Clinical toxicology testing and performing enhancing drugs Flashcards
what is impacted the most from society due to alcohol abuse
lost productivity
why is urine a preferred specimen
higher [] of drugs compared to others
screening assay compatible
limitations of urine as a specimen
dont know how much or when drugs were ingested
ritalin/methlyphenidate or oral hypoglycemics will NOT be detected
how long can weed stay in the urine
30 days
how long can herioin and alcohol stay in the urine
less than a day
what is the workflow for testing of drugs
1 immunoassay testing (screen)
2. GCMS = targeted scan
3. LC/MS/MS = opiod ID
What is KIMS immunoassay based on
competitive homogenous immunoassay by using R1 and R2
What does KIMS detect
THC
Benzodiazepines
Opiates (poppy seeds pos)
what is a false pos for KIMS
Oxaprozin aka daypro
How does a KIMS immunoassay work
when drug is not present - clumping of ab = high absorbance
when drug is present - binds to ab without clumping = low absorbance
How does EMIT and DRI immunoassays work
when drug is not present - G6PD binds to reagent 1 ab = no reaction
when drug is present - G6PD is free and converts G6P into NADH = absorbance change
what drugs can EMIT and DRI test
antidepressants
oxycodone (ONLY DRI)
what absorbance is EMIT and DRI use
340nm
how does CEDIA immunoassay work
when drug is not present - ED is bound to reagent 1 ab = no reaction
when drug is present - ED is bound to EA and converts CPR = absorbance change
what absorbance does CEDIA use
570nm
what drugs does CEDIA detect
Fentanyl
what drugs are immunoassays good at for avoiding cross reactivity
lorazepam and temazepam glucuronide
what factors is mass spec based on
based on retention time and fragmentation patterns
what drug is seen as impurities
oxycodone
3 ways of adulterating a sample
- internal and external dilution (drinking or adding water)
- tampering (adding agent)
- substitution (not your sample)
how do we test if a sample has been tempered or adulterated
test pH
how do we test if a sample has been substituted
test creatinine and specific gravity
why are stat drugs not tested
does not rule out poisoning
no good information from acute care
many drugs cause similar symptoms
false pos possible
what is the role of WADA in drug regulation
world anti doping association acredited by 1 lab
establishes banned substances
normal physiological proccess of athleetes
what happens when you abuse steroids
- High BP/LDL
- liver and heart damage
- cancer
- premature epiphyseal fusion
What synthetic PED causes liver damage when abused
anavar
what endogenous PED causes organomegaly
insulin
what stimulants cause cardiac arrest
amphetamines
what stimulant causes bronchoconstriction
clenbuterol
what biological PED causes acceleration of existing cancers
hCG
what ratio of testosterone: epitestosterone indicates doping
> 6;1
why is epitestosterone better to ID PED usage
more stable in blood
what tests are used to confirm EPO
laminar flow immunoassay (chromatography - screening) and isoelectric focussing (electrophoresis - confirmatory) for exogenous doping rHuEPO and darbepoetin alpha
how does WADA perform EPO testing
Biological passports
what are issues with hGH detection
- cross reactivity (similar hormones related)
- hormone standardization (many forms of hGH)
how do we test for hGH (avoiding issues with detection)
test for IGF-1
what are the cons of immunoassay for PED screenign
easy to tamper
false pos = binding random compounds
false neg = poor binding affinity
what are SARMS for and an example of
Ligandrol = for muscle growth
why are exogenous use of endogenous hormones difficult to detect
endogenous hormones fluctuates and diurnal variation
