Isolation of acidic, neutral, and basic drugs from whole blood using a single mixed-mode solid-phase extraction column

Sub-ppm determination of perfluorinated carboxylic acids in solution by UV-vis high-performance liquid chromatography through solid phase extraction

This study investigated a novel and sensitive analytical method based on a simple heat-based derivatization using 3-bromoacetyl coumarin as the reagent and analysis with a HPLC-UV system or just a UV-vis spectrometer to allow the sub-ppm determination of PFCAs in water solution with the potential for utilization in simple laboratories and field laboratory scenarios. A Strata-X-AW cartridge was used for the solid phase extraction (SPE) procedure and higher than 98% recoveries were obtained. The derivatization condition showed that a high efficiency of peak separation was obtained with obviously different retention time among various PFCAs derivatives using HPLC-UV analysis. The derivatization stability and repeatability showed favorable results with stable derivatized analytes for ≤12 h and a relative standard deviation (RSD) of <2% for all repetitions. The limit of detection for the HPLC-UV analysis was between 0.1 ppm and 0.5 ppm. A satisfactory linearity response was found with R² >0.998 for all individual PFCA compounds. The limit of detection for simple UV-Vis analysis was <0.0003 ppm to measure the presence of PFCAs. Contamination of standards with humic substances and measurement of industrial samples in a complex wastewater matrix showed no adverse effects on the accuracy of PFCA determination by using the developed methodology.

Toxicokinetic Study of a Gastroprotective Dose of Capsaicin by HPLC-FLD Method

BACKGROUND

A low dose of capsaicin and its natural homologs and analogs (capsaicinoids) have shown to prevent development of gastric mucosal damage of alcohol and non-steroid anti-inflammatory drugs. Based on this experimental observation, a drug development program has been initiated to develop per os applicable capsaicin containing drugs to eliminate gastrointestinal damage caused by non-steroid anti-inflammatory drugs.

METHODS

As a part of this program, a sensitive and selective reverse-phase high-performance liquid chromatography-based method with fluorescence detection has been developed for quantification of capsaicin and dihydrocapsaicin in experimental dog's plasma.

RESULTS

The method was evaluated for a number of validation characteristics (selectivity, repeatability, and intermediate precision, LOD, LOQ, and calibration range). The limit of detection (LOD) was 2 ng/mL and the limit of quantification (LOQ) was 10 ng/mL for both capsaicin and dihydrocapsaicin. The method was used for analysis of capsaicin and dihydrocapsaicin in the plasma samples obtained after per os administration of low doses (0.1, 0.3, and 0.9 mg/kg bw) of Capsaicin Natural (USP 29) to the experimental animals.

CONCLUSIONS

The obtained results indicated that the administered capsaicinoids did not reach the general circulation.

Opioid Deaths in Milwaukee County, Wisconsin 2013-2017: The Primacy of Heroin and Fentanyl

Heroin and fentanyl are the overwhelming and increasing cause of opioid deaths in Milwaukee County, Wisconsin. We reviewed all drug and opioid deaths from 2013 to 2017 to delineate the specific opioid drugs involved and changes in their incidence. From 2013 to 2017, 980 deaths were due to opioids, rising from 184 in 2013 to 337 in 2017. In 2017, opioid deaths exceeded combined non-natural deaths from homicide and suicide. Illicit heroin and fentanyl/analogs caused 84% of opioid deaths and 80% of drug deaths, with no increase in deaths due to oral prescription drugs such as oxycodone and hydrocodone. Any approach to decreasing this dramatic increase in opioid deaths should first focus on interdicting the supply and cheap availability of these illicit opioids. Fentanyl and its analogs represent the most deadly opioids and the greatest threat to human life in our population.

Experimental versus theoretical log D7.4 , pKa and plasma protein binding values for benzodiazepines appearing as new psychoactive substances

The misuse of benzodiazepines as new psychoactive substances is an increasing problem around the world. Basic physicochemical and pharmacokinetic data is required on these substances to interpret and predict their effects upon humans. Experimental log D7.4 , pKa and plasma protein binding values were determined for 11 benzodiazepines that have recently appeared as new psychoactive substances (3-hydroxyphenazepam, 4'-chlorodiazepam, desalkylflurazepam, deschloroetizolam, diclazepam, etizolam, flubromazepam, flubromazolam, meclonazepam, phenazepam, and pyrazolam) and compared with values generated by various software packages (ACD/I-lab, MarvinSketch, ADMET Predictor and PreADMET). ACD/I-LAB returned the most accurate values for log D7.4 and plasma protein binding while ADMET Predictor returned the most accurate values for pKa . Large variations in predictive errors were observed between compounds. Experimental values are currently preferable and desirable as they may aid with the future 'training' of predictive models for these new psychoactive substances.

[Optimization of the solid-phase extraction procedure for the screening of the medicinal and narcotic substances in the blood by gas chromatography with mass-spectrometric detection]

This paper was designed to describe the application of the method for solid-phase extraction of the medicinal and narcotic substances having different physicochemical composition by gas chromatography with mass-spectrometric detection (GC-MS) for the purpose of their screening in the blood. The solid-phase extraction technique was optimized by means of the Box-Behnken modeling with the evaluation of the influence on the effectiveness of extraction of various factors including pH of the buffer solution, eluent composition, the type and the volume of the solutions used to wash the sorbent.

