. [PMID: 11897968 DOI: 10.1097/00007691-200204000-00004] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
During the past decade, capillary electrophoresis (CE) emerged as a promising, effective, and economical approach for the analysis of licit and illicit drugs and their metabolites in biologic samples. This review provides an overview of the principles of CE, the features of CE instrumentation, and the key aspects of CE-based drug assays that were developed for therapeutic drug monitoring (TDM), clinical and forensic toxicology, and assessment of drug metabolism and pharmacokinetics. CE performed in fused-silica capillaries has sufficiently matured and can thus be applied routinely, whereas chip-based instrumentation comprising fully integrated assays is still in development. Despite the attractive advantages of electrokinetic capillary technology, relatively few CE-based assays for TDM and for drug screening of clinical and forensic interest have been adopted in the routine arena. The lack of complete systems designed for unattended operation, the reluctance of bioanalysts to replace a satisfactory existing method, and tight budgets are believed to have hindered the widespread replacement of older (mainly chromatographic) technology. Another limitation of CE is that this technique is somewhat less sensitive than other analytic techniques used for drug analysis in biologic fluids. New instrumental developments featuring user-friendly software and the introduction of assay kits, however, should increase the number of validated CE drug tests becoming used on a routine basis.
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Affiliation(s)
- Wolfgang Thormann
- Department of Clinical Pharmacology, University of Bern, Murtenstrasse 35, CH-3010 Bern, Switzerland.
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Maurer HH. Role of gas chromatography-mass spectrometry with negative ion chemical ionization in clinical and forensic toxicology, doping control, and biomonitoring. Ther Drug Monit 2002; 24:247-54. [PMID: 11897971 DOI: 10.1097/00007691-200204000-00007] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This paper reviews procedures for the detection or quantification of drugs, pesticides, pollutants, and/or their metabolites relevant to clinical and forensic toxicology, doping control, or biomonitoring using gas chromatography-mass spectrometry with negative ion chemical ionization (GC-MS-NICI). Papers written in English between 1995 and 2000 are reviewed. Procedures are included for the analysis of the following halogen-containing or derivatizable compounds in common biosamples, such as whole blood, plasma, or urine, and in alternative matrices such as sweat, hair, bone, or muscle samples of humans or rats: benzodiazepines, cannabinoids, opioids, acetylsalicylic acid, angiotensin-converting enzyme inhibitors, ketoprofen, methylphenidate enantiomers, tegafur, zacopride, anabolic steroids, chlorophenols, chlorpyrifos, hexachlorocyclohexanes, organochlorines, and polychlorinated biphenyls. The principal information on each procedure is summarized in three tables to facilitate the selection of a method suitable for a specific analytic problem.
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Affiliation(s)
- Hans H Maurer
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, University of Saarland, D-66421 Homburg (Saar), Germany.
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Backofen U, Matysik FM, Lunte CE. Determination of cannabinoids in hair using high-pH* non-aqueous electrolytes and electrochemical detection. Some aspects of sensitivity and selectivity. J Chromatogr A 2002; 942:259-69. [PMID: 11822390 DOI: 10.1016/s0021-9673(01)01348-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Non-aqueous capillary electrophoresis with electrochemical detection (NACE-ED) was applied to the determination of cannabinoids in hair. The effect of different electrolyte compositions on the selectivity of the separation of tetrahydrocannabinol (THC), cannabinol (CBN), cannabidiol (CBD) and tetrahydrocannabinol carboxylic acid (THCA) was studied. Complete electrophoretic resolution was obtained using a strongly basic background electrolyte consisting of 5 mM sodium hydroxide dissolved in acetonitrile-methanol (1:1). Electrochemical detection yielded well defined signals in the oxidation mode. In order to obtain low limits of detection experimental parameters, which determine the sensitivity and the noise level, were optimized. A crucial parameter for sensitive measurements using a wall-tube flow cell as end-column detector is the distance between the capillary outlet and the working electrode. The highest signal-to-noise ratio using a 50 microm I.D. capillary was obtained at a distance of 25 microm. When the capillary outlet was moved away from the working electrode, thus reducing the strength of the separation field present at the working electrode, a large low frequency noise developed. This rise was attributed to disturbances of the hydrodynamic pattern in the flow cell. Analytical aspects such as sensitivity, reproducibility and selectivity were addressed in this work. The precision of NACE-ED regarding migration time and peak height for a sample containing 1 microg/ml THC was 0.4% and 1.1% (RSD), respectively (n=5). The calibration curve was linear for concentrations ranging between 0.1 and 10 microg/ml (r=0.998). The limit of detection for THC was 37 ng/ml, which is almost two orders of magnitude lower when compared with on-column UV detection. The method was evaluated using hair samples containing cannabinoids as sample material.
