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首页> 外文期刊>Journal of Analytical Toxicology >Qualitative Identification of Fentanyl Analogs and Other Opioids in Postmortem Cases by UHPLC-Ion Trap-MSn
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Qualitative Identification of Fentanyl Analogs and Other Opioids in Postmortem Cases by UHPLC-Ion Trap-MSn

机译：UHPLC离子陷阱 - MSN在淘压病例中芬太尼类似物和其他阿片类药物的定性鉴定

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摘要

Since 2013, the Miami-Dade County Medical Examiner Department has experienced an increase in the number of opioid-related deaths. The majority of cases coincided with the introduction of fentanyl into the local heroin supply. From 2014 to 2015, Miami-Dade County experienced a near 600% increase in fentanyl-related deaths, followed by an additional 200% increase in 2016. In 2015, two novel fentanyl analogs were identified in medical examiner cases: beta-hydroxythiofentanyl and acetyl fentanyl. In 2016, four additional fentanyl analogs emerged: para-fluoroisobutyryl fentanyl, butyryl fentanyl, furanyl fentanyl and carfentanil, as well as the synthetic opioid U-47700. In order to address this epidemic, a method was developed and validated to identify 44 opioid-related and analgesic compounds in postmortem samples using ultra high performance liquid chromatography ion trap mass spectrometry with MSn capabilities. The limit of detection for all compounds ranged from 0.1 to 5 ng/mL, with a majority having MS3 spectral fragmentation. Blood, urine, liver or brain specimens from similar to 500 postmortem cases were submitted for analysis based on case history and/or initial screening results. Of those cases, 375 were positive for illicit fentanyl and/or one or more fentanyl analogs. Due to the potency of these compounds, they were almost always included in the cause of death. Worth emphasizing and extremely alarming is the detection of carfentanil in 134 cases, 104 of which were initially missed by gas chromatography mass spectrometry. By incorporating this sensitive, highly specific, and evolving screening procedure into the workflow, the toxicology laboratory continues to effectively assist the medical examiners in determining the cause and manner of death of decedents in Miami-Dade County.
机译：自2013年以来，迈阿密戴德县医学审查员部经历了与表述相关死亡人数的增加。大多数病例随着芬太尼引入当地海洛因供应而恰逢。从2014年到2015年，迈阿密 - 戴德县的芬太尼相关死亡人数越来越多，随后在2016年增加了200％的增加。2015年，在医学检查案例中发现了两种新的芬太尼类似物：β-羟基戊烷基和乙酰基芬太尼。 2016年，出现了四种额外的芬太尼类似物：对氟代异丁基芬太尼，丁酰芳基，呋喃基，芬太尼，以及合成的阿片类药物U-47700。为了解决这种流行病，通过使用超高效液相色谱离子阱质谱法具有MSN能力，开发并验证了一种方法，以鉴定在后模拟样品中的44种阿片类药物和镇痛化合物。所有化合物的检测极限范围为0.1至5ng / ml，大部分具有MS3光谱碎片。根据案例历史和/或初始筛查结果，提交了类似于500次蛋白病例的血液，尿液，肝脏或脑标本。在这些情况下，375对于非法芬太尼和/或一种或多种芬太尼类似物是阳性的。由于这些化合物的效力，它们几乎总是包括在死因中。值得强调和极其惊人的是在134例中检测Carfentanil，其中104例最初被气相色谱质谱法遗漏。通过将这种敏感的，高度具体和不断发展的筛选程序纳入工作流程，毒理学实验室继续有效地帮助医学审查员确定迈阿密戴德县死者死亡的原因和方式。

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