1
|
Delaney SR, Konforte D, Stefan C, Palaty J, Sun D, McDonald K, Thompson H, Werb D, Beriault DR. Drug checking services as a surveillance tool for clinical laboratories: Examining trends in the unregulated fentanyl supply. Clin Biochem 2023; 111:11-16. [PMID: 36379241 DOI: 10.1016/j.clinbiochem.2022.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/26/2022] [Accepted: 11/09/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Timely assessment and understanding of drug trends is essential for clinical laboratories to effectively respond to the overdose epidemic. In this proof-of-concept study, we sought to determine whether information obtained through Toronto's Drug Checking Services (DCS) and cross-provincial urine drug testing (UDT) data can be used as a surveillance tool for clinical laboratories and discuss the value of collaboration between the clinical laboratory, clinicians, and community partners to optimize patient care. DESIGN & METHODS Mass spectrometry-based UDT data from LifeLabs Ontario (n = 127,529) and British Columbia (n = 14,848), and drug checking data from Toronto DCS (n = 3,308 drugs or used paraphernalia) was collected between August 2020 and October 2021. Fentanyl co-positivity with toxic adulterants such as benzodiazepine-related drugs and fentanyl analogues were examined. RESULTS The percent co-positivity of fentanyl with etizolam, flualprazolam, flubromazolam, carfentanil, and acetylfentanyl in both Ontario UDT and DCS drugs/used paraphernalia showed similar trends. Regional differences in co-positivity with etizolam and fentanyl analogues were noted between Ontario and British Columbia UDT with patterns consistent over the entire 15-month collection period. CONCLUSIONS Clinical laboratories should connect with their local DCS, if available, to understand and monitor unregulated drug trends. These data can be used as an important tool to help clinical laboratories tailor their UDT menus and thereby provide a community-focused service to improve patient care.
Collapse
Affiliation(s)
- Sarah R Delaney
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada; Department of Laboratory Medicine, St. Michael's Hospital, Toronto, ON, Canada; Toronto's Drug Checking Service, Canada.
| | | | - Cristiana Stefan
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada; Toronto's Drug Checking Service, Canada; Clinical Laboratory and Diagnostic Services, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | | | - Karen McDonald
- Toronto's Drug Checking Service, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Hayley Thompson
- Toronto's Drug Checking Service, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Dan Werb
- Toronto's Drug Checking Service, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Division of Infectious Diseases and Global Public Health, University of California San Diego, USA
| | - Daniel R Beriault
- Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON, Canada; Department of Laboratory Medicine, St. Michael's Hospital, Toronto, ON, Canada; Toronto's Drug Checking Service, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| |
Collapse
|
2
|
Borden SA, Saatchi A, Vandergrift GW, Palaty J, Lysyshyn M, Gill CG. A new quantitative drug checking technology for harm reduction: Pilot study in Vancouver, Canada using paper spray mass spectrometry. Drug Alcohol Rev 2021; 41:410-418. [PMID: 34347332 PMCID: PMC9292878 DOI: 10.1111/dar.13370] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/08/2021] [Accepted: 07/18/2021] [Indexed: 01/04/2023]
Abstract
Introduction Drug checking services for harm reduction and overdose prevention have been implemented in many jurisdictions as a public health intervention in response to the opioid overdose crisis. This study demonstrates the first on‐site use of paper spray mass spectrometry for quantitative drug checking to address the limitations of current on‐site drug testing technologies. Methods Paper spray mass spectrometry was used to provide on‐site drug checking services at a supervised consumption site in the Downtown Eastside of Vancouver, British Columbia, Canada during a 2‐day pilot test in August 2019. The method included the targeted quantitative measurement of 49 drugs and an untargeted full scan to assist in identifying unknown/unexpected components. Results During the pilot, 113 samples were submitted for analysis, with 88 (78%) containing the client expected substance. Fentanyl was detected in 45 of 59 expected fentanyl samples, and in 50 (44%) samples overall at a median concentration of 3.6% (w/w%). The synthetic precursor of fentanyl, 4‐anilino‐N‐phenethyl‐piperidine (4‐ANPP), was found in 74.0% of all fentanyl samples at a median concentration of 2.2%, suggesting widespread poor manufacturing practices. Etizolam was detected in 10 submitted samples anticipated to be fentanyl at a median concentration of 2.5%. No clients submitting these samples expected etizolam or a benzodiazepine in their sample. In three instances, it was co‐measured with fentanyl, and in seven cases it was detected alone. Discussion and Conclusions The quantitative capabilities and low detection limits demonstrated by paper spray mass spectrometry offer distinct benefits over existing on‐site drug checking methods and harm reduction services.