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Affiliation(s)
- Ulli Backofen
- University of Kansas, Department of Chemistry, Lawrence 66045, USA
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Boone CM, Douma JW, Franke JP, de Zeeuw RA, Ensing K. Screening for the presence of drugs in serum and urine using different separation modes of capillary electrophoresis. Forensic Sci Int 2001; 121:89-96. [PMID: 11516892 DOI: 10.1016/s0379-0738(01)00457-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Capillary electrophoresis (CE) is a modern separation technique that has some distinct advantages for toxicological analysis, such as a high efficiency, fast analysis, flexibility, and complementary separation mechanisms to chromatographic methods. CE can be applied in various modes, which each have a different separation mechanism or selectivity. The most common mode is capillary zone electrophoresis (CZE), in which charged analytes migrate in a buffer under the influence of an electric field. In micellar electrokinetic chromatography (MEKC), micelles are added to the buffer which interact with the analytes. MEKC can also be used for the separation of neutral compounds. In non-aqueous CE (NACE), the aqueous buffer is replaced by a background of electrolytes in organic solvents. A sample that needs to be screened can easily be analyzed subsequently by these CE modes using the same instrumentation. The aim of the study was to develop procedures for the analysis of basic and acidic drugs in serum and urine using CZE, MEKC, and NACE. A test mixture that consisted of six basic and six acidic compounds was used to study the separation behavior of five CE methods. The results showed that three methods (based on CZE, MEKC, and NACE) were suitable for the analysis of basic compounds and three methods (based on CZE and MEKC) for the analysis of acidic compounds. For the extraction of analytes from serum and urine, a solid-phase extraction (SPE) and a liquid-liquid extraction (LLE) method were compared. Both SPE and LLE methods provided clean extracts after extraction of the basic compounds from serum and urine. The extracts of acidic compounds contained more matrix interferences, especially for urine. The SPE method had some advantages compared to LLE, as it lead to cleaner extracts and higher peaks, and as it elutes basic and acidic compounds in one fraction. The potentials and pitfalls of the various methods for screening purposes in analytical toxicology are discussed.
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Affiliation(s)
- C M Boone
- Department of Bioanalysis and Toxicology, University Centre for Pharmacy, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands.
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Mardones C, Ríos A, Valcárcel M. Determination of nonsteroidal anti-inflammatory drugs in biological fluids by automatic on-line integration of solid-phase extraction and capillary electrophoresis. Electrophoresis 2001; 22:484-90. [PMID: 11258759 DOI: 10.1002/1522-2683(200102)22:3<484::aid-elps484>3.0.co;2-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A new, automatic method for the clean-up, preconcentration, separation, and quantitation of nonsteroidal anti-inflammatory drugs (NSAIDs) in biological samples (human urine and serum) using solid-phase extraction coupled on-line to capillary electrophoresis is proposed. Automatic pretreatment is carried out by using a continuous flow system operating simultaneously with the capillary electrophoresis equipment, to which it is linked via a laboratory-made mechanical arm. This integrated system is controlled by an electronic interface governed via a program developed in GWBasic. Capillary electrophoresis is conducted by using a separation buffer consisting of 20 mM NaHPO4, 20 mM beta-cyclodextrin and 50 mM SDS at pH 9.0, an applied potential of 20 kV and a temperature of 20 degrees C. The analysis time is 10 min and the detection limits were between 0.88 and 1.71 microg mL(-1). Automatic clean-up and preconcentration is accomplished by using a C-18 minicolumn and 75% methanol as eluent. The limit of detection of NSAIDs can be up to 400-fold improved when using sample clean-up. The extraction efficiency for these compounds is between 71.1 and 109.7 microg mL(-1) (RSD 2.0-7.7%) for urine samples and from 77.2 to 107.1 microg mL(-1) (RSD 3.5-7.1%) for serum samples.