Recent developments in extraction procedures relevant to analytical toxicology

Sample preparation is an important step in the development of an analytical method but is often regarded as time-consuming, laborious work. Optimum sample preparation leads to enhanced selectivity and sensitivity, however, and reduces amounts of interfering matrix compounds, resulting in less signal suppression or enhancement. Recent developments in extraction techniques that could be of interest in clinical and forensic toxicology, for example liquid-liquid, solid-phase, and headspace extraction, are summarized in this review. The advantages and disadvantages of several extraction techniques are discussed, to enable the reader to choose an appropriate method of extraction for his or her application. Attention is paid to current trends in analytical toxicology, for example miniaturization, high throughput, and automation.

Requirements for bioanalytical procedures in postmortem toxicology

The application of analytical techniques in postmortem toxicology is often more difficult than in other forms of forensic toxicology owing to the variable and often degraded nature of the specimens and the diverse range of specimens available for analysis. Consequently, analysts must ensure that all methods are fully validated for the particular postmortem specimen(s) used. Collection of specimens must be standardized to minimize site-to-site variability and should if available include a peripheral blood sample and at least one other specimen. Urine and vitreous humor are good specimens to complement blood. In some circumstances solid tissues such as liver are recommended as well as gastric contents. Substance-screening techniques are the most important element since they will determine the range of substances that were targeted in the investigation and provide initial indication of the possible role of substances in the death. While immunoassay techniques are still commonly used for the most common drugs-of-abuse, chromatographic screening methods are required for general unknown testing. These are still predominately gas chromatography (GC) based using nitrogen/phosphorous detection and/or mass spectrometry (MS) detection, although some laboratories are now using time-of-flight MS or liquid chromatography (LC)-MS(MS) to cover a sometimes more limited range of substances. It is recommended that laboratories include a second chromatographic method to provide coverage of acidic and other substances not readily covered by a GC-based screen when extracts do not include all physiochemical types. This may include a gradient high-performance liquid chromatography (HPLC) photodiode array method, or better LC-MS(MS). Substance-specific techniques (e.g., benzodiazepines, opiates) providing a second form of identification (confirmation) are now divided between GC-MS(MS) and LC-MS(MS) procedures. LC-MS(MS) has taken over from many methods for the more polar compounds previously used in HPLC or in GC methods requiring derivatization. Analysts using LC-MS will need to obtain clean extracts to avoid poor and variable sensitivity caused by background suppression of the signal. Isolation techniques in postmortem toxicology tend to favor liquid extraction; however solid-phase extraction and solid-phase microextraction methods are available for many analytes.

Sample preparation on polymeric solid phase extraction sorbents for liquid chromatographic-tandem mass spectrometric analysis of human whole blood—A study on a number of beta-agonists and beta-antagonists

Alternative strategies for sample preparation of human blood samples were evaluated including protein precipitation (PP) and solid phase extraction (SPE) on Waters Oasis polymeric columns. Gradient chromatography within 15 min was performed on a Hypersil Polar-RP column combined with a Sciex API 2000 triple quadrupol instrument equipped with an electro-spray interface. Beta-agonists and beta-antagonists available on the Swedish market were included in the study. A combination of zinc sulphate and ethanol was found effective for PP. A clear supernatant was achieved that either could be injected directly on the LC-MS-MS system for analysis or transferred to a SPE column for further extraction and analyte concentration. Retention on the hydrophilic-lipophilic balanced sorbent HLB as well as the mixed mode cationic MCX and anionic MAX sorbents were investigated. On HBL the relative lipophilicity of the target analytes was investigated. At a high pH when the amino alcohols are deprotonised the more non-polar analytes (e.g., carvediol, betaxolol, bisoprolol and propranolol) were well retained on the sorbent and for the majority methanol content higher than 50% in water (v/v) was needed for elution. Some analytes though, with additional weak acidic functionalities (fenoterol, salbutamol, sotalol, and terbutaline) were poorly retained. On MAX the retention of these weak acids was improved when loaded under basic conditions but under neutral conditions analyte recoveries was comparable with HLB. On MCX all the analytes were well retained allowing a wash step of 100% methanol at neutral and low pH. By applying the supernatant from PP in combination with an additional portion of aqueous formic acid (2%) the analytes could be loaded and retained. High extraction recoveries were found for most analytes but for a few, significant losses were seen during PP (e.g., formoterol) and/or evaporation (e.g., fenoterol, formoterol, labetalol and terbutaline). The effectiveness of the sample preparation was evaluated by ESI ion-suppression studies by post column infusion of the target analyte. An ethanol zinc sulphate aq mixture was found to be more effective than acetonitrile, methanol or ethanol for PP of human whole blood samples. Beside suppression by salts in the front peak, only limited suppression from other artefacts such as more lipophilic compounds was found late in the chromatograms. Some tendency though to concentrate more lipophilic artefacts on the Oasis sorbents was seen. These findings show that the Oasis MCX sorbent is well suited for sample preparation of beta-agonists and beta-antagonists from human whole blood if the objective is to cover a great number of the analytes in the same assay.

