ABSTRACT
OBJECTIVES: Perform a comparison of results obtained with a LC-MS/MS method and a Remedi® instrument on clinical serum samples. DESIGN AND METHODS: Results obtained on 146 selected plasma samples were compared between the two methods. RESULTS: On the 336 positive identifications, 89% were obtained using the LC-MS/MS technique and 57% by the LC-DAD. Benzodiazepines were well recognized by LC-MS/MS. For some compounds such as antidepressant agents, sensitivity was improved using LC-MS/MS. Moreover, this method extended the panel of drugs detected in clinical toxicology. CONCLUSION: The new software platform developed for screening and identification of small molecules (SmileMS) allows an easy and reproducible detection of drugs and toxic compounds in blood for general unknown screening. It offers automated generation of reports, which makes the LC-MS/MS easier to use without having specialised skills in mass spectrometry. This LC-MS/MS screening method will be a reliable alternative to the Remedi® instrument in the global process of screening in emergency clinical toxicology laboratories.
Subject(s)
Chromatography, Liquid , Pharmaceutical Preparations/analysis , Tandem Mass Spectrometry , Humans , Pharmaceutical Preparations/bloodABSTRACT
OBJECTIVES: Evaluate a new LC-MS/MS screening method for drugs and drugs of abuse as an alternative to the existing methods used in clinical toxicology laboratories. DESIGN AND METHODS: The work was divided in two parts. The first part was dedicated to the technical development and evaluation of the method for which a set of 97 drugs and relevant metabolites was used to perform a complete investigation of matrix effects and lower limit of identification (LOI). The second part was a comparison of identified drugs between LC-MS/MS and Remedi® instrument on clinical serum samples. RESULTS: The method offers good performance allowing an automatic peak detection and compound identification. The limit of identification is equivalent to 50 µg/L for the majority of the studied compounds. The process efficiency (PE) is higher than 70% for 65% of the evaluated compounds. Thus, a sufficient detection capability in terms of limit of detection for identification and PE satisfied the expected performance. CONCLUSION: The described methodology allows the identification of the main drugs incriminated in intoxications within a quite short analysis time. The separation of most of the analytes is performed in 15 min. The procedure is sufficiently sensitive and selective.
