Clinical Toxicology

LC/MS/MS is now widely used in confirmation analysis in clinical toxicology. The technique is particularly useful for polar, non-volatile, thermally labile compounds which are difficult to analyze by gas chromatography-based techniques. In addition, the sample pre-treatment requirements of LC/MS/MS make it an invaluable tool in high throughput toxicology laboratories. In addition to confirmatory and quantitative analysis, LC/MS is also a powerful tool for drug screening. Waters has developed an LC/MS toxicology library specifically for screening applications.

The utilization of LC/MS (and particularly LC/MS/MS) in clinical toxicology laboratories has increased significantly in recent years. The sensitivity, rapid analysis, selectivity and simple sample pretreatment requirements have led to LC/MS/MS methods being adopted as the first choice for many important applications. In addition to the common illicit drugs such as amphetamines, opiates, cannabis, LSD and cocaine, many prescribed ‘legal’ drugs have a high potential for abuse and are knowingly abused or accidentally misused e.g. benzodiazepines and the prescribed opiates, methadone and buprenorphine.

Drugs of abuse analysis is typically a two-part process - an initial screening test is usually followed by a confirmatory analysis of putative positive results screens. The most widely used screening technique is immunoassay while GC/MS is the most utilized technique for confirmation analysis. LC/MS/MS is now an established technique for confirmation analysisand is increasingly used for screening applications.

Underpinning our customers successes are Waters Services and Support initiatives which are designed specifically for clinical laboratories looking for performance optimization and the reassurance that they can get on-site support if an issue should arise. Waters provides priority on-site services, repairs, telephone support, and offers optional remote monitoring and diagnostic capabilities minimizing any downtime and optimizing your investment. Waters is committed to the results you gain from our integrated system solutions.

As such, the program sets new standards for MassTrak™ Systems support in your clinical laboratory.

• Guaranteed prioritized service
• Guaranteed two-hour response for callback after receipt of a support call
• Guaranteed on-site response time of two business days (48 hours)
• Single vendor support for HPLC and mass spectrometry systems and applications

Clinical toxicologists worldwide now recognize the outstanding selectivity, sensitivity and robustness of LC-MS/MS technology. Waters Systems bring the power of LC/MS, LC-MS/MS, UPLC-MS/MS and GC-MS/MS to the laboratory in robust, easy-to-use and cost-effective total system solutions.

Advantages of MassTrak™ Clinical Systems:

• New levels of sample throughput, performance and flexibility for both screening and confirmation applications
• Greatly increased sample throughput due to minimal sample preparation and fast chromatography [Ultra Performance LC^® chromatography]
• Accurate measurement in alternative sample matrices such as oral fluid, sweat and hair
• Confirmation analysis with the highest degree of confidence

With LC-MS/MS, amphetamines, opiates, benzodiazepines, GHB and many other drugs of abuse can be analyzed without prior derivatization or complex sample pre-treatment. The high sensitivity of LC-MS/MS means that small sample volumes can be used. For example, using LC-MS/MS, accurate quantification can be achieved from as little as 50 microliters of oral fluid.

Short UPLC-MS/MS run times, combined with simple, fast sample pre-treatment, mean that sample throughput is greatly increased when compared to traditional GC/MS methods.

MassTrak Systems™ with TargetLynx™ Application Manager enable the quantification and verification of drugs of abuse in a single LC run with a high degree of confidence.