Collapse
Affiliation(s)
- Scott A Borden
- Applied Environmental Research Laboratories, Department of Chemistry, Vancouver Island University, Nanaimo, Canada.,Department of Chemistry, University of Victoria, Victoria, Canada
| | - Armin Saatchi
- Applied Environmental Research Laboratories, Department of Chemistry, Vancouver Island University, Nanaimo, Canada
| | - Gregory W Vandergrift
- Applied Environmental Research Laboratories, Department of Chemistry, Vancouver Island University, Nanaimo, Canada.,Department of Chemistry, University of Victoria, Victoria, Canada
| | - Jan Palaty
- LifeLabs Medical Laboratories, Burnaby, Canada
| | - Mark Lysyshyn
- School of Population and Public Health, University of British Columbia, Vancouver, Canada.,Vancouver Coastal Health Authority, Vancouver, Canada
| | - Chris G Gill
- Applied Environmental Research Laboratories, Department of Chemistry, Vancouver Island University, Nanaimo, Canada.,Department of Chemistry, University of Victoria, Victoria, Canada.,Department of Chemistry, Simon Fraser University, Burnaby, Canada.,Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, USA
| |
Collapse
|
3
|
Lei X, Xu X, Liu L, Kuang H, Xu L, Hao C, Xu C. Rapid quantitative determination of fentanyl in human urine and serum using a gold-based immunochromatographic strip sensor. J Mater Chem B 2021; 8:8573-8584. [PMID: 32814936 DOI: 10.1039/d0tb01509a] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Fentanyl is a typical opioid that is used in surgical anesthesia. However, when abused, fentanyl can lead to addiction and even death. To better control the use of fentanyl, it is necessary to develop rapid and sensitive detection methods. In this study, an ultrasensitive monoclonal antibody (mAb) was prepared and used to develop an indirect competitive enzyme-linked immunosorbent assay (ic-ELISA) and a colloidal gold-based immunochromatographic strip (CG-ICS) for the analysis of fentanyl in urine and serum. Under optimum conditions, the anti-fentanyl mAb belonging to the subtype of IgG2b showed a half-maximal inhibitory concentration (IC50) of 0.11 ng mL-1 and a linear range of detection of 0.020-0.50 ng mL-1. Fenanyl-spiked original urine and serum diluted eight times were used for the analysis of fentanyl by ic-ELISA and CG-ICS. IC50 from the standard curves was 0.46 ng mL-1 for urine and 2.6 ng mL-1 for serum in ic-ELISA and 1.6 ng mL-1 for urine and 6.27 ng mL-1 for serum in CG-ICS. The recovery test revealed that the ic-ELISA and CG-ICS, with a recovery rate of 87.0-108.4% and a coefficient of variation of 3.3-10.9%, were the same reliable tools as the liquid chromatography tandem mass spectrometry for fentanyl analysis in real samples.
Collapse
Affiliation(s)
- Xianlu Lei
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China. and International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Xinxin Xu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China. and International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Liqiang Liu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China. and International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Hua Kuang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China. and International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Liguang Xu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China. and International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Changlong Hao
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China. and International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| | - Chuanlai Xu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China. and International Joint Research Laboratory for Biointerface and Biodetection, and School of Food Science and Technology, Jiangnan University, Wuxi, People's Republic of China
| |
Collapse
|
4
|
Wallgren J, Vikingsson S, Rautio T, Nasr E, Åstrand A, Watanabe S, Kronstrand R, Gréen H, Dahlén J, Wu X, Konradsson P. Structure Elucidation of Urinary Metabolites of Fentanyl and Five Fentanyl Analogs using LC-QTOF-MS, Hepatocyte Incubations and Synthesized Reference Standards. J Anal Toxicol 2021; 44:993-1003. [PMID: 32104892 PMCID: PMC7819469 DOI: 10.1093/jat/bkaa021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Fentanyl analogs constitute a particularly dangerous group of new psychoactive compounds responsible for many deaths around the world. Little is known about their metabolism, and studies utilizing liquid chromatography–quadrupole time-of-flight mass spectrometry (LC–QTOF-MS) analysis of hepatocyte incubations and/or authentic urine samples do not allow for determination of the exact metabolite structures, especially when it comes to hydroxylated metabolites. In this study, seven motifs (2-, 3-, 4- and β-OH as well as 3,4-diOH, 4-OH-3-OMe and 3-OH-4-OMe) of fentanyl and five fentanyl analogs, acetylfentanyl, acrylfentanyl, cyclopropylfentanyl, isobutyrylfentanyl and 4F-isobutyrylfentanyl were synthesized. The reference standards were analyzed by LC–QTOF-MS, which enabled identification of the major metabolites formed in hepatocyte incubations of the studied fentanyls. By comparison with our previous data sets, major urinary metabolites could tentatively be identified. For all analogs, β-OH, 4-OH and 4-OH-3-OMe were identified after hepatocyte incubation. β-OH was the major hydroxylated metabolite for all studied fentanyls, except for acetylfentanyl where 4-OH was more abundant. However, the ratio 4-OH/β-OH was higher in urine samples than in hepatocyte incubations for all studied fentanyls. Also, 3-OH-4-OMe was not detected in any hepatocyte samples, indicating a clear preference for the 4-OH-3-OMe, which was also found to be more abundant in urine compared to hepatocytes. The patterns appear to be consistent across all studied fentanyls and could serve as a starting point in the development of methods and synthesis of reference standards of novel fentanyl analogs where nothing is known about the metabolism.