HPLC-DAD for analysis of different classes of drugs in plasma

A solid-phase extraction technique and HPLC-DAD method for drug screening in plasma were developed. This analytical method extracts and tests a number of drugs of different classes. The method includes; an acidic and basic Solid Phase Extraction (SPE) of plasma with C18 cartridges, a gradient elution of a modified cyano column with acidic buffer/acetonitrile eluent and a photodiode array ultraviolet (UV) detection. The drug screening procedure applied uses retention index and UV spectral data for the identification of compounds, may be appropriate in particular laboratory settings.

Determination of several psychiatric drugs in whole blood using capillary gas–liquid chromatography with nitrogen phosphorus detection: comparison of two solid phase extraction procedures

A simple and reliable gas chromatographic method with nitrogen-phosphorus detection without derivatization was developed for the detection of several psychiatric drugs in whole blood as part of systematic toxicological analyses (STA). Drugs included mirtazapine, chlorpromazine, methotrimeprazine (levomepromazine), clothiapine, olanzapine, clozapine, haloperidol, and thioridazine. All drugs were studied at concentrations of 100-2,000 microg/L, except haloperidol that was studied at concentrations of 400-8,000 microg/L. In order to select the best blood purification procedure and therefore increase the signal to noise ratio we have compared two solid-phase extraction (SPE) columns, Chem Elut and Bond Elut Certify, for their recovery, precision, sensitivity and matrix purification efficiency. Recoveries for these drugs using Chem Elut columns at 500 and 2,000 microg/L (2,000 and 8,000 microg/L for haloperidol) were in the range 21-65%, with intra-assay and inter-assay precisions of less than 17% and 19%, respectively. Limits of detection (LODs) and limits of quantitation (LOQs) for mirtazapine, chlorpromazine, methotrimeprazine, clothiapine, olanzapine, clozapine, and thioridazine ranged from 62 to 161 microg/L and from 205 to 531 microg/L, respectively. LOD and LOQ for haloperidol were 442 and 1,458 microg/L, respectively. Recoveries of these compounds using Bond Elut Certify columns at 500 and 2,000 microg/L (2,000 and 8,000 microg/L for haloperidol) were in the range 44-97%, with intra-assay and inter-assay precisions of less than 7% and 14%, respectively. LODs and LOQs for mirtazapine, chlorpromazine, methotrimeprazine, clothiapine, olanzapine, clozapine, and thioridazine ranged from 37 to 66 microg/L and from 122 to 218 microg/L, respectively. LOD and LOQ for haloperidol were 156 and 515 microg/L, respectively. Linearity was observed in the studied range for all compounds with r(2) values of >0.999. The use of the mixed-mode bonded-silica Bond Elut Certify columns showed advantages comparing with Chem Elut columns for the screening of these psychotropic agents such as higher recoveries, cleaner extracts, better sensitivity, better precision and less solvent consumption and subsequent disposal.

Development of a multi-target screening analysis for 301 drugs using a QTrap liquid chromatography/tandem mass spectrometry system and automated library searching

A new multi-target screening (MTS) procedure for drugs in blood and urine for toxicological analysis has been developed using a hybrid triple-quadrupole linear ion trap mass spectrometer (QTrap) for the fast detection and identification of 301 forensically important drugs, e.g. tranquilizers (benzodiazepines), hypnotics, drugs of abuse (opiates, cocaine, amphetamines, cannabinoids), antidepressants, neuroleptics, and some cardiac drugs, in one single liquid chromatography/tandem mass spectrometry (LC/MS/MS) analysis. Samples were extracted either with liquid-liquid extraction or solid-phase extraction. A multiple reaction monitoring (MRM) as survey scan and an enhanced product ion (EPI) scan as dependent scan were performed in an information-dependent acquisition (IDA) experiment. Finally, drug identification was carried out by library search with a newly developed MS/MS library based on EPI spectra at three different collision energies in positive mode. The advantage of this newly developed method is the possibility to detect and identify 301 drugs in one single LC/MS/MS run.

Ion suppression effects in liquid chromatography-electrospray-ionisation transport-region collision induced dissociation mass spectrometry with different serum extraction methods for systematic toxicological analysis with mass spectra libraries

Ion suppression effects during electrospray-ionsation mass spectrometry (ESI-MS) caused by different sample preparation procedures for serum were investigated. This topic is of importance for systematic toxicological analysis for which LC-ESI-MS has been developed with transport-region collision-induced dissociation (ECI-CID) and mass spectra library searching. With continuous postcolumn infusion of two test compounds-codeine and glafenine-the ion suppression effects of extracted biological matrix obtained after a standard liquid-liquid extraction, a mixed-mode solid-phase extraction (SPE) method, a protein precipitation method and a combination of precipitation with polymer-based mixed-mode SPE have been investigated. Extracted ion chromatograms of codeine ([M+H](+), m/z 300) and glafenine ([M-H](-), m/z 371) were used for monitoring ion suppression. Severe ion suppression effects for codeine and glafenine were detected in positive and in negative ionisation modes, respectively, in the LC-front peak after serum clean-up with SPE (acid/neutral fraction) and protein precipitation as well as with protein precipitation combined with SPE. Less ion suppression of codeine in positive mode was found with liquid-liquid extraction of serum samples. No ion suppression was detected with the second fraction of the mixed-mode SPE (using RP-C(8) and cation-exchange phase) in both ionisation modes. All suppression effects were caused by polar and unretained matrix components, which were present after extraction and/or protein precipitation. However, no specific ion suppression was seen after elution of the polar LC-front throughout the whole gradient. It could be demonstrated, that ion suppression is not generally present at any retention time when using reversed-phase HPLC with rather long gradient programs, but may play an important role in case of high-throughput LC-MS analysis, when the analyte is not separated from the LC-front, or in flow injection analysis without chromatographic separation.

