LC-MS/MS application in pharmacotoxicological field: current state and new applications

Nowadays, it is vital to have new, complete, and rapid methods to screen and follow pharma-cotoxicological and forensic cases. In this context, an important role is undoubtedly played by liquid chromatography-tandem mass spectrometry (LC-MS/MS) thanks to its advanced features. This instrument configuration can offer comprehensive and complete analysis and is a very po-tent analytical tool in the hands of analysts for the correct identification and quantification of analytes. The present review paper discusses the applications of LC-MS/MS in pharmacotoxico-logical cases because it is impossible to ignore the importance of this powerful instrument to the rapid development of pharmacological and forensic advanced research in recent years. On one side, pharmacology is fundamental for drug monitoring and helping people to find the so-called “personal therapy” or “personalized therapy”. On the other side, toxicological and forensic LC-MS/MS represents the most critical instrument configuration applied for screening and re-search of drugs and illicit drugs, giving critical support to law enforcement. Often the two areas are stackable, and for this reason, many methods include analytes attributable to both fields of application. In this manuscript, drugs and illicit drugs were divided in separate sections, with particular attention in the first section to therapeutic drug monitoring (TDM) and clinical ap-proaches with a focus on central nervous system (CNS). The second section is focused on the methods developed in the last years for the de-termination of illicit drugs, often in combination with CNS drugs. All references herein considered cover the last 3 years, except for some specific and peculiar applications for which some more dated but still recent articles have been consid-ered.