RESUMO
Clozapine is indicated for the treatment of schizophrenia and related psychotic disorders. Several methods have been developed for monitoring Clozapine levels; however, they possess limited specificity and are often laborious. This study describes a simple liquid chromatography/tandem mass spectrometer (LCMS) method in human serum. The ion transitions monitored were m/z 327, 270, 296 for Clozapine, m/z 313, 192, 227 for Norclozapine and m/z 328, 271 for Loxapine. The assay is linear (25-1000 ng/ml) and showed a good correlation (r=0.98) within the analytical range of 79-1210 ng/ml in human serum. This assay is highly specific and sensitive for the simultaneous measurements of Clozapine and Norclozapine. The simplification of this assay makes it ideal for high throughput analyses of the patient samples in a routine clinical laboratory staffed with general medical technologists.
Assuntos
Cromatografia Líquida/métodos , Clozapina/análogos & derivados , Clozapina/sangue , Espectrometria de Massas em Tandem/métodos , Cromatografia Líquida de Alta Pressão , Clozapina/uso terapêutico , Humanos , Loxapina/sangue , Esquizofrenia/sangue , Esquizofrenia/tratamento farmacológico , Espectrometria de Massas por Ionização por ElectrosprayRESUMO
The case history and toxicological findings of a fatal PineSol intoxication are presented. An 89-year-old white female with Alzheimer's disease accidentally drank PineSol and was subsequently brought to the hospital where she was pronounced dead on arrival. Significant autopsy findings included acute erosive gastritis. There appeared to be no aspiration of PineSol into the lungs. Isopropanol along with 1-alpha-terpineol are the two major toxic ingredients of PineSol. The toxicological screening and quantitiation of 1-alpha-terpineol in postmortem fluids was performed by gas chromatography-mass spectrometry using a simple one-step extraction. Postmortem blood, urine, and gastric levels of 1-alpha-terpineol were 11.2 mg/L, 5.76 mg/L, and 15.3 g/L, respectively. Postmortem blood, vitreous humor, urine, and gastric acetone concentrations were 25, 31, 33, and 28 mg/dL. Postmortem concentrations of isopropanol were less than 10 mg/dL in the blood, vitreous humor, urine, and gastric contents. The cause of death was ruled acute 1-alpha-terpineol intoxication due to accidental ingestion of PineSol, presumably caused by confusion related to Alzheimer's disease.
Assuntos
2-Propanol/intoxicação , Acidentes Domésticos , Doença de Alzheimer , Produtos Domésticos/intoxicação , Monoterpenos , Terpenos/intoxicação , 2-Propanol/metabolismo , Idoso , Idoso de 80 Anos ou mais , Monoterpenos Cicloexânicos , Cicloexenos , Evolução Fatal , Feminino , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Terpenos/farmacocinética , Distribuição TecidualRESUMO
Many instruments are used in forensic toxicology to screen biologic samples for drugs and other compounds. Many of these screening instruments (and others) are used to confirm positive screening tests. The focus of this article is the use of a high pressure liquid chromatograph/mass spectrometer (HPLC/MS) for screening forensic postmortem and human performance DWI cases. This screening procedure involves an HPLC with a particle beam interfaced to a mass spectrometer detector and a photodiode array detector. Drugs such as the antidepressants, drugs of abuse, over-the-counter cold and pain preparations, anticonvulsants, benzodiazepines, and some medications that are not available in the United States are selected at therapeutic and subtherapeutic levels. Limits of detection and extraction efficiencies are presented for many compounds. Several cases are discussed showing different drug combinations.
