A fast and simple approach for the quantification of 40 illicit drugs, medicines, and pesticides in blood and urine samples by UHPLC‐MS/MS

Abstract

Based on data collected by the “Information System on Diseases of Compulsory Declaration”, an agency responsible for poisoning notifications in Brazil, just short of 500,000 humans in that country were exposed to xenobiotics during the period 2013‐2017. The most commonly detected substances included medications (e.g., analgesics, benzodiazepines, antidepressants, anticonvulsants), drugs of abuse and pesticides. In this month's Special Feature, a group of investigators report a fast and simple UHPLC‐MS/MS approach for the quantification of 40 of the most important components in the context of emergency toxicology in Brazil. The method reported by Dr. Franco de Oliveira and colleagues is applicable to the analysis of both blood and urine samples. When their method was applied to 320 samples collected at the Poison Control Center, São Paulo, between December 2014 and December 2017, almost 90% of these (i.e., 285/320) tested positive for one or more of the targeted analytes. Of these samples, 58 were positive for blood only, 22 were positive for urine only, and the remaining 205 were positive for both matrices. Of the positive blood samples, 27 shown a concentration higher than the therapeutic or normal ranges. The authors suggest their method delivers the sensitivity, selectivity and speed necessary to aid in the emergency room triage process and to improve emergency healthcare outcomes in a busy hospital setting.

A Prospective Study to Assess the Value of Liquid Chromatography-Tandem Mass Spectrometry in the Management of Paediatric Poisoning at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa

“…(18,19) However, as technology has improved, mass spectrometers have become cheaper and faster. (18,23,29,(39)(40)(41) A study by Caspar et al demonstrated its value in 24/7 toxicology by analysing 22 drugs and active metabolites in a qualitative and quantitative manner. (30) In the study done be Caspar et al, the total run time for a test was 11 minutes, extrapolated to the emergency care setting, such run times would enable the clinician to treat the patient accordingly and in a timely point-of-care manner.…”

Is COVID-19 the current world-wide pandemic having effects on the profile of psychoactive substance poisonings?

“…Recent times have shown an increasing number of intoxication cases, resulting in damaging public health issues all around the globe, and Brazil is not an exception [ 1 ]. Most of the cases observed denoted the use of psychoactive substances, such as recreational drugs and medication for psychiatric use [ 2 ].…”