Sensitive and specific multiresidue methods for the determination of pesticides of various classes in clinical and forensic toxicology

Original and sensitive multiresidue methods are presented for the detection and quantitation, in human biological matrices, of 61 pesticides of toxicological significance in human. These methods involved rapid solid-phase extraction using new polymeric support (HLB and MCX) OASIS cartridges. Gas chromatography-mass spectrometry (GC-MS) was used for volatile (organophosphate, organochlorine, phtalimide, uracil) pesticides and liquid chromatography-ionspray-mass spectrometry (LC-MS) for thermolabile and polar pesticides (carbamates, benzimidazoles). Acquisition was performed in the selected ion monitoring (SIM) mode. Extraction recovery varied owing to the nature of pesticides, but was satisfactory for all. Limits of detection (LODs) and limits of quantitation (LOQs) ranged, respectively, from 2.5 to 20 and from 5 to 50ng/ml. An excellent linearity was observed from LOQs up to 1000ng/ml for all the pesticides studied. The proposed procedures yielded reproducible results with good inter-assay accuracy and precision. A few cases of intoxication are presented to demonstrate the diagnostic interest of these methods: in two cases were determined lethal concentrations of endosulfan and carbofuran; in four other cases, the procedures helped diagnose intoxication with, respectively, parathion-ethyl, the association of bromacil and strychnine, bifenthrin and aldicarb.

Multiresidue determination method for organophosphorus pesticides in serum and whole blood by gas chromatography-mass-selective detection

This paper describes a rapid, specific and sensitive method for the determination of 29 organophosphorus pesticides in blood and serum, involving a rapid solid-phase extraction procedure using Oasis HLB cartridges and gas chromatography coupled to mass-selective detection. The ionization was performed by electron Impact and acquisition in the single ion monitoring mode followed three specific ions per analyte. Extraction recoveries were satisfactory and ranged between 40 and 108% in blood and serum. Limits of detection ranged from 5 to 25 ng/ml and limits of quantitation (LOQs) ranged from 10 to 50 ng/ml, in blood and serum. An excellent linearity was observed from these LOQs up to 1000 ng/ml. Intra- and inter-assay precision and accuracy were satisfactory for most of the pesticides analyzed.

Systematic analysis of acid, neutral and basic drugs in horse plasma by combination of solid-phase extraction, non-aqueous partitioning and gas chromatography-mass spectrometry

A sample preparation method for mass chromatographic detection of doping drugs from horse plasma is described. Bond Elut Certify (1 g/6 ml) is used for the extraction of 4 ml of horse plasma. Fractionation is performed with 6 ml of CHCl3-Me2CO (8:2) and 5 ml of 1% TEA-MeOH according to its property. Simple and effective clean-up based on non-aqueous partitioning is adopted to remove co-eluted contaminants in both acid and basic fractions. Two kinds of 1-(N,N-diisopropylamino)-n-alkanes are co-injected with the sample into the GC-MS system for the calculation of the retention index. Total recoveries of 107 drugs are examined. Some data of post administration plasma are presented. This procedure achieves sufficient recoveries and clean extracts for GC-MS analysis. The method is able to detect ng/ml drug levels in horse plasma.

Comprehensive Drug Screening by Integrated Use of Gas Chromatography/Mass Spectrometry and Remedi HS

The authors evaluated an integrated approach for the screening of drugs in biosamples consisting of gas chromatography/mass spectrometry analysis of serum or whole blood (SB/GC-MS) and of high-performance liquid chromatographic and ultraviolet (HPLC-UV) analysis of urine with the REMEDi HS Biorad system (U/REM) (Bio-rad; Segrate, MI, Italy). Urine and blood samples from 26 suspected intoxicated patients and from 22 suspected lethal poisoning cases were examined. Eighty-one of the 99 parent drugs/main metabolites detected were identified by SB/GC-MS and 54 with U/REM. Thirty-six drugs/metabolites were identified with both methods, 45 by SB/GC-MS alone, and 18 by U/REM alone. Absence of the mass spectrometry (MS) spectra in the reference library and high polarity of the analytes were the main reasons for failed identification by SB/GC-MS. Unsuccessful identifications with U/REM were basically caused by the absence of the UV spectra in the reference library or by low chromatographic and spectroscopic selectivity as in the case of barbiturates and benzodiazepines (BZD), which represented 11% and 51%, respectively, of the 45 SB/GC-MS unique identifications. Urine samples of 14 BZD-positive cases were also submitted to enzymatic hydrolysis and analyzed with the REMEDi UBz assay, and results were compared with those obtained by SB/GC-MS: 14 of the 22 identified BZD were detected with both methods, three by U/REM only, and five by SB/GC-MS only. In conclusion, the integrated use of SB/GC-MS and U/REM approaches greatly enhances the amount and quality of analytical information obtainable by applying either method alone.

