title: A simple and sensitive GC/MS method for the determination of atropine during therapy of anticholinesterase poisoning in serum samples.
abstract: Atropine is used in the daily clinical practice for the treatment of poisonings caused by anticholinesterase pesticides, due to its sympathomimetic action. The investigation of the cause of the adverse effects that appear during atropine administration showed the necessity for the development and validation of a simple, rapid, sensitive, and specific method for the determination of atropine levels in serum samples. The developed method includes liquid-liquid extraction with ethyl acetate: dichloromethane (3:1, v/v) and derivatization using N,O-bis(trimethylsilyl)-trifluoracetamide (BSTFA) with 1% trimethylchlorsilane (TMCS) in acetonitrile environment. The method was found to be selective, linear, accurate, and precise according to international guidelines. The recovery was higher than 85.9%, the limit of quantification was 2.00 ng/ml, and the calibration curve was linear within the range of 2.00-500 ng/ml (R(2)  ≥ 0.992). Accuracy and precision were also calculated and were found to be less than 5.2 and 8.7%, respectively. The developed method was applied in a real case of accidental poisoning with chlorpyrifos in order to determine the atropine serum levels of the patient. The proposed method proved to be useful for the investigation of adverse effects that appear during atropine treatment of patients poisoned by anticholinesterase pesticides and it can also be used for the investigation of poisonings caused after consumption of atropine containing plants.
authors: Department of Forensic Medicine and Toxicology, School of Medicine, National and Kapodistrian University of Athens, Mikras Asias 75, Athens, Greece. jopamal@hotmail.com
authors: Ioannis
authors: I
authors: Papoutsis
authors: Panagiota
authors: P
authors: Nikolaou
authors: Chara
authors: C
authors: Spiliopoulou
authors: Constantinos
authors: C
authors: Pistos
authors: Maria
authors: M
authors: Stefanidou
authors: Sotirios
authors: S
authors: Athanaselis
mesh_terms: D000328:Adult; D001285:Atropine / Q000097:blood* / Q000302:isolation & purification; D004390:Chlorpyrifos / Q000506:poisoning; D002800:Cholinesterase Inhibitors / Q000506:poisoning; D008401:Gas Chromatography-Mass Spectrometry / Q000191:economics / Q000379:methods; D006801:Humans; D007306:Insecticides / Q000506:poisoning; D059625:Liquid-Liquid Extraction / Q000379:methods; D008297:Male; D018727:Muscarinic Antagonists / Q000097:blood* / Q000302:isolation & purification / Q000627:therapeutic use; D010276:Parasympatholytics / Q000097:blood* / Q000302:isolation & purification / Q000627:therapeutic use; D012680:Sensitivity and Specificity
chemical_list: D002800:Cholinesterase Inhibitors; D007306:Insecticides; D018727:Muscarinic Antagonists; D010276:Parasympatholytics; D001285:Atropine; D004390:Chlorpyrifos