Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University, Homburg, Germany.
Ther Drug Monit. 2022 Oct 1;44(5):599-605. doi: 10.1097/FTD.0000000000000974.
Every year, more new psychoactive substances (NPSs) emerge in the market of the drugs of abuse. NPSs belong to various chemical classes, such as synthetic cannabinoids, phenethylamines, opioids, and benzodiazepines. The detection of NPSs intake using different types of biological matrices is challenging for clinical toxicologists because of their structural diversity and the lack of information on their toxicokinetics, including their metabolic fate.
PubMed-listed articles reporting mass spectrometry-based bioanalytical approaches for NPSs detection published during the past 5 years were identified and discussed. Furthermore, the pros and cons of using common biological matrices in clinical toxicology (CT) settings to screen for NPSs are highlighted in this review article.
Twenty-six articles presenting multianalyte screening methods for use in the field of CT were considered. The advantages and disadvantages of different biological matrices are discussed with a particular view of the different analytical tasks in CT, especially emergency toxicology. Finally, an outlook introduces the emerging trends in biosamples used in CT, such as the exhaled breath.
Blood and urine represent the most common biological matrices used in a CT setting; however, reports concerning NPSs detection in alternative matrices are also available. Noteworthy, the selection of the biological matrix must depend on the clinician's enquiry because the individual advantages and disadvantages must be considered.
每年，都有更多的新型精神活性物质（NPS）出现在滥用药物市场上。NPS 属于各种化学类别，如合成大麻素、苯乙胺类、阿片类和苯二氮䓬类。由于其结构多样性以及关于其毒代动力学（包括代谢命运）的信息缺乏，临床毒理学家在使用不同类型的生物基质检测 NPS 摄入方面面临挑战。
本文确定并讨论了过去 5 年中在 PubMed 上列出的关于基于质谱的 NPS 检测的生物分析方法的文章。此外，本文还强调了在临床毒理学（CT）环境中使用常见生物基质筛查 NPS 的优缺点。
考虑了 26 篇介绍多分析物筛选方法在 CT 领域应用的文章。讨论了不同生物基质的优缺点，并特别关注 CT 中不同的分析任务，特别是急诊毒理学。最后，展望介绍了 CT 中使用的生物样本的新兴趋势，如呼气。
血液和尿液是 CT 环境中最常用的生物基质；然而，也有关于替代基质中 NPS 检测的报告。值得注意的是，生物基质的选择必须取决于临床医生的询问，因为必须考虑到个体的优缺点。
