[Selected psychoactive drugs--clinical problems and medical-legal aspects]

The multifarious aspects of psychoactive drug use present a significant challenge to the contemporary analyst. During the first stage of the present experiment, the recovery from human serum and urine of some psychoactive drugs with acidic or basic properties was studied. The efficiency of this process was determined using solutions of drug standards added to serum or urine. Classic liquid-liquid extraction, as well as solid phase extraction methods were compared. The efficiency of recovery was checked using high-performance liquid chromatography (HPLC). The results of this study confirm the usefulness of RP-18 sorbent from Merck and the importance in terms of quantitative analysis of the technique selected for isolation of the xenobiotic from the biological material. The second stage of the experiment was aimed at qualitative determination of some narcotics using thin-layer chromatography (TLC). By stepwise comparison and elimination it was possible to develop an optimal system of chromatographic separation using laminar staining. The proposed system and the conditions for separation ofxenobiotics with six selected elution systems and laminar visualization confirm the feasibility of separating 22 psychoactive drugs. The practical use of the system is limited mainly to screening. Conditions for quantitative analysis of diazepam, tramadol, and pethidine in biological material (serum, urine) using high-performance liquid chromatography, as well as morphine in serum using an immunoenzyme assay have been developed. The procedures have been applied to analysis of narcotics and psychoactive drugs administered prior to anesthesia (morphine, diazepam, pethidine) or for suppression of post-operative pain (morphine, tramadol) in 31 patients of an intensive care unit. 10 ml of blood was drawn at fixed times: 30 minutes prior to surgery (S1), at start of surgery (S2), 60 minutes later (S3), 30 minutes after administration of analgesic (S4), and 60 minutes after administration of analgesic (S5). Urine samples were also collected: immediately after surgery (M1) and 90 minutes after administration of analgesic (M2).