Use of clonidine for chemical submission

CASE REPORT

An East-European prostitute in Amsterdam robbed several victims, after having sedated them with clonidine solution (available as plastic ampoules of eyedrops) added to her victims' drinks. One victim was hospitalized. His symptoms included bradycardia, hypotension, hypothermia, pallor, cyanosis, and impaired consciousness. Treatment included isoprenaline for 28 hours. The victim was released from hospital the next day. In court, the female offender confessed and was sentenced to prison for 3 1/2 years. She may have administered doses as high as 8 mg clonidine.

Enantioselective high-performance liquid chromatographic analysis of the 5-HT1A receptor agonist 8-hydroxy-2-(di-n-propylamino)tetralin. Application to a pharmacokinetic-pharmacodynamic study in rats

A rapid, sensitive and enantioselective HPLC assay for the simultaneous determination of the reference 5-HT1A receptor agonists, R-(+)- and S-(-)-8-hydroxy-2-(di-n-propylamino)tetralin (R-8-OH-DPAT and S-8-OH-DPAT, respectively), in rat blood is presented. A selective extraction procedure was developed using a preliminary sample clean-up followed by isolation of R- or S-8-OH-DPAT on mixed-mode NARC-2 solid-phase columns. Separation of the enantiomers was performed by high-performance liquid chromatography using a Chiracel OD-R column. Detection was obtained using an electrochemical detector set at a voltage of 0.63 V. The mobile phase consisted of a 50 mM phosphate buffer (pH 5.5)-acetonitrile (80:20, v/v) mixture. At a flow-rate of 1 ml min(-1), the total run time was approximately 14 min. The limit of detection for R- and S-8-OH-DPAT was 0.5 ng ml(-1). In the concentration range between 50 ng ml(-1) and 1000 ng ml(-1) intra- and inter-day relative standard deviations were less than 12%. The assay was applied to a pharmacokinetic-pharmacodynamic study in rats in which decrease of body temperature was used as a measure of 5-HT1A receptor-mediated effect. Values for clearance, volume of distribution at steady state and terminal elimination rate constant were 22+/-2 ml min(-1), 1969+/-473 ml and 156+/-34 min for R-8-OH-DPAT and 16+/-1 ml min(-1), 3353+/-347 ml and 334+/-36 min for S-8-OH-DPAT, respectively. No enantiomeric interconversion was observed in vivo from R-8-OH-DPAT to S-8-OH-DPAT or vice versa.

On-line coupling of solid-phase extraction with mass spectrometry for the analysis of biological samples. I. Determination of clenbuterol in urine

The potential of the direct coupling of solid-phase extraction (SPE) with mass spectrometry (MS) for the analysis of biological samples is demonstrated. For SPE a cartridge exchanger is used and the eluate is directly introduced into the mass spectrometer. This system has been investigated for the determination of clenbuterol in urine. With mixed-mode cartridges, a considerable ion suppression has been obtained. The mass spectrum at the elution time of clenbuterol is dominated by that of creatinine and adduct formation of clenbuterol and creatinine has been observed. The whole procedure including injection of 1 ml urine, washing and desorption has been developed with cartridges containing 8-microm C18-bonded silica. If only a single MS step is used, the selectivity and, therefore, the sensitivity are insufficient. The detection limit is about 100 ng/ml. However, with atmospheric pressure chemical ionisation and the tandem MS mode the detection limit has been decreased to about 2 ng/ml and the ion suppression is only about 10%. For the electrospray ionisation the detection limit is about 10-times higher and the ion suppression is less favourable. The repeatability for the SPE-MS-MS procedure was 6.5% at 10 ng/ml (n=5) and the difference between the response factors at 10 ng/ml and 100 ng/ml was only 2.5%. The MS behaviour of clenbuterol and the matrix under the present conditions is discussed.

Chromatographic screening techniques in systematic toxicological analysis

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.

Systematic toxicological analysis of drugs and poisons in biosamples by hyphenated chromatographic and spectroscopic techniques

The introduction of hyphenated chromatographic-spectroscopic techniques represented a substantial step-forward for Systematic Toxicological Analysis (STA), increasing the amount and quality of information obtainable from the analysis of a biological sample, and enhancing the possibilities of identifying unknown drugs and poisons. STA methods based either on GC-MS or on HPLC-UV published in the last decade are reviewed in this paper. The different analytical phases, i.e. sample preparation (pretreatment, extraction, derivatisation), chromatographic separation and detection/identification are examined in detail in order to emphasise the complementarity of the two approaches. In addition, the first STA method based on HPLC-MS is illustrated and some applications of TLC-UV to drug screening are also described. Finally, an overview of semi- and fully-automated STA methods is given.

