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The abuse of prescription drugs that act on the central nervous system
is one of the most serious social problems in the world. Among those drugs,
benzodiazepines (BZPs) have largely replaced barbiturates as an xiolytic and
hypnotic drugs [1]. As the number of people who misuse those drugs for
recreational purposes has increased in recent years, there is an urgent need
to develop a highly reliable analytical method that can be used in forensic
science and emergency medicine. However, as various impurities are present
in biological specimens, a pretreatment method that can efficiently extract,
concentrate, and purify an extremely small amount of the target compound
is critical for analyzing biological specimens. Several approaches, such as
solid phase extraction (SPE) [2,3], solid-phase micro
bar sorptive extraction [6,7], and liquid phase micro extraction [8,9], have
been used so far. Dispersive solid phase extraction (DSPE) was used for the
clean upof crude extracts from different sample matrices [10]. However, the
extracts still contained some matrix contaminants, because DSPE could not
selectively purify the target compound. Furthermore, DSPE could not be used
for sample concentration. Dispersive liquid micro extraction (DLLME) [11]
features a high pre concentration capability, a short extraction time, and low
cost, but lacks selectivity for different analytes. In addition, a dispersion may
not form during the analysis of biological specimens [12].We have developed
a novel extraction method called the solid phase dispersive extraction (SPDE)
method [13], in which micro particles (solid phase) are dispersed in a liquid
sample, and have used it for the determination of van comycin in serum
samples [14]. After the dispersion of the micro particles (solid phase) in a
liquid sample (liquid phase), equilibrium between the two phases is
immediately reached. In addition, various micro particles can be used in
SPDE, similar to SPE; thus, SPDE has high selectivity, in contrast with DLLME
and DSPE. In this study, we evaluated the extraction efficiency of SPDE when
used in combination with liquid chromatography/time of flight mass
2. Experimental
2.1. Materials and reagents
Bromazepam,
nitrazepam,
lorazepam,
alprazolam,
triazolam,
made by Frontier Science Co. (Hokkaido, Japan). The filter paper used was
No. 5B of Japanese Industrial Standards P3801.
2.2 Serum and urine samples
The lyophilized serum product, Consera (Nissui Pharmaceutical Co.,
Ltd., Tokyo, Japan), was used as a blank for the serum tests.Urine sample
from a healthy non dosed volunteer was used as ablank for the urine tests.
Blood and urine samples were collected from a patient receiving clinical
doses of etizolam. This study was per formed in accordance with the ethical
standards of the Declaration of Helsinki. The sample donors were recruited
on a voluntary basis and informed about the study objectives. The samples
were kept at 20C until analysis.
2.3. Basic SPDE method
An aqueous suspension (50 L) of Oasis HLB gel was introduced into
a 2 mL micro test tube. Then, 500 L of BZP standard solution (500 ng/ mL)
and 500 L of 10 mM aqueous ammonium for mate were added sequentially.
Subsequently, a centrifugal filter and a new micro test tube for receiving the
filtrate were attached (Fig. 1). After the solid phase was homogeneously
dispersed by light vortexing for a few seconds, the whole device was
inverted and then centrifuged at 3000 g for 10 s (Fig. 1). The micro test
tube containing the filtrate was removed, and a new micro test tube
containing a washing solution (1 mL of 5% aqueous methanol solution) was
attached. The whole centrifugal filter device was again inverted (i.e.,
returned to the original position), and then centrifuged at 3000 g for 10 s
to introduce the washing solution into the opposite micro test tube
containing the Oasis HLB gel. The solid-phase gel was then dispersed and
centrifuged as described above. Again, the micro test tube containing the
filtrate was removed, and a new micro test tube containing an eluting
solution (500 L of methanol) was attached to introduce the eluting solution
into the opposite micro test tube containing the solid phase gel. The solid
phase gel was dispersed by light vortex ing followed by ultrasonic cation for
10 s, and the solution was centrifuged as described above. The filtrate was
analyzed by LC/TOF-MS.
