Novel Trends in Analytical Methods for β-Blockers: An Overview of Applications in the Last Decade

Real-world research on beta-blocker usage trends in China and safety exploration based on the FDA Adverse Event Reporting System (FAERS)

BACKGROUND

Beta-blockers are widely used, with continuously updated clinical recommendations. However, their application faces challenges in personalized treatment and safety. The study aimed to investigate the frequency and patterns of prescribing beta-blockers in China and to explore potential adverse event risk signals associated with beta-blockers, providing reference for rational medication use in clinical settings.

METHODS

Prescription data for beta-blockers from January 2018 to June 2023 were extracted through the Hospital Prescription Analysis Collaborative Project in China to analyze clinical usage trends. While adverse drug reaction reports for beta-blockers were obtained from the FDA Adverse Event Reporting System (FAERS) database. The classification and standardization of adverse drug event (ADE) reports were based on the preferred terms (PT) and corresponding system organ classes (SOC) from the Medical Dictionary for Regulatory Activities (MedDRA). Signal detection utilized a proportion imbalance method.

RESULTS

In clinical practice, metoprolol dominated beta-blocker prescriptions in China, accounting for 62.2%. Beta-blockers were primarily prescribed to the elderly (65.7%) and male patients (57.0%). However, off-label use of beta-blockers was relatively widespread. For instance, sotalol was prescribed for hypertension at 18.25%, while esmolol was used for angina and heart failure at rates of 12.94% and 14.98%, respectively. In addition, we identified newly discovered adverse reactions associated with beta-blockers, such as BRASH syndrome (metoprolol: n = 186, ROR = 391.285; carvedilol: n = 72, ROR = 256.459), acute kidney injury (bisoprolol: n = 247, ROR = 5.641), premature baby (labetalol: n = 110, ROR = 91.385), and sleep disorder (propranolol: n = 254, ROR = 10.98).

CONCLUSIONS

Metoprolol led the beta-blocker market in China. Attention was warranted regarding the newly discovered adverse reactions, such as the risk of acute kidney injury with bisoprolol and the potential for BRASH syndrome with metoprolol and carvedilol.

Application of UHPLC-QqQ-MS/MS Method for Quantification of Beta-Adrenergic Blocking Agents (β-Blockers) in Human Postmortem Specimens

Betablockers are one of the most frequently used medications in cardiology. They can lead to fatal drops in blood pressure and heart rhythm disturbances. Death is functional, and poisoning with this group of drugs can be difficult to detect. The liquid-liquid extraction (LLE) method developed using ethyl acetate at pH 9 successfully identified 18 β-blockers in human blood. The method's limit of quantification (LOQ) was in the range of 0.1 to 0.5 ng/mL. No carryover of substances between samples was detected, and no interfering ion current signals were observed in the biological samples at the retention times of the compounds or internal standards. All compounds had a coefficient of determination (R2) above 0.995. Intraday and interday precision (RSD%) and accuracy (RE%) for low and high QC levels were within 1.7-12.3% and -14.4 to 14.1%, respectively. Very good recovery (80.0-119.6%) and matrix effect (±20.0%) values were achieved for all compounds. In addition, fragmentation spectra were collected for all the examined substances, and high-resolution spectra were presented for landiolol and metipranolol, because they are not available in commercial HRMS spectra databases. The developed method was applied in authentic postmortem samples.

Lab-in-syringe automated protein precipitation and salting-out homogenous liquid-liquid extraction coupled online to UHPLC-MS/MS for the determination of beta-blockers in serum

A sample preparation method involving tandem implementation of protein precipitation and salting-out homogenous liquid-liquid extraction was developed for the determination of beta-blockers in serum. The entire procedure was automated using a computer-controlled syringe pump following the Lab-In-Syringe approach. It is based on the denaturation of serum proteins with acetonitrile followed by salt-induced phase separation upon which the proteins accumulate as a compact layer at the interphase of the solutions. The extract is then separated and diluted in-syringe before being submitted to online coupled UHPLC-MS/MS. A 1 mL glass syringe containing a small stir bar for solution mixing at up to 3000 rpm, was used to deal with sample volumes as small as 100 μL. A sample throughput of 7 h^-1 was achieved by performing the chromatographic run and sample preparation procedure in parallel. Linear working ranges were obtained for all analytes between 5 and 100 ng mL^-1, with LOD values ranging from 0.4 to 1.5 ng mL^-1. Accuracy values in the range of 88.2-106% and high precision of <11% RSD suggest applicability for routine analysis that can be further improved using deuterated standards.

Analysis of β-blockers and β2-agonists in environmental and biological samples by magnetic solid-phase extraction combined with high-performance liquid chromatography-tandem mass spectrometry

β-Blockers and β2-agonists are commonly prescribed for therapeutic treatments and are also administered to livestock, leading to their presence in both environmental and biological samples. Hence, the development of sensitive, rapid, and reliable analytical methods for the determination of β-blockers and β2-agonists in environmental and biological samples is important. In this study, MIL-101(Cr)-NH₂ &GO-coated SiO₂ /Fe₃ O₄ magnetic particles were prepared as sorbents for magnetic solid-phase extraction and then combined with high-performance liquid chromatography-tandem mass spectrometry for the analysis of 20 β-blockers and eight β2-agonists. The experimental parameters of magnetic solid-phase extraction were studied in detail, and the optimal conditions were established. Under optimal conditions, the limits of detection were in the range of 0.002-0.007 μg/L with enrichment factors of 20.2-24.9. The developed method was successfully applied for the determination of 20 β-blockers and eight β2-agonists in river water, human urine, and freeze-dried pork liver powder. Bisoprolol and salbutamol were detected at concentrations of 2.78 mg/L in human urine and 11.5 μg/kg in freeze-dried pork liver powder.

Multi-functional porous organic polymers for highly-efficient solid-phase extraction of β-agonists and β-blockers in milk

A simple, accurate, and highly sensitive analytical method was developed in this study for the determination of ten β-agonists and five β-blockers in milk. In this method, new adsorbent phosphonic acid-functionalized porous organic polymers were synthesized through a direct knitting method. The synthesis procedure of the materials and the extraction conditions (such as the composition of loading buffer and eluent) were optimized. Benefitting from the high surface area (545–804 m² g⁻¹), multiple functional framework and good porosity, the phosphonic acid-functionalized porous organic polymers showed a high adsorption rate and high adsorption capacity for β-agonists (224 mg g⁻¹ and 171 mg g⁻¹ for clenbuterol and ractopamine, respectively). The analytes were quantified by ultra-high-performance liquid chromatography coupled to high-resolution tandem mass spectrometry. It showed a good linearity (with R² ranging from 0.9950 to 0.9991 in the linear range of 3–5 orders of magnitude), with low limits of quantification ranging from 0.05 to 0.25 ng g⁻¹. The limits of detection of the method for the analytes were measured to be in the range of 0.02 to 0.1 ng g⁻¹. The recoveries of target analytes from real samples on the material were in the range of 62.4–119.4% with relative standard deviations of 0.6–12.1% (n = 4). Moreover, good reproducibility of the method was obtained with the interday RSD being lower than 11.7% (n = 5) and intraday RSD lower than 12.2% (n = 4). The proposed method was accurate, reliable and convenient for the simultaneous analysis of multiple β-agonists and β-blockers. Finally, the method was successfully applied for the analysis of such compounds in milk samples.

Novel phosphonic acid-functionalized porous organic polymers were synthesized through direct knitting method. It shows high adsorption efficiency and high adsorption capacity for multiple β-agonists and β-blockers analysis.

Analytical Methods for Determination of Antiviral Drugs in Different Matrices: Recent Advances and Trends

Viruses are the main pathogenic substances that cause severe diseases in humans and other living things. They are among the most common microorganisms, and consequently, antiviral drugs have emerged to prevent and treat viral infections. Antiviral drugs are an essential drug group considering their prescription and consumption rates for different diseases and indications. Therefore, it is crucial to develop accurate and precise analytical methods to detect antiviral drugs in various matrices. Chromatographic techniques are used frequently for the quantification purpose since they allow simultaneous determination of antivirals. Electrochemical methods have also gained importance since the analysis can be performed quickly without the need for pretreatment. Spectrophotometric and spectrofluorimetric methods are used because they are simple, inexpensive, and less time-consuming methods. The purpose of this review is to present an overview of the analysis of currently used antiviral drugs from 2010 to 2021. Since studies on antiviral drugs are numerous, selected publications were reviewed in this article. The analysis of antiviral drugs was divided into three main groups: chromatographic, spectrometric, and electrochemical methods which were applied to different matrices, including pharmaceutical, biological, and environmental samples.

