Biomedical Engineering Reference
In-Depth Information
in urine to pharmacological effects is hardly possible. For urine sample preparation
simple dilution is often sufficient prior to direct injection onto the HPLC column.
Methods used to detect atropine and scopolamine [
12-
14,
55
] as well as ipratro-
pium and
N
-butyl-scopolamine [
78
] are listed in Table
8
.
More conventional drug screening approaches are designed as multi-analyte pro-
cedures for detection of a specified and limited number of analytes typically per-
formed by LC-MS/MS in the MRM mode [
117
]. In contrast, more modern
procedures make use of a linear QTrap instrument applying a survey of complex
scan modes, e.g., MRM, information dependent acquisition (IDA), and enhanced
product ion scan (EPI). Resulting data are compared with library entries for
identification as presented by Mueller et al. [
118
]. This new concept of multi-target
screening (MTS) comprises 301 forensically important drugs also including atro-
pine, benztropine, methyl scopolamine, cocaine and scopolamine.
To conclude this section some curious and daunting examples of TA intoxica-
tions analysed by LC-MS should be mentioned.
Incidental and accidental intake of atropine and scopolamine, which are the main
tropane alkaloids in plants of the
solanecae
family, may provoke poisoning of man
and livestock [
11,
13-
15,
55,
57,
119-
122
] causing agitation, aggression, hallucina-
tions, dry mouth and skin, mydriasis, loss of consciousness followed by coma com-
bined with tachycardia, hypotension, and hyperthermia [
57,
121
] . A detailed
statistical analysis of paediatric plant exposures in Germany within the years 1998-
2004 has been provided by Pietsch et al. [
123
]. They found that most prevalent
victims of accidental plant exposures are children in the age of 1-6 years presum-
ably being misled by the attractive plump berries.
A curious case of hallucinogenic scopolamine intoxication has been reported from
a prison inmate who smoked cigarettes spiked with the bronchodilatory antispasmotic
buscopan. LC-ESI MS/MS analysis proved that the API of this drug (
N
-butyl-
scopolamine, Fig.
1
) undergoes pyrolysis during smoking thus producing scopolamine
that was directly inhaled with the cigarette smoke and caused systemic effects [
124
] .
An alarming toxidram of atropine-poisoning in combination with cocaine abuse
was described by Boermans et al. [
53
]. A high number of habitual cocaine users
were brought to the hospital due to assumed cocaine intoxication but showed untyp-
ical signs and symptoms (e.g. restlessness, excitability, hallucinations, abdominal
pain, vomiting and muscular spasm). Analysis of serum by LC-ESI MS/MS revealed
the presence of atropine and confirmed the suspicion that users unintentionally
consumed atropine-adulterated cocaine (25 % w/w Atr
2
SO
4
) thus provoking acute
mortal danger by cardiovascular effects (Table
8
). The source and reason for
atropine adulteration was not addressed in the paper.
An unsavoury case study of TA poisoning was reported by Kintz et al. proving
the systematic and continuous scopolamine intake of children who were forced by
their own mother to take 4-10 Feminax tablets per day for months. Evidence of
scopolamine was achieved by LC-ESI MS/MS analysis of hair samples (Table
3
).
The Children survived and their mother had to face a charge of their offence [
56
] .
Moreover, TA were also misused to commit suicide sometimes in combination
with alcohol and other drugs [
125-
127
] .
