Volume 27, Issue 2 (April 1982)
A Purinethol® (6-Mercaptopurine) Fatality in a Case of Prescription Negligence: A Gas Chromatographic Determination of 6-Mercaptopurine
A 64-year-old white female was given Purinethol® (6-mercaptopurine) in place of propylthiouracil. A gas chromatographic method for the determination of 6-mercaptopurine in blood and other biological tissues has been developed. Samples were extracted with chloroform/isopropanol (4:1) at pH 7.0 and back-extracted into 0.SN sodium hydroxide (NaOH). The NaOH fraction was neutralized and buffered at pH 7.0 and extracted with chloroform/isopropanol (4:1). Quantitation was made by gas chromatography following methylation of the drug with trimethylanilinum hydroxide on an OV-101 or OV-225 column, using an internal standard. 6-Mercaptopurine was identified in all tissues by gas chromatography/mass spectrometry. The derivatized drug was identified by its electron impact mass spectrum as a dimethylated compound that has a molecular ion at m/e 180, which is also the base peak. The highest concentration of Purinethol was found in blood (110 mg/L). Concentrations in other tissues have been given. This is probably the first reported death by Purinethol.