Assessment of adherence to diuretics and β-blockers by serum drug monitoring in comparison to urine analysis

Ritscher, Sabrina; Georges, Coralie; Wunder, Cora; Wallemacq, Pierre; Persu, Alexandre; Toennes, Stefan W.

doi:10.1080/08037051.2020.1763775

Cited by 8 publications

(5 citation statements)

References 26 publications

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“…However, the details of chromatographic column, mobile phase solvents, run time, internal standard used and assay range were not reported. In a recent study (Ritscher et al, 2020; Schmieder et al, 2016) analyses of urine extracts of furosemide and other antihypertensive drugs were performed with LC–MS/MS using methodone‐d 9 as an internal standard. The assay employed liquid–liquid extraction of 200 μl of urine samples with ethyl acetate followed by evaporation and reconstitution in mobile phase solvents.…”

Section: Discussionmentioning

confidence: 99%

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Development, validation, and implementation of an UHPLC–MS/MS method for the quantitation of furosemide in infant urine samples

Vedar

Bamat

Zuppa

et al. 2021

Biomedical Chromatography

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Furosemide is a diuretic drug used to increase urine flow in order to reduce the amount of salt and water in the body. It is commonly utilized to treat preterm infants with chronic lung disease of prematurity. There is a need for a simple and reliable quantitation of furosemide in human urine. We have developed and validated an ultra-high performance liquid chromatography-tandem mass spectrometry method for furosemide quantitation in human urine with an assay range of 0.100-50.0 μg/ml. Sample preparation involved solid-phase extraction with 10 μl of urine.Intra-day accuracies and precisions for the quality control samples were 94.5-106 and 1.86-10.2%, respectively, while inter-day accuracies and precision were 99.2-102 and 3.38-7.41%, respectively. Recovery for furosemide had an average of 23.8%, with an average matrix effect of 101%. Furosemide was stable in human urine under the assay conditions. Stability for furosemide was shown at 1 week (room temperature, 4, À20 and À78 C), 6 months (À78 C), and through three freeze-thaw cycles. This robust assay demonstrates accurate and precise quantitation of furosemide in a small volume (10 μl) of human urine. It is currently being implemented in an ongoing pediatric clinical study.

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Section: Discussionmentioning

confidence: 99%

“…Furosemide concentrations are typically quantified in human plasma or serum by validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) methods (Heffron et al, 2013;Ritscher et al, 2019Ritscher et al, , 2020. Sample analysis with urine is a useful approach for quantitative analysis of drugs, especially in pediatrics.…”

Section: Introductionmentioning

confidence: 99%

Development, validation, and implementation of an UHPLC–MS/MS method for the quantitation of furosemide in infant urine samples

Vedar

Bamat

Zuppa

et al. 2021

Biomedical Chromatography

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“…Studies have shown that there are not only reasonable congruities but also differences between detection of medication in urine versus blood. 79,80 Larger studies are needed to study correlation between nonadherence results based on urine and blood samples, but if there is a good correlation between blood and urine chemical nonadherence results, this would not necessarily mean that these can be used interchangeably. Further studies are needed on the usefulness of quantitative measurement of drugs in adherence screening.…”

Section: Fallacies Of Chemical Adherence Testing and Gaps In Knowledgementioning

confidence: 99%

Nonadherence in Hypertension: How to Develop and Implement Chemical Adherence Testing

et al. 2022

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Nonadherence to antihypertensive medication is common, especially in those with apparent treatment-resistant hypertension (true treatment-resistant hypertension requires exclusion of nonadherence), and its routine detection is supported by clinical guidelines. Chemical adherence testing is a reliable and valid method to detect adherence, yet methods are unstandardized and are not ubiquitous. This article describes the principles of chemical adherence testing for hypertensive patients and provides a set of recommendations for centers wishing to develop the test. We recommend testing should be done in either of two instances: (1) in those who have resistant hypertension or (2) in those on 2 antihypertensives who have a less than 10 mm Hg drop in systolic blood pressure on addition of the second antihypertensive medication. Furthermore, we recommend that verbal consent is secured before undertaking the test, and the results should be discussed with the patient. Based on medications prescribed in United Kingdom, European Union, and United States, we list top 20 to 24 drugs that cover >95% of hypertension prescriptions which may be included in the testing panel. Information required to identify these medications on mass spectrometry platforms is likewise provided. We discuss issues related to ethics, sample collection, transport, stability, urine versus blood samples, qualitative versus quantitative testing, pharmacokinetics, instrumentation, validation, quality assurance, and gaps in knowledge. We consider how to best present, interpret, and discuss chemical adherence test results with the patient. In summary, this guidance should help clinicians and their laboratories in the development of chemical adherence testing of prescribed antihypertensive drugs.

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“…9,31 Furthermore, medication adherence can be underestimated for highly metabolized drugs with low renal excretion or very short half-lives. 31,35 Still, limited data on pharmacokinetic parameters in urine are available for various drugs (of abuse). 57 Therefore, bioanalytical adherence assessment in urine is usually performed qualitatively to exclude the intake of certain drugs or drug classes in patients with SUD.…”

Section: Adherence Monitoring In Urinementioning

confidence: 99%

Section: Adherence Monitoring In Urinementioning

confidence: 99%

Sample Matrices for Mass Spectrometry–Based Adherence Monitoring: A Systematic Critical Review

Jacobs,

Wagmann,

Meyer

2023

Therapeutic Drug Monitoring

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Background: Analytical monitoring of adherence using mass spectrometry (MS) plays an important role in clinical toxicology. Unambiguous detection of drugs (of abuse) and/or their metabolites in body fluids is needed to monitor intake of medication as prescribed or to monitor abstinence as a follow-up to detoxification procedures. This study focused on the advantages and disadvantages of different sample matrices used for MS-based adherence monitoring. Methods: Relevant articles were identified through a literature search in the PubMed database. English articles published between January 01, 2017, and December 31, 2022, were selected using the keywords “adherence assess*” or “adherence monit*” or “compliance assess*” or “compliance monit*” in combination with “mass spectrom*” in the title or abstract. Results: A total of 51 articles were identified, 37 of which were within the scope of this study. MS-based monitoring was shown to improve patient adherence to prescribed drugs. However, MS analysis may not be able to assess whether treatment was rigorously followed beyond the last few days before the sampling event, except when hair is the sample matrix. For medication adherence monitoring, blood-based analyses may be preferred because reference plasma concentrations are usually available, whereas for abstinence control, urine and hair samples have the advantage of extended detection windows compared with blood. Alternative sample matrices, such as dried blood samples, oral fluid, and exhaled breath, are suitable for at-home sampling; however, little information is available regarding the pharmacokinetics and reference ranges of drug (of abuse) concentrations. Conclusions: Each sample matrix has strengths and weaknesses, and no single sample matrix can be considered the gold standard for monitoring adherence. It is important to have sufficient information regarding the pharmacokinetics of target substances to select a sample matrix in accordance with the desired purpose.

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Assessment of adherence to diuretics and β-blockers by serum drug monitoring in comparison to urine analysis

Cited by 8 publications

References 26 publications

Development, validation, and implementation of an UHPLC–MS/MS method for the quantitation of furosemide in infant urine samples

Development, validation, and implementation of an UHPLC–MS/MS method for the quantitation of furosemide in infant urine samples

Nonadherence in Hypertension: How to Develop and Implement Chemical Adherence Testing

Sample Matrices for Mass Spectrometry–Based Adherence Monitoring: A Systematic Critical Review

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