Collapse
Affiliation(s)
- Jakob Wallgren
- Department of Physics, Chemistry and Biology, Linköping University, Linköping 58183, Sweden
| | - Svante Vikingsson
- Division of Drug Research, Department of Medical and Health Sciences, Linköping University, Linköping 58185, Sweden.,Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping 58758, Sweden
| | - Tobias Rautio
- Department of Physics, Chemistry and Biology, Linköping University, Linköping 58183, Sweden
| | - Enas Nasr
- Department of Physics, Chemistry and Biology, Linköping University, Linköping 58183, Sweden
| | - Anna Åstrand
- Division of Drug Research, Department of Medical and Health Sciences, Linköping University, Linköping 58185, Sweden
| | - Shimpei Watanabe
- Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping 58758, Sweden
| | - Robert Kronstrand
- Division of Drug Research, Department of Medical and Health Sciences, Linköping University, Linköping 58185, Sweden.,Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping 58758, Sweden
| | - Henrik Gréen
- Division of Drug Research, Department of Medical and Health Sciences, Linköping University, Linköping 58185, Sweden.,Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping 58758, Sweden
| | - Johan Dahlén
- Department of Physics, Chemistry and Biology, Linköping University, Linköping 58183, Sweden
| | - Xiongyu Wu
- Department of Physics, Chemistry and Biology, Linköping University, Linköping 58183, Sweden
| | - Peter Konradsson
- Department of Physics, Chemistry and Biology, Linköping University, Linköping 58183, Sweden
| |
Collapse
|
5
|
Pharmacokinetics and pharmacodynamics of cyclopropylfentanyl in male rats. Psychopharmacology (Berl) 2021; 238:3629-3641. [PMID: 34613431 PMCID: PMC8629808 DOI: 10.1007/s00213-021-05981-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 09/06/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND Illicitly manufactured fentanyl and its analogs are a major driving force behind the ongoing opioid crisis. Cyclopropylfentanyl is a fentanyl analog associated with many overdose deaths, but limited knowledge is available about its pharmacology. In the present study, we developed a bioanalytical method for the determination of cyclopropylfentanyl and its main metabolite cyclopropylnorfentanyl and evaluated pharmacokinetic-pharmacodynamic relationships in rats. METHOD An ultra-high performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) method was developed and validated for determination of cyclopropylfentanyl and cyclopropylnorfentanyl in rat plasma. Male Sprague-Dawley rats fitted with jugular catheters and temperature transponders received cyclopropylfentanyl (30, 100, and 300 μg/kg) or saline subcutaneously. Blood specimens were withdrawn over an 8-h time period, along with measurements of pharmacodynamic endpoints. RESULTS The analytical method was validated, and both analytes exhibited a low limit of quantification (15 pg/mL). Cyclopropylfentanyl caused dose-related increases in hot plate latency (ED50 = 48 µg/kg) and catalepsy (ED50 = 87 µg/kg) and produced long-lasting hypothermia at the highest dose. Plasma cyclopropylfentanyl rose rapidly in a dose-related fashion, reaching maximal concentration (Cmax) after 15-28 min, whereas metabolite Cmax occurred later at 45-90 min. Cyclopropylfentanyl Cmax values were similar to concentrations measured in non-fatal intoxications in humans; however, differences in parent drug: metabolite ratio indicated possible interspecies variance in metabolism. CONCLUSION Our study shows that cyclopropylfentanyl produces typical opioid-like effects in male rats. Cyclopropylfentanyl displays much greater analgesic potency when compared to morphine, suggesting that cyclopropylfentanyl poses increased overdose risk for unsuspecting users.
Collapse
|
6
|
Eshleman AJ, Nagarajan S, Wolfrum KM, Reed JF, Nilsen A, Torralva R, Janowsky A. Affinity, potency, efficacy, selectivity, and molecular modeling of substituted fentanyls at opioid receptors. Biochem Pharmacol 2020; 182:114293. [PMID: 33091380 DOI: 10.1016/j.bcp.2020.114293] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/15/2020] [Accepted: 10/15/2020] [Indexed: 01/04/2023]
Abstract
Substituted fentanyls are abused and cause rapid fatal overdose. As their pharmacology is not well characterized, we examined in vitro pharmacology and structure-activity relationships of 22 substituted fentanyls with modifications of the fentanyl propyl group, and conducted in silico receptor/ligand modeling. Affinities for mu, kappa, and delta opioid receptors (MOR, KOR, and DOR, respectively) heterologously expressed in mammalian cells were assessed in agonist radioligand binding assays. At MOR, furanyl fentanyl had higher affinity than fentanyl, while acryl, isobutyryl and cyclopropyl fentanyls had similar affinities. Comparing affinities, thiophene and methoxyacetyl fentanyls had highest selectivity for MOR (2520- and 2730-fold compared to KOR and DOR, respectively). Functional activities were assessed using [35S]GTPγS binding assays. At MOR, furanyl fentanyl had higher potency and 11 substituted fentanyls had similar high potencies compared to fentanyl. Eight compounds were full agonists of MOR and twelve compounds were partial agonists, with efficacies from 8.8% (phenyl fentanyl) to 60.2% (butyryl fentanyl). All efficacious compounds had selective functional potency for MOR. The predicted binding poses of flexible fentanyl and rigid morphine against MOR show partially overlapping binding pockets, with fentanyl maintaining additional interaction with the transmembrane (TM) 2 helix. Subsequent molecular dynamics simulations revealed a predominant fentanyl binding pose involving various TM interactions. The piperidine nitrogen of substituted fentanyls establishes a salt-bridge with the conserved D-1473.32 residue and the propanamide carbonyl group establishes a hydrogen bond with the indole side-chain (-NH) of W-3187.35. The simulation suggests theN-linked phenethyl group may regulate the rotameric switch of W-2936.48. The predicted binding pose, in conjunction with in vitro binding affinity, clarified the molecular basis of the binding/selectivity profile of furanyl fentanyl and other derivatives at the sequence level. In summary, substituted fentanyls with high MOR potencies, selectivities, and efficacies are likely to have abuse and overdose potential. The work presented here is a prototype to investigate fentanyl derivatives and their abuse potential.
