Alfazil, Abdulkareem Abdulwahab
Stability of drugs and pesticides of forensic toxicological interest and their metabolites in biological samples.
PhD thesis, University of Glasgow.
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Loss of analyte from biological samples during the post-mortem interval or during storage has potentially serious implications in forensic toxicology and represents a challenge for the forensic toxicologist, especially in the interpretation of case results. The initial aim of the studies in this thesis was to evaluate the stability of some important drugs and compounds in blood under different storage conditions in order to optimize the preservation of these compounds. A second aim was to evaluate a new method of stabilizing these compounds in blood by storing them as dried blood spots on filter paper. The third aim was to investigate methods by which corrections could be made for analyte losses based on quantification of their degradation products, which would serve as markers of the former presence of the compounds even if they were no longer detectable.
The background to toxicology and its classification systems is reviewed along with the most common areas of application, including forensic toxicology. Details are given of the most commonly-used matrices and of current problems facing forensic toxicologists, particularly the problem of analyte instability. The literature concerning stability of drugs and pesticides in biological samples are reviewed and discussed as well as methods applied to enhance and stabilize analytes for long storage periods. Background is provided on methodologies used in the work reported in this thesis, including extraction techniques and instrumental analysis by LC-MS/MS and GC/MS. Also, because of its importance in forensic toxicology at present validation procedures and requirements are also discussed.
An initial study was made of drug stability during storage in blood samples for 1 year under conventional laboratory conditions using selected drugs from the benzodiazepine group, alprazolam, lorazepam, oxazepam and estazolam. Blank blood containing these drugs at low and high concentrations was stored in tubes at -20° C, 4°C and room temperature. Half of the tubes contained fluoride-oxalate preservative. Blood samples were analysed on the first (day zero), second and fourth days, and after one week, two weeks, one month, two months, three months, six months and one year using a method which was developed and validated for this study based on solid phase extraction (SPE) and liquid chromatography-tandem mass spectrometry (LC-MS/MS). Alprazolam and estazolam were stable at -20° C and 4° C, but decreased by almost 10% at room temperature (RT) at both concentrations. Lorazepam and oxazepam were stable at 20°C but were poorly stable at 4° C and decreased by 100% at RT by the end of the 1 year period. Sodium fluoride stabilised the drugs by approximately 13% compared to unpreserved samples. The long-term stability of alprazolam and estazolam is attributed to the presence of the trizolo ring in their structures which makes the compounds more resistant to hydrolysis, the most prominent degradation reaction affecting benzodiazepines.
A similar study was performed on the stability of morphine-3- and 6-glucuronide and codeine-6-glucuronide in blood and urine under the same storage conditions. These compounds were stable at -20° C, losing less than 7% but losses were higher at 4° C, up to 18% in blood and 28% in urine, and at room temperature up to 54% in blood and 78% in urine after 1 year. Sodium fluoride did not have a significant effect (<10% increase in stability).
An investigation was carried out on stabilisation of hydrolytically-labile benzodiazepines and cocaine in blood during storage as dried blood spots (DBS) on filter paper. An analytical method was developed and validated for this study based on SPE and LC-MS/MS analysis. The drugs selected were flunitrazepam, temazepam, oxazepam, lorazepam, nitrazepam, diazepam and cocaine. Blood spots (100 µl blood) on Guthrie card 903 containing the drugs at 1000ng/ml were dried overnight at RT. Spots were cut out and extracted with buffer (pH 6), which was analysed with the validated method. DBS were stored in duplicate at RT, 4°C and -20°C for up to one year. Degradation of the drugs in DBS in all storage conditions was less than for the corresponding liquid blood samples stored under similar conditions. More than 80% of each analyte could be recovered from DBS after one month while 15 % cocaine and 74 % of the benzodiazepines were recovered after 1 year under all conditions.
The degradation of diazepam, temazepam, chlorodiazepoxide and oxazepam by hydrolysis was studied over a 1 month period under conditions designed to accelerate the reaction (80 °C, pH 2 and 12) and the hydrolysis products 2-methylamino 5-chlorobenzophenone (MACB) and 2-amino 5-chlorobenzophenone (ACB) were analysed by a method based on SPE and LC-MS/MS which was developed and validated for this study. MACB and ACB in whole blood and urine were evaluated as indicators of the original drug concentrations. Blank blood and urine containing these compounds at 1000 ng/ml stored at high temperature (80°C) and under acidic (pH 2) and basic (pH 12) conditions at room temperature for one month. The samples were analyzed in duplicate at days 1, 2, 4, 7, 14 and 30. MACB and ACB were the main hydrolysis products and their concentrations increased as degradation of the drugs proceeded. They could be detected when the starting materials had completely disappeared. However, MACB and ACB were found to be further degraded under some of the conditions used and a further study was made of the conversion of MACB to ACB. It was concluded that the drugs studied were more sensitive to alkaline pH than to acidic pH or high temperature and that MACB and ACB can be used to confirm the original presence of these drugs in samples, especially when they have decomposed due to poor or prolonged storage conditions.
A final study was made of organophosphates (OPs) and their dialkylphosphate (DAP) hydrolysis products. A new method was developed and validated for analysis of OPs and DAPs in blood samples based on SPE and GCMS after derivatization with N-tert-butyldimethylsilyl-N-methyltrifluroacetamide. The influence of sodium fluoride preservative and storage as DBS on filter paper on the stability of OPs in blood was assessed over a 3 day period at RT. With preservative, DAPs concentrations increased as degradation of the OPs proceeded and they could be detected when the parent compounds had completely disappeared. OPs in DBS showed good stability in comparison to liquid blood samples containing NAF and the parent compounds were detected at the end of the observation period.
It was concluded that careful attention should be given to the storage of samples to avoid loss of analyte and erroneous interpretation of results. DBS could be an effective and inexpensive way of increasing analyte retention but routine use of preservatives without evaluation of their effects is discouraged, as these may accelerate loss of analyte.
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