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Affiliation(s)
- C Mardones
- Analytical Chemistry Division, University of Córdoba, Spain
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25
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Petibois C, Déléris G, Cazorla G. Perspectives in the utilisation of Fourier-transform infrared spectroscopy of serum in sports medicine: health monitoring of athletes and prevention of doping. Sports Med 2000; 29:387-96. [PMID: 10870865 DOI: 10.2165/00007256-200029060-00002] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Doping prevention is mainly directed to providing information on the dangers of doping to young athletes and to every profession concerned with athletic performance. Unfortunately, repression is also necessary in the fight against doping. Measurement of performance-enhancing drugs is complex, partly because of the large number of prohibited substances. A number of sophisticated analytical techniques are increasingly being used to provide the maximum detection time window. However, the effectiveness of methods to separate exogenous from endogenous biological molecules and the cost of antidoping analyses makes controls invalid or impossible. Moreover, most athletes, because of the metabolic and psychological stresses caused, legitimately refuse blood testing. It is becoming crucial to introduce new methods in the form of longitudinal health monitoring, since this is probably the most effective tool to prevent the use of doping agents when athletes become overtrained and/or overstressed. This paper describes new methods using Fourier-transform infrared spectroscopy to analyse serum from 50 microl samples of capillary blood. This technique has been shown to allow determination of the concentration of a wide range of biological molecules in a single microsample with clinically useful accuracy, and to provide a 'discriminatory biomolecular profile' to differentiate individuals on the basis of their physiological status. A specific application of this methodology is to perform longitudinal health monitoring in athletes, allowing prevention of overtraining. It is proposed to apply such methods in longitudinal studies for health monitoring and prevention of doping.
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Affiliation(s)
- C Petibois
- INSERM Unit 443, Bio-Organic Chemistry Group, University Victor Segalen/Bordeaux 2, France
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26
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Boone CM, Franke JP, de Zeeuw RA, Ensing K. Intra- and interinstrument reproducibility of migration parameters in capillary electrophoresis for substance identification in systematic toxicological analysis. Electrophoresis 2000; 21:1545-51. [PMID: 10832886 DOI: 10.1002/(sici)1522-2683(20000501)21:8<1545::aid-elps1545>3.0.co;2-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The intra- and interinstrument reproducibilities of four capillary electrophoresis instruments were studied for identification purposes in systematic toxicological analysis (STA). A test set of 20 acidic test compounds and 5 reference compounds were analyzed for five days on each instrument using capillary zone electrophoresis (CZE) and micellar electrokinetic chromatography (MEKC). The buffers consisted of 90 mM borate set at pH 8.4 (CZE) and 20 mM phosphate and 50 mM sodium dodecyl sulfate set at pH 7.5 (MEKC). All analyses were carried out using fused silica capillaries at an electric field strength of 52.6 kV/m. The use of a reproducible identification parameter is very important in STA. To deal with the poor reproducibility of the migration time, we recently introduced the corrected effective mobility. In this study, we investigated the intra- and interinstrument reproducibility of the migration time, the effective mobility, and the corrected effective mobility. Large differences in intra-instrument reproducibility were found when the migration time was used. The calculation of the effective mobility and the corrected effective mobility diminished these differences and enhanced the interinstrument reproducibility roughly by a factor 3. For (corrected) effective mobilities, intrainstrument reproducibilities were between 0.8-2.6% and interinstrument reproducibilities were between 3.2-3.9%.
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Affiliation(s)
- C M Boone
- Department of Analytical Chemistry and Toxicology, University Center for Pharmacy, Groningen, The Netherlands.
