Separation of opiate isomers using electrospray ionization and paper spray coupled to high-field asymmetric waveform ion mobility spectrometry

One limitation in the growing field of ambient or direct analysis methods is reduced selectivity caused by the elimination of chromatographic separations prior to mass spectrometric analysis. We explored the use of high-field asymmetric waveform ion mobility spectrometry (FAIMS), an ambient pressure ion mobility technique, to separate the closely related opiate isomers of morphine, hydromorphone, and norcodeine. These isomers cannot be distinguished by tandem mass spectrometry. Separation prior to MS analysis is, therefore, required to distinguish these compounds, which are important in clinical chemistry and toxicology. FAIMS was coupled to a triple quadrupole mass spectrometer, and ionization was performed using either a pneumatically assisted heated electrospray ionization source (H-ESI) or paper spray, a direct analysis method that has been applied to the direct analysis of dried blood spots and other complex samples. We found that FAIMS was capable of separating the three opiate structural isomers using both H-ESI and paper spray as the ionization source.

Alcohol calculations and their uncertainty

A dilution model is widely used to link blood alcohol concentration and the quantity of alcohol consumed. Whilst some authors use the total body water formulation of that model, others use the Widmark Factor formulation. A paper by Forrest gave a table of example values of the Widmark Factor and Barbour, based on Forrest's work and using Forrest's computer program, subsequently presented Forrest's results by way of a chart. Whilst the results of Forrest and Barbour are often used interchangeably, there is a significant difference between them on the factors for women. This paper examines the source of the unexpected discrepancy. It is essential to quote an error range, in blood alcohol concentration calculations, for the results. The extent of that error range was investigated by Gullberg who also employed the Widmark Factor formulation. Gullberg concluded that when reporting a calculated blood alcohol concentration, a coefficient of variation of ± 21% should be applied. Similarly, Gullberg concluded that when calculating the volume of drink, a coefficient of variation of 12½ % should be applied. The present paper derives and publishes the formulae for calculating this coefficient of variation. It is then shown that Gullberg's conclusions are mistaken: the coefficient of variation is not some fixed percentage but must be calculated in each case.

[The determination of the low and medium molecular weight substances in the blood serum as the additional diagnostic criterion in the cases of lethal poisoning with narcotic drugs]

The objective of the present study was the comparative analysis of the concentrations of the low and medium molecular weight substances in the blood serum in the cases of lethal poisoning with narcotic drugs, alcoholic intoxication, and endogenous intoxication associated with various diseases. The spectrogram profile of the low and medium molecular weight substances present in the blood serum obtained in the case of lethal poisoning with narcotic drugs exhibited a peak at 260-274 nm that was not found in an analogous profile in the case of alcoholic intoxication or a disease. It is concluded that the proposed analysis can be used as an additional diagnostic criterion for the documentation of poisoning with narcotic drugs and/or other potent agents.

[The determination of the ethanol elimination rate in the blood based on its concentration in the exhaled air]

The objective of the present study was to calculate the blood ethanol level from its content in the exhaled air. The plot of the blood ethanol level versus its content in the exhaled air was constructed and used to determine the rate of ethanol elimination from the blood. The result proved to lie within the range corresponding to the normal-for-age values. These data put in question the opinion of the independent specialist about disturbances in the alcohol dehydrogenase activity in blood manifested as a considerable increase of the rate of acetaldehyde reduction to ethanol with the decreasing ethanol dehydration rate. It is concluded that the prfoposed algorithm can be recommended for the application in the practical work of various expert services.

Screening approach by ultra-high performance liquid chromatography-tandem mass spectrometry for the blood quantification of thirty-four toxic principles of plant origin. Application to forensic toxicology

