Postmortem distribution of ropivacaine and its metabolite in human body fluids and solid tissues by GC-MS/MS using standard addition method.

PURPOSE: An analytical method was developed for determining ropivacaine and its main metabolite, 3-hydroxyropivacaine in biomedical samples using gas chromatography-tandem mass spectrometry (GC-MS/MS). Then, this established method was applied to investigate the distribution of ropivacaine and its metabolite in human fluids and solid tissues obtained from an authentic case ropivacaine involved. METHODS: The fluid sample was added acetonitrile, and solid tissue was homogenized using a freezer mill and then added into acetonitrile. Then, an internal standard solution was added to the mixtures. The mixture was centrifuged at 12,000 × g for 5 min, and the upper layer of acetonitrile was transferred to magnesium sulfate and octadecyl silica (C18) gel for cleaning up the sample. After centrifugation, the upper layer was then evaporated to dryness with nitrogen, and dissolved with methanol, then injected into the GC-MS/MS system. RESULTS: The coefficients of determination (r2) of constructed calibration curves were all greater than 0.999. The limits of detection for ropivacaine and 3-hydroxyropivacaine in target samples were 15 ng/mL and 10 ng/mL, respectively. The recovery rates of ropivacaine and 3-hydroxyropivacaine ranged from 97.6% to 103% and from 96.5% to 104%, respectively. The inter-day precision values of ropivacaine and 3-hydroxyropivacaine were not greater than 6.25% and 7.98%, respectively, and the inter-day trueness values were not greater than 6.90% and 8.33%, respectively; the intra-day precision and trueness values of ropivacaine and 3-hydroxyropivacaine were not greater than 3.20%, 6.78%, 7.84% and 8.99%, respectively. CONCLUSIONS: GC-MS/MS method for simultaneous detection and quantification of ropivacaine and 3-hydroxyropivacaine in biological samples was successfully developed. The method could also be applied to samples obtained from an authentic case; their distribution among tested fluids and solid tissues were also measured. This is the first report on the distribution of ropivacaine and its major metabolite 3-hydroxyropivacaine in a human case.

Detection and quantification of etomidate and metomidate in human hairs by ultraperformance liquid chromatography with triple quadrupole mass spectrometry (UPLC-MS/MS).

PURPOSE: Intravenous narcotic agents, such as etomidate and metomidate, has been widely spread and abused in the world, including in Korea and China; thus, it is important to establish validated and sensitive analytical method for these compounds. Human hair as a biological sample has various advantages, including a wide detection window of drugs, compared to other typical samples, such as urine and blood in investigation. The purpose of this communication is to develop a reliable and useful method for the simultaneous detection and quantification of etomidate and metomidate in human hair samples by ultraperformance liquid chromatography combined with triple quadrupole mass spectrometry (UPLC-MS/MS), and to apply it for authentic samples in abuse cases. METHODS: The hair samples were washed with a detergent solution, followed by with water and acetone. After drying, they were cut into approximately 2 mm sections and then ground to powder by a low-temperature grinder. The 20 mg of hair powder plus internal standard in 1 mL of methanol was vortexed and then centrifuged to obtain the supernatant layer, followed by subjecting to analysis. RESULTS: The coefficient of determination (r2) values of the calibration curves of etomidate and metomidate in the hair samples were both more than 0.99 in the range of 1-500 ng/mg and 1-500 pg/mg, respectively. The limits of detection and lower limits of quantification were 0.5 and 1 pg/mg, respectively, for the both target compounds. Other tested validation data were all satisfactory. Etomidate and metomidate could be detected in the all hair samples and cigarette oil, which were seized by the police. The concentrations of etomidate and metomidate obtained from 10 samples from suspects were 5.48-45.7 ng/mg and 3.60-377 pg/mg, respectively. The concentrations of etomidate and metomidate in the cigarette oil were 95.8 µg/mg and 2.8 µg/mg, respectively. CONCLUSIONS: In this study, a simple and reliable analytical method for etomidate and metomidate in the human hair has been established. To the best of our knowledge, this is the first report to establish a method for the simultaneous detection and quantification of etomidate and metomidate in the human hair, and to apply it to authentic samples seized in authentic cases.

Simple quantification of propofol and its metabolites in blood and urine using gas chromatography-tandem mass spectrometry (GC-MS/MS).

An analytical method which was used for the simultaneous detection and quantification of propofol and its metabolites in human blood and urine by gas chromatography-tandem mass spectrometry (GC-MS/MS) was newly established and applied to authentic human samples obtained from the deceased. The QuEChERS method was employed, and then analyzed by GC-MS/MS. We separately used sulfatase and ß-glucuronidase to hydrolyze the urine sample and calculated the increase of propofol and 4-hydroxypropofol before and after the hydrolysis. The results of urinary concentrations in urine from the subject were: 4.88 µg/mL for propofol, 0.53 µg/mL for 4-hydroxypropofol, 3.35 µg/mL for propofol-glucuronide, 0.31 µg/mL for the total concentration of 1-(2,6-diisopropyl-1,4-quinol)-glucuronide plus 4-(2,6-diisopropyl-1,4-quinol)-glucuronide, and 0.39 µg/mL for 4-(2,6- diisopropyl-1,4-quinol)-sulfate. The lower limit of quantification was 10 ng/mL for all determined compounds; the extraction recoveries were not less than 57.2 %. Intraday and interday precisions and accuracies were all less than 10 %. The calibration curves for propofol and 4-hydroxypropofol in human urine showed the correlation values of not less than 0.999; propofol and 4-hydroxypropofol in blood also presented good linearities in the concentration ranges of 0.1-10 µg/mL. The two compounds had good stability within 7 days at 25, 4, and -20 ℃. To our knowledge, this is the first trial to establish a simple and reliable method to simultaneously detect and quantify of propofol and its phase I and II metabolites in human blood and urine samples by GC-MS/MS.