Collapse
Affiliation(s)
- Amy J Eshleman
- Research Service, Veterans Affairs Portland Health Care System, Portland, OR, United States; Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States; Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, United States
| | - Shanthi Nagarajan
- Medicinal Chemistry Core, Oregon Health and Science University, Portland, OR, United States
| | - Katherine M Wolfrum
- Research Service, Veterans Affairs Portland Health Care System, Portland, OR, United States
| | - John F Reed
- Research Service, Veterans Affairs Portland Health Care System, Portland, OR, United States
| | - Aaron Nilsen
- Medicinal Chemistry Core, Oregon Health and Science University, Portland, OR, United States
| | - Randy Torralva
- Research Service, Veterans Affairs Portland Health Care System, Portland, OR, United States; Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
| | - Aaron Janowsky
- Research Service, Veterans Affairs Portland Health Care System, Portland, OR, United States; Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States; Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, United States; The Methamphetamine Abuse Research Center, Oregon Health and Science University, Portland, OR, United States.
| |
Collapse
|
7
|
Distinguishing Between Cyclopropylfentanyl and Crotonylfentanyl by Methods Commonly Available in the Forensic Laboratory. Ther Drug Monit 2020; 41:519-527. [PMID: 30807539 DOI: 10.1097/ftd.0000000000000617] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND The opioid analgesic fentanyl and its analogues pose a major health concern due to its high potency and the increasing number of overdose deaths worldwide. The analogues of fentanyl may differ in potency, toxicity, and legal status, and it is therefore important to develop analytical methods for their correct identification. This can be challenging since many fentanyl analogues are structural isomers. Two fentanyl isomers that have been in the spotlight lately due to difficulties regarding separation and identification are cyclopropylfentanyl and crotonylfentanyl, which have been reported to display nearly identical fragmentation patterns and chromatographic behavior. METHODS Chromatographic separation of cyclopropylfentanyl and crotonylfentanyl by ultra-high-performance liquid chromatography was investigated using 3 different stationary phases (high strength silica T3, ethylsiloxane/silica hybrid C18, and Kinetex biphenyl) using gradient elution with a mobile phase consisting of 10 mM ammonium formate pH 3.1 and MeOH. Detection was performed by tandem mass spectrometry. In addition, the major metabolites of the 2 compounds formed on incubation with human liver microsomes were identified by ultra-high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry analysis. RESULTS Baseline separation of cyclopropylfentanyl and crotonylfentanyl was achieved on the ethylsiloxane/silica hybrid C18 column with retention times of 6.79 and 7.35 minutes, respectively. The major metabolites of the 2 analogues formed by human liver microsomes differed, with the main biotransformation being N-dealkylation and carboxylation for cyclopropylfentanyl and crotonylfentanyl, respectively. We demonstrated the usefulness of the 2 approaches by unambiguously identifying cyclopropylfentanyl, as well as its metabolites, in 2 authentic postmortem blood samples. CONCLUSIONS In this study, we successfully demonstrated that cyclopropylfentanyl and crotonylfentanyl can be distinguished by methods commonly available in forensic laboratories.
Collapse
|
8
|
Sofalvi S, Lavins ES, Brooker IT, Kaspar CK, Kucmanic J, Mazzola CD, Mitchell-Mata CL, Clyde CL, Rico RN, Apollonio LG, Goggin C, Marshall B, Moore D, Gilson TP. Unique Structural/Stereo-Isomer and Isobar Analysis of Novel Fentanyl Analogues in Postmortem and DUID Whole Blood by UHPLC–MS-MS. J Anal Toxicol 2019; 43:673-687. [DOI: 10.1093/jat/bkz056] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 03/01/2019] [Accepted: 04/27/2019] [Indexed: 01/05/2023] Open
Abstract
Abstract
The presented analytical method enabled the Toxicology Department at the Cuyahoga County Medical Examiner’s Office to identify 26 and quantitatively report 24 compounds in 500 μL of whole blood, including fentanyl analogues (fentalogues) such as methoxyacetyl fentanyl (MeOAF) and cyclopropyl fentanyl (CPF). This second-generation method (FG2) was developed with the objective to improve the existing analysis (FG1) by decreasing sample size, lowering limits of detection (LOD) and lower limit of quantitation, minimizing ion suppression and resolving chromatographic interferences. Interferences may occur in the analysis of fentanyl, MeOAF, CPF, 3-methylfentanyl (3MF), butyryl fentanyl and isobutyryl fentanyl due to isobars and structural or geometric isomerism with another analogue or metabolite. The isomeric and isobaric fentalogues were grouped into three sets. The LOD established for Set 1 [MeOAF, para-methoxyacetyl fentanyl, para-fluoro acryl fentanyl (isobar), fentanyl carbamate], 2-furanyl fentanyl, Set 2 [CPF, (E)-crotonyl fentanyl] and carfentanil was 0.0125 ng/mL. The LOD established for N-methyl norfentanyl, norfentanyl, norcarfentanil, despropionyl fentanyl (4-ANPP), acetyl fentanyl, β-hydroxy fentanyl, benzyl fentanyl, acryl fentanyl, alfentanil, fentanyl, para-fluoro fentanyl, Set 3 [(±)-trans-3MF, (±)-cis-3MF, isobutyryl and butyryl fentanyl], para-fluoroisobutyryl fentanyl, sufentanil, phenyl fentanyl and cyclopentenyl fentanyl was 0.0625 ng/mL. Seven-point linear calibration curves were established between 0.025 and 4.0 ng/mL for the 8 analytes with the lower LOD and 0.125 and 20 ng/mL for the 18 analytes with the higher LOD. 4-ANPP and cyclopentenyl fentanyl met qualitative reporting criteria only. The results for five postmortem and two driving under the influence of drugs authentic case samples are presented. To the authors’ knowledge, FG2 is the first published method that achieved baseline resolution of the nine structural/stereo isomers and one isobar by ultra-high performance liquid chromatography–MS-MS and provided quantitative validation data for nine compounds. FG2 may be used as the new baseline for future isomers that need to be chromatographically separated.