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27
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Manetto G, Crivellente F, Tagliaro F. Capillary electrophoresis: a new analytical tool for forensic toxicologists. Ther Drug Monit 2000; 22:84-8. [PMID: 10688266 DOI: 10.1097/00007691-200002000-00018] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In capillary electrophoresis, electrophoretic or electrokinetic separations are carried out in tiny capillaries at high voltages (10-30 kV), thus achieving high efficiency (N > 105), resolution power, and mass sensitivity (down to 10(-18)-10(-20) moles). The main characteristics of capillary electrophoresis are versatility of application (from inorganic ions to large DNA fragments), use of different separation modes with different selectivity, low demands on sample volume, negligible running costs, possibility of interfacing with different detection systems including mass spectrometry, and the ruggedness and simplicity of the instrumentation. Capillary electrophoresis applications in the forensic sciences are now rapidly growing, particularly in forensic toxicology. The present paper briefly describes the basic principles of capillary electrophoresis and presents a selected review of its main applications to the analysis of illicit/controlled drugs in biologic samples. An original analytical approach to the determination of carbohydrate deficient transferrin, a new marker of chronic alcohol abuse, based on capillary electrophoresis is also described. It is concluded that the peculiar separation mechanisms and the high complementarity of capillary electrophoresis to chromatography make it a new powerful tool of investigation in the hands of forensic toxicologists.
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Affiliation(s)
- G Manetto
- Department of Public Medicine and Health, University of Verona, Italy
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28
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Chapter 6 Sedatives and hypnotics. ACTA ACUST UNITED AC 2000. [DOI: 10.1016/s1567-7192(00)80056-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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29
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Drummer OH. Chromatographic screening techniques in systematic toxicological analysis. JOURNAL OF CHROMATOGRAPHY. B, BIOMEDICAL SCIENCES AND APPLICATIONS 1999; 733:27-45. [PMID: 10572973 DOI: 10.1016/s0378-4347(99)00265-0] [Citation(s) in RCA: 102] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A review of techniques used to screen biological specimens for the presence of drugs was conducted with particular reference to systematic toxicological analysis. Extraction systems of both the liquid-liquid and solid-phase type show little apparent difference in their relative ability to extract a range of drugs according to their physio-chemical properties, although mixed-phase SPE extraction is a preferred technique for GC-based applications, and liquid-liquid were preferred for HPLC-based applications. No one chromatographic system has been shown to be capable of detecting a full range of common drugs of abuse, and common ethical drugs, hence two or more assays are required for laboratories wishing to cover a reasonably comprehensive range of drugs of toxicological significance. While immunoassays are invariably used to screen for drugs of abuse, chromatographic systems relying on derivatization and capable of extracting both acidic and basic drugs would be capable of screening a limited range of targeted drugs. Drugs most difficult to detect in systematic toxicological analysis include LSD, psilocin, THC and its metabolites, fentanyl and its designer derivatives, some potent opiates, potent benzodiazepines and some potent neuroleptics, many of the newer anti-convulsants, alkaloids colchicine, amantins, aflatoxins, antineoplastics, coumarin-based anti-coagulants, and a number of cardiovascular drugs. The widespread use of LC-MS and LC-MS-MS for specific drug detection and the emergence of capillary electrophoresis linked to MS and MS-MS provide an exciting possibility for the future to increase the range of drugs detected in any one chromatographic screening system.
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Affiliation(s)
- O H Drummer
- Department of Forensic Medicine, Monash University, Victorian Institute of Forensic Medicine, Melbourne, Australia.
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30
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Maurer HH. Systematic toxicological analysis procedures for acidic drugs and/or metabolites relevant to clinical and forensic toxicology and/or doping control. JOURNAL OF CHROMATOGRAPHY. B, BIOMEDICAL SCIENCES AND APPLICATIONS 1999; 733:3-25. [PMID: 10572972 DOI: 10.1016/s0378-4347(99)00266-2] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This paper reviews systematic toxicological analysis (STA) procedures for acidic drugs and/or metabolites relevant to clinical and forensic toxicology or doping control using gas chromatography, gas chromatography-mass spectrometry, liquid chromatography, thin-layer chromatography and capillary electrophoresis. Papers from 1992 to 1998 have been taken into consideration. Screening procedures in biosamples (whole blood, plasma, serum, urine, vitreous humor, brain, liver or hair) of humans or animals (horse, or rat) are included for the following drug classes: angiotensin-converting enzyme (ACE) inhibitors and angiotensin II (AT-II) blockers, anticoagulants of the 4-hydroxy coumarin type, barbiturates, dihydropyridine calcium channel blockers (calcium antagonists), diuretics, hypoglycemic sulfonylureas and non-steroidal anti-inflammatory drugs (NSAIDs). Methods for confirmation of preliminary results obtained by screening procedures using immunoassay or chromatographic techniques are also included. Furthermore, procedures for the simultaneous detection of several drug classes are reviewed. The toxicological question to be answered and the consequences for the choice of an adequate method, the sample preparation and the chromatography itself are discussed. The basic information about the biosample assayed, work-up, separation column, mobile phase or separation buffer, detection mode and validation data of each procedure is summarized in 16 tables. They are arranged according to the drug class and the analytical method. Examples of typical applications are presented. Finally, STA procedures are reviewed and described allowing simultaneous screening for different (acidic) drug classes.
