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Objectives: A semi-quantitative method in clinical toxicology was developed using an extraction with a micro-elution solid phase (SPE) followed by an analysis with an Ultra-High-Performance Liquid Chromatography- Photodiode Array system (UHPLC-PDA). The study was performed on 122 medicinal compounds according to the recommendations of the NF EN ISO 15189. Methods: After testing different SPE cartridges, the Stratar -X cartridge was selected based on its better extraction yields. A manual extraction protocol from plasma was set up for 3 concentrations (0.1 mg/L, 1 mg/L and 10 mg/L) with methanol as the eluting solvent. UHPLC analysis was performed with a mobile phase gradient of ammonium acetate 5 mM/Acetonitrile (ACN) (85/15, v/v) at pH 3.8 ± 0.05 and ACN on a BEH column C18 1.7 µm, 2.1 mm × 150 mm. The flow rate was 0.45 mL/min and the analytes were detected by PDA (190-400 nm). Results: Extraction yields were satisfactory, as well as the precision (repeatability CV% < 6.54%). Inter-assay CVs were high (CV > 15% for a few molecules) but were less significant when relativized by the two internal standards (flurazepam and prazepam). The semi-quantification was achieved with the support of two endpoints, and LOD and LOQ values were compared with therapeutic or toxic values. Conclusion: The method described is simple and fast. The results showed the ability of the Stratar -X to extract molecules belonging to several classes of drugs with different physicochemical properties. [ABSTRACT FROM AUTHOR]

Toxicological screening is the analysis of biological samples to detect and identify unknown compounds. The high selectivity and sensitivity of liquid chromatography (LC) coupled to mass spectrometry (MS) or tandem mass spectrometry (MS/MS) technology provide an attractive alternative to the current methods (LC-UV, GC/MS, etc.). For these reasons, an increasing number of applications are being published. This paper is a brief overview of LC-MS(/MS) screening methods developed for clinical toxicology in recent years. Various sample treatments, chromatographic separations and detection by mass spectrometry can be combined to obtain screening methods adapted to the constraints and needs of clinical toxicology laboratories. Currently the techniques are in the hands of specialists, mainly in academic institutions. However, the evolution in technology should allow application of these techniques as a tool in toxicology laboratories, thus allowing a more widespread exploitation of their potential.

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Over the past decade great progress has been made in metals and metalloids analysis. This analysis is a basic stage in toxicity assessment and is indispensable in achieving a realistic evaluation of substance toxicity. A recently introduced technique, inductively coupled plasma mass spectrometry (ICP-MS) is progressively replacing atomic absorption. This analysis permits multi-elementary determinations, approximately 30 elements, with an optimal gain in sensitivity in many biological matrices: i.e. whole blood, plasma, urine, hair, nail, biopsy samples. Moreover, this method allows semiquantitative determination with an additional 30 supplementary elements, which enables the toxicologist to sufficiently estimate the toxic levels and metal exposure. The authors demonstrate that the ICP-MS could be very useful for a wide range of clinical applications. Furthermore, this procedure offers new exploration possibilities in various fields such as clinical toxicology, forensic toxicology as well as work place testing or environmental exposure and permits epidemiologic studies. This analytical method in fact also provides a new scientific approach. To our knowledge we are the first to propose: the metallic profile. [Copyright &y& Elsevier]

Copyright of EMC-Toxicologie--Pathologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Suicide poisonings with drugs used for animal euthanasia are rare in the medical literature. The authors describe the case of a 38-year-old veterinary surgeon who killed himself in his office with intravenous injection of two molecules: dexmedetomidine and pentobarbital. Method: Description of a clinical observation of the Marseille Poison Control Centre. Results: The two veterinary drugs used by the patient were high quantities of pentobarbital, which is a barbiturate no longer used in France as a human medicine, and dexmedetomidine, which is an a2 agonist used in veterinary medicine for its hypnotic and analgesic properties. As soon as the family (also working as veterinary practitioners) discovered the poisoned patient, the antidote of dexmedetomidine was injected, and the emergency medical team that arrived found the patient to have respiratory arrest with a Glasgow coma scale of 3. Despite being taken to an intensive care unit he died from complications of respiratory arrest 13 days after the overdose. Discussion: The role of each of the molecules (pentobarbital and dexmedetomidine) in the development of the clinical features and the influence of the administration of the antidote are discussed in this paper. Conclusion: It seems important to inform medical practitioners and clinical toxicologists about these veterinary products and their pharmacological properties in order to be able to manage such a situation. [ABSTRACT FROM AUTHOR]