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      Die Intensivmedizin 

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      Springer Berlin Heidelberg

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          Poisoning Severity Score. Grading of Acute Poisoning

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            Position of chromatographic techniques in screening for detection of drugs or poisons in clinical and forensic toxicology and/or doping control

            This paper reviews chromatographic screening procedures for simultaneous detection of several drug classes relevant to clinical and forensic toxicology or doping control in urine or blood using gas chromatography-mass spectrometry (GC-MS), liquid chromatography coupled with a diode-array detector (LC-DAD) or a mass spectrometer (LC-MS). The pros and cons of the different techniques and procedures are discussed leading to the following conclusions and perspectives. GC-MS, especially in the electron ionization full-scan mode, is still the method of choice for comprehensive screening providing best separation power, specificity and universality, although requiring derivatization. LC-DAD is also often used for screening, but its separation power and its specificity are still inferior to those of GC-MS. Finally, LC-MS has shown to be an ideal supplement, especially for the detection of more polar, thermolabile and/or low-dose drugs, especially in blood plasma. It may become the gold standard in clinical and forensic toxicology and doping control if, at a later date, the costs of the apparatus will be markedly reduced, the current disadvantages like irreproducibility of fragmentation, reduction of ionization by matrix, etc. will be overcome, and finally if one of the increasing number of quite different techniques will become the apparatus standard.
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              Mithridates VI Eupator, father of the empirical toxicology.

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                Book Chapter
                2011
                : 1101-1111
                10.1007/978-3-642-16929-8_86
                f23551f8-fdb7-447e-8287-b3a3194b5ee7
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