Storage of urine specimens in point of care (POC) urine drug testing cups reduces concentrations of many drugs

BACKGROUND

Many clinical toxicology laboratories receive urine specimens in urine cups that contain point of care (POC) drug testing strips. We conducted this study to evaluate the effect on the stability of commonly measured drugs in the clinical toxicology laboratory when urine is exposed to POC urine drug testing cups.

METHODS

Drug free urine was spiked with 85 drugs that were measured by a validated liquid chromatography mass spectrometry (LCMS) method after exposure to POC urine drug testing cups at ambient and 2-6 °C temperatures. Alterations ≥20% were defined as significant changes in the drugs concentration.

RESULTS

Concentrations of amitriptyline, cyclobenzaprine, fentanyl, fluoxetine, flunitrazepam, nortriptyline, paroxetine, and sertraline were significantly reduced when urine specimens were stored inside POC urine drug testing cups for 24 h at ambient temperature. Storage of urine in urine chemistry dipsticks reduced the concentration of several drugs. When spiked urine was exposed to an increasing number of POC urine drug testing strips, the concentrations of some drugs were reduced in a dose-dependent manner. The drugs that were absorbed by POC urine drug testing strips were partially back extracted from the strips.

CONCLUSION

Exposure of urine specimens to POC urine drug testing strips reduces the concentration of several drugs measured by LCMS method.

Simultaneous Quantification of Citalopram and its Main Metabolite, Desmethylcitalopram, in Human Saliva by UHPLC

Background:

This study was designed to develop a reliable method for simultaneous quantita-tion of Citalopram (CIT) and its main active metabolite, Desmethylcitalopram (DCIT), in saliva of patients undergoing treatment with CIT.

Methods:

To compare two procedures of saliva purification, Solid-Phase (SPE) and Liquid-Liquid (LLE) extractions, saliva samples obtained from healthy volunteers were spiked with adequate quantities of CIT and DCIT. Different cartridges were used for SPE, while dichloromethane for LLE. Chromatographic separation and quantitation were carried out by UHPLC with DAD detector using a C-18 column and a mixture of acetonitrile and redistilled water (37:63, v:v) with the addition of formic acid (pH 3.5) as a mobile phase.

Results:

A comparison of both purification procedures showed that the most satisfactory results were obtained by SPE using Discovery C18 cartridge and redistilled water with formic acid (pH 3.5) as a washing solvent. Dichloromethane proved to be the best extractant in LLE. Both procedures enabled the separation of analytes from human saliva with high precision and recovery.

Conclusions:

Validation of the developed UHPLC procedure revealed that, regardless of how the sample was purified, the method was characterized by good linearity (between 10 and 1000 ng/mL), sensitivity, reproducibility, specificity and low values of limits of detection and quantitation. The limits of quantitation were 4.0 and 8.0 ng/mL for SPE and LLE, respectively. The efficiency of the method in therapeutic drug monitoring of CIT and DCIT in saliva of patients was confirmed.

Determination of antidepressants in human urine extracted by magnetic multiwalled carbon nanotube poly(styrene-co-divinylbenzene) composites and separation by capillary electrophoresis

Poly(styrene-co-divinylbenzene)-coated magnetic multiwalled carbon nanotube composite synthesized by in-situ high temperature combination and precipitation polymerization of styrene-co-divinylbenzene has been employed as a magnetic sorbent for the solid phase extraction of antidepressants in human urine samples. Fluoxetine, venlafaxine, citalopram and sertraline were, afterwards, separated and determined by capillary electrophoresis with diode array detection. The presence of magnetic multiwalled carbon nanotubes in native poly(styrene-co-divinylbenzene) not only simplified sample treatment but also enhanced the adsorption efficiencies, obtaining extraction recoveries higher than 89.5% for all analytes. Moreover, this composite can be re-used at least ten times without loss of efficiency and limits of detection ranging from 0.014 to 0.041 μg/mL were calculated. Additionally, precision values ranging from 0.08 to 7.50% and from 0.21 to 3.05% were obtained for the responses and for the migration times of the analytes, respectively.

Hollow fiber based liquid–liquid–liquid microextraction combined with sweeping micellar electrokinetic chromatography for the sensitive determination of second-generation antidepressants in human fluids

HF-LPME is combined with sweeping MEKC for the sensitive determination of second-generation antidepressants in human fluids.

Trends in drug testing in oral fluid and hair as alternative matrices

The use of alternative matrices such as oral fluid and hair has increased in the past decades because of advances in analytical technology. However, there are still many issues that need to be resolved. Standardized protocols of sample pretreatment are needed to link the detected concentrations to final conclusions. The development of suitable proficiency testing schemes is required. Finally, interpretation issues such as link to effect, adulteration, detection markers and thresholds will hamper the vast use of these matrices. Today, several niche areas apply these matrices with success, such as drugs and driving for oral fluid and drug-facilitated crimes for hair. Once those issues are resolved, the number of applications will markedly grow in the future.

Human saliva-based quantitative monitoring of clarithromycin by flow injection chemiluminescence analysis: a pharmacokinetic study

Human saliva quantitative monitoring of clarithromycin (CLA) by chemiluminescence (CL) with flow injection analysis was proposed for the first time, which was based on the quenching effect of CLA on luminol-bovine serum albumin (BSA) CL system with a linear range from 7.5 × 10(-4) to 2.0 ng/ml. This proposed approach, offering a maximum sample throughput of 100 h(-1), was successfully applied to the quantitative monitoring of CLA levels in human saliva during 24 h after a single oral dose of 250 mg intake, with recoveries of 95.2 ∼ 109.0% and relative standard deviations lower than 6.5 % (N = 7). Results showed that CLA reached maximum concentration of 2.28 ± 0.02 μg/ml at approximately 3 h, and the total elimination ratio was 99.6 % in 24 h. The pharmacokinetic parameters including absorption rate constant (0.058 ± 0.006 h(-1)), elimination rate constant (0.149 ± 0.009 h(-1)) and elimination half-life time (4.66 ± 0.08 h) were obtained. A comparison of human saliva and urine monitoring was also given. The mechanism study of BSA-CLA interaction revealed the binding of CLA to BSA is an entropy driven and spontaneous process through hydrophobic interaction, with binding constant K BSA-CLA of 4.78 × 10(6) l/mol and the number of binding sites n of 0.82 by flow injection-chemiluminescence model. Molecular docking analysis further showed CLA might be in subdomain IIA of BSA, with K BSA-CLA of 6.82 × 10(5) l/mol and ΔG of -33.28 kJ/mol.