Collapse
Affiliation(s)
- Szabolcs Sofalvi
- Toxicology Department, Cuyahoga County Medical Examiner’s Office (CCMEO), 11001 Cedar Avenue, Cleveland, OH 44106, USA
| | - Eric S Lavins
- Toxicology Department, Cuyahoga County Medical Examiner’s Office (CCMEO), 11001 Cedar Avenue, Cleveland, OH 44106, USA
| | - Ian T Brooker
- Toxicology Department, Cuyahoga County Medical Examiner’s Office (CCMEO), 11001 Cedar Avenue, Cleveland, OH 44106, USA
| | - Claire K Kaspar
- Toxicology Department, Cuyahoga County Medical Examiner’s Office (CCMEO), 11001 Cedar Avenue, Cleveland, OH 44106, USA
| | - John Kucmanic
- Toxicology Department, Cuyahoga County Medical Examiner’s Office (CCMEO), 11001 Cedar Avenue, Cleveland, OH 44106, USA
| | - Carrie D Mazzola
- Toxicology Department, Cuyahoga County Medical Examiner’s Office (CCMEO), 11001 Cedar Avenue, Cleveland, OH 44106, USA
| | - Christie L Mitchell-Mata
- Toxicology Department, Cuyahoga County Medical Examiner’s Office (CCMEO), 11001 Cedar Avenue, Cleveland, OH 44106, USA
| | - Cassandra L Clyde
- Toxicology Department, Cuyahoga County Medical Examiner’s Office (CCMEO), 11001 Cedar Avenue, Cleveland, OH 44106, USA
| | - Rindi N Rico
- Toxicology Department, Cuyahoga County Medical Examiner’s Office (CCMEO), 11001 Cedar Avenue, Cleveland, OH 44106, USA
| | - Luigino G Apollonio
- Toxicology Department, Cuyahoga County Medical Examiner’s Office (CCMEO), 11001 Cedar Avenue, Cleveland, OH 44106, USA
| | | | | | | | - Thomas P Gilson
- Toxicology Department, Cuyahoga County Medical Examiner’s Office (CCMEO), 11001 Cedar Avenue, Cleveland, OH 44106, USA
| |
Collapse
|
9
|
Cutler C, Hudson S. In vitro metabolism of the novel synthetic opioid agonist cyclopropylfentanyl and subsequent confirmation in authentic human samples using liquid chromatography-high resolution mass spectrometry. Drug Test Anal 2019; 11:1134-1143. [PMID: 31081594 DOI: 10.1002/dta.2611] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 04/12/2019] [Accepted: 04/24/2019] [Indexed: 02/03/2023]
Abstract
Novel synthetic opioids (NSOs) are a class of novel psychoactive substances (NPS) that are growing in popularity and presenting a significant public health risk. Included in this class are derivatives of the highly potent analgesic, fentanyl. Cyclopropylfentanyl (CycP-F) was first reported to the EU Early Warning System in August 2017, and was subsequently linked to more than 100 deaths in the US alone. Limited pharmacological, pharmacokinetic or toxicological data is available for many emerging NSOs; however we can expect novel fentanyl analogues to present limited detection windows, short onset, narrow therapeutic indices and the potential for very high potency. Knowledge of the metabolism of these drugs is essential for the identification of analytical targets for their detection. Therefore in vitro metabolites of CycP-F were produced using human liver microsomal incubations. Metabolites formed were elucidated using liquid chromatography-high resolution accurate mass analysis (LC-HRAM). Identified metabolites were added to our accurate mass screening database for NPS which was utilised for subsequent screening analysis. CycP-F and metabolites were identified in two human blood case samples. Eleven metabolites were identified in vitro, with the major metabolites produced via N-dealkylation, monohydroxylation and N-oxidation. Analysis of the positive case samples identified four in vivo metabolites, all of which were observed in vitro. The major metabolite identified in vitro and in vivo was the N-dealkylated nor-metabolite; two further mono-hydroxylated and one dihydroxylated metabolite were detected in vivo.
