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      Analysis, identification and confirmation of synthetic opioids using chloroformate chemistry: Retrospective detection of fentanyl and acetylfentanyl in urine and plasma samples by EI-GC-MS and HR-LC-MS

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          Abstract

          Electron Impact Gas Chromatography-Mass Spectrometry (EI-GC-MS) and High Resolution Liquid Chromatography-Mass Spectrometry (HR-LC-MS) have been used in the analysis of products arising from the trichloroethoxycarbonylation of fentanyl and acetylfentanyl in urine and plasma matrices. The method involves the initial extraction of both synthetic opioids separately from the matrices followed by detection of the unique products that arise from their reaction with 2,2,2-trichloroethoxycarbonyl chloride (Troc-Cl), namely Troc-norfentanyl and Troc-noracetylfentanyl. The optimized protocol was successfully evaluated for its efficacy at detecting these species formed from fentanyl and acetylfentanyl when present at low and high levels in urine (fentanyl: 5 and 10 ng/mL and acetylfentanyl: 20 and 100 ng/mL) and plasma (fentanyl: 10 and 20 ng/mL and acetylfentanyl: 50 and 200 ng/mL), values that reflect levels reported in overdose victims. The HR-LC-MS method’s LOQ (limit of quantitation) for the Troc-norfentanyl and Troc-noracetylfentanyl products was determined to be ~10 ng/mL for both species. Even though the superiority in the detection of these species by HR-LC-MS over EI-GC-MS, the latter method proved to be important in the detection of the second product from the reaction, namely 2-phenylethyl chloride that is crucial in the determination of the original opioid. This observation highlights the importance of using complimentary analytical techniques in the analysis of a sample, whether biological or environmental in nature. The method herein serves as a complementary, qualitative confirmation for the presence of a fentanyl in collected urine, plasma and by extension other biological samples amenable to the common extraction procedures described for opioid analysis. More importantly, the method’s main strength comes from its ability to react with unknown fentanyls to yield products that can be not only detected by EI-GC-MS and HR-LC-MS but can then be used to retrospectively identify an unknown fentanyl.

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          Mass spectral reference libraries: an ever-expanding resource for chemical identification.

          The basic principles, practices, and pitfalls in the process of compound identification by searching mass spectral reference libraries are presented. Factors affecting the identification process are discussed as members of one of three major contributors to identification confidence: prior probability, risk of false negative results, and risk of false positive results. More general concerns and the problem of "unknown unknowns" are then explored.
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            Reframing the Opioid Epidemic as a National Emergency

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              Opioids and Cardiac Arrhythmia: A Literature Review

              Objective: One of the most important side effects of opioids is their influence on the electrical activity of the heart. This review focusses on the effects of opioids on QT interval prolongation and their arrhythmogenic liability. Methods: By using various keywords, papers published up to 2018 in different databases were searched and identified. The search terms were opioids names, corrected QT interval, human-ether-a-go-go gene, torsades de pointes (TdP), cardiac arrhythmias, opioid dependence and other relevant terms. It emphasized the effects of each opioid agent alone on electrocardiogram (ECG) and some interactions. Results: Available data indicate that some opioids such as methadone are high-risk even at low doses, and have potential for prolongation of the QT interval and development of TdP, a dangerous ventricular tachycardia. A number of opioids such as tramadol and oxycodone are intermediate risk drugs and may develop long QT interval and TdP in high doses. Some other opioids such as morphine and buprenorphine are low-risk drugs and do not produce QT interval prolongation and TdP at least in routine doses. Opium-consumers are at higher risk of supra-ventricular arrhythmias, sinus bradycardia, cardiac block and atrial fibrillation. Conclusion: The cardiac arrhythmogenicity of various opioids is different. Methadone has a higher capability to induce long QT interval and dangerous arrhythmias in conventional doses than others. To reduce of arrhythmogenic risk, high doses of opioids must be used cautiously with periodic monitoring of ECG in high-risk consumers such as patients under opioid maintenance treatment.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: Writing – review & editing
                Role: Formal analysisRole: MethodologyRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLOS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                2 November 2022
                2022
                : 17
                : 11
                : e0275931
                Affiliations
                [1 ] Forensic Science Center, Lawrence Livermore National Laboratory, Livermore, CA, United States of America
                [2 ] Nuclear and Chemical Sciences Division, Lawrence Livermore National Laboratory, Livermore, CA, United States of America
                [3 ] Physical and Life Sciences Directorate, Lawrence Livermore National Laboratory, Livermore, CA, United States of America
                [4 ] Biosciences and Biotechnology Division, Lawrence Livermore National Laboratory, Livermore, CA, United States of America
                Fisheries and Oceans Canada, CANADA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0002-8641-9077
                https://orcid.org/0000-0002-8691-9063
                Article
                PONE-D-22-22025
                10.1371/journal.pone.0275931
                9629642
                36322521
                62820e6b-5690-417c-af32-9eedd4f310ed

                This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.

                History
                : 5 August 2022
                : 27 September 2022
                Page count
                Figures: 14, Tables: 0, Pages: 25
                Funding
                Funded by: United States Department of Energy
                Award ID: DE-AC52-07NA27344
                Funded by: funder-id http://dx.doi.org/10.13039/100006227, Lawrence Livermore National Laboratory;
                Award ID: PLS-21-FS-036
                Award Recipient :
                This work was performed under the auspices of the U. S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344. The was funded fully by a Mid-Career Research Grant awarded by the Lawrence Livermore National Laboratory (PLS-21-FS-036) to C. A. V. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology and Life Sciences
                Anatomy
                Body Fluids
                Urine
                Medicine and Health Sciences
                Anatomy
                Body Fluids
                Urine
                Biology and Life Sciences
                Physiology
                Body Fluids
                Urine
                Medicine and Health Sciences
                Pharmacology
                Drugs
                Analgesics
                Opioids
                Medicine and Health Sciences
                Pain Management
                Analgesics
                Opioids
                Medicine and Health Sciences
                Pharmacology
                Drugs
                Opioids
                Physical Sciences
                Chemistry
                Chemical Compounds
                Chlorides
                Research and Analysis Methods
                Spectrum Analysis Techniques
                Inductively Coupled Plasma Emission Spectroscopy
                Research and Analysis Methods
                Chromatographic Techniques
                Gas Chromatography-Mass Spectrometry
                Physical Sciences
                Chemistry
                Analytical Chemistry
                Mass Spectrometry
                Gas Chromatography-Mass Spectrometry
                Research and Analysis Methods
                Spectrum Analysis Techniques
                Mass Spectrometry
                Gas Chromatography-Mass Spectrometry
                Physical Sciences
                Chemistry
                Analytical Chemistry
                Mass Spectrometry
                Mass Spectra
                Research and Analysis Methods
                Spectrum Analysis Techniques
                Mass Spectrometry
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                Chromatographic Techniques
                Liquid Chromatography
                Liquid Chromatography-Mass Spectrometry
                Physical Sciences
                Chemistry
                Analytical Chemistry
                Mass Spectrometry
                Liquid Chromatography-Mass Spectrometry
                Research and Analysis Methods
                Spectrum Analysis Techniques
                Mass Spectrometry
                Liquid Chromatography-Mass Spectrometry
                Biology and Life Sciences
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                Medicine and Health Sciences
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                Custom metadata
                The data underlying the results presented in the study are available from the Lawrence Livermore National Laboratory, Forensic Science Center and are included in the Supporting Information accompanying this publication.

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