Journal Article

Simultaneous Determination of Carisoprodol and Acetaminophen in an Attempted Suicide by Liquid Chromatography-Mass Spectrometry with Positive Electrospray Ionization

Tomohiro Matsumoto, Toshiyuki Sano, Toshiyasu Matsuoka, Minoru Aoki, Yoshitaka Maeno and Masataka Nagao

in Journal of Analytical Toxicology

Volume 27, issue 2, pages 118-122
Published in print March 2003 | ISSN: 0146-4760
Published online March 2003 | e-ISSN: 1945-2403 | DOI: http://dx.doi.org/10.1093/jat/27.2.118
Simultaneous Determination of Carisoprodol and Acetaminophen in an Attempted Suicide by Liquid Chromatography-Mass Spectrometry with Positive Electrospray Ionization

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An adult female ingested a considerable quantity of carisoprodol/acetaminophen tablets, which are not commercially available in Japan, in an attempt to commit suicide. Generally, because of lack of the appreciable ultraviolet absorbance or fluorescence, carisoprodol and its major metabolite meprobamate are determined by gas chromatography or gas chromatography-mass spectrometry. Complicated derivatization is, however, necessary to that methodology. Thus, we investigated the derivatization-free, highly sensitive, and simultaneous determination of carisoprodol, meprobamate, and acetaminophen by means of liquid chromatography-mass spectrometry (LC-MS) with positive electrospray ionization. A semi-micro ODS column was used. Ammonium acetate solution (10mM) and acetonitrile were used as mobile phase at a flow rate of 150 µL/min using gradient elution. MS parameters were as follows: capillary voltage, 3.5 kV; cone voltage, +30 V; extractor voltage, 5 kV; and ion source temperature, 100°C. Urine samples pretreated by Oasis™ HLB cartridge, or plasma samples deproteinized by adding ice-cold acetonitrile were analyzed by LC-MS. The limits of quantitation for each compound were as follows: 0.50 ng/mL for carisoprodol; 10 ng/mL for acetaminophen; and 1.0 ng/mL for meprobamate. In the present case, carisoprodol and acetaminophen were the only drugs detected. Meprobamate was also found as the metabolite of carisoprodol in both urine and plasma. The plasma levels of carisoprodol, acetaminophen, and meprobamate on arrival were 29.5, 245, and 46.7 µg/mL, respectively. These levels were extremely high compared with therapeutic plasma concentrations. Despite the high plasma concentrations of these drugs, which correspond to fatal levels, the patient survived.

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Subjects: Medical Toxicology ; Toxicology (Non-medical)

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