title: The postmortem distribution of vardenafil (Levitra) in an aviation accident victim with an unusually high blood concentration.
abstract: Vardenafil (Levitra) is one of the most widely prescribed treatments for erectile dysfunction. This report presents a rapid and reliable method for the identification and quantification of vardenafil in postmortem fluids and tissues, applies this method to a postmortem case, and describes the distribution of vardenafil in various fluids and tissues. This procedure utilizes sildenafil-d8, which is structurally closely related to vardenafil, as an internal standard for more accurate and reliable quantitation. The method incorporates solid-phase extraction and liquid chromatography-tandem mass spectrometry (MS) and MS-MS-MS utilizing an atmospheric pressure chemical ionization ion trap MS in the positive chemical ionization mode. Solid-phase extraction proved to be exceptionally efficient providing recoveries that ranged from 94% to 97%. The limit of detection for vardenafil was determined to be 0.19 ng/mL. The linear dynamic range for this compound was 0.39-200 ng/mL. This method was successfully applied to postmortem fluid and tissue specimens obtained from an aviation accident victim. The distribution of vardenafil in various fluids and tissues and the unusually high concentration of vardenafil in the victim's blood are examined.
authors.affiliation: Civil Aerospace Medical Institute, Federal Aviation Administration, Analytical Toxicology and Accident Research Laboratory, AAM-610, CAMI Building, 6500 S. MacArthur Blvd., Oklahoma City, Oklahoma 73169-6901, USA. r.d.johnson@faa.gov
authors.forename: Robert D
authors.initials: RD
authors.lastname: Johnson
authors.forename: Russell J
authors.initials: RJ
authors.lastname: Lewis
authors.forename: Mike K
authors.initials: MK
authors.lastname: Angier
mesh_terms: D000060:Accidents, Aviation; D001646:Bile / Q000737:chemistry; D002851:Chromatography, High Pressure Liquid; D006801:Humans; D007093:Imidazoles / Q000097:blood* / Q000493:pharmacokinetics; D007668:Kidney / Q000378:metabolism; D008099:Liver / Q000378:metabolism; D008168:Lung / Q000378:metabolism; D008297:Male; D013058:Mass Spectrometry; D018482:Muscle, Skeletal / Q000378:metabolism; D009206:Myocardium / Q000378:metabolism; D010726:Phosphodiesterase Inhibitors / Q000097:blood* / Q000493:pharmacokinetics; D010879:Piperazines / Q000097:blood* / Q000493:pharmacokinetics; D052616:Solid Phase Extraction; D013450:Sulfones / Q000097:blood / Q000493:pharmacokinetics; D014018:Tissue Distribution; D014227:Triazines / Q000097:blood / Q000493:pharmacokinetics; D000069058:Vardenafil Dihydrochloride
chemical_list: D007093:Imidazoles; D010726:Phosphodiesterase Inhibitors; D010879:Piperazines; D013450:Sulfones; D014227:Triazines; D000069058:Vardenafil Dihydrochloride