Fast fabric phase sorptive extraction of selected β-blockers from human serum and urine followed by UHPLC-ESI-MS/MS analysis

A fast fabric phase sorptive extraction method is presented herein for the rapid isolation of selected beta-blocker drugs from human serum and urine. Among many high efficiency sol-gel sorbent coated FPSE membranes, sol-gel CW20 M coated FPSE membrane was identified as the best FPSE membrane for the target beta-blocker drugs possessing logP values ranging from 0.1 (highly polar) to 3.1 (moderately polar). Due to the engineered affinity towards the analytes via complementary intermolecular interactions and high mass transfer rate of the analytes from the bulk sample solution to the FPSE membrane, the extraction is accomplished in relatively short time (15 min) while its high permeability permits the direct extraction of biological samples without any other pretreatment. The advantages of the fabricated extraction membrane were exploited for the determination of six beta-blockers (namely atenolol, nadolol, metoprolol, oxprenolol, labetalol and propranolol) in biological matrices in combination with UHPLC-ESI-MS/MS. Important parameters including extraction time, sample volume, sorbent size, elution solvent, etc. affecting the performance of the extraction were systematically investigated. The linearity of the method was evaluated in the range of 50-5000 ng mL^-1 by constructing weighted (1/X) matrix-matched calibration curves. The intra-day and inter-day trueness were ranged between - 17.2 to 13.3% and - 10.8 to 12.6%, respectively. The intra-day and inter-day precision were less than 11.5 and 14.5 %, respectively. The proposed analytical scheme was successfully applied to the determination of the target drugs in human serum and urine.

Vortex assisted liquid-liquid microextraction based on in situ formation of a natural deep eutectic solvent by microwave irradiation for the determination of beta-blockers in water samples

In this study, a simple, green, and reliable method combining vortex-assisted liquid-liquid microextraction based on in situ formation of a novel hydrophobic natural deep eutectic solvent (NADES-VA-LLME) and high-performance liquid chromatography (HPLC) was developed for the determination of metoprolol and propranolol in water samples. The novel NADES was synthesized in situ within only 20 s by subjecting the water sample containing azelaic acid and thymol to microwave irradiation at 50 ˚C. Initial studies indicated that a 17:1 ratio of thymol to azelaic acid yielded the highest response for analytes. The influence of 7 parameters, including NADES volume, salt amount, sample pH, vortex time, centrifugation time, microwave time, and temperature, were screened using a 2^7-3 fractional factorial design. The obtained significant parameters were optimized by response surface methodology employing a Box-Behnken design. The method displayed satisfactory linearity (r=0.9996) for metoprolol and propranolol with limits of detection of 0.2 and 0.1 µg/L, respectively. The relative standard deviation at 2.5, 40, and 80 µg/L levels was lower than 6%, with accuracy in the range of 90.8-100.2%. Enrichment factors were 147.0 and 144.4 for metoprolol and propranolol, respectively. This study demonstrates that the developed in situ NADES-VA-LLME-HPLC technique can be considered as a fast and environmentally friendly alternative for isolation/preconcentration of β-blockers from water samples.

Advantages and Pitfalls of Capillary Electrophoresis of Pharmaceutical Compounds and Their Enantiomers in Complex Samples: Comparison of Hydrodynamically Opened and Closed Systems

Several research disciplines require fast, reliable and highly automated determination of pharmaceutically active compounds and their enantiomers in complex biological matrices. To address some of the challenges of Capillary Electrophoresis (CE), such as low concentration sensitivity and performance degradation linked to the adsorption and interference of matrix components, CE in a hydrodynamically closed system was evaluated using the model compounds Pindolol and Propranolol. Some established validation parameters such as repeatability of injection efficiency, resolution and sensitivity were used to assess its performance, and it was found to be broadly identical to that of hydrodynamically opened systems. While some reduction in separation efficiency was observed, this was mainly due to dispersion caused by injection and it had no impact on the ability to resolve enantiomers of model compounds even when spiked into complex biological matrix such as blood serum. An approximately 18- to 23-fold increase in concentration sensitivity due to the employment of wide bore capillaries was observed. This brings the sensitivity of CE to a level similar to that of liquid chromatography techniques. In addition to this benefit and unlike in hydrodynamically opened systems, suppression of electroosmotic flow, which is essential for hydrodynamically closed systems practically eliminates the matrix effects that are linked to protein adsorption.