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Affiliation(s)
- H H Maurer
- Department of Toxicology, Institute of Pharmacology and Toxicology, University of Saarland, Homburg (Saar), Germany.
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Abstract
Capillary zone electrophoresis (CZE) and micellar electrokinetic capillary chromatography (MEKC) were used for the separation of widely different compounds from natural materials including compounds from tea, acids from different matrices, flavonoids and alkaloids, toxins and toxicological compounds, proteins and polypeptides, biogenic amines, phenolic compounds in alcoholic beverages, Chinese medicinal drugs, compounds in cells and cell extracts, and miscellaneous other applications. A section dealing with recent reviews related to natural products is also included.
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Affiliation(s)
- H J Issaq
- SAIC Frederick, NCI-Frederick Cancer Research and Development Center, MD 21702, USA.
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Thormann W, Wey AB, Lurie IS, Gerber H, Byland C, Malik N, Hochmeister M, Gehrig C. Capillary electrophoresis in clinical and forensic analysis: recent advances and breakthrough to routine applications. Electrophoresis 1999; 20:3203-36. [PMID: 10596826 DOI: 10.1002/(sici)1522-2683(19991001)20:15/16<3203::aid-elps3203>3.0.co;2-e] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This paper is a comprehensive review article on capillary electrophoresis (CE) in clinical and forensic analysis. It is based upon the literature of 1997 and 1998, presents CE examples in major fields of application, and provides an overview of the key achievements encountered, including those associated with the analysis of drugs, serum proteins, hemoglobin variants, and nucleic acids. For CE in clinical and forensic analysis, the past two years witnessed a breakthrough to routine applications. As most coauthors of this review are associated with diagnostic or forensic laboratories now using CE on a routine basis, this review also contains data from routine applications in drug, protein, and DNA analysis. With the first-hand experience of providing analytical service under stringent quality control conditions, aspects of quality assurance, assay specifications for clinical and forensic CE and the pros and cons of this maturing, cost-and pollution-controlled age technology are also discussed.
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Affiliation(s)
- W Thormann
- Department of Clinical Pharmacology, University of Bern, Switzerland.
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Abstract
This paper provides an overview on the current status of capillary electrophoresis (CE) and capillary electrochromatography (CEC). The focus is largely on the current application areas of CE where routine methods are now in place. These application areas include the analysis of DNA, clinical and forensic samples, carbohydrates, inorganic anions and metal ions, pharmaceuticals, enantiomeric species and proteins and peptides. More specific areas such the determination of physical properties, microchip CE and instrumentation developments are also covered. The application, advantages and limitations of CEC are covered. Recent review articles and textbooks are frequently cited to provide readers with a source of information regarding pioneering work and theoretical treatments.
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Affiliation(s)
- K D Altria
- GlaxoWellcome R&D, Ware, Hertfordshire, UK.
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Caslavska J, Allemann D, Thormann W. Analysis of urinary drugs of abuse by a multianalyte capillary electrophoretic immunoassay. J Chromatogr A 1999; 838:197-211. [PMID: 10327639 DOI: 10.1016/s0021-9673(99)00115-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This paper characterizes a novel multianalyte competitive binding, electrokinetic capillary-based immunoassay for urinary methadone, opiates, benzoylecgonine (cocaine metabolite) and amphetamines. After incubation of 25 microliters urine with the reactants for several minutes in the presence of an internal standard, a small aliquot of the mixture is applied onto a fused-silica capillary and the unbound fluorescein labelled drug tracers are monitored by capillary electrophoresis with on-column laser induced fluorescence detection. The multianalyte assay is shown to be rapid, simple, quantitative, capable of recognizing urinary drug concentrations > or = 30 ng/ml and suitable for screening of patient urines. Data are demonstrated to compare well with those obtained by routine screening methods based on enzyme multiplied immunoassay techniques and fluorescence polarization immunoassays. The electrokinetic capillary assay has been validated via analysis of external quality control urines and confirmation analysis of patient urines using GC-MS.