Collapse
|
10
|
Chromatographic separation of the isobaric compounds cyclopropylfentanyl, crotonylfentanyl, methacrylfentanyl, and para-methylacrylfentanyl for specific confirmation by LC-MS/MS. J Chromatogr B Analyt Technol Biomed Life Sci 2019; 1118-1119:164-170. [DOI: 10.1016/j.jchromb.2019.04.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/12/2019] [Accepted: 04/15/2019] [Indexed: 11/19/2022]
|
11
|
Wilde M, Pichini S, Pacifici R, Tagliabracci A, Busardò FP, Auwärter V, Solimini R. Metabolic Pathways and Potencies of New Fentanyl Analogs. Front Pharmacol 2019; 10:238. [PMID: 31024296 PMCID: PMC6461066 DOI: 10.3389/fphar.2019.00238] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 02/26/2019] [Indexed: 12/11/2022] Open
Abstract
Up to now, little is known about the metabolic pathways of new fentanyl analogs that have recently emerged on the drug markets worldwide with high potential for producing addiction and severe adverse effects including coma and death. For some of the compounds, limited information on the metabolism has been published, however, for others so far no information is available. Considering the well characterized metabolism of the pharmaceutically used opioid fentanyl and the so far available data, the metabolism of the new fentanyl analogs can be anticipated to generally involve reactions like hydrolysis, hydroxylation (and further oxidation steps), N- and O-dealkylation and O-methylation. Furthermore, phase II metabolic reactions can be expected comprising glucuronide or sulfate conjugate formation. When analyzing blood and urine samples of acute intoxication cases or fatalities, the presence of metabolites can be crucial for confirmation of the uptake of such compounds and further interpretation. Here we present a review on the metabolic profiles of new fentanyl analogs responsible for a growing number of severe and fatal intoxications in the United States, Europe, Canada, Australia, and Japan in the last years, as assessed by a systematic search of the scientific literature and official reports.
Collapse
Affiliation(s)
- Maurice Wilde
- Department of Forensic Toxicology, Institute of Forensic Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany.,Hermann Staudinger Graduate School, University of Freiburg, Freiburg im Breisgau, Germany
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Roberta Pacifici
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Adriano Tagliabracci
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Excellence SBSP, Università Politecnica delle Marche, Ancona, Italy
| | - Francesco Paolo Busardò
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Excellence SBSP, Università Politecnica delle Marche, Ancona, Italy
| | - Volker Auwärter
- Department of Forensic Toxicology, Institute of Forensic Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Renata Solimini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| |
Collapse
|
12
|
Varshneya NB, Walentiny DM, Moisa LT, Walker TD, Akinfiresoye LR, Beardsley PM. Opioid-like antinociceptive and locomotor effects of emerging fentanyl-related substances. Neuropharmacology 2019; 151:171-179. [PMID: 30904478 DOI: 10.1016/j.neuropharm.2019.03.023] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 02/27/2019] [Accepted: 03/16/2019] [Indexed: 10/27/2022]
Abstract
The emergence of several fentanyl-related substances in the recreational drug marketplace has resulted in a surge of opioid overdose deaths in the United States. Many of these substances have never been examined in living organisms under controlled conditions. In the present study, seven fentanyl-related substances were tested in adult male Swiss Webster mice for their effects on locomotion and antinociception and compared to those of fentanyl and morphine. In locomotor activity tests, fentanyl (1, 10 mg/kg), morphine (100, 180 mg/kg), isobutyrylfentanyl (10 mg/kg), crotonylfentanyl (10 mg/kg), para-fluorobutyrylfentanyl (10, 100 mg/kg), para-methoxybutyrylfentanyl (10 mg/kg), thiophenefentanyl (100 mg/kg), and benzodioxolefentanyl (0.1 mg/kg) produced significant (p ≤ 0.05) dose-dependent increases in locomotion. Valerylfentanyl, however, was without effects on locomotion up to 100 mg/kg. In warm-water tail-withdrawal tests, all substances produced significant (p ≤ 0.05) dose-dependent increases in antinociception with increasing ED50 values (CI) of isobutyrylfentanyl [0.0768 mg/kg (0.044-0.128)] > fentanyl [0.0800 mg/kg (0.0403-0.164)] > para-methoxybutyrylfentanyl [0.106 mg/kg (0.0516-0.195)] > crotonylfentanyl [0.226 mg/kg (0.176-0.292)] > para-fluorobutyrylfentanyl [0.908 mg/kg (0.459-1.58)] > thiophenefentanyl [4.66 mg/kg (3.65-5.95)] > valerylfentanyl [6.43 mg/kg (3.91-10.5)] > morphine [7.82 mg/kg (5.42-11.0)] > benzodioxolefentanyl [46.3 mg/kg (25.8-83.4)]. Naltrexone (1 mg/kg) increased antinociceptive ED50 values several fold in decreasing magnitudes of isobutyrylfentanyl (233x) > para-methoxybutyrylfentanyl (37.7x) > thiophenefentanyl (34.6x) > valerylfentanyl (11.9x) > para-fluorobutyrylfentanyl (10.9x) > benzodioxolefentanyl (8.42x) > crotonylfentanyl (6.27x) > fentanyl (3.95x) > morphine (1.48x). These findings establish that locomotor and antinociceptive effects of several fentanyl-related substances are similar to those of morphine and fentanyl and are mediated by opioid receptors.
