Screening and quantitative determination of drugs in diluted urine by UPLC-MS-MS

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Screening and quantitative determination of drugs in diluted urine by UPLC-MS-MS Solfrid Hegstad, PhD Department of Clinical Pharmacology St.Olavs Hospital

St.Olavs Hospital

Department of Clinical Pharmacology Clinical samples: Urine, serum, blood and hair 2010: Urine: 55000 (~65 %) Serum: 27000 (~30 %) Blood: 3600 (~4 %) Hair: 110 (~0.1 %) Postmortem samples: 200

Contents Screening of drugs in urine Ethyl glucuronide and Ethyl sulfate in urine

Background-Screening of drugs in urine 55000 urine samples per year Opioid-dependent patients in a medicationassisted rehabilitation program (LAR-Midt) Confirm buprenorphine or methadone treatment Control side-drug use Liquid-liquid extraction and singel LC-MS 80 % are positive, % 10 confirmed (IS14) by GC-MS

Aims Rapid, simple, specific and robust methods Reduce the costs per sample Dilution of sample (MSMS) Eliminate the use of toxic organic LLE solvents Small sample volume 50-100 µl: Less consumptions of IS/std/enzyme Automation: Less manually workload Short runtime (UPLC): Reduced number of instruments

Why two separate methods? Concentration level Analytical signal (MS) Chemical properties (glucuronides)

Method 1

Method 2

Sample preparation Method 1 Pipetting robot Tecan Freedom EVO Separation UPLC Acquity (Waters) 50 µl urine, IS, 1:250 30 % methanol in water Analytical column BEH C18 2,1X50 Mobile phase Flow 0.1 % NH 3, 2mM NH 3 formate/ methanol 0.6 ml/min Injection volume 5 µl Column temperature 50 ºC Run time 3.0 min

Sample preparation Method 2 Pipetting robot Tecan Freedom EVO Separation UPLC Acquity (Waters) 100 µl urine, 1:10 methanol,buffer, Enzymatic hydrolysis Analytical column HSS T3 2,1X100 Mobile phase Flow 0.1 % HCOOH/acetonitrile 0.7 ml/min Injection volume 7.5 µl Column temperature 50 ºC Run time 2.8 min

Detection Metode 1 Metode 2 Xevo TQ-S ESI MRM Positive mode Positive mode Negative mode Number of transition 2 per analyte* 2 per analyte Tramadol*; One transition, a metabolite is included to confirm identity Load ahead

Challenges To obtain linear calibration curve; detuning, alternative transition or C13 isotope CID fragmentation of amphetamine Stability of BEH C18 column Analytical separation of hydromorphone and morphine

BEH C18 Morphine and hydromorphone Hydromorphone HSS T3 Morphine

Summary: Screening of drugs in urine Two methods Simple and automatic sample preparation Short run time Validation Implementation of method

Ethyl glucuronide and Ethyl sulfate in urine

Ethyl glucuronide (EtG) and ethyl sulfate (EtS) in urine Ethanol mainly transformed to acetic acid Formation of EtG/EtS < 0.1 % of alcohol elimination Excreted in urine Markers of ethanol intake A larger surveillance window compared to ethanol (12 h)

Detection in urine EtG/EtS Up to 24 h after intake of 1-2 bottles of beer. Up to 48 h after intake of 3-4 bottles of beer Up to 130 h after heavy drinking

Sample preparation EtG and EtS in urine Pipetting robot Tecan Freedom EVO Separation UPLC Acquity (Waters) 100 µl urine, 1:20 Water and IS Analytical column HSS T3 2,1X100 Mobile phase Flow 0.1 % HCOOH/methanol 0.6 ml/min Injection volume 5 µl Column temperature 50 ºC

Gradient table Time (min) 0.1 % HCOOH in Methanol (%) water (%) Initial 99 1 1.0 80 20 1.1 10 90 1.5 10 90 1.7 99 1

Detection Waters Xevo TQ-S Negativ mode ESI MRM Analyte Transition (m/z) Cone (V) CE (ev) Internal standard EtG EtG EtS 221.0 > 85.1 40 15 EtG-d 5 221.0 >75.1 40 15 125.0 > 97.1 50 15 EtS-d 5 226.0 > 85.1 40 15 EtS-d 5 5 130.0 > 97.8 50 15

Table 1 Calibration range, Correlation Coefficient, LOQ, Within-assay precision, Betweenassay precision and Accuracy Analyte Calibration range, (ng/ml) Correlation Coefficient R 2 n=5 LOQ, (ng/ml) Theoretical Concentration (ng/ml) Within -assay RSD (n=10) % Between -assay RSD (n=10) % Accuracy (n=10) % EtG 200-20000 0.999 100 300 5 8 2 3000 4 4 4 7000 3 3 2 15000 4 EtS 200-20000 0.999 80 300 5 6 4 3000 4 4 4 7000 3 3 3 15000 4

Table 2 Matrix Effect Analyte Theoretical Concentration (ng/ml) ME (%) RSD (%) ME corrected with internal standard (%) RSD (%) EtG 300 83 11 100 6 7000 82 10 94 3 EtS 300 160 14 107 2 7000 141 12 100 2

Potential applications Driving license renewal Workplace testing Control of prison inmates Social and child welfare services Forensic toxicology Victims of sexual abuse

Victims of sexual abuse 74 samples 2010/2011 Number of samples Ethanol EtG EtS 24 Positive Positive Positive 30 Negative Positive Positive 20 Negative Negative Negative

Summary: EtG and EtS in urine Simple and automatic sample preparation Specific and robust Validation Implementation of method

Acknowledgement Technical assistance: Lisa Sylten Lisbeth Michelsen Audhild Naavik Method development: Sigurd Hermansson