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- Novel synthetic opioids – toxicological aspects and analysisPublication . Tabarra, Inês; Soares, Sofia; Rosado, Tiago; Gonçalves, Joana; Luís, Ângelo; Malaca, Sara; Barroso, Mário; Keller, Thomas; Restolho, José; Gallardo, EugeniaOver the past few years, there has been an emerging number of new psychoactive drugs. These drugs are frequently mentioned as “legal highs”, “herbal highs”, “bath salts” and “research chemicals”. They are mostly sold and advertised on online forums and on the dark web. The emerging new psychoactive substances are designed to mimic the effects of psy- choactive groups, which are often abused drugs. Novel synthetic opioids are a new trend in this context and represent an alarming threat to public health. Given the wide number of fatalities related to these compounds reported within the last few years, it is an important task to accurately identify these compounds in biologic matrices in order to administer an effective treatment and reverse the respiratory depression caused by opioid related substan- ces. Clinicians dealing with fentanyl intoxication cases should consider that it could, in fact, be a fentanyl analogue. For this reason, it is a helpful recommendation to include synthetic opioids in the routine toxicological screening procedures, including analysis in alternative matrices, if available, to investigate poly-drug use and possible tolerance to opioids. To address this public health problem, better international collaboration, effective legislation, effective investigation, control of suspicious “research chemicals” online forums and continu- ous community alertness are required. This article aims to review diverse reported fatalities associated with new synthetic opioids describing them in terms of pharmacology, metabol- ism, posology, available forms, as well as their toxic effects, highlighting the sample proce- dures and analytical techniques available for their detection and quantification in biological matrices
- Stability of Cocaine, Opiates, and Metabolites in Dried Saliva SpotsPublication . Almeida, Ema; Soares, Sofia; Gonçalves, Joana; Rosado, Tiago; Fernández, Nicolás; Rodilla, Jesus M.; Passarinha, Luís A.; Barroso, Mário; Gallardo, EugeniaDrug abuse still represents a global problem, and it is associated with an increased risk of diseases, injuries, and deaths. Cocaine (COC) and opiates are the most abused drugs and account for a significant number of fatalities. Therefore, it is important to develop methods capable of effectively identifying and quantifying these substances. The present study aims to evaluate the long- term stability of COC, ecgonine methylester (EME), benzoylecgonine (BEG), cocaethylene (COET), norcocaine (NCOC), morphine (MOR), codeine (COD) and 6-monoacetylmorphine (6-MAM) in oral fluid samples. The analytes of interest were isolated from the matrix (50 μL) using the dried saliva spots (DSS) sampling approach and were subsequently analyzed by gas chromatography coupled with tandem mass spectrometry (GC–MS/MS). The parameters that could influence the stability of the target compounds were studied, and these were storage temperature, light, use of preservatives (and respective concentrations), and time. The effects of each parameter were evaluated using the design of experiments (DOE) approach. The stability of the target analytes was improved when the DSS were stored at room temperature, in the presence of light and using 1% sodium fluoride. The best conditions were then adopted for the DSS storage and long-term stability was assessed. COD was only stable for 1 day, EME was stable for 3 days, COC, COET, NCOC and 6-MAM were stable for 7 days, MOR for 14 days and BEG remained stable throughout the study (136 days). This is the first study that evaluates the stability of these compounds in oral fluid samples after application in DSS cards, and optimizes the conditions in order to improve their stability
- An Update on the Implications of New Psychoactive Substances in Public HealthPublication . Simão, Ana Y.; Antunes, Mónica; Cabral, Emanuel; Oliveira, Patrik; Rosendo, Luana M.; Brinca, Ana Teresa; Alves, Estefânia; Marques, Hernâni; Rosado, Tiago; Passarinha, Luís A.; Andraus, Maristela; Barroso, Mário; Gallardo, EugeniaThe emergence of new psychoactive substances has earned a great deal of attention, and several reports of acute poisoning and deaths have been issued involving, for instance, synthetic opiates. In recent years, there have been profound alterations in the legislation concerning consumption, marketing, and synthesis of these compounds; rapid alert systems have also been subject to changes, and new substances and new markets, mainly through the internet, have appeared. Their effects and how they originate in consumers are still mostly unknown, primarily in what concerns chronic toxicity. This review intends to provide a detailed description of these substances from the point of view of consumption, toxicokinetics, and health consequences, including case reports on intoxications in order to help researchers and public health agents working daily in this area.
