RATIONALE Paper spray offers a rapid screening test without the need for sample preparation. The incomplete extraction of paper spray allows for further testing using more robust, selective and sensitive techniques such as liquid chromatography/mass spectrometry (LC/MS). Here we develop a two-step process of paper spray followed by LC/MS to (1) rapidly screen a large number of samples and (2) confirm any disputed results. This demonstrates the applicability for testing medication adherence from a fingerprint. METHODS Following paper spray analysis, drugs of abuse samples were analysed using LC/MS. All analyses were completed using a Q Exactive™ Plus Orbitrap™ mass spectrometer. This two-step procedure was applied to fingerprints collected from patients on a maintained dose of the antipsychotic drug quetiapine. RESULTS The extraction efficiency of paper spray for two drugs of abuse and metabolites was found to be between 15 and 35% (analyte dependent). For short acquisition times, the extraction efficiency was found to vary between replicates by less than 30%, enabling subsequent analysis by LC/MS. This two-step process was then applied to fingerprints collected from two patients taking the antipsychotic drug quetiapine, which demonstrates how a negative screening result from paper spray can be resolved using LC/MS. CONCLUSIONS We have shown for the first time the sequential analysis of the same sample using paper spray and LC/MS, as well as the detection of an antipsychotic drug from a fingerprint. We propose that this workflow may also be applied to any type of sample compatible with paper spray, and will be especially convenient where only one sample is available for analysis.

中文翻译：

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纸质喷雾筛查和液相色谱/质谱法确认药物依从性测试：两步过程。

RATIONALE纸浆喷雾无需样品制备即可提供快速筛查测试。纸喷雾的不完全提取允许使用更强大，选择性和灵敏的技术（例如液相色谱/质谱（LC / MS））进行进一步测试。在这里，我们开发了一个两步的纸浆喷涂过程，然后进行LC / MS分析，以（1）快速筛选大量样品，并（2）确认任何有争议的结果。这证明了从指纹测试药物依从性的适用性。方法在进行纸喷雾分析之后，使用LC / MS分析滥用样品的药物。所有分析均使用Q Exactive™Plus Orbitrap™质谱仪完成。此两步过程适用于在维持剂量的抗精神病药物喹硫平上从患者身上收集的指纹。结果发现纸浆对两种滥用药物和代谢物的提取效率在15％至35％之间（取决于分析物）。对于较短的采集时间，发现两次重复之间的萃取效率相差不到30％，从而可以通过LC / MS进行后续分析。然后，将这一分两步的过程应用于从两名服用抗精神病药物喹硫平的患者那里收集的指纹，这表明如何使用LC / MS解决纸质喷雾的阴性筛查结果。结论我们首次显示了使用纸喷雾和LC / MS对同一样品进行的顺序分析，以及从指纹中检测到抗精神病药。我们建议，该工作流程也可以应用于与纸张喷雾兼容的任何类型的样品，