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Affiliation(s)
- J Caslavska
- Department of Clinical Pharmacology, University of Bern, Switzerland
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35
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Abstract
Capillary electrophoresis has become one of the advanced analytical methods for drugs in pharmaceutical, therapeutic, diagnostic and forensic applications. This review discusses key issues and provides key references to the topic of drug analysis using capillary electrophoresis. It gives readers a brief summary of the current status of the technology and serves as an editorial for the paper symposium "Capillary electrophoresis in drug analysis".
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Affiliation(s)
- W Thormann
- Department of Clinical Pharmacology, University of Bern, Switzerland.
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Kraemer T, Maurer HH. Determination of amphetamine, methamphetamine and amphetamine-derived designer drugs or medicaments in blood and urine. JOURNAL OF CHROMATOGRAPHY. B, BIOMEDICAL SCIENCES AND APPLICATIONS 1998; 713:163-87. [PMID: 9700558 DOI: 10.1016/s0378-4347(97)00515-x] [Citation(s) in RCA: 137] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This paper reviews procedures for the determination of amphetamine, methamphetamine and amphetamine-derived designer drugs or medicaments in blood and urine. Papers published from 1991 to early 1997 were taken into consideration. Gas chromatographic and liquid chromatographic procedures with different detectors (e.g., mass spectrometer or diode array) were considered as well as the seldom used thin-layer chromatography and capillary electrophoresis. Enantioselective procedures are also discussed. A chapter deals with amphetamine-derived medicaments, e.g. anoretics, antiparkinsonians or vasodilators, which are metabolized to amphetamine or methamphetamine. Differentiation of an intake of such medicaments from amphetamine or methamphetamine intake is discussed. Basic information about the biosample assayed, internal standard, work-up, GC column or LC column and mobile phase, detection mode, reference data and validation data of each procedure is summarized in Tables. Examples of typical applications are presented.
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Affiliation(s)
- T Kraemer
- Department of Toxicology, University of Saarland, Homburg (Saar), Germany
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37
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Tagliaro F, Manetto G, Crivellente F, Scarcella D, Marigo M. Hair analysis for abused drugs by capillary zone electrophoresis with field-amplified sample stacking. Forensic Sci Int 1998; 92:201-11. [PMID: 9627979 DOI: 10.1016/s0379-0738(98)00016-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The present paper describes the methodological optimisation and validation of a capillary zone electrophoresis method for the determination of morphine, cocaine and 3,4-methylenedioxymethamphetamine (MDMA) in hair, with injection based on field-amplified sample stacking. Diode array UV absorption detection was used to improve analytical selectivity and identification power. Analytical conditions: running buffer 100 mM potassium phosphate adjusted to pH 2.5 with phosphoric acid, applied potential 10 kV, temperature 20 degrees C, injection by electromigration at 10 kV for 10 s, detection by UV absorption at the fixed wavelength of 200 nm or by recording the full spectrum between 190 and 400 nm. Injection conditions: the dried hair extracts were reconstituted with a low-conductivity solvent (0.1 mM formic acid), the injection end of the capillary was dipped in water for 5 s without applying pressure (external rinse step), then a plug of 0.1 mM phosphoric acid was loaded by applying 0.5 psi for 10 s and, finally, the sample was injected electrokinetically at 10 kV for 10 s. Under the described conditions, the limit of detection was 2 ng/ml for MDMA, 8 ng/ml for cocaine and 6 ng/ml for morphine (with a signal-to-noise ratio of 5). The lowest concentration suitable for recording interpretable spectra was about 10-20-times the limit of detection of each analyte. The intraday and day-to-day reproducibility of migration times (n = 6), with internal standardisation, was characterised by R.S.D. values < or = 0.6%; peak area R.S.D.s were better than 10% in intraday and than 15% in day-to-day experiments. Analytical linearity was good with R2 better than 0.9990 for all the analytes.
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Affiliation(s)
- F Tagliaro
- Institute of Forensic Medicine, University of Verona, Italy
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