title: Interpretation of pharmaceutical drug concentrations in young children's head hair.
abstract: Three separate cases of child administration of prescription drugs are described. Following liquid-liquid extraction, high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) was used to identify and quantify methadone, 2-ethylidene-1,5-dimethyl-3,3-diphenyl-1-pyrrolidine (EDDP), tramadol, amitriptyline, and nortriptyline in children's hair. The children's age ranged from 14 months to 7 years; in all three cases, the drug in question was detected in more than one section of hair. Methadone was detected in the concentration range of 0.65-0.99 and 0.04-0.4 ng/mg; tramadol was detected in the concentration range of 1.5-2.2 ng/mg; amitriptyline and nortriptyline were detected in the concentration range of 0.18-1.06 and 0.38-2.0 ng/mg, respectively. In each case, the children's parents admitted to or were found guilty of drug administration to the child. These cases demonstrate the added value of hair testing and emphasize the importance of using hair samples to complement conventional analyses.
authors.affiliation: Office of the Chief Medical Examiner, 7007-116 Street NW, Edmonton, AB, T6H 5R8, Canada.
authors.forename: Craig
authors.initials: C
authors.lastname: Chatterton
authors.forename: Kirsten
authors.initials: K
authors.lastname: Turner
authors.forename: Nadine
authors.initials: N
authors.lastname: Klinger
authors.forename: Matthieu
authors.initials: M
authors.lastname: Etter
authors.forename: Mathieu
authors.initials: M
authors.lastname: Duez
authors.forename: Vincent
authors.initials: V
authors.lastname: Cirimele
mesh_terms: D000328:Adult; D000639:Amitriptyline / Q000032:analysis; D000929:Antidepressive Agents, Tricyclic / Q000032:analysis; D002648:Child; D016241:Child of Impaired Parents; D002675:Child, Preschool; D002853:Chromatography, Liquid; D005260:Female; D053593:Forensic Toxicology; D006197:Hair / Q000737:chemistry*; D006801:Humans; D007223:Infant; D008691:Methadone / Q000032:analysis; D009294:Narcotics / Q000032:analysis; D009661:Nortriptyline / Q000032:analysis; D011759:Pyrrolidines / Q000032:analysis; D015813:Substance Abuse Detection / Q000379:methods*; D053719:Tandem Mass Spectrometry; D014147:Tramadol / Q000032:analysis
chemical_list: D000929:Antidepressive Agents, Tricyclic; D009294:Narcotics; D011759:Pyrrolidines; D000639:Amitriptyline; D014147:Tramadol; D009661:Nortriptyline; D008691:Methadone; C010724:2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine
keywords: amitriptyline; children's hair; drug administration; forensic science; forensic toxicology; high-performance liquid chromatography-tandem mass spectrometry; methadone; tramadol