1
|
Sacco MA, Gualtieri S, Spiliopoulou C, Tarallo AP, Verrina MC, Aquila I. The Role of Toxicology Investigations in Overdose Deaths. Cureus 2025; 17:e79352. [PMID: 40125171 PMCID: PMC11929145 DOI: 10.7759/cureus.79352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2025] [Indexed: 03/25/2025] Open
Abstract
Overdose involves the administration of one or more narcotic substances in quantities exceeding the body's tolerance threshold, leading to toxic effects ranging from mild to fatal. The clinical manifestations of an overdose vary depending on the toxic substance's specific molecular action, such as stimulation or suppression of the nervous system. Common toxic agents include synthetic opioids like fentanyl, cocaine, barbiturates, benzodiazepines, and cannabinoids. This study emphasizes the critical role of forensic toxicology in identifying overdose deaths, focusing on the molecular mechanisms of toxicity, post-mortem redistribution, and the interpretation of toxicological findings. Advanced methodologies such as gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) are discussed as pivotal tools for identifying toxic substances and their metabolites. Biological matrices such as blood, urine, vitreous humor, and organ tissues are evaluated for their utility in toxicological investigations. Accurate interpretation of results informs not only the cause of death but also patterns of substance abuse, contributing to the development of preventive strategies. This study highlights the growing complexity of psychoactive substances, emphasizing the necessity for precise and innovative toxicological techniques in forensic practice.
Collapse
Affiliation(s)
- Matteo A Sacco
- Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, ITA
| | - Saverio Gualtieri
- Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, ITA
| | - Chara Spiliopoulou
- Department of Forensic Medicine and Toxicology, National and Kapodistrian University of Athens School of Medicine, Athens, GRC
| | - Alessandro P Tarallo
- Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, ITA
| | - Maria C Verrina
- Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, ITA
| | - Isabella Aquila
- Department of Medical and Surgical Sciences, Institute of Legal Medicine, Magna Graecia University, Catanzaro, ITA
| |
Collapse
|
2
|
Ultra-high performance liquid chromatography-MS/MS (UHPLC-MS/MS) in practice: analysis of drugs and pharmaceutical formulations. FUTURE JOURNAL OF PHARMACEUTICAL SCIENCES 2019. [DOI: 10.1186/s43094-019-0007-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Abstract
Background
UHPLC-MS/MS is connected in various research facilities for the qualitative and quantitative investigation of a pharmaceutical substance, pharmaceutical items, and biological specimen.
Main body
The commence review article is an endeavor to offer pervasive awareness around assorted aspects and details about the UHPLC-MS/MS and related techniques with the aim on practice to an estimation of medicinal active agents in the last 10 years. The article also focused on isolation, separation, and characterization of present impurity in drug and biological samples.
Conclusion
Review article compiles a general overview of medicinally important drugs and their analysis with UHPLC-MS/MS. It gives fundamental thought regarding applications of UHPLC-MS/MS for the study on safety limit. The summary of developed UHPLC-MS/MS methods gives a contribution to the future trend and limitations in this area of research.
Collapse
|
3
|
Franco de Oliveira SCWSE, Zucoloto AD, de Oliveira CDR, Hernandez EMM, Fruchtengarten LVG, de Oliveira TF, Yonamine M. A fast and simple approach for the quantification of 40 illicit drugs, medicines, and pesticides in blood and urine samples by UHPLC-MS/MS. JOURNAL OF MASS SPECTROMETRY : JMS 2019; 54:600-611. [PMID: 31066158 DOI: 10.1002/jms.4369] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 04/29/2019] [Accepted: 04/30/2019] [Indexed: 06/09/2023]
Abstract
A fast and simple approach to overcome challenges in emergency toxicological analysis, using ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) has been developed, for the detection of analytes in blood and urine samples from the following drug classes: analgesics, benzodiazepines, antidepressants, anticonvulsants, drugs of abuse, and pesticides. These substances are relevant in the context of emergency toxicology in Brazil. The sample preparation procedure was relatively easy and fast to perform. The method was fully validated giving limits of in the range of 0.5 and 20 ng mL-1 for blood and urine samples. The intraday and interday precision and accuracy were considered adequate for all analytes once the relative standard deviation (RSD) (%) was lower than 20% for quality control (QC) low and lower than 15% for CQ medium and high. The developed method was successfully applied to 320 real samples collected at the Poison Control Center of São Paulo, and 89.1% have shown to be positive for some of the analytes. This confirms its applicability and importance to emergency toxicological analysis, and it could be very useful in both fields of clinical and forensic toxicology.
Collapse
Affiliation(s)
- Sarah C W S E Franco de Oliveira
- School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP, Brazil
- Pharmacosciences Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil
| | - Alexandre D Zucoloto
- School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP, Brazil
- Poison Control Center of São Paulo, São Paulo, SP, Brazil
| | | | | | | | - Tiago F de Oliveira
- Pharmacosciences Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil
| | - Mauricio Yonamine
- School of Pharmaceutical Sciences, University of São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
4
|
Gheddar L, Feisthauer E, Eibel A, Ameline A, Geraut A, Raul JS, Kintz P. Intoxication aiguë à l’olanzapine : à propos d’un cas de décès. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2018. [DOI: 10.1016/j.toxac.2018.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
5
|
Ruan CJ, Guo W, Zhou M, Guo GX, Wang CY, Li WB, de Leon J. Quantitative determination of risperidone, paliperidone and olanzapine in human serum by liquid chromatography-tandem mass spectrometry coupled with on-line solid-phase extraction. Biomed Chromatogr 2018; 32:e4209. [DOI: 10.1002/bmc.4209] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 01/20/2018] [Accepted: 01/29/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Can-Jun Ruan
- Laboratory of Clinical Psychopharmacology and The National Clinical Research Centre for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital; Capital Medical University; Beijing China
| | - Wei Guo
- Department of Pharmacy and The National Clinical Research Centre for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital; Capital Medical University; Beijing China
| | - Miao Zhou
- Laboratory of Clinical Psychopharmacology and The National Clinical Research Centre for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital; Capital Medical University; Beijing China
| | - Gui-Xin Guo
- Laboratory of Clinical Psychopharmacology and The National Clinical Research Centre for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital; Capital Medical University; Beijing China
| | - Chuan-Yue Wang
- Department of Psychiatry, The National Clinical Research Centre for Mental Disorders and Beijing Key Laboratory of Mental Disorders and Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital; Capital Medical University; Beijing China
| | - Wen-Biao Li
- Laboratory of Clinical Psychopharmacology and The National Clinical Research Centre for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital; Capital Medical University; Beijing China
| | - Jose de Leon
- Mental Health Research Center, Eastern State Hospital; Lexington KY USA
- Psychiatry and Neurosciences Research Group (CTS-549); Institute of Neurosciences, University of Granada; Granada Spain
- Biomedical Research Centre in Mental Health Net, Santiago Apóstol Hospital; University of the Basque Country; Vitoria Spain
| |
Collapse
|
6
|
Graphene nanocomposite modified glassy carbon electrode for voltammetric determination of the antipsychotic quetiapine. Mikrochim Acta 2016. [DOI: 10.1007/s00604-016-1781-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
7
|
Development of MEPS–UHPLC/PDA methodology for the quantification of clozapine, risperidone and their major active metabolites in human urine. Microchem J 2015. [DOI: 10.1016/j.microc.2015.05.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
8
|
Persona K, Madej K, Knihnicki P, Piekoszewski W. Analytical methodologies for the determination of benzodiazepines in biological samples. J Pharm Biomed Anal 2015; 113:239-64. [DOI: 10.1016/j.jpba.2015.02.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 02/05/2015] [Accepted: 02/09/2015] [Indexed: 10/24/2022]
|
9
|
Abstract
AbstractBenzodiazepines (BDZs) are generally commonly used as anxiolytic and/or hypnotic drugs as a ligand of the GABAA-benzodiazepine receptor. Moreover, some of benzodiazepines are widely used as an anti-depressive and sedative drugs, and also as anti-epileptic drugs and in some cases can be useful as an adjunct treatment in refractory epilepsies or anti-alcoholic therapy. High-performance liquid chromatography (HPLC) methods, thin-layer chromatography (TLC) methods, gas chromatography (GC) methods, capillary electrophoresis (CE) methods and some of spectrophotometric and spectrofluorometric methods were developed and have been extensively applied to the analysis of number of benzodiazepine derivative drugs (BDZs) providing reliable and accurate results. The available chemical methods for the determination of BDZs in biological materials and pharmaceutical formulations are reviewed in this work.
Collapse
|
10
|
Ribeiro FW, Mendonça GL, Soares JE, Freire VN, De Souza D, Casciano PN, de Lima-Neto P, Correia AN. Exploiting the Reduction of Haloperidol: Electrochemical and Computational Studies Using Silver Amalgam and HMDE Electrodes. Electrochim Acta 2014. [DOI: 10.1016/j.electacta.2014.06.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
11
|
Wróblewski K, Petruczynik A, Waksmundzka-Hajnos M. Determination of some psychotropic drugs in human plasma by HPTLC. ACTA CHROMATOGR 2014. [DOI: 10.1556/achrom.26.2014.2.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
12
|
López-Guarnido O, Tabernero MJ, Hernández AF, Rodrigo L, Bermejo AM. Rapid determination of quetiapine in blood by gas chromatography-mass spectrometry. Application to post-mortem cases. J Appl Toxicol 2013; 34:1104-8. [DOI: 10.1002/jat.2944] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 09/09/2013] [Accepted: 09/09/2013] [Indexed: 12/11/2022]
Affiliation(s)
- Olga López-Guarnido
- Department of Legal Medicine and Toxicology; University of Granada School of Medicine; Avda. Madrid, 11 18071 Granada Spain
| | - María Jesús Tabernero
- Institute of Legal Medicine, Forensic Toxicology Service, Faculty of Medicine San Francisco; s/n 15782 Santiago de Compostela Spain
| | - Antonio F. Hernández
- Department of Legal Medicine and Toxicology; University of Granada School of Medicine; Avda. Madrid, 11 18071 Granada Spain
| | - Lourdes Rodrigo
- Department of Legal Medicine and Toxicology; University of Granada School of Medicine; Avda. Madrid, 11 18071 Granada Spain
| | - Ana M. Bermejo
- Institute of Legal Medicine, Forensic Toxicology Service, Faculty of Medicine San Francisco; s/n 15782 Santiago de Compostela Spain
| |
Collapse
|