[M8] Part 2: Toxicology Flashcards
Enumerate the therapeutic drugs
- Salicylates
- Acetaminophen
Other name for Salicylates
Acetylsalicylic acid or Aspirin
Common analgesic, antipyretic, and anticoagulant
Salicylates
Relieves pain
Analgesic
Anti-fever
Antipyretic
Blocks cyclooxygenase reducing thromboxane and prostaglandins
Salicylates
Salicylates
Blocks _______ reducing _______ and _______
cyclooxygenase
thromboxane
prostaglandins
Salicylates
important for blood coagulation
Thromboxane and prostaglandins
Salicylates
Adverse effects:
→ Platelet aggregation inhibition
→ Gastrointestinal function interference
→ Rye Syndrome in Children
→ Viral infection
Salicylates (Toxicity)
Serum level of _____ ingestion denotes toxicity
> 90 mg/dL
Salicylates (Toxicity)
Enumerate the Acute ingestion (high doses)
→ Metabolic acidosis
→ Respiratory alkalosis
→ Inhibits Kreb’s cycle
→ Ketone formation
→ Death
Salicylates (Toxicity)
Occurs because salicylates are acids
Metabolic acidosis
Salicylates (Toxicity)
Salicylate has direct stimulation respiratory center = hyperventilation
Respiratory alkalosis
Salicylates (Toxicity)
Respiratory alkalosis:
Salicylate has direct stimulation _______ = ______
respiratory center
hyperventilation
Salicylate (Toxicity)
Increasing lactate and pyruvate formation
Inhibit Kreb’s cycle
Salicylate (Toxicity)
Inhibits Kreb’s cycle:
Increasing _____ and_____ formation
lactate
pyruvate
Salicylates (Toxicity)
Inhibit Kreb’s cycle:
The increase in lactate and pyruvate formation could lead to ____
muscle cramps
Salicylates (Toxicity)
Treatment:
→ Neutralization and Elimination
→ Maintaining electrolyte imbalance
Salicylates
Mention the method used in its Analysis
● Gas Chromatography
● Liquid Chromatography
● Chromogenic Assay
Salicylates (Analysis)
highest analytical sensitivity
Liquid Chromatography
Salicylates (Analysis)
What type of Reaction is used in Chromogenic Assay
Trinder reaction
Salicylates (Analysis)
Chemical reaction of Chromogenic Assay
Salicylate + ferric nitrate —> colored complex
Salicylates (Analysis)
Reagent used in Chromogenic Assay
Ferric nitrate
Salicylates (Analysis)
Chromogenic assay is measured _______
spectrophotometrically
Acetaminophen a.k.a
Paracetamol
Paracetamol is what type of Therapeutic drugs
Acetaminophen
Famous US brand of Acetaminophen
Tylenol
Common analgesic
Acetaminophen
Acetaminophen
common ____
analgesic
Overdose is associated with severe hepatotoxicity
Acetaminophen
Acetaminophen
Overdose is associated with _______
severe hepatotoxicity
Acetaminophen
Overdose value:
300 ug/mL 2 hours after ingestion
predicts acetaminophen-induced hepatic damage based on serum concentration at a known time after ingestion
Rumack-Matthew Nomogram
Acetaminophen
Rumack-Matthew Nomogram
predicts acetaminophen-induced ______ based on ________ at a known time after ingestion
hepatic damage
serum concentration
Acetaminophen
A graphical presentation
Rumack-Matthew Nomogram
Acetaminophen
If the toxic concentration is reached, it it subjective of acetaminophen induced hepatic damage
Rumack-Matthew Nomogram
Acetaminophen
Rumack-Matthew Nomogram:
If the toxic concentration is reached, it it subjective of_________________________
acetaminophen induced hepatic damage
Acetaminophen
Should NOT be used among ethanol abused patients.
Rumack-Matthew Nomogram
Acetaminophen
Rumack-Matthew Nomogram:
Should NOT be used among ______ patients.
ethanol abused
Acetaminophen
Why is Rumack-Matthew Nomogram not used among ethanol abused patients?
They metabolize acetaminophen at rapid rate
Acetaminophen
Enumerate the methods used in Analysis
Immunoassay
HPLC
Acetaminophen (Analysis)
Commonly used
Immunoassay
Acetaminophen (Analysis)
Reference method
HPLC
Enumerate the drugs of abuse
- Amphetamines
- Ecstasy
- Anabolic Steroid
- Cannabinoids
- Cocaine
- Opiates
- Phencyclidine
- Sedatives-Hypnotics
Its most common form is Shabu
Amphetamines
Amphetamines
Most common form _____
Shabu
Used for treatment for narcolepsy and attention deficit disorder
Amphetamines
Amphetamines
Used for treatment for ______ and __________
narcolepsy
attention deficit disorder
uncontrolled sleeping
Narcolepsy
Has low therapeutic dose
Amphetamins
Very close to toxic dose
Amphetamines
Develops tolerance → Has high potential abuse
Amphetamins
Drug for reducing weight
Amphetamines
Amphetamines
Drug for reducing weight → It may induce ________
Anorexia nervosa
Blocks dopamine receptors in the brain
Amphetamines
Amphetamines
Blocks _______ in the brain
Blocks dopamine receptors in the brain
Examples of Amphetamines
→ Amphetamines
→ Methamphetamines
→ Methylphenidate
→ Benzphenidate
→ Diethylpropion
Amphetamines (Examples)
shabu/ice
Methamphetamins
Amphetamines
Methamphetamines a.ka
shabu/ice
Poor man’s ecstasy
Amphetamines (Examples)
Drug used for treatment hyperactive children
Methylphenidate
Amphetamines
Examples of Amphetamine-like compounds
→ Ephedrine
→ Pseudoephedrine
→ Phenylpropanolamine
Amphetamines (Amphetamine-like compounds)
Content of a chinese drug said to be effective against COVID-19
Ephedrine
What is the Chinese drug whose content is Ephemerine
lianhua qingwen
Amphetamines (Amphetamine-like compounds)
May elicit hypertension
Ephedrine
Amphetamines
Initial effect:
increased mental and physical capacity
Amphetamines (Initial effect)
Why is increased mental and physical capacity the initial effect of Amphetamines
Because it blocks dopamine receptors in the brain
Amphetamines
Subsequent effects
restlessness
irritability
psychosis
Amphetamines
Subsequent effects develops ____
Dependence
An amphetamine derivative
Ecstasy
Ecstasy
The amphetamine derivative (long name)
3,4 methylenedioxymethamphetamine
A designer drug
Ecstasy
Ecstasy
What does a designer drug mean?
