Development of a Lc-ms/Ms Method to Detect and Quantify Pyridostigmine in Plasma

Abstract

Pyridostigmine is a reversible acetylcholinesterase inhibitor that has been used to help treat myasthenia gravis and reduce nerve agent effects. By reversibly binding to acetylcholinesterase, Pyridostigmine causes elevation of acetylcholine, which is beneficial in disease states where increased contractility is needed. The present study relates to the investigation of Pyridostigmine to treat cardiac patients. A sensitive and specific liquid chromatography tandem mass spectrometry (LC-MS/MS) method was developed to detect Pyridostigmine in plasma samples from study participants dosed with this drug. The method was validated according to Scientific Working Group in Forensic Toxicology (SWGTOX) guidelines and used to quantify the amount of Pyridostigmine in the patient plasma samples. Solid phase extraction (SPE) was used to extract the drug from the plasma matrix. The SPE and LC-MS/MS method successfully quantified Pyridostigmine in the study participants, facilitating the development of a dosing model by research partners.