title: Real-time monitoring of exhaled drugs by mass spectrometry.
abstract: Future individualized patient treatment will need tools to monitor the dose and effects of administrated drugs. Mass spectrometry may become the method of choice to monitor drugs in real time by analyzing exhaled breath. This review describes the monitoring of exhaled drugs in real time by mass spectrometry. The biological background as well as the relevant physical properties of exhaled drugs are delineated. The feasibility of detecting and monitoring exhaled drugs is discussed in several examples. The mass spectrometric tools that are currently available to analyze breath in real time are reviewed. The technical needs and state of the art for on-site measurements by mass spectrometry are also discussed in detail. Off-line methods, which give support and are an important source of information for real-time measurements, are also discussed. Finally, some examples of drugs that have already been successfully detected in exhaled breath, including propofol, fentanyl, methadone, nicotine, and valproic acid are presented. Real-time monitoring of exhaled drugs by mass spectrometry is a relatively new field, which is still in the early stages of development. New technologies promise substantial benefit for future patient monitoring and treatment.
authors.affiliation: Department of Chemistry and Applied Biosciences, ETH Zürich, CH-8093, Zürich, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Berchtold
authors.forename: Marija
authors.initials: M
authors.lastname: Bosilkovska
authors.forename: Youssef
authors.initials: Y
authors.lastname: Daali
authors.forename: Bernhard
authors.initials: B
authors.lastname: Walder
authors.forename: Renato
authors.initials: R
authors.lastname: Zenobi
mesh_terms: D001274:Atmospheric Pressure; D001944:Breath Tests / Q000295:instrumentation / Q000379:methods*; D003199:Computer Systems; D016903:Drug Monitoring / Q000295:instrumentation / Q000379:methods*; D045853:Exhalation; D006801:Humans; D013058:Mass Spectrometry / Q000295:instrumentation / Q000379:methods*; D010599:Pharmacokinetics; D012143:Respiratory Physiological Phenomena; D021241:Spectrometry, Mass, Electrospray Ionization / Q000295:instrumentation / Q000379:methods; D055549:Volatile Organic Compounds / Q000032:analysis
chemical_list: D055549:Volatile Organic Compounds
keywords: ambient mass spectrometry; breath analysis; drug analysis; real-time analysis