A modified form of the available drug of abuse
Ecstasy
Effects
→ Hallucinations
→ Euphoria
→ Emphatic and emotional response
→ Increased visual
→ Tactile sensitivity
Ecstasy
What effect is the wear off effect
Adverse effect
Ecstasy
Enumerate the Adverse effects
→ Headaches
→ Nausea
→ Vomiting
→ Anxiety
→ Agitation
→ Impaired memory
→ Violent behavior
→ Tachycardia
→ Hypertension
→ Respiratory depression
→ Seizure
→ Hyperthermia
→ Multiple organ toxicity
Testosterone derivatives
Anabolic Steroid
Anabolic steroid
______ derivatives
Testosterone
Developed as treatment for male hypogonadism
Anabolic steroid
Anabolic steroid
Developed as treatment for _______
male hypogonadism
Anabolic steroid:
Recent study shoes it (inc/dec) ______
Increase
Muscle mass
Steroids used by athletes are ____
anabolic steroids
Anabolic steroid
Enumerate the chronic use effects
→ Toxic hepatitis
→ Accelerated atherosclerosis
→ Abnormal platelet aggregation
→ Cardiomegaly
→ Testicular atrophy
→ Sterility and impotence
Group of psychoactive marijuana
Cannabinoids
Cannabinoids
Group of ______ found in ______
Psychoactive compounds
Marijuana
CNS stimulant
Cannabinoids
Cannabinoids
most potent and abundant compound of marijuana
Tetrahydrocannabinoid (THC)
Cannabinoids
A lipophilic substance
THC
Cannabinoids (THC)
A ____ substance
lipophilic
Cannabinoids
Rapidly distributed to hydrophobic compartments
THC
Cannabinoids (THC)
Rapidly distributed to _________
hydrophobic compartments
Cannabinoids (THC)
Examples of hydrophobic compartments
Brain
Fats
Cannabinoids
Can reach the brain within 30 seconds upon exposure
THC
Cannabinoids (THC)
Can reach the brain within ______ upon exposure
30 seconds
Cannabinoids
A hallucinogen
THC
Naturally-derived drug
Cannabinoids
Cannabinoids
Naturally-derived drug from the leaves of _____
Cannabis sativa
Cannabinoids
Enumerate the effecs:
→ Sense of well-being
→ Euphoria
Extreme happiness
Euphoria
Cannabinoids (THC)
Adverse effect:
memory and intellectual impairment
Cannabinoids
Toxic Effects:
→ Paranoia
→ Disorientation
→ Altered physical senses
→ Bronchopulmonary disorders
Cannabinoids
What is the major urinary metabolite
11-nor-deltatetrahydrocannabinol-9-carboxylic acid (THC-COOH)
What major urinary metabolite of cannabinoids is detected in drug testing
11-nor-deltatetrahydrocannabinol-9-carboxylic acid (THC-COOH)
T/F: 11-nor-deltatetrahydrocannabinol-9-carboxylic acid (THC-COOH) CANNOT be detected in urine
FALSE: CAN be detected in urine
11-nor-deltatetrahydrocannabinol-9-carboxylic acid (THC-COOH)
Detected in urine:
______ - single THC use
Up to 3-5 days
11-nor-deltatetrahydrocannabinol-9-carboxylic acid (THC-COOH)
Detected in urine:
______ - chromic users
Up to 4 weeks
11-nor-deltatetrahydrocannabinol-9-carboxylic acid (THC-COOH)
Detected in urine:
Chronic use : ______ (some books)
Up to 45 days
Cannabinoids are in ____ (lipophilic substances).
adipose tissue
Cannabinoids are in adipose tissue (_______).
lipophilic substances
T/F: Cannabinoids are NOT readily excreted in the urine (slow elimination)
True
They are eliminated if fats are metabolized
Cannabinoids
Cannabinoids
Methods:
→ Immunoassay (screening)
→ GC-MS (confirmatory)
a.k.a Crack
Cocaine
Cocaine
a.k.a _____
Crack
An alkaloid salt
Cocaine
Cocaine
An alkaloid salt (_____)
ecgonine
Effective local anesthetic for nasopharyngeal surgery
Cocaine
Cocaine
Effective local anesthetic for ___________
nasopharyngeal surgery
Potent CNS stimulator (excitement, euphoria)
Cocoine
Cocaine
Potent ____ stimulator (______, ________)
CNS
excitement, euