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Quantitative, Multidrug Pain Medication Testing by Liquid Chromatography: Tandem Mass Spectrometry (LC-MS/MS)
1Pathology and Laboratory Medicine Service, VA Eastern Colorado Health Care System, PLMS 113, 1055 Clermont St, Denver, CO, 80220, USA. geza.bodor@va.gov.
Methods in Molecular Biology (Clifton, N.J.)
|December 15, 2015
Summary
This study presents a method for simultaneously measuring 43 drugs in urine, aiding in minimizing side effects, detecting multidrug abuse, and preventing prescription drug diversion.
Area of Science:
- Clinical Chemistry
- Forensic Toxicology
- Pharmacology
Background:
- Narcotic analgesics, including opiates and opioids, are crucial for chronic pain but carry risks like respiratory depression, coma, death, tolerance, dependence, and addiction.
- Patients may abuse non-opioid narcotics or divert prescription drugs, necessitating comprehensive monitoring.
- Simultaneous monitoring of numerous prescription and illicit drugs is essential for minimizing side effects, detecting multidrug abuse, and proving diversion.
Purpose of the Study:
- To describe a quantitative method for measuring 43 different drugs in urine.
- To include narcotic pain medications, benzodiazepines, NIDA drugs, and other commonly abused medications in the analytical panel.
- To provide a tool for minimizing side effects, detecting multidrug abuse, and proving drug diversion.
Main Methods:
- Quantitative measurement of 43 drugs in urine using isotope-dilution mass spectrometry (IDMS).
- Utilizes deuterated internal standards to correct for potential extraction inefficiencies and interferences.
- Employs reversed-phase, gradient High-Performance Liquid Chromatography (HPLC) separation on a Phenyl-Hexyl column.
- Detection via triple-quadrupole tandem mass spectrometry with electrospray ionization in positive mode, collecting data in scheduled MRM (sMRM) mode.
- Quantification based on comparing analyte to internal standard peak area ratios against a seven-point calibration curve.
Main Results:
- A validated method for the simultaneous quantitative measurement of 43 drugs in urine.
- The method effectively corrects for interferences using deuterated internal standards.
- Accurate quantification is achieved through comparison with a seven-point calibration curve.
Conclusions:
- This method enables simultaneous monitoring of a wide range of prescription and illicit drugs in urine.
- It serves as a valuable tool for clinicians and forensic toxicologists in managing pain medication, detecting abuse, and addressing drug diversion.
- The IDMS approach ensures reliable and accurate quantification, crucial for patient safety and legal applications.
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