Plant poisonings have left their mark on history and still cause many deaths, whether intentional or accidental. The means to show toxicological evidence of such poisonings should be implemented with great care. This article presents a technique for measuring thirty-nine toxic principles of plant origin in the blood, covering a large amount of toxins from local or exotic plants: α-lobeline, α-solanine, aconitine, ajmaline, atropine, brucine, cephalomannine, colchicine, convallatoxin, cymarine, cytisine, digitoxin, digoxin, emetine, gelsemine, ibogaine, jervine, kavain, lanatoside C, lupanine, mitragynine, neriifolin, oleandrin, ouabain, paclitaxel, physostigmine, pilocarpine, podophyllotoxin, proscillaridin A, reserpine, retrorsine, ricinine, scopolamine, senecionine, sparteine, strophanthidin, strychnine, veratridine and yohimbine. Analysis was carried out using an original ultra-high performance liquid chromatography separation coupled with tandem mass spectrometry detection. Extraction was a standard solid phase extraction performed on Oasis(®) HLB cartridge. Thirty-four of the thirty-nine compounds were put through a validation procedure. The assay was linear in the calibration curve range from 0.5 or 5 μg/L to 1000 μg/L according to the compounds. The method is sensitive (LOD from 0.1 to 1.6 μg/L). The within-day precision of the assay was less than 22.5% at the LLOQ, and the between-day precision was less than 21.5% for 10 μg/L for all the compounds included. The assay accuracy was in the range of 87.4 to 119.8% for the LLOQ. The extraction recovery and matrix effect ranged from 30 to 106% and from -30 to 14%, respectively. It has proven useful and effective in several difficult forensic cases.

[Extraction of flutamide from aqueous solutions]

The objective of the present study was to elucidate peculiarities of flutamide extraction from aqueous solutions using he liquid-liquid extraction technique and spectrophotometry in the visible spectrum. The results of flutamide extraction were shown to depend on the chemical nature of the extractant, pH of the aqueous phase as well as its saturation with water and electrolytes. The study has demonstrated that the optimal conditions for flutamide extraction by ethylacetate are created by using the aqueous phase with the pH values in the range from 1.0 to 12.0. We have calculated extraction factor necessary for the luberation of the desired amount of flutamide from the aqueous solutions with the use of a concrete solvent.

[The problems of expert evaluation of the results of forensic chemical investigations of clozapine in the biological material]

The objective of the present review was to analyse the problems of expert evaluation of the results of forensic chemical investigations of clozapine in the biological material. Such an analysis is needed because many topical aspects of the quantitative evaluation of toxic clozapine concentrations remain unclear. The treatment with clozapine is associated with its accumulation in blood in concentrations up to 2 mg/l in the absence of any toxic effect allegedly due to the development of tolerability of this agent. In the tolerant patients the ratio of the main clozapine metabolite, norclozapine, to clozapine itself in the serum amounts to 0.6-0.9. This value falls down to 0.3-0.4 in case of acute intoxication. In the case of identification of other pharmaceutical products narcotic drugs together with clozapine their influence on the activity of enzymes responsible for clozapine biotransformation should be taken into consideration. The concomitant intake of clozapine and alcohol may be dangerous for the clozapine-intolerant subjects. It is concluded that the above observations must be borne in mind in the assessment of the results of forensic chemical analysis.

Quantitative low-volume assay for simultaneous determination of fentanyl, norfentanyl, and minor metabolites in human plasma and urine by liquid chromatography-tandem mass spectrometry (LC-MS/MS)

A rapid and sensitive liquid chromatography/tandem mass spectrometric (LC-MS/MS) method for simultaneous quantification of fentanyl (F), norfentanyl (NF), despropionylfentanyl (DPF), and hydroxynorfentanyl (OHNF) in human plasma and urine specimens has been developed and validated according to international guidelines. Analytes were extracted from 250-μL plasma or urine by liquid-liquid extraction. OHNF in urine affords a second extraction step and analysis with a different column. Calibration curves in plasma were linear from 0.05-10 ng/mL for F, 0.07-0.5 ng/mL for NF, 0.02-1.0 ng/ml for DPF, and 0.67-3.0 ng/mL for OHNF; in urine, from 0.09-10.0, 0.17-50, 0.08-1.0, and 1.0-5.0 ng/mL for F, NF, DPF, and OHNF, respectively. Analytical bias and intra- and inter-assay imprecision were within ± 15 % of target, except for OHNF in plasma and DPF in urine at the respective lower quality control level. All analytes were stable in processed samples when stored for 24 h at room temperature. Recoveries and process efficiencies were above 82.9 and 75.1 % for all analytes in plasma and urine. The low level of DPF in plasma indicated with a matrix effect of 71.3 % moderate ion suppression, all other analytes in plasma and urine showed no matrix effects. The lower limit of quantification (LOQ) in plasma was 0.05, 0.07, 0.02 and 0.67 ng/mL for F, NF, DPF, and OHNF, respectively. In urine, the LOQ of F, NF, DPF, and OHNF were 0.09, 0.17, 0.08, and 1.28 ng/mL, respectively. This assay has been applied to human specimens collected during a clinical drug-drug interaction study.

