Targeted Opioid Screening Assay for Pain Management Using High-Resolution Mass Spectrometry
Darlington Danso1, Loralie J Langman1, Paul J Jannetto2
1Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
Abstract:
The use and adherence monitoring of opioids in pain management is recommended by numerous clinical practice guidelines. Many physicians use urine immunoassay screening tests, which suffer from a lack of sensitivity and specificity, to verify compliance to pain medications. However, several immunoassay tests are required to comprehensively detect the synthetic, semisynthetic, and natural opioids due to the limited cross-reactivity of each assay. Superior testing strategies are required to specifically identify low concentrations of opioids found in adherent pain management patients. Therefore we present a method for the qualitative identification of 33 opioids and metabolites (codeine, codeine-6-β-glucuronide, morphine, morphine-6-β-glucuronide, 6-acetylmorphine, hydrocodone, norhydrocodone, dihydrocodeine, hydromorphone, hydromorphone-3-β-glucuronide, oxycodone, noroxycodone, oxymorphone, oxymorphone-3-β-glucuronide, noroxymorphone, meperidine, normeperidine, methadone, EDDP, propoxyphene, norpropoxyphene, tramadol, O-desmethyltramadol, tapentadol, tapentadol-β-glucuronide, N-desmethyltapentadol, buprenorphine, norbuprenorphine, norbuprenorphine glucuronide, naloxone, naloxone glucuronide, fentanyl, and norfentanyl) in unhydrolyzed urine using a liquid chromatography tandem mass spectrometry (LC-MS/MS) with high-resolution, accurate-mass Orbitrap detection.
More Related Videos
Related Concept Videos
High-Resolution Mass Spectrometry (HRMS)
Analgesia and Pain Management
Mass Spectrometry: Overview
Tandem Mass Spectrometry
Mass Spectrometry: Isotope Effect
Mass Spectrometry of Amines