Quantification of nimetazepam and its metabolite in human hair samples using liquid chromatography-tandem mass spectrometry: Case report.

Nimetazepam (marketed brand names; Erimin and Lavol) is an intermediate acting benzodiazepine derivative, which was widely used mainly in East and Southeast Asian region countries including Japan, Malaysia, Brunei, the Philippines, Thailand, Indonesia, Hong Kong, Singapore and China. Nimetazepam and its metabolite 7-aminonimetazepam were quantified from human hair samples by liquid chromatography tandem-mass spectrometry (LC-MS/MS), under selective reaction monitoring mode. Using diazepam-d5 as an internal standard, the concentration of nimetazepam and its metabolite 7-aminonimetazepam could be determined by matrix matched calibration method. Extraction of the target compounds was performed by using methanol, followed by evaporation and being concentrated with nitrogen. The Limit of quantification concentrations of nimetazepam and its metabolite 7-aminonimetazepam in hair samples were both 25 pg/mg by established method. The concentrations of nimetazepam in hair samples obtained from 2 users were 27.4, and 22.0 pg/mg, respectively; the concentrations of 7-animonimetazepam in hair samples were 54.2 and 29.1 pg/mg, respectively. In our study, the 7-aminonimetazepam concentrations in hair was higher than those of nimetazepam in the authentic hair samples. To our knowledge, this is the first report to establish the detailed procedure for quantificating nimetazepam and 7-aminonimetazepam in human hair by LC-MS/MS.

Quantification of the benzimidazole opioid analog isotonitazene in human hair using liquid chromatography-tandem mass spectrometry.

Benzimidazole opioids were originally developed from the late 1950s to 1970s as analgesics for medical use, although a lot of them could not be approved as licit medicines because of their severe side effects and physical dependence. Such benzimidazole opioid analogs as abused drug, however, have recently been found in illicit drug markets throughout the world. Isotonitazene is one such benzimidazole opioids, whose analgesic potency can be as much as 500 times greater than that of morphine, according to previous animal studies. In line with this potency, a couple of hundred fatalities related to it were reported to date. In this study, a well validated method for the quantification of isotonitazene in human hair samples using liquid chromatography (LC)-tandem mass spectrometry (MS/MS) was established, and could be applied to authentic samples which were seized by the police security bureau. Isotonitazene concentrations in the seized hair averaged 6.11 pg/mg. The LLOQ and LOD of this method were 1.25 and 2.5 pg/mg, respectively; the calibration curve of the substance in hair samples showed a good linearity in the concentration range of 2.5-250 pg/mg (r > 0.999); the extraction recovery rates were 87.3-105% in the tested range; the inter- and intra-day precisions and accuracies (%biases) were not greater than 9.09% for each determination. Isotonitazene in human hair showed good stability at room temperature and under dark storage conditions for 30 days. As for matrix effect in hair samples, moderate ion suppression of target substances could be found. This is the first report for the analysis of isotonitazene in human hair samples.

Non-pulmonary vein foci induced before and after pulmonary vein isolation in patients undergoing ablation therapy for paroxysmal atrial fibrillation: incidence and clinical outcome.

OBJECTIVE: To evaluate the incidence and clinical outcome of adenosine triphosphate (ATP) plus isoproterenol (ISP)-induced non-pulmonary vein (PV) foci before and after circumferential PV isolation (CPVI) during index ablation in patients with paroxysmal atrial fibrillation (PAF). METHODS: In 80 consecutive patients undergoing catheter ablation for drug-refractory, symptomatic PAF at our hospital from April 2010 to January 2011, atrial fibrillation (AF) was provoked with ATP (20 mg) and ISP (20 µg/min) administration before and after CPVI. The spontaneous initiation of AF was mapped and recorded. RESULTS: Before ablation, AF mostly originating from PVs (PV vs. non-PV, 36/70 vs. 3/70; P<0.01) was induced in 39 patients with sinus rhythm. CPVI significantly suppressed AF inducibility; however, more non-PV foci were provoked (post-CPVI vs. pre-CPVI, 13/76 vs. 3/70; P=0.016). Patients with pre- and post-CPVI induced AF (n=49) were divided according to non-PV foci being induced (group N, n=17) or not (group P, n=32). After mean (19.2±8.2) months follow-up, 88.2% (15/17) and 65.6% (21/32) of patients in groups N and P, respectively, were free from AF recurrence (P=0.088). CONCLUSIONS: ATP+ISP administration effectively provokes non-PV foci, especially after CPVI in PAF patients. Although in this study difference did not achieve statistical significance, supplementary ablation targeting non-PV foci might benefit clinical outcome.