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Mass Spectrometry: Complex Analysis

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High-throughput and Comprehensive Drug Surveillance Using Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry

High-throughput and Comprehensive Drug Surveillance Using Multisegment Injection-Capillary Electrophoresis-Mass Spectrometry

Published on: April 23, 2019

Benzodiazepine analysis by an improved LC-MS/MS method illustrates usage patterns in Washington State.

Ka Keung Chan¹, Andrea J Moore¹, Andrew N Hoofnagle¹

¹Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA 98195, USA.

Clinica Chimica Acta; International Journal of Clinical Chemistry

|March 19, 2023

Summary

The enhanced liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay improves benzodiazepine detection, identifying new illicit drugs and reducing false positives from immunoassays. This leads to better patient care and laboratory practices.

Keywords:

Designer benzodiazepines Epidemiology False positives LC-MS/MS Validation

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Area of Science:

Clinical Chemistry
Forensic Toxicology
Analytical Chemistry

Background:

The rise in illicit benzodiazepine use necessitates improved detection methods.
Current standard methods involve immunoassay followed by LC-MS/MS.

Purpose of the Study:

To develop and validate an improved LC-MS/MS assay for urine benzodiazepine detection.
To expand the benzodiazepine testing panel and assess immunoassay performance.

Main Methods:

Developed and validated an enhanced LC-MS/MS assay for urine benzodiazepines.
Expanded the drug panel by five, totaling fifteen benzodiazepines.
Compared immunoassay results with LC-MS/MS findings for performance evaluation.

Main Results:

Clonazepam and alprazolam were the most frequently detected benzodiazepines.
Etizolam and flualprazolam showed regional prevalence.
Immunoassays exhibited cross-reactivity, causing false positives/negatives; the enhanced LC-MS/MS assay reduced these inaccuracies.

Conclusions:

Emerging illicit benzodiazepines require updated detection capabilities.
The expanded LC-MS/MS assay accurately characterizes benzodiazepine epidemiology, improving patient care.
This study offers a model for clinical laboratories expanding testing or updating instrumentation.