Collapse
Affiliation(s)
- Neil B Varshneya
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, USA
| | - D Matthew Walentiny
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, USA
| | - Lea T Moisa
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, USA
| | - Teneille D Walker
- Diversion Control Division, Drug Enforcement Administration, United States Department of Justice, Springfield, VA, USA
| | - Luli R Akinfiresoye
- Diversion Control Division, Drug Enforcement Administration, United States Department of Justice, Springfield, VA, USA
| | - Patrick M Beardsley
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, USA.
| |
Collapse
|
13
|
Roda G, Faggiani F, Bolchi C, Pallavicini M, Dei Cas M. Ten Years of Fentanyl-like Drugs: a Technical-analytical Review. ANAL SCI 2019; 35:479-491. [PMID: 30686797 DOI: 10.2116/analsci.18r004] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Synthetic opioids, such as fentanyl and its analogues, are a new public health warning. Clandestine laboratories produce drug analogues at a faster rate than these compounds can be controlled or scheduled by drug agencies. Detection requires specific testing and clinicians may be confronted with a sequence of severe issues concerning the diagnosis and management of these contemporary opioid overdoses. This paper deals with methods for biological sample treatment, as well as the methodologies of analysis that have been reported, in the last decade, in the field of fentanyl-like compounds. From this analysis, it emerges that the gold standard for the identification and quantification of 4-anilinopiperidines is LC-MS/MS, coupled with liquid-liquid or solid-phase extraction. In the end, the return to the scene of illicit fentanyls can be considered as a critical problem that can be tackled only with a global multidisciplinary approach.
Collapse
Affiliation(s)
- Gabriella Roda
- Department of Pharmaceutical Sciences, University of Milan
| | | | | | | | | |
Collapse
|
14
|
Mallette JR, Casale JF, Hays PA. Characterization and differentiation of cyclopropylfentanyl from E-crotonylfentanyl, Z-crotonylfentanyl, and 3-butenylfentanyl. Sci Justice 2019; 59:67-74. [DOI: 10.1016/j.scijus.2018.07.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 07/16/2018] [Accepted: 07/22/2018] [Indexed: 11/28/2022]
|
15
|
Brockbals L, Staeheli SN, Gentile S, Schlaepfer M, Bissig C, Bolliger SA, Kraemer T, Steuer AE. Fatal poisoning involving cyclopropylfentanyl - Investigation of time-dependent postmortem redistribution. Forensic Sci Int 2018; 294:80-85. [PMID: 30497048 DOI: 10.1016/j.forsciint.2018.11.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/07/2018] [Accepted: 11/12/2018] [Indexed: 10/27/2022]
Abstract
A growing number of fatal overdoses involving opioid drugs, in particular involving fentanyl and its analogues, pose an immense threat to public health. Postmortem casework of forensic toxicologists in such cases is challenging, as data on pharmacodynamic and pharmacokinetic properties as well as reference values for acute toxicities and data on potential postmortem redistribution (PMR) mechanisms often do not exist. A fatal case involving cyclopropylfentanyl was investigated at the Zurich Institute of Forensic Medicine and the Zurich Forensic Science Institute; an unknown powder found at the scene was reliably identified as cyclopropylfentanyl by gas chromatography-infrared spectroscopy (GC-IR). Femoral blood samples were collected at two time points after death; 11h postmortem (t1) and during the medico-legal autopsy 29h after death (t2). At the autopsy, additional samples from the heart blood, urine and gastric content were collected. Cyclopropylfentanyl was quantified using a validated liquid chromatography-tandem mass spectrometric (LC-MS/MS) method. Femoral blood concentration of cyclopropylfentanyl at autopsy was 19.8ng/mL (t1=15.7ng/mL; heart blood concentration at autopsy=52.4ng/mL). In the light of the current literature and under the exclusion that no other morphological findings could explain the cause of death, contribution of cyclopropylfentanyl to death was proposed (polydrug use). Significant postmortem concentration increases of cyclopropylfentanyl in femoral blood during 18h after the first sampling were observed, thus indicating a relevant potential to undergo PMR. A central-to-peripheral blood concentration ratio of 2.6 supports this. Consequently, the current case suggests that postmortem cyclopropylfentanyl concentration should always be interpreted with care.
Collapse
Affiliation(s)
- Lana Brockbals
- Department of Forensic Pharmacology and Toxicology, Zurich Institute of Forensic Medicine, University of Zurich, Switzerland
| | - Sandra N Staeheli
- Department of Forensic Pharmacology and Toxicology, Zurich Institute of Forensic Medicine, University of Zurich, Switzerland
| | - Simon Gentile
- Department of Forensic Medicine & Imaging, Zurich Institute of Forensic Medicine, University of Zurich, Switzerland
| | | | | | - Stephan A Bolliger
- Department of Forensic Medicine & Imaging, Zurich Institute of Forensic Medicine, University of Zurich, Switzerland
| | - Thomas Kraemer
- Department of Forensic Pharmacology and Toxicology, Zurich Institute of Forensic Medicine, University of Zurich, Switzerland
| | - Andrea E Steuer
- Department of Forensic Pharmacology and Toxicology, Zurich Institute of Forensic Medicine, University of Zurich, Switzerland.
