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Published:
Journal of Analytical Toxicology,
ISSN 0146-4760,
Volume 24,
Number 7, October,
pp. 478-482
Here is where the title stuff goes
Cocaine
and its Major Metabolites in Plasma and Urine Samples from Patients in an Urban
Emergency Medicine Setting
Robert
H. Williams1, Jack A. Maggiore1, Steve M. Shah1, Timothy B. Erickson2, and Adam
Negrusz3
1Department of Pathology, Division of Clinical Pathology (M/C 750), University
of Illinois at Chicago Medical Center, 840 South Wood Street, 201G CSB, Chicago,
Illinois 60612; 2Department of Emergency Medicine, Division of Toxicology (M/C
724), University of Illinois at Chicago Medical Center, 808 South Wood Street,
471 CME, Chicago, Illinois 60612; and 3Department of Pharmaceutics and Pharmacodynamics
(M/C 865), University of Illinois at Chicago Medical Center, 833 South Wood
Street, 365 PHARM, Chicago, Illinois 60612
In this retrospective
study, we examined the levels of cocaine and its major metabolites in plasma
and urine from 29 randomly selected emergency department patients (19 males
and 10 females, aged 19 to 55) whose urine screened positive for benzoylecgonine
using fluorescence polarization immunoassay. Levels of cocaine along with benzoylecgonine,
ecgonine methyl ester, and norcocaine were quantitated in EDTA plasma and urine
from each patient using gas chromatographymass spectrometry with selected
ion monitoring. Admission diagnosis and history were also obtained for each
patient. In plasma, the levels were 16130 ng/mL for cocaine (n = 3), 2796
ng/mL for ecgonine methyl ester (n = 9), and 181390 ng/mL for benzoylecgonine
(n = 22). Norcocaine was not detected in any of the plasma samples. In urine,
the concentration ranges were 440,130 ng/mL for cocaine (n = 23), 36660,500
ng/mL for ecgonine methyl ester (n = 27), and 92520 ng/mL for norcocaine
(n = 9). All urine samples were positive for benzoylecgonine (1063,361,000
ng/mL), and benzoylecgonine was the only metabolite present in two urine samples
(at concentrations of 407 and 435 ng/mL). Two patients had plasma and urine
samples positive for all analytes (except norcocaine in plasma). The patient
with the highest urinary concentrations of cocaine (40,130 ng/mL), ecgonine
methyl ester (660,500 ng/mL), benzoylecgonine (3,361,000 ng/mL), and norcocaine
(2520 ng/mL) had a small quantity of benzoylecgonine (465 ng/mL) in plasma.
No correlation was noted with patient history, admitting diagnosis or symptomatology,
or plasma/urine levels of cocaine or any of its metabolites.
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