Page 32 - Advances in Forensic Applications of Mass Spectrometry - Jehuda Yinon

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alcohol, reduce the ability to drive a car or to work with machines, and they
often are the cause of poisonings. Therefore, screening for antihistamines is
necessary in clinical, forensic, and occupational toxicology. Identification of
50 H -blockers and their metabolites in urine has been described. This pro-
1
cedure allows rapid and specific detection and differentiation of therapeutic
concentrations of alkanolamine-, alkylamine-, ethylenediamine-, pipera-
zine-, and phenothiazine antihistamines (H -blockers). They are integrated
1
in a systematic GC/MS screening procedure. 1,224,237–239 Simultaneous screen-
ing and quantitation of 18 antihistamine drugs in blood has been described
using liquid chromatography ionspray tandem MS. 30

1.4.1.1.12 Antiparkinsonian Drugs. Antiparkinsonian drugs may lead to
severe poisonings because of their central depressive and anticholinergic prop-
erties. Toxicological detection of these drugs has been described as part of a
systematic screening and confirmation procedure. 1,132,240 Selegiline is of special
interest since it is metabolized to R(–)-methamphetamine and R(–)-amphet-
amine, which interfere with immunoassays for amphetamines. 5,132,133,241 Enan-
tioselective procedures help with differentiation of selegiline and
132
amphetamine/methamphetamine ingestion in urine and blood. 44
1.4.1.1.13 Beta-Blockers (b-Adrenoceptor Blockers). b-Adrenoceptor
blockers, conveniently named beta-blockers, are widely used, and therefore
they are frequently encountered in clinical and forensic analysis as well as in
242
doping control. For both indications, GC/MS urine screening procedures
have been published using enzymatic or acidic hydrolysis, followed by various
248
derivatization procedures. 1,243–249 Leloux et al. studied the effectiveness of
three derivatization procedures: TFA of the amino group and TMS of the
hydroxy group, twofold TFA, and n-butylboronylation to form a cyclic bor-
onate. The combination of N-TFA with O-TMS proved to be the best pro-
cedure. Detection of beta-blockers in human urine by GC/MS-MS has been
described and the implications have been discussed for doping control. 250

1.4.1.1.14 Antiarrhythmics (Class I and IV). Antiarrhythmics may lead
to severe cardiac and central nervous disorders if overdosed. As the symptoms
of such overdosing are similiar to symptoms of poisonings with other drugs
or to symptoms of internal or neurological diseases, a toxicological analysis
may be of great importance for diagnosis. Before quantification in plasma,
the drug must first be identified, preferably within a systematic screening
procedure. 1,244,251

1.4.1.1.15 Laxatives. Abuse of laxatives may lead to serious disorders like
hypokalemia or chronic diarrhea. Toxicological screening should be

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