Acidic and neutral drugs screen in blood with quantitation using microbore high-performance liquid chromatography-diode array detection and capillary gas chromatography-flame ionization detection.

Blood previously acidified with aqueous saturated ammonium chloride solution was extracted with ethyl acetate. The dried extract was subjected to acetonitrile-hexane partition. The acetonitrile portion was analysed for the presence of acidic and neutral drugs by HPLC-DAD (200 mm x 2.1 mm I.D. microbore ODS-Hypersil column) and GC-FID (25 m narrow-bore x 0.25 mm I.D. HP-5 column with 0.33 micron film thickness). The protocol was found to be suitable for both clinical toxicology (including emergency toxicology) and postmortem toxicology. At least 66 drugs of interest were unequivocally identified by RRTs (HPLC) and UV spectra (DAD) match while another 12 were unequivocally identified by double RRTs match (HPLC and GC). Quantitation was facilitated by incorporating calibration blood standards in each assay batch. The five drugs most commonly encountered in clinical blood specimens (1150 cases) were: paracetamol (47.4% of the cases); chlormezanone (6.6%), theophylline (1.74%), naproxen (1.65%) and mefenamic acid (1.56%). The following drugs were detected in toxicologically significant quantities in postmortem blood specimens (245 cases): phenobarbitone (1.22% of the cases), naproxen (0.82%), chlormezanone (0.82%), theophylline (0.82%), carbamazepine (0.41%) and paracetamol (0.41%).