Olanzapine is a thienobenzodiazepine class antipsychotic that strongly antagonises the 5-HT2A serotonin receptor, but acute poisonings are reported rarely. Symptoms of an overdose include disorder of consciousness, hypersalivation, myosis, and coma. Serum concentration higher than 0.1 mg/L is toxic, while concentration above 1 mg/L can be fatal. Here we report key data about 61 patients admitted to the National Poison Control Centre in Belgrade, Serbia over olanzapine poisoning in 2017 and 2018. The ingested doses ranged from 35 to 1680 mg, and time from ingestion to determination from two to 24 hours. In 34 patients olanzapine serum concentrations were in the therapeutic range and in 27 in the toxic range. In five patients they were higher than fatal, but only one patient died. The most common symptoms of poisoning were depressed consciousness (fluctuating from somnolence to coma), tachycardia, hypersalivation, hypotension, myosis, and high creatine kinase. All patients but one recovered fully after nonspecific detoxification and symptomatic and supportive therapy.
Olanzapin je antipsihotik koji pripada grupi tienobenzodiazepina. Kao i drugi atipični antipsihotici, olanzapin je jak antagonist 5-HT2A serotoninskih receptora. Akutna trovanja olanzapinom su rijetka. Simptomi predoziranja uključuju duboki ili fluktuirajući poremećaj stanja svijesti s hipersalivacijom i miozom, kao i komu i smrt u slučaju ingestije velikih doza. Koncentracije olanzapina u serumu veće od 0,1 mg/L smatraju se toksičnima, a letalnima veće od 1 mg/L. U radu su prikazana akutna trovanja olanzapinom zabilježena u Nacionalnom centru za kontrolu trovanja u Beogradu tijekom dvije godine. Koncentracije olanzapina u serumu pacijenata akutno otrovanih olanzapinom određene su pouzdanom metodom tekuće kromatografije s masenom spektrometrijom. Registriran je 61 pacijent s predoziranjem olanzapinom: u njih 34 koncentracije olanzapina bile su u terapijskom opsegu, a u njih 27 zabilježene su toksične koncentracije. Pet pacijenata imalo je koncentracije veće od letalnih, a zabilježen je i jedan smrtni ishod. Najčešći simptomi trovanja bili su hipotenzija, tahikardija i povećanje aktivnosti enzima kreatin kinaze. Nakon primjene nespecifičnog detoksikacijskog simptomatskog i potpornog liječenja svi pacijenti osim jednog su se potpuno oporavili.

PPCPs are found almost everywhere in the environment especially at an alarming rate and at very low concentration in the aquatic systems. Many methods-including pressurized hot water extraction (PHWE), pressurized liquid extraction (PLE), ultrasound-assisted extraction (UAE), and micro-assisted extraction (MAE)-have been employed for their extraction from both surface waters and biota. Solid-phase extraction (SPE) proved to be the best extraction method for these polar, non-volatile, and thermally unstable compounds in water. However, ultrasonic extraction works better for their isolation from sediment because it is cheap and consumes less solvent, even though SPE is preferred as a clean-up method for sediment samples. PPCPs are in groups of-acidic (e.g., diclofenac, ibuprofen, naproxen), neutral (e.g., caffeine, carbamazepine, fluoxetine), and basic pharmaceuticals, as well as antibiotics and estrogens amongst others. PPCPs which are present in trace levels (ng/L) are more often determined by liquid chromatography-mass spectrometry (LC-MS), gas chromatography-mass spectrometry (GC-MS), and high-performance liquid chromatography-ultraviolent (HPLC-UV). Of these, LC-MS and LC-MS-MS are mostly employed for the analysis of this class of compounds, though not without a draw-back of matrix effect. GC-MS and GC-MS-MS are considered as alternative cost-effective methods that can also give better results after derivatization.

This review describes published high performance liquid chromatography/mass spectrometry (HPLC-MS) methods for the determination of anticancer drugs in human urine as non-invasive tool for monitoring of health care worker exposure to antineoplastic and cytotoxic drugs. HPLC-MS is a sensitive and specific method for analysis of anticancer drugs and their metabolites in biological fluids. In this review, a tabular summary and overview of published HPLC-MS methods are presented, as well as future trends and limitations in this area of research.