- Analysis of opiates in urine using microextraction by packed sorbent and gas Chromatography- Tandem mass spectrometryPublication . Simão, Ana Y.; Monteiro, Catarina; Marques, Hernâni; Rosado, Tiago; Margalho, Cláudia; Barroso, Mário; Andraus, Maristela; Gallardo, EugeniaOpiates recreational consumption has always been a concern in society, public health, and in clinical toxicology analysis. The aim of this study was to develop and fully validate an analytical method, which was simple and rapid for the determination of tramadol, codeine, morphine, 6- acetylcodeine, 6-monoacetylmorphine and fentanyl using gas chromatography coupled to tandem mass spectrometry. The procedure includes the use of microextraction by packed sorbent for sample clean-up. A mixed mode sorbent was used, allowing the minimal use of solvents. The method was validated in urine samples, with the ability to detect and quantify all analytes with satisfactory linearity (in the range of 1 – 1000 ng/mL for all analytes, except for fentanyl (10–1000 ng/mL)). Extraction efficiency varied from 17 to 107%, which did not impair sensitivity, taking into account the low LLOQs obtained (1 ng/ mL for all analytes; and 10 ng/mL for fentanyl). The developed procedure proved to be fast, selective, and accurate for use in routine analysis, with a low volume of sample (250 µL).
- The Determination of Cannabinoids in Urine Samples Using Microextraction by Packed Sorbent and Gas Chromatography-Mass SpectrometryPublication . Rosendo, Luana M.; Rosado, Tiago; Oliveira, Patrik; Simão, Ana Y.; Margalho, Cláudia; Costa, Suzel; Passarinha, Luís A.; Barroso, Mário; Gallardo, EugeniaCannabis is the most consumed illicit drug worldwide, and its legal status is a source of concern. This study proposes a rapid procedure for the simultaneous quantification of Δ9-tetrahydrocannabinol (THC), 11-hydroxy-Δ9-tetrahydrocannabinol (11-OH-THC), 11-nor-9-carboxy-Δ9-tetrahydrocannabinol (THC-COOH), cannabidiol (CBD), and cannabinol (CBN) in urine samples. Microextraction by packed sorbent (MEPS) was used to pre-concentrate the analytes, which were detected by gas chromatography–mass spectrometry. The procedure was previously optimized, and the final conditions were: conditioning with 50 µL methanol and 50 µL of water, sample load with two draw–eject cycles, and washing with 310 µL of 0.1% formic acid in water with 5% isopropanol; the elution was made with 35 µL of 0.1% ammonium hydroxide in methanol. This fast extraction procedure allowed quantification in the ranges of 1–400 ng/mL for THC and CBD, 5–400 ng/mL for CBN and 11-OH-THC, and 10–400 ng/mL for THC-COOH with coefficients of determination higher than 0.99. The limits of quantification and detection were between 1 and 10 ng/mL using 0.25 mL of sample. The extraction efficiencies varied between 26 and 85%. This analytical method is the first allowing the for determination of cannabinoids in urine samples using MEPS, a fast, simple, and low-cost alternative to conventional techniques
- New Method for the Monitoring of Antidepressants in Oral Fluid Using Dried Spot SamplingPublication . Soares, Sofia; Rosado, Tiago; Barroso, Mário; Gallardo, EugeniaThe increase in the consumption of antidepressants is a public health problem worldwide, as these are a class of compounds widely used in the treatment of several illnesses, such as depression and anxiety. This work aimed to develop and optimize a method for the quantification of a number of antidepressants and their metabolites (fluoxetine, venlafaxine, O-desmethylvenlafaxine, citalopram, sertraline, and paroxetine) in 100 μL of oral fluid using the dried saliva spots (DSS) sampling approach and gas chromatography coupled with tandem mass spectrometry (GC–MS/MS). The method was validated, presenting linearity within the studied range, with detection and quantification limits ranging between 10 and 100 ng/mL, and coefficients of determination (R2) of at least 0.99 for all analytes. Recoveries were between approximately 13 and 46%. The analysis of precision and accuracy presented acceptable coefficients of variation and relative errors, considering the criteria usually accepted in the validation of bioanalytical procedures. The method herein described is the first to be reported using DSS for the extraction of antidepressants, proving to be a sensitive, simple, and fast alternative to conventional techniques, and capable of being routinely applied in clinical and forensic toxicology scenarios
- Solid Phase-Based Microextraction Techniques in Therapeutic Drug MonitoringPublication . Soares, Sofia; Rosado, Tiago; Barroso, Mário; Gallardo, EugeniaTherapeutic drug monitoring is an established practice for a small group of drugs, particularly those presenting narrow therapeutic windows, for which there is a direct relationship between concentration and pharmacological effects at the site of action. Drug concentrations in biological fluids are used, in addition to other clinical observation measures, to assess the patient’s status, since they are the support for therapy individualization and allow assessing adherence to therapy. Monitoring these drug classes is of great importance, as it minimizes the risk of medical interactions, as well as toxic effects. In addition, the quantification of these drugs through routine toxicological tests and the development of new monitoring methodologies are extremely relevant for public health and for the well-being of the patient, and it has implications in clinical and forensic situations. In this sense, the use of new extraction procedures that employ smaller volumes of sample and organic solvents, therefore considered miniaturized and green techniques, is of great interest in this field. From these, the use of fabric-phase extractions seems appealing. Noteworthy is the fact that SPME, which was the first of these miniaturized approaches to be used in the early ‘90s, is still the most used solventless procedure, providing solid and sound results. The main goal of this paper is to perform a critical review of sample preparation techniques based on solid-phase microextraction for drug detection in therapeutic monitoring situations.
- Determination of Ketamine and Norketamine in hair samples using MEPS as sample clean-upPublication . Simão, Ana Y.; Oliveira, Patrik; Rosendo, Luana M.; Rosado, Tiago; Gallardo, Eugenia; Andraus, Maristela; Barroso, MárioIntroduction and Aim: The use of hair samples to determine ketamine (K) and its metabolite, norketamine (NK), has been studied by several authors, using different clean-up approaches. However, microextraction by packed sorbent (MEPS), a miniaturized form of the classic solid-phase extraction has not been applied to date for the purpose. Therefore, a method to determine K and NK in hair samples was developed, optimized, and validated using MEPS as sample clean-up. Materials & Methods: Hair samples were scissor-cut into small fragments, and rinsed with methanol to remove dirt and externally deposited material. Following an overnight incubation with methanol at 65 ºC (no stirring), the compounds were analysed by GC-MS/MS without the need of derivatization procedures; MEPS conditions were: conditioning (5 x 250 µL of methanol and 4 x 250 µL of deionized water); load (10 x 150 µL of hair extract); washing (50 µL of 0.1% acetic acid and 50 µL of 10% methanol); and elution (100 µL of 3% ammonium hydroxide in methanol). Results & Discussion: The procedure resulted in acceptable recoveries, 39-61% for K and 32-43% for NK, and allowed reaching limits of quantification (LOQs) of 50 pg/mg for both analytes. The analytical method presented acceptable accuracy and precision with coefficients of variation typically lower than 15% and BIAS within ± 15%, except at the LOQ (20%). The method was successfully applied to 2 authentic samples, and ketamine concentrations were below 0.05 and 0.18 ng/mg. Norketamine was not detected. Conclusions: This work is the first analytical method using MEPS coupled to GC-MS/MS for the determination of K and NK in hair samples. Following a comparison with a SPE-based method using authentic samples, it was considered rapid and suitable for routine analysis. Acknowledgments: FCT (UIDB /00709/2020 and UIDP/00709/2020). A.Y. Simão acknowledges the PhD fellowship from FCT (2020.09070.BD).
- Validação de um método analítico para a determinação de antidepressivos em fluido oral com recurso a MEPS e análise por GC-MS/MSPublication . Soares, Sofia; Rosado, Tiago; Barroso, Mário; Gallardo, EugeniaO consumo de antidepressivos representa uma problemática a nível mundial, apresentando Portugal uma das taxas de prevalência de doenças mentais mais elevadas da Europa. A monitorização terapêutica é uma prática instituída para um pequeno número de fármacos para os quais há uma relação direta entre a concentração e o efeito farmacológico, envolvendo habitualmente a determinação de drogas no soro, plasma ou sangue. O presente trabalho descreve uma metodologia para a determinação de antidepressivos (fluoxetina, venlafaxina, sertralina, citalopram, paroxetina e metabolitos) em fluido oral (250 μL) com recurso à microextração em seringa empacotada (MEPS) e à cromatografia gasosa acoplada à espectrometria de massa em tandem (GC-MS/MS). A técnica MEPS foi otimizada utilizando a ferramenta estatística Design of Experiments (DoE). Previamente à MEPS procedeu-se à precipitação proteica do fluido oral com 500 μL de acetonitrilo gelado, após a qual se centrifugou, decantou e se evaporou o sobrenadante. Posteriormente, dissolveu-se o resíduo em 1 mL de tampão fosfato 25 mM (pH 6). A técnica de MEPS otimizada consistiu no acondicionamento com 250 μL de metanol (MeOH) e 250 μL de 0,1% HCOOH em H2O; load de 150 μL da amostra (12×); lavagem com 4x50 μL de HCOOH a 1% em H2O; secagem por aspiração de 4x50 μL de ar; eluição com 4x100 μL 1% NH4OH em MeOH. O eluato foi evaporado e procedeu-se à derivatização por 2 min em microondas a 800 W, após o qual se injetaram 2 μL no sistema cromatográfico. O método foi validado de acordo com as diretrizes internacionalmente aceites da Food and Drug Administration para o intervalo de linearidade entre 10 e 500 ng/mL. Obtiveram-se valores de coeficiente de determinação de pelo menos 0,99 e os valores de erro relativo e coeficiente de variação foram definidos de acordo com os critérios de validação. Os limites de quantificação foram estabelecidos entre os 10 e os 100 ng/mL e as recuperações absolutas variaram entre 12 e 93%. A estabilidade foi estudada para amostras processadas, estabilidade de bancada e ciclos de congelação/descongelação e a metodologia foi aplicada na análise de amostras autênticas de fluido oral. De salientar que este é o primeiro trabalho que utiliza MEPS para determinação de antidepressivos e metabolitos em amostras de fluido oral.
- Optimization and validation of an analytical method for the determination of opiates in urine using microextraction by packed sorbentPublication . Simão, Ana Y.; Monteiro, Catarina; Marques, Hernâni; Rosado, Tiago; Barroso, Mário; Andraus, Maristela; Gallardo, EugeniaAccording to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), approximately 1.3 million individuals have used opiates, both for medical and illicit purposes1, presenting a significant public health challenge2,3. To address this issue, methods for quantifying these substances are needed. Urine is a commonly employed matrix in clinical and forensic toxicological analyses due to its ease of collection and ample availability. Its short detection window is particularly effective for monitoring recent drug exposure4,5. This study aimed to optimize a method for determining tramadol, codeine, morphine, 6-acetylmorphine, 6- acetylcodeine, and fentanyl in urine samples (250 μL). The process involved centrifugation, acid hydrolysis, and extraction using microextraction by packed sorbent (MEPS). MEPS offered a rapid, environmentally friendly, and reusable extraction technique6. All parameters that influence the extraction were previously optimized. The method was validated following international guidelines, demonstrating excellent linearity [1 to 1000 ng/mL for all compounds, except for fentanyl (10 to 1000 ng/mL), with coefficients of determination of at least 0.99], and presenting coefficients of variation and bias ≤ 15% for precision and accuracy, except for the lowest calibrator (≤ 20%). Recoveries obtained ranged from 17 to 107%, with lowest percentages for morphine (12 to 17%). Despite the low extraction efficiency obtained for morphine, it was possible to detect concentrations as low as 1 ng/mL for all compounds, except for fentanyl (10 ng/mL). The method was successfully applied to real samples from consumers of these substances. This is the first method to use MEPS and GC-MS/MS for the simultaneous determination of these six opioids in urine samples.