Gas chromatographic determination of midazolam in low-volume plasma samples.

A gas chromatographic method for the sensitive determination of midazolam in plasma volumes as low as 40 microliters was developed, utilizing clinazolam as the internal standard. After liquid-liquid extraction at basic pH into 1-chlorobutane-dichloromethane (96:4) a 2- to 4-microliters portion of the reconstituted extract was injected under electronic pressure control onto a 12 m x 0.2 mm I.D. methyl silicone capillary column, and was exposed to a three-step temperature program from 120 to 310 degrees C, to separate the analytes from the plasma constituents. The compound of interest was identified and quantified by means of a mass-selective detector. The assay was linear from 10 to 500 ng/ml using 40 microliters of plasma (limit of quantification: 10 ng/ml) and was linear from 0.25 to 100 ng/ml using 500 microliters of plasma (limit of quantification: 0.25 ng/ml). The intra-day precision for the 40-microliters aliquots varied from 2.2 to 6.6%, the corresponding accuracy from -7.4 to -4.4%; the inter-day precision ranged from 5 to 7.2% and the corresponding accuracy from -7.2 to -5.1%.

Plasma concentrations of flumazenil during liver transplantation.

Six patients were given flumazenil (1 mg) during the anhepatic period of liver transplantation. We found higher mean plasma flumazenil concentrations during the anhepatic period than occurred in patients with hepatic cirrhosis. It was only possible to measure plasma flumazenil concentrations in four patients after revascularisation of the donor liver. Of these, elimination half-lives could be calculated in only three patients (normal in one and prolonged in two). In these two patients the elimination half-lives were prolonged to the same extent as in patients with fulminant hepatic failure. The changes during the anhepatic period occur because the liver contributes to the central volume of distribution. After revascularisation of the donor organ the prolonged half-lives indicate that transplanted livers may not recover normal metabolic functions immediately.

Experience with a sulfonamide diuretic in a large urine drug testing program.

Gas chromatography/mass spectrometry (GC/MS) with selected ion monitoring is a common confirmation method for tetrahydrocannabinol (THC) metabolites in urine. Department of Defense laboratories use this method for analysis of 11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid (THCA) following ion exchange column purification and methylation. Furosemide, a common diuretic which is excreted into urine, will be isolated with THCA in the extraction procedure, will appear in the chromatographic window [retention time relative to 11-nor-delta-9-tetrahydrocannabinolmethyl ether-9-carboxylic acid methyl ester (THCA-Me) of 1.13], and will exhibit the six ions monitored for THCA-Me and its trideuterated analog. The results indicate that methylated furosemide and other common diuretics can easily be distinguished from THCA-Me. They also allow one to explain in court the extraneous peaks in a chromatogram and to correct for the overutilization of derivatizing reagent.