2.4. Pretreatment of serum and urine samples
Five hundred micro liters of serum was spiked with 10 L of de salkyl flu
razepam (10 g/mL) as the surrogate, and mixed well with 500 _L of ace to
nitrile to precipitate proteins. Then, the mixture was filtered through the
centrifugal filter (3000 g, 10 min). The filtrate was purged under nitrogen
at 40C to near dryness. Next, 500 L of 1 M ammonium acetate aqueous
solution and 10 L of glucuronidase (10,000 units/mL ) were added to the
residue, and the mixture was incubated at 37C for 1 h to achieve de
conjugation. The de conjugation was performed in accordance with the
information provided by the reagent manufacturer. Then, the whole solution
was subjected to SPDE. As for the urine sample,10 L of de salkyl flu razepam
(10 g/mL), 100 L of 1 M ammonium acetate aqueous solution, and 10 L of
glucuronidase Fig (10,000 units/mL) were added to 1 mL of urine sample, and
thewhole mixture was incubated at 37C for 1 h to achieve de conjugation.
Then, the whole solution was subjected to SPDE.
2.5. Apparatus
An Alliance HT 2795 system equipped with an LCT Premier XE TOF-MS
(Waters Corporation, Milford, MA, USA) was used. LC separation was
performed with a Porshell 120 EC-C18 column(100 mm 4.6 mm I.D., 2.7
_m; Agilent Technologies, Inc., Santa Clara, CA, USA). Column temperature
was maintained at 40C.The mobile phase was a mixture of ammonium for
mate (pH 3.0,10 mM) ace to nitrile (70:30, v/v), and was delivered at the flow
rate of 0.5 mL/min. A 5
sealing
property
compared
to
previously
reported
system
For serum samples, the average recoveries of BZPs spiked at50 ng/mL
and 500 ng/mL were 89.6105.0% (RSD: 2.16.8%) and93.6110.4% (RSD:
2.14.2%), respectively (Table 1). For urine samples, the average recoveries
of BZPs spiked at the same concentrations were 88.7105.5% (RSD: 2.9
6.4%) and 91.5101.1% (RSD:3.65.5%), respectively. Table 2 shows intraday and inter-day as say data for BZPs in serum and urine samples spiked at
100 ng/mL. Statistical analyses were performed using one-way analysis of
variance. The repeatability values ranged from 1.6% to 7.0% (serum),
and2.8% to 7.4% (urine), and the intermediate precision values were from
2.4% to 8.0% (serum), and 3.4% to 7.0% (urine). These data suggested that
SPDE-LC/TOF-MS has sufficient sensitivity and precision for monitoring
residual BZPs in biological samples.
3.3. Analysis of serum and urine samples from patient receiving clinical
doses of Etizolam
Serum and urine samples from a patient receiving clinical doses of
etizolam (De pas ) were analyzed. The major metabolites of etizolam are 8hydroxy etizolam and hydroxy etizolam, and their glucuronide conjugates, all
of which are excreted in urine [15]. The serum and urine samples were
subjected to de conjugation with glucuronidase. Blood and urine of the
patient receiving clinical doses of De pas (2 mg) were periodically sampled
(3, 6, and 9 hafter oral administration) and subjected to SPDE-LC/TOF-MS
analysis. The typical chromatograms of the serum and urine samples
obtained 3 h after oral administration exhibited an etizolam peak(Fig. 3(A)
and (B)). The accurate mass (359.0733 20 m Da) of the proton adducts of
expected etizolam metabolites in the total ion chromatogram of urine sample
was determined and drawn as amass chromatogram. Peaks (a) and (b) were
observed (Fig. 3(C))at the retention times of 4 min and 10 min,
respectively. The chemical formula C17H15ClN4SO for both etizolam
metabolites is consistent with the molecular ion peaks from mass
spectrometry, and isotopic peaks indicate the presence of chlorine (Fig.
3(D)), as expected. Thus, we attributed peaks (a) and (b) to the etizolam
metabolites. However, because 8-hydroxy etizolam and hydroxyl.