Development of validated stereoselective methods for methadone determination in clinical samples

A stereoselective analysis of methadone (Mtd) in whole blood and serum was developed using liquid chromatography on a protein based chiral stationary phase. Liquid-liquid extraction (LLE) and solid phase extraction methods were applied before chromatographic analysis. The extraction procedure, as well as the choice of the biological matrix, showed significant differences in the extraction yield and in the precision of the assays. Serum was selected for this assay and LLE was chosen as the preparation step because of its simplicity and rapidity. The total procedure was validated and applied to clinical samples. Samples taken from 45 heroin-addicted patients were analyzed. A correlation was found between the dose administered and Mtd concentration (total and R-form), but interindividual variability of the total normalized Mtd was seen (concentration varied from 90 to 530 ng/ml). Furthermore, two populations were apparently observed with a mean Mtd concentration of 200 and 475 ng/ml, respectively. Stereoselective analyses showed that more than 50% of the patients presented a nonracemic ratio, and particularly about 25% showed a preferential metabolism of the active R-Mtd enantiomer. Therefore, the stereoselective determination of Mtd is necessary to improve the quality of the treatment of heroin addiction.

Semi-automated solid-phase extraction procedure for the high-performance liquid chromatographic determination of alinastine in biological fluids

A solid-phase extraction (SPE) method for sample clean-up followed by a reversed-phase HPLC procedure for the assay of alinastina (pINN) in biological fluids is reported. The effects of the sample pH, composition of the washing and elution solvents and the nature of the SPE cartridge on recovery were evaluated. The selectivity of SPE was examined using spiked rat urine and plasma samples and the CH and PH cartridges gave rise to the cleanest extracts. The recoveries obtained in spiked rat urine and plasma samples were 91.2+/-2.7 and 99.9+/-2.8%, respectively. The proposed SPE method coupled off-line with a reserved-phase HPLC system with fluorimetric detection was applied to the quantitation of alinastine in real rat urine samples. The analytical method was also applied and validated for the determination of alinastine in dog plasma. The recovery from spiked dog plasma samples using the PH cartridge was around 65%. The within-day and between-day precisions were 7 and 12%, respectively. The detection and quantitation limits in dog plasma were 0.024 and 0.078 microg/ml, respectively.

Fully-automated systematic toxicological analysis of drugs, poisons, and metabolites in whole blood, urine, and plasma by gas chromatography-full scan mass spectrometry

The availability of automated, rapid and reliable methods for the systematic toxicological analysis (STA) of drugs and poisons in biosamples is of great importance in clinical and forensic toxicology laboratories. Gas chromatography-continuous scan mass spectrometry (GC-MS) possesses a high potential in STA because of its selectivity and identification power. However, in order to develop a fully automated STA method based on GC-MS two main obstacles have to be overcome: (a) sample preparation is rather sophisticated owing to the need to isolate analytes from the aqueous matrix and to allow a correct GC repartition of polar analytes; (b) the large amount of information collected within a single analysis makes it difficult to isolate relevant analytical information (mass spectra of analytes) from the chemical noise. Using a bench-top GC-MS system equipped with a laboratory robot for sample preparation (the Hewlett-Packard 7686 PrepStation) and an original method for mass spectral purification, a fully automated STA procedure was developed involving isolation of drugs from the sample (whole blood with minimal pretreatment, plasma, urine) by means of solid-phase extraction, derivatization (trimethylsilylation) of the acidic-neutral and of the basic extracts, GC-MS analysis, processing of data, and reporting of results. Each step of the procedure, and the method for data analysis in particular, can be easily integrated with other existing STA methods based on GC-MS.

Solid-phase extraction procedures in systematic toxicological analysis

In systematic toxicological analysis (STA) the substance(s) present is (are) not known at the start of the analysis. In such an undirected search the extraction procedure cannot be directed to a given substance but must be a general procedure where a compromise must be reached in that the substances of interest are isolated at a yield as high as possible and the interfering substances from the biological material are removed. When using solid-phase extraction (SPE) it is desirable to have procedures using just one column. An overview of screening procedures using diatomaceous earth, polystyrene-divinylbenzene copolymer and mixed-mode bonded silica as column material in SPE is given. The latter type of sorbent is most popular at the moment and the critical steps in the procedure are outlined in more detail. Recent developments of SPE disks look very promising for STA.

Acidic and neutral drugs screen in blood with quantitation using microbore high-performance liquid chromatography-diode array detection and capillary gas chromatography-flame ionization detection

Blood previously acidified with aqueous saturated ammonium chloride solution was extracted with ethyl acetate. The dried extract was subjected to acetonitrile-hexane partition. The acetonitrile portion was analysed for the presence of acidic and neutral drugs by HPLC-DAD (200 mm x 2.1 mm I.D. microbore ODS-Hypersil column) and GC-FID (25 m narrow-bore x 0.25 mm I.D. HP-5 column with 0.33 micron film thickness). The protocol was found to be suitable for both clinical toxicology (including emergency toxicology) and postmortem toxicology. At least 66 drugs of interest were unequivocally identified by RRTs (HPLC) and UV spectra (DAD) match while another 12 were unequivocally identified by double RRTs match (HPLC and GC). Quantitation was facilitated by incorporating calibration blood standards in each assay batch. The five drugs most commonly encountered in clinical blood specimens (1150 cases) were: paracetamol (47.4% of the cases); chlormezanone (6.6%), theophylline (1.74%), naproxen (1.65%) and mefenamic acid (1.56%). The following drugs were detected in toxicologically significant quantities in postmortem blood specimens (245 cases): phenobarbitone (1.22% of the cases), naproxen (0.82%), chlormezanone (0.82%), theophylline (0.82%), carbamazepine (0.41%) and paracetamol (0.41%).

