Comprehensive method for the detection and quantification of drugs of abuse in urine by liquid chromatography mass spectrometry in a drug rehabilitation clinical setting
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Abstract
Within the clinical setting of drug rehabilitation, it is important to be able to monitor for the use of drugs using sensitive and selective techniques whilst accounting for high throughput and numbers of patients to provide rapid results to clinicians. To meet this need, a comprehensive LC-MS-MS method for the confirmation and quantitation of a wide variety of drugs of abuse relevant to drug rehabilitation in the United Arab Emirates has been developed, validated and applied to patient urine samples. Following automated solid phase extraction, detection and quantitation involved multiple reaction monitoring with electrospray ionization. With few exceptions, within and between-batch accuracy and precision performance was shown to be within 20% across all drug types including amphetamines and related stimulants, benzodiazepines, opiates/opioids, cocaine and metabolites, cannabinoids, hallucinogens and ketamine (including metabolites) in urine. Results for 280 drug positive patient specimens showed good agreement with the previous in-house GC–MS approach. The LC-MS-MS replaces the existing GC-MS approach and can be expanded easily with the introduction of additional MRM transitions as and when required (e.g. if new or other drugs of abuse are to be considered) to support the work of the clinical team in this special area of clinical toxicology and medicine.
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References
2. Al Ghafri H, Abuelgasim EA, Ali AY, Al Mamari S, Gawad TA, Alawadhi A, Shawky M, Hassan N, Elliott S. A 6-year review of drug trends in the United Arab Emirates from the perspective of the National Rehabilitation Center (NRC), Abu Dhabi. Current Topics in Toxicology. 2020;16:151-156.
3. Al Ghafri H, Elrasheed A, Al-Mamari S, Assaf M, Al Jenaibi M, Elarabi H, Alawadhi A. Rashi A, Al Meheiri F, Jawad T, Yousif A, Elliott S. Assessment of the use of point-of-care pregabalin testing for drug monitoring, compared to gas chromatography mass-spectrometry – a pilot study. J Med Toxicol Clin Forensic Med. 2018;4:1-3.
4. Krasowski MD, Pizon AF, Siam MG, Giannoutsos S, Iyer M, Ekins S. Using molecular similarity to highlight the challenges of routine immunoassay-based drug of abuse/toxicology screening in emergency medicine. BMC Emerg Med. 2009;9:5
5. Saitman A, Park HD, Fitzgerald RL. Using molecular similarity to highlight the challenges of routine immunoassay-based drug of abuse/toxicology screening in emergency medicine. J. Anal. Toxicol. 2014;38(7):387-396.
6. Orfanidis A, Gika HG, Theodoridis G, Mastrogianni O, Raikos N. A UHPLC-MS-MS Method for the Determination of 84 Drugs of Abuse and Pharmaceuticals in Blood. J Anal Toxicol. 2021;45(1):28-43.
7. Tang MH, Ching CK, Lee CY, Lam YH, Mak TW. Simultaneous detection of 93 conventional and emerging drugs of abuse and their metabolites in urine by UHPLC-MS/MS.
J Chromatogr B Analyt Technol Biomed Life Sci. 2014;969:272-284.
8. Valen A, Leere Øiestad ÅM, Strand DH, Skari R, Berg T. Determination of 21 drugs in oral fluid using fully automated supported liquid extraction and UHPLC-MS/MS. Drug Test Anal. 2017;9(5):808-823.
9. Galloway JH, Ashford M, Marsh ID, Holden M, Forrest AR. A method for the confirmation and identification of drugs of misuse in urine using solid phase extraction and gas-liquid chromatography with mass spectrometry. J Clin Pathol. 1998;51(4):326-329.
10. Paterson S, Cordero R, McCulloch S, Houldsworth P. Analysis of urine for drugs of abuse using mixed-mode solid-phase extraction and gas chromatography-mass spectrometry. Ann Clin Biochem. 2000;37:690-700.
11. Wille SM, Coucke W, De Baere T, Peters FT. Update of standard practices for new method validation in forensic toxicology. Curr. Pharm. Des. 2018;23@5442–5454.