| |
Collapse
|
16
|
Brede WR, Krabseth HM, Michelsen LS, Aarset H, Jamt JP, Slørdal L. A Wolf in Sheep’s Clothing. J Anal Toxicol 2018; 43:e7-e8. [DOI: 10.1093/jat/bky080] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 08/31/2018] [Accepted: 09/19/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Wenche Rødseth Brede
- Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
| | - Hege-Merete Krabseth
- Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
| | | | - Harald Aarset
- Department of Pathology and Medical Genetics, St. Olav University Hospital, Trondheim, Norway
| | | | - Lars Slørdal
- Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| |
Collapse
|
17
|
Kennedy JH, Palaty J, Gill CG, Wiseman JM. Rapid analysis of fentanyls and other novel psychoactive substances in substance use disorder patient urine using paper spray mass spectrometry. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2018; 32:1280-1286. [PMID: 29757475 DOI: 10.1002/rcm.8164] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 05/02/2018] [Accepted: 05/02/2018] [Indexed: 05/28/2023]
Abstract
RATIONALE Drug overdose deaths due to fentanyls and other novel psychoactive substances (NPS) are on the rise. The higher potencies of fentanyl analogs compared with morphine require new technologies to identify and quantitate NPS. METHODS Paper spray tandem mass spectrometry (MS/MS) and high-resolution mass spectrometry were used to identify and measure fentanyl analogs as well as common drugs of abuse in urine samples from substance use disorder clinics. Ten-microliter urine samples were deposited directly on paper spray cartridges previously loaded with internal standards, dried, and analyzed with no other sample treatment. Quantitative results were obtained using MS/MS. Individual drugs were identified using high-resolution accurate mass spectrometry, and confirmed by data-dependent MS/MS. RESULTS Calibration curves in urine were linear over a range of 0.5-50 ng/mL with R2 of 0.99 or better for eight representative fentanyl analogs. Cartridges preloaded with internal standards demonstrated satisfactory quantitative results compared with LC/MS. Direct identification and confirmation of fentanyl analogs and other common drugs of abuse in urine using high-resolution accurate mass and MS/MS fragmentation were demonstrated at low picogram levels. CONCLUSIONS Paper spray mass spectrometry can reliably identify and quantitate fentanyl analogs and other drugs of abuse in urine. Using paper spray cartridges as collection devices reduces exposure and transportation risks associated with biological fluids. Cartridges preloaded with labeled internal standards can be effective for targeted screening of fentanyl analogs and other drugs of abuse.
Collapse
Affiliation(s)
| | - Jan Palaty
- LifeLabs Medical Laboratory Services, Burnaby, BC, V5G 4V8, Canada
| | - Chris G Gill
- Vancouver Island University, Applied Environmental Research Laboratories (AERL), Chemistry Department, Nanaimo, BC, V9R 5S5, Canada
- University of Victoria, Department of Chemistry, Victoria, BC, V8P 5C2, Canada
- Simon Fraser University, Department of Chemistry, Burnaby, BC, V5A 1S6, Canada
- University of Washington, Department of Environmental and Occupational Health Sciences, Seattle, WA, 98195, USA
| | | |
Collapse
|
18
|
Maher S, Elliott SP, George S. The analytical challenges of cyclopropylfentanyl and crotonylfentanyl: An approach for toxicological analysis. Drug Test Anal 2018; 10:1483-1487. [PMID: 29803198 DOI: 10.1002/dta.2417] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 05/18/2018] [Accepted: 05/22/2018] [Indexed: 11/12/2022]
Abstract
New psychoactive substances (NPS) are increasingly being seen in forensic casework globally and encompass a number of types of drugs including "designer opioids", especially fentanyl analogues, which are of particular concern due to their high potency and significant risk of toxicity. They are often sold as heroin or mixed with other illicit drugs and therefore users may be unaware they are taking such hazardous compounds. Two fentanyl analogues that have recently been detected are cyclopropylfentanyl and crotonylfentanyl. In order to accurately determine the prevalence of such compounds in clinical and forensic casework, including potential toxicity, they need to be correctly identified using definitive and defensible techniques. Cyclopropylfentanyl and crotonylfentanyl are structural isomers, and it has previously been highlighted that these 2 compounds are analytically difficult to specifically identify owing to their similarity in structure and chromatographic behaviour. To further investigate in an attempt to overcome this problem, analysis of certified reference material using high performance liquid chromatography with diode array UV detection (HPLC-DAD), liquid chromatography-tandem mass spectrometry (LC-MS/MS), and liquid chromatography-quadrupole time-of-flight-mass spectrometry (LC-QToF-MS) has been performed. Whilst the compounds were shown to have an identical mass-spectral fragmentation pattern, they had different UV spectra. This was coupled with a discernible difference in retention time with the HPLC conditions applied, allowing differentiation of the 2 compounds. Using this approach, cyclopropylfentanyl was positively identified and subsequently quantified in 4 fatalities with the exclusion of crotonylfentanyl.
Collapse
Affiliation(s)
- Shane Maher
- Alere Forensics, Malvern Hills Science Park, Geraldine Road, Malvern, WR14 3SZ, UK
| | - Simon P Elliott
- Alere Forensics, Malvern Hills Science Park, Geraldine Road, Malvern, WR14 3SZ, UK
| | - Steve George
- Alere Forensics, Malvern Hills Science Park, Geraldine Road, Malvern, WR14 3SZ, UK
| |
Collapse
|