Clinical evaluation of Toxi · Prep™: a semiautomated solid-phase extraction system for screening of drugs in urine

A prototype Toxi · Prep (TP) system that utilizes solid-phase extraction (SPE) has been developed as a method for broad-spectrum drug screening and identification of tetrahydrocannabinol (THC) metabolites in urine. TP can simultaneously extract up to seven specimens while automating the process of sample extraction, washing, and elution onto a chromatogram. TP was compared with the Toxi · Lab A (TL-A) system for extraction of basic drugs only. In a blind study, 33 distinct drugs and metabolites were detected in 55 urines over 13 runs. Of the drug occurrences, 68.8% (141 of 205) were detected on both TP and TL-A. Of the 13 runs, quinidine and quinine, nortriptyline metabolites, and diphenhydramine were noted more frequently on TP than TL-A, whereas nicotine and metabolites, morphine, and methadone metabolites were more frequently noted on TL-A. Twenty specimens were analyzed for THC metabolites. Of the cases positive for THC metabolites, 100% (16 of 16) were positive by both methods. Time and motion studies for all runs proved an overall labor reduction for extraction and spotting by ∼40%.

Screening for drugs of abuse (II): Cannabinoids, lysergic acid diethylamide, buprenorphine, methadone, barbiturates, benzodiazepines and other drugs

Requirements for the provision of an efficient and reliable service for drugs of abuse screening in urine have been summarized in Part I of this review. The requirements included rapid turn-around times, good communications between requesting clinicians and the laboratory, and participation in quality assessment schemes. In addition, the need for checking/confirmation of positive results obtained for preliminary screening methods was stressed. This aspect of the service has assumed even greater importance with widespread use of dip-stick technology and the increasing number of reasons for which drug screening is performed. Many of these additional uses of drug screening have possible serious legal implications, for example, screening school pupils, professional footballers, parents involved in child custody cases, persons applying for renewal of a driving licence after disqualification for a drug-related offence, doctors seeking re-registration after removal for drug abuse, and checking for compliance with terms of probation orders; as well as pre-employment screening and work-place testing. In many cases these requests will be received from a general practitioner or drug clinic with no indication of the reason for which testing has been requested. This also raises the serious problems of a chain of custody, provision of two samples, stability of samples, and secure and lengthy storage of samples in the laboratory-samples may be requested by legal authorities several months after the initial testing. The need for confirmation of positive results is now widely accepted but it may be equally important to confirm unexpected negative results. Failure to detect the presence of maintenance drugs may lead to the patient being discharged from a drug treatment clinic and, if attendance at the clinic is one of the terms of continued employment, to dismissal. It seems likely that increasing abuse of drugs and the efforts of regulatory authorities to control this, will lead to the manufacture of more designer drugs. Production of substituted phenethylamines was facilitated by the drug makers' cook book, 'PIHKAL' (Phenethylamines I Have Known And Loved) by Dr Alexander Shulgin and Ann Shulgin, and production of substituted tryptamines is promised in their next book, TIHKAL. Looking to the future, laboratories will need to ensure that they can detect and quantitate an ever-increasing number of drugs and related substances. The question of confidence in results of drugs of abuse testing raised in 1993 by Watson has assumed even greater importance as a result of attention focused on the OJ Simpson trial in Los Angeles. Toxicological investigations are likely to be challenged more frequently in the future. Even if analyses have been performed by GC-MS, there is a need to establish the level of match between the spectrum of the unknown substance and a library spectrum which is considered acceptable for legal purposes. It will also be essential to ensure that computer libraries contain spectra for all substances likely to be encountered in drugs of abuse screening.

Drug screening in biological fluids. The need for a systematic approach

In this paper the key steps towards drug screening in biological fluids are considered: (i) sample work up-isolation-concentration; (ii) differentiation-detection; (iii) identification. For (i) solid-phase extraction has very good potential; for (ii) thin-layer chromatography, gas chromatography and high-performance liquid chromatography, in combination with their respective detection modes, each have their particular advantages and disadvantages; for (iii) extensive computerized data bases are essential. It is emphasized that each step must be approached and carried out in a systematic way, not only to make sure that all substances of interest can be detected, but also for their correct identification. To this end all analytical procedures and techniques used require extensive validation of their detection and identification properties.

