Simultaneous determination of cocaine/crack and its metabolites in oral fluid, urine and plasma by liquid chromatography-mass spectrometry and its application in drug users.

INTRODUCTION: A single LC-MS equipment was used to validate three methods for simultaneously analyzing cocaine (COC), benzoylecgonine (BZE), cocaethylene (CE), anhydroecgonine methyl ester (AEME) and anhydroecgonine (AEC) in oral fluid (OF), urine and plasma. METHODS: The methods were carried out using a Kinetex HILIC column for polar compounds at 30°C. Mobile phase with isocratic condition of acetonitrile: 13mM ammonium acetate pH 6.0: methanol (55:35:10 v/v/v) at 0.8mL/min flow rate was used. RESULTS: After buffer dilution (OF) and protein precipitation (urine and plasma), calibration curve ranges were 4.25-544ng/mL for oral fluid and 5-320ng/mL for urine and plasma with correlation coefficients (r) between 0.9947 and 0.9992. The lowest concentration of the calibration curves were the lower limit of quantification. No major matrix effect could be noted, demonstrating the efficiency of the cleaning procedure. DISCUSSION: The methods were fully validated and proved to be suitable for analysis of 124 cocaine and/or crack cocaine users. Among the subjects, 56.5% reported daily use of cocaine in the previous three months. Results show a high prevalence of the analytes, with BZE as the most prevalent (94 cases), followed by COC (93 cases), AEC (70 cases), CE (33 cases) and AEME (13 cases). In addition, the concentration of BZE in urine was higher compared to OF and plasma found in the real samples, showing the facility of accumulation in chronic users in matrices with a large detection window.

Profile of drug spend among elderly individuals from different socioeconomic groups / Perfil de gastos com medicamentos entre idosos em diferentes grupos socioeconômicos

Abstract The increase in the elderly population is associated with increased health care costs. The objective of the present study was to describe the results of research conducted in groups of elderly persons from different socioeconomic classes in Porto Alegre in the state of Rio Grande do Sul, and to compare the drugs spending profiles of different groups. A cross-sectional study was performed using a sample of individuals aged 60 years or older who participated in community groups. Analysis of variance (ANOVA) and the Tukey test were used to analyze the difference in costs of drugs among different socioeconomic classes. A total of 225 seniors were interviewed and females were predominant in all classes. The most common chronic diseases included hypertension, which occurred in 21.0%, 36.0% and 38.0% of elderly persons in social classes A, C and E, respectively. The average number of medications was 5.34 (±2.64) in social class A, 4.07 (±2.73) in social class C and 4.28 (±2.39) in social class E. The share of household income spent on medication for elderly persons in classes A, C and E was 4.0%, 5.7% and 10.0%, respectively. The drugs with the highest monthly cost for each patient in class A, C and E, respectively, were antipsychotic and anti-Parkinson's medication, diabetes medicine, and medication for the treatment of bone disease. It was concluded that there are specific differences in the cost and expenses incurred on spending on medication for the elderly of different socioeconomic classes. AU

Resumo O aumento da população idosa está associado a um aumento dos custos de saúde. Este estudo objetivou apresentar os resultados da pesquisa realizada em grupos de idosos de diferentes classes socioeconômicas, em Porto Alegre-RS, bem como comparar os perfis de gastos com medicamentos entre estes grupos. Trata-se de estudo transversal, com amostra composta por pessoas de 60 anos ou mais de idade, participantes de grupos de convivência. Para analisar a diferença nas despesas entre as classes socioeconômicas foram utilizados a análise de variância (ANOVA) e o teste de Tukey. Foram entrevistados 225 idosos. Em todas as classes o sexo feminino foi predominante. A doença crônica mais comuns foi a hipertensão, que ocorreu em 21,0%, 36,0% e 38,0% dos idosos nas classes A, C e E, respectivamente. Na classe A, o número médio de medicamentos foi 5,34 (±2,64), na classe C 4,07 (±2,73) e na classe E 4,28 (±2,39). A parcela da renda familiar mensal gasta com medicamentos para os idosos nas classes A, C e E foi 4,0%, 5,7% e 10,0%, respectivamente. Os medicamentos que representaram o maior custo mensal para cada paciente nas classes A, C e E, respectivamente, foram: antiparkinson e antipsicóticos, medicamentos para diabetes e medicamento para o tratamento de doença óssea. Concluiu-se que existem diferenças específicas em relação ao custo e as despesas incorridas com medicamentos para os idosos de diferentes classes socioeconômicas. AU