Utveckling av en LC-MS/MS metod för analys av 12 antipsykotiska läkemedel och 9 metaboliter i humanplasma

Sammanfattning: Antipsychotics (AP) are used to treat psychotic symptoms in patients with e.g. schizophrenia or bipolar disorder. To find the right treatment may be difficult and demands carefully monitoring of the concentration in blood tests. In psychopharmacology therapeutic drug monitoring (TDM) of antipsychotics is an important tool for optimizing the treatment. With repeated blood tests it is possible to monitor the patient response, interactions and compliance. The aim of this project was to develop a method for sample preparation and analysis by UHPLC-MS/MS suitable for 12 antipsychotic drugs and 9 major metabolites in human plasma samples. The project was divided in to six different steps (1) Preparation of stock solutions and infusions of the analytes and internal standards. (2) Calculation of the monoisotopic molecular weight. (3) Optimization of the cone voltage and collision energy (4) Optimization of the chromatography by selecting the ideal mobile phase and column (5) Preparation of the calibration curve (5) Extraction with protein precipitation (6) Analysis on an Acquity I Class coupled to an Xevo TQ-XS MS and separation on a Cortects UPLC C18 (1.6 µm 2.1x50 mm) with gradient elution at 0.5 ml/min and a 5.20-min run-time. Detection was made with MRM, monitoring 2 ion transitions per compound. Isotope labeled internal standards were used for 9 of the compounds. In order for the method to be used in routine analysis, some work remains to be done regarding validating, optimizing the mass spectrometer's settings, testing for extraction yield, matrix effects and analysis of patient samples.