Uniform solid-phase extraction procedure for toxicological drug screening in serum and urine by HPLC with photodiode-array detection

In this HPLC–diode-array detection method for toxicological drug screening, a mixed-mode solid-phase extraction procedure is optimized for isolation of a broad range of drugs from serum and urine. Basic, neutral, and weakly acidic drugs are uniformly recovered. The extract from the solid-phase cartridge is readily injected to a reversed-phase HPLC column for separation by gradient elution. Unknown drugs and metabolites in urine and serum samples from acute drug poisoning cases are rapidly identified by matching their retention times and ultraviolet spectra with hundreds of reference compounds in the library. Urine metabolites of common toxicants from various medications and drugs of abuse are recorded, with their changes of retention times and ultraviolet spectra as related to their metabolic transformations. Glucuronide conjugates of common benzodiazepines, tricyclic antidepressants, and beta-blockers are examined directly without chemical or enzymatic hydrolysis. The system is reliable for diverse clinical investigations of drug overdoses, drug-induced psychoses, and substance abuse.

Evaluation of a solid-phase extraction procedure for the simultaneous determination of morphine, 6-monoacetylmorphine, codeine and dihydrocodeine in plasma and whole blood by GC/MS

Different procedures of solid-phase extraction were re-examined and a new solid-phase extraction procedure was developed using gas chromatography-mass spectrometry for the simultaneous detection and quantitation of morphine, 6-monoacetylmorphine, codeine and dihydrocodeine in plasma and whole blood. The effects of different types of sorbent and buffer solutions on the recoveries and purity of the extracts were also studied. Some preparation techniques on whole blood samples were also investigated. The method developed using Chromabond C18 (100) with spiked plasma samples had good recoveries for all opiates of interest: morphine 93.1% +/- 7.4%, 6-monoacetylmorphine 68.0% +/- 6.7%, codeine 77.0% +/- 8.3% and dihydrocodeine 67.9% +/- 8.4%. The detection limit of all compounds was less than 5 micrograms/L. The blank plasma showed no interfering peaks in the GC/MS-analysis.

Applicability of various brands of mixed-phase extraction columns for opiate extraction from blood and serum

Four commercially available types of mixed-phase solid-phase extraction (SPE) columns (Bond Elut Certify, Isolute Confirm HCX, Chromabond Drug and Bakerbond Narc-2) were examined in order to compare the extraction efficiencies and chromatographic purity of extracts. The absolute recovery of morphine, 6-monoacetylmorphine and codeine was examined in blood and serum (ten samples each at two concentration levels), using SPE columns of the same batch. GC-MS (ion trap) and HPLC with amperometric detection were used for quantitation. A distinct variability in extraction recovery was observed among the same batches of all brands of SPE columns. All extracts were chromatographically pure and no interfering peaks were observed, neither in GC-MS nor in HPLC examinations, but in some extracts large peaks of plasticizers were identified. The measurements of flow velocities of the same samples of blood or serum through the SPE columns of the same batch showed very large variability of random character. The morphometric analysis of particles was performed for two batches of each sort of SPE columns by means of an image analysing system. Symmetrical distribution of particle size was observed only in Chromabond MN Drug packing, while in other cartridges large fractions of fine particles and nonhomogenous distribution were found. Only in one case the morphometric findings were pretty concordant with the data available from the manufacturer; in two cases, observed data varied considerably from that expected, and in one case no information was available at all. The study showed generally that there was room for improvement in the quality of mixed-phase SPE columns.

Stereoselective determination of methadone in serum by HPLC following solid-phase extraction on disk

A solid-phase extraction (SPE) technique for methadone has been developed using a mixed-mode solid-phase extraction disk which contains both hydrophobic and cation-exchange functional groups. The SPE technique was used to isolate the drug from the biological matrix and to prepare a cleaner sample prior to stereoselective analysis by HPLC on a silica column with covalently bound alpha 1-acid glycoprotein (Chiral-AGP) followed by ultraviolet detection at 205 mm. The within-run precision was less than 5% for the complete method over the therapeutic range. The quantification limit was 25 ng ml-1. The between-run precision was less than 15% at the quantification limit. The between-run precision at other concentrations was less than 8.5% with an accuracy of more than 95%. The mean recovery for R-methadone was 78.5% and the mean recovery for S-methadone was 73.4%. The complete procedure has been validated. This method was successfully used for the analysis of 15 clinical cases.

Analysis of olanzapine in human plasma utilizing reversed-phase high-performance liquid chromatography with electrochemical detection

A sensitive reversed-phase HPLC method for the analysis of olanzapine in human plasma is described. Isolation of olanzapine from plasma was accomplished by solid-phase extraction utilizing an ion-exchange/reversed-phase cartridge designed for basic drug extraction. The drug was subsequently separated by reversed-phase HPLC and monitored by electrochemical detection (ED). Electrochemical analysis was used to detect olanzapine due to its uniquely low oxidative potential. Ascorbic acid was added to prevent oxidation during extraction. The limit of quantitation for the assay was established at 0.25 ng/ml utilizing a 1-ml human plasma sample. The average inter-day accuracy was 96.6% with a average precision (% C.V.) of 3.22% over the concentration range of 0.25 to 100 ng/ml. This method was applied to human plasma samples from human clinical trials with olanzapine. The HPLC-ED method compared favorably with a negative chemical ionization GC-MS method previously utilized for analysis of olanzapine in human plasma.