A rapid method to screen poisoning causative agents in an acute care hospital in Japan

A simple, rapid analysis is required to simultaneously analyse medicinal toxicants in emergency medical care. In this regard, the analysis of blood samples by LC-MS/MS equipped with a spin column, involving a rapid, simple pretreatment, has attracted attention. In this study, sample pretreatment using a Monospin C18 column was performed to screen 11 medicinal toxicants in blood samples by LC-MS/MS.

Serum samples supplemented with 11 medical toxicants-acetaminophen, salicylic acid, nitrazepam, diphenhydramine, bromvalerylurea, phenobarbital, amitriptyline, risperidone, fenitrothion, malathion and methomyl-were pretreated with the Monospin C18 column according to Pretreatment I and Pretreatment II, followed by LC-MS/MS analysis.

All toxicants were not detected by a single pretreatment method but were detected by two pretreatment methods. According to Pretreatment I, 10 medicinal toxicants-excluding salicylic acid-were detected. The recovery rates of all medicinal toxicants, except acetaminophen and methomyl, were greater than or equal to 80%. Salicylic acid was detected by Pretreatment II, with a recovery rate of 57.1%. Although the coefficient of variation was less than that reported in previous methods employing SPE, the recovery rates were better possibly because of the simultaneous adsorption of water- and lipid-soluble substances and evaporation by drying.

As LC-MS/MS analysis using Monospin C18 can simultaneously and rapidly screen several medicinal toxicants present in blood samples, it is expected to be highly suitable for clinical settings.