[Specific features of the distribution of 2,4- and 2,6-dimethyl derivatives of hydroxybenzene in the body of the warm-blooded animals]

This study was designed to elucidate the specific features of the distribution of 2,4- and 2,6-dimethyl derivatives of hydroxybenzene in the body of the warm-blooded animals (rats) after the intragastric administration of these poisonous substances. It was shown that large amounts of these compounds are present in the unmetabolized form in the blood and internal organs of the experimental animals. Their largest quantities were found in the stomach contents, spleen, and small intestines.

[Determination of olanzapine in cadaveric blood]

The authors present the results of experimental isolation of olanzapine from the biological objects in conjunction with the detailed description of the method for olanzapine extraction from cadaveric blood with the use of one of the amphiphilic solvents (e.g. acetone), purification by solvent extraction, and TLC-screening. Olanzapine was quantitatively determined by UV-spectrophotometry following its chromatography and elution. It was shown that one-step extraction from cadaveric blood by the proposed method made it possible to detect 55% of the total olanzapine content. The method was validated in the studies of blood and liver from the laboratory animals (rats) and can be recommended for the investigation in a chemical toxicological laboratory.

Cleaning up blood samples using a modified "QuEChERS" procedure for the determination of drugs of abuse and benzodiazepines by UPLC-MSMS(☆)

The "QuEChERS" (quick, easy, cheap, effective, rugged, and safe) dispersive SPE (dSPE) method is an emerging sample preparation technique that is becoming increasingly popular in the area of multi-residue pesticide analysis in food and agricultural products. A simplified QuEChERS extraction method followed by ultra high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) has been developed for the simultaneous determination of forensically relevant drugs of abuse (opiates including buprenorphine, methadone and fentanyl and analogues, cocaine and metabolites, amphetamines, LSD) and benzodiazepines and analogues (Z-drugs) in 1mL of human whole blood performing a sole extraction. The method was validated showing good repeatability, accuracy and linearity; LODs were 0.5ng/mL for all benzodiazepines tested while for drugs of abuse LODs varied from 0.05 to 2ng/mL. The method showed high throughput capabilities and was applied on various forensic cases for determination of pharmaceuticals and drugs of abuse.

[Peculiarities of isolation of 4-nitroanilin from the biological material]

The objective of the present work was to elucidate the peculiarities of isolation of 4-nitroanilin from the biological material with the use of TLC and HPLC techniques, low-pressure column chromatography, and spectrophotometry. The results of the study made it possible to substantiate the application of 1,4-dioxane as an agent for the isolation of 4-nitroanilin from the biological material. The optimal conditions of the procedure for isolation of 4-nitroanilin from the hepatic tissue using 1,4-dioxane were determined. It was shown that the 4-nitroanilin thus obtained can be purified from the co-extracted substances on a L 40/100 mcm silicagel column. The quantitative assessment of the isolation of different amounts of 4-nitroanilin from the cadaveric liver is proposed taking into consideration the extraction conditions.

[The detection of clozapine in the tissues of an exhumed corpse]

The authors report the case of finding clozapine in the tissues of an exhumed corpse. The circumstances surrounding the death and the results of primary examination of the corpse are described; in addition, the results of repeated expertise are presented. The data obtained in this study are compared with the relevant literature publications. Special attention is given to the peculiarities of interpretation of the results of forensic chemical expertise essential for the formulation of the scientifically-sound conclusion.

A simple extraction and LC-MS/MS approach for the screening and identification of over 100 analytes in eight different matrices

In the present study, a liquid chromatography-tandem mass spectrometry (LC-MS/MS) multi-analyte approach using one single work-up approach in whole blood, plasma, serum, post-mortem blood, liver tissue, gastric content, hair, and urine was developed for fast target screening and reliable identification of 130 analytes often requested in clinical and forensic toxicology. Samples (500 μL each) of whole blood, plasma, serum, post-mortem blood, tissue (homogenized 1 + 4 with water), as well as 3 g of distilled gastric contents, 1 mL of urine, or 20 mg of pulverized hair were extracted at different pH values with an diethyl ether-ethyl acetate mixture (1:1). Separation and identification were performed using LC-QTRAP with electrospray ionization in positive mode. For identification 1 scheduled multi-reaction-mode (sMRM) method with 390 transitions was developed covering benzodiazepines, Z-drugs, antidepressants, neuroleptics, opioids, new synthetic drugs, and phosphodiesterase type 5 inhibitors. For positive sMRM transitions with intensities exceeding 5000 cps, dependent scans (EPI scan collision energy, 35 eV, collision energy spread, 15 eV) were performed for library search using our in-house library. The method was developed with respect to selectivity, matrix effects, recovery, process efficiency, limit of detection, and applicability. The simple work-up procedure was suitable for all biosamples with exception of urine in respect to low concentrated analytes, which showed median recovery values of 59%. The method was selective for 130 analytes in all 8 biosamples. For 106 analytes, the limit of detection in whole blood, plasma, and serum was lower than the lowest therapeutic concentration listed in blood level lists.

Molecularly imprinted polymer for selective determination of Δ9-tetrahydrocannabinol and 11-nor-Δ9-tetrahydrocannabinol carboxylic acid using LC-MS/MS in urine and oral fluid

The use of molecularly imprinted polymers (MIPs) for solid phase extraction (MISPE) allows a rapid and selective extraction compared with traditional methods. Determination of Δ(9)-tetrahydrocannabinol (THC) and 11-nor-Δ(9)-tetrahydrocannabinol carboxylic acid (THC-COOH) in oral fluid (OF) and urine was performed using homemade MISPEs for sample clean-up and liquid chromatography tandem mass spectrometry (LC-MS/MS). Cylindrical MISPE shaped pills were synthesized using catechin as a mimic template. MISPEs were added to 0.5 mL OF or urine sample and sonicated 30 min for adsorption of analytes. For desorption, the MISPE was transfered to a clean tube, and sonicated for 15 min with 2 mL acetone:acetonitrile (3:1, v/v). The elution solvent was evaporated and reconstituted in mobile phase. Chromatographic separation was performed using a SunFire C18 (2.5 μm; 2.1 × 20 mm) column, and formic acid 0.1% and acetonitrile as mobile phase, with a total run time of 5 min. The method was fully validated including selectivity (no endogenous or exogenous interferences), linearity (1-500 ng/mL in OF, and 2.5-500 ng/mL in urine), limit of detection (0.75 and 1 ng/mL in OF and urine, respectively), imprecision (%CV <12.3%), accuracy (98.2-107.0% of target), extraction recovery (15.9-53.5%), process efficiency (10.1-46.2%), and matrix effect (<-55%). Analytes were stable for 72 h in the autosampler. Dilution 1:10 was assured in OF, and Quantisal™ matrix effect showed ion suppression (<-80.4%). The method was applied to the analysis of 20 OF and 11 urine specimens. This is the first method for determination of THC and THC-COOH in OF using MISPE technology.

[The identification and quantitative measurement of mirtazapine isolated from the biological material by high performance liquid chromatography]

The present study was designed to estimate the effectiveness of isolation of mirtazapine from the liver, blood, and urine. The conditions were developed for the identification and quantitative measurement of the isolated mirtazapine with the use of high performance liquid chromatography and detection from the UV-spectrum and mass-spectrometry. The retention time of mirtazapine isolated from the liver was 2.88 +/- 0.08 min. The straight-line equation within the range of mirtazapine concentrations from 1 to 20 mc/ml was characterized by the dependence: Y = 3.25 x 10(4)X - 6.27 x 10(3) (r = 0.9997). The study showed that it is possible to isolate 46.44 +/- 1.89% of mirtazapine present in the liver and 50.4 +/- 1.05% from blood using extraction by acetonitrile acidified with an 1 M hydrochloric acid solution. Chloroform extraction from urine at pH 7.0-8.0 releases 90.22 +/- 1.88% of mirtazapine.

[Changes in the biochemical, chemical and toxicological characteristics of pericardial fluid in the case of fatal narcotic intoxication]

This article describes the biochemical and chemical-toxicological investigations into the properties of the pericardial fluid designed to improve the effectiveness of forensic medical examination of the cases of fatal drug poisoning. The objectives of the study were the detection and determination of the type of narcotic substances in the pericardial fluid, evaluation of the quantitative changes in enzyme activities (AST, ALT and CPK) in the pericardial fluid, and the development of the criteria for the forensic medical diagnostics of fatal drug poisoning. The materials used in the study were the pericardial fluid and blood taken during forensic medical examination of 247 corpses of men (87.04%) and women (12.96%) at the age from 13 to 35 years who died from different causes. They were divided into two groups. The study group was comprised of 142 subjects who died from drug poisoning, the control group consisted of 105 subjects who died from other causes. The methods used to study the pericardial fluid included gas-liquid chromatography to detect the presence and the type of the poisonous drugs, as well as biochemical and colorimetric methods to determine the amount of enzymes AST, ALT, and CPK. The study revealed no traces of drugs or their metabolites in the pericardial fluid from the 105 control corpses. Positive results of the forensic drug tests were obtained in all the 142 cases of the study group. The changes in the parameters and the biochemical composition of pericardial fluid and blood in fatal drug poisoning were reliably established including the alteration of the enzyme levels, such as AST, ALT, and CPK. In the control group, the quantitative parameters of the enzyme activities did not exceed the normal values whereas in the study group a significant increase of AST, ALT, and CPK levels in the pericardial fluid and blood in comparison with the normal values was documented. Conclusion: the results obtained in the studies of both groups provide a basis on which to propose the reliable criteria for forensic medical diagnostics of fatal drug poisoning taking into consideration the changes in the chemical, toxicological, and biochemical parameters of the pericardial fluid.

GHB in Biological Specimens: Which Cut-off Levels Should be Taken into Consideration in Forensic Toxicological Investigation?

Gamma-hydroxybutyrate (GHB) is a central nervous system depressant endogenously produced and also employed as a recreational drug of abuse since the 90s, attracting notable attention particularly in those cases of drug facilitated sexual assault (DFSA). The implication of GHB among DFSA cases generates numerous concerns, making the interpretation of the toxicological findings often significantly difficult. In this review the Authors have explored GHB behaviour in ante-mortem and post-mortem specimens, taking into consideration its endogenous production, the post mortem interval, the time between sampling and analysis, the storage conditions (temperature and presence/absence of preservatives) and the usefulness of alternative matrices such as hair, bile and vitreous humour. Moreover, the cut-off values currently recommended in forensic toxicology in order to discriminate between endogenous and exogenous levels have been examined.

[Forensic-medical diagnostics of doping cases in sports]

The present review of the literature is focused on the problem of forensic-medical diagnostics of doping cases in sports, with special reference to the main classes of pharmaceutical products forbidden for use by the International Olympic Committee. The main causes of death among the athletes as a result of using doping substances are considered. Much attention is given to adverse reactions induced by long-time intake of anabolic steroids many of which can be identified at autopsy.

[Clozapine intoxication: theoretical aspects and forensic-medical examination ]

This literature review is focused on diagnostics of acute clozapine intoxication with the fatal outcome. According to the Russian authors, clozapine intoxication ranks first in the structure of criminal poisoning and accounted for 99.7% of all the cases that occurred in Moscow during the period from 2003 to 2006. Toximetric investigations of clinical manifestations of clozapine intoxication revealed that the threshold clozapine concentration in blood is 0.12 ± 0.06 mg/I, the critical and lethal concentrations are 1.01 ± 0.2 mg/I and 3.5 ± 1.5 mg/I respectively. Autopsy on corpses of the victims of clozapine intoxication showed that most clozapine-induced pathological changes have a non-specific character (including largely circulatory disorders and dystrophic changes in parenchymatous organs). Clozapine poisoning is associated with the lengthening of QT-interval on ECG; at the values in excess of 500 ms, the risk of severe arrhythmia and sudden death significantly increases. Clozapine intake may lead to the development of potentially fatal myocarditis (the so-called clozapine-associated eosinophilic myocardium) in somatically healthy subjects. Foreign researchers report the possibility of a post-mortem increase of blood clozapine content compared with its antemortem level. They also showed that simultaneous use of substances stimulating activity of cytochrome P-450 enzymes (ethyl alcohol, finlepsin, fenitrin, nicotine) and clozapine accelerates metabolism and thereby reduces clozapine concentration in blood. It is concluded that comprehensive investigations of clozapine intoxication are needed taking into consideration pathomorphological changes induced by this agent, its potential interaction with other factors influencing human body, and the results of forensic chemical expertise of the fatal cases.