PubMed · 428700
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Fatalities due to propoxyphene.. https://pubmed.ncbi.nlm.nih.gov/428700/
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Dextropropoxyphene and nordextropropoxyphene were extracted from urine samples with mixed mode solid-phase extraction cartridges. After elution and evaporation to dryness, the eluate was dissolved in mobile phase and each sample was injected in a LC-ESI-MS system. Quantification was carried out in the selected ion monitoring mode. This article shows the possibility to analyse drugs of abuse substances in urine with a single quadrupole mass spectrometer if only a thorough work-up procedure and a sufficient chromatographic separation is accomplished. In order to enhance the fragmentation of the analytes, in-source fragmentation was carried out. One fragment and the pseudomolecular ion per analyte together with chromatographic retention times were sufficient to verify that the sought compound was found in the samples. In- and between day variation was lower than 10% and the recovery was well above 90%. The analytes were quantified in the range 100-10000 ng/ml urine.
This case illustrates some common problems faced in general practice--the effects of personality and family dynamics on symptom reporting, the balance between over-investigation and under-investigation, and the dilemma of when to refuse to comply with patient requests for medication. Dealing with these is the art of good medicine.
The detection of drugs of abuse in urine by four commercial immunoassay systems (TDx, BCL and PFI-20 opiates, and PFI-20 morphine) and one commercial TLC system (Toxi-Lab) was investigated and results compared with those obtained by a dual-column capillary GC system. The TDx system was the most reliable method for preliminary screening of urines for opiates; all the commercial immunoassay systems gave some results which were at variance with those of the GC. The GC method proved to be more reliable than the commercial TLC system in discriminating between the different opiates and is recommended for identification of drugs of abuse in urine specimens in which positive results have been obtained with preliminary screening procedures.