Exploring Cerumen as an Alternative Matrix for Drug Detection and Quantification: Method Development and Application...

Area of Science:

• Forensic Toxicology
• Clinical Chemistry
• Pharmacology

Background:

• Cerumen (earwax) is a complex biological matrix.
• It is emerging as a novel specimen for xenobiotic detection.
• Cerumen analysis has potential clinical and forensic applications.

Purpose of the Study:

• To develop and apply an LC-MS/MS method for detecting 33 psychoactive medications in cerumen and urine.
• To compare drug detection in cerumen and urine in psychiatric inpatients.
• To explore the utility of cerumen for monitoring drug administration.

Main Methods:

• Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was employed.
• Samples of cerumen and urine were collected from 60 psychiatric inpatients.
• Qualitative analysis of 33 psychoactive medications was performed.

Main Results:

• Cerumen and urine results were generally consistent.
• Haloperidol, quetiapine, and nebivolol were detected more frequently in cerumen.
• Drugs were detected in cerumen even without recent administration or when absent in urine.

Conclusions:

• Cerumen is a valuable specimen for detecting psychoactive medications, complementing urine analysis.
• It aids in monitoring acute and chronic drug administration, and even post-cessation.
• Drug disposition in cerumen is complex, influenced by drug properties and physiological pathways.