3.4. Drug monitoring in blood and urine
Fig. 4 shows time course of the concentrations of etizolam and its two
metabolites in serum and urine samples following oral administration. For the
urine sample, the drug concentration was corrected by creatinine values. The
maximum concentration of etizolam in blood was reached 3 h after oral
administration, consistent with previously reported data [16]. Accordingly,
the metabolites and the parent compound should be monitored when urine is
analyzed to identify the causative agent when drug poisoning or abuseis
suspected. In conclusion, SPDE-LC/TOF-MS is useful for therapeutic drug
monitoring in emergency medicine and forensic science.
Acknowledgement
This study was supported by a Grant-in-Aid for Scientific Research from
the Ministry of Education, Culture, Sports, Science and Technology of Japan
(Grant No. 20590043).
TERJEMAHAN B. INDONESIA
pengantar
Penyalahgunaan obat resep yang bekerja pada sistem saraf pusat
adalah salah satu masalah sosial yang paling serius di dunia. Di antara obat
metode
pengobatan
pra
yang
efisien
dapat
mengekstrak,
2. Percobaan
2.1. Bahan dan reagen
BROMAZEPAM,
nitrazepam,
lorazepam,
alprazolam,
triazolam,
sebagai
standar
nimetazepam,
diperoleh
dari
Dainippon
Sumitomo Pharma Co, Ltd (Osaka, Jepang). Desalkyl razepam flu, yang
digunakan sebagai pengganti untuk pengukuran TOF-MS, dibeli dari Cerilliant
Corporation (Round Rock, TX, USA). Escherichia coli glucuronidase untuk de
konjugasi dibeli dari Sigma Aldrich Corp (St. Louis, MO, USA). fase terbalik
(RP) polimer Oasis HLB fase padat gel (30 m O.D.) diperoleh dengan
menghapus gel dari kartrid seri SPE sesuai Oasis HLB (Waters Corporation,
Milford, MA, USA). Sebelum digunakan, gel fase padat pertama kali AC
dengan metanol dan air murni. Kemudian, larutan keruh dari fase gel padat
disiapkan pada konsentrasi 5 mg / 50 L. Filter prototipe sentrifugal dibuat
khusus oleh Frontier Ilmu Co (Hokkaido, Jepang). kertas filter yang digunakan
adalah Nomor 5B dari Jepang Standar Industri P3801.
2.2 Serum dan urine sampel
Produk terliofilisasi serum, Consera (Nissui Pharmaceutical Co, Ltd,
Tokyo, Jepang), digunakan sebagai kosong untuk sampel serum tests.Urine
dari relawan non tertutup sehat digunakan sebagai kosong untuk tes urine.
Sampel darah dan urin dikumpulkan dari pasien yang menerima dosis klinis
etizolam. Penelitian ini per dibentuk sesuai dengan standar etika Deklarasi
Helsinki. Para donor sampel direkrut atas dasar sukarela dan informasi
tentang tujuan studi. Sampel disimpan di 20C sampai analisis.
pemulihan BZP oleh SPDE diselidiki. Karena pemulihan yang relatif tinggi
lebih dari 80% diperoleh ketika 5 mg fase padat gel digunakan, jumlah yang
dianggap
optimal
untuk
pencampuran
dengan
sampel.
Kami
juga
menganalisis filtrat dan solusi mencuci setelah satu SPDE. Karena tidak ada
BZP terdeteksi, kita mengasumsikan bahwa hampir semua BZPs dalam fase
cair diekstraksi dengan fase gel padat setelah satu SPDE. Hasil ekstraksi dari
setiap BZP ditentukan dengan menghitung pemulihan obat dalam larutan
standar, dan berada di kisaran 81,3-89,2% (RSD: 1,8-6,9%). Hasil ini
menunjukkan bahwa adsorpsi ke dan desorpsi dari gel padat-fase terjadi
hampir seketika. Sebagai partikel mikro dalam suspensi dapat bergerak
bebas
dan
memiliki
luas
permukaan
yang
besar,
mereka
memiliki