ABSTRACT
Opiates are commonly used for pain treatment, especially for sharp pain like carcinoma pain. Two opiates are generally prescribed in our hospital: morphine and codeine in association with paracetamol. Most of the patients were given oral forms. Incorporation of morphine and codeine in hair of these patients was studied. Opiates testing in hair is performed by gas chromatography-mass spectrometry (GC-MS), using acid hydrolysis in presence of deuterated standards, a three-step liquid extraction and derivatization with BSTFA + TMCS. Results of codeine and morphine content in hair during pain treatment showed no correlation group between dose and concentration of the drug in hair. However, codeine values in hair during pain treatment compared to codeine in the hair of codeine abusers was significantly different (P < 0.0001).
Subject(s)
Codeine/pharmacokinetics , Hair/metabolism , Morphine/pharmacokinetics , Narcotics/pharmacokinetics , Pain/drug therapy , Acetaminophen/pharmacokinetics , Analgesics, Non-Narcotic/pharmacokinetics , Gas Chromatography-Mass Spectrometry , Humans , Neoplasms/complications , Neoplasms/drug therapy , Neoplasms/metabolism , Pain/etiology , Pain/metabolismABSTRACT
Phenobarbital analysis was performed in vertex hair of patients by gas chromatography mass spectrometry (GC/MS). After washing with dichloromethane, about 250 mg were ground to dust in a ball mill. A 50-mg sample was stirred mechanically for 10 min with 3 ml of NH4Cl/HCl buffer (pH 2.0) containing phenobarbital D5. A solid phase extraction was performed (extrelut Merck) and elution was achieved with chloroform/isopropanol/n-heptane (50:17:33; v/v). A full scan (40-240 uma) acquisition was realized by GC/MS with an ion trap (ITD 700 Finnigan) using a DB5-MS chromatographic column. Quantification was achieved by integrating dominants ions (phenobarbital, 204; phenobarbital D5, 209). Compared to serum, hair concentrates phenobarbital during anti-epileptic therapy (average value 36.4 ng/mg, n = 40 vs. 18.7 mg/l, n = 23). A group correlation exists between phenobarbital in hair and phenobarbital in serum, and between phenobarbital in hair and clinic observation in some typical cases. Phenobarbital in hair yields good information over a long period, especially when blood collection has not been made, when clinical disorders are observed on long-term therapeutic observance.
