A Purinethol (6-mercaptopurine) fatality in a case of prescription negligence: a gas chromatographic determination of 6-mercaptopurine.
A 64-year-old white female was given Purinethol (6-mercaptopurine) in place of propylthiouracil. A gas chromatographic method for the determination of 6-mercaptopurine in blood and other biological tissues has been developed. Samples were extracted with chloroform/isopropanol (4:1) at pH 7.0 and back-extracted into 0.5N sodium hydroxide (NaOH). The NaOH fraction was neutralized and buffered at pH 7.0 and extracted with chloroform/isopropanol (4:1). Quantitation was made by gas chromatography following methylation of the drug with trimethylanilinum hydroxide on an OV-101 or OV-225 column, using an internal standard. 6-Mercaptopurine was identified in all tissues by gas chromatography/mass spectrometry. The derivatized drug was identified by its electron impact mass spectrum as a dimethylated compound that has a molecular ion at m/e 180, which is also the base peak. The highest concentration of Purinethol was found in blood (110 mg/L). Concentrations in other tissues have been given. This is probably the first reported death by Purinethol.
D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology; D002849:Chromatography, Gas / Q000379:methods*; D011307:Drug Prescriptions; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D008318:Malpractice; D015122:Mercaptopurine / Q000032:analysis / Q000506:poisoning*; D008875:Middle Aged; D013806:Theophylline
D013806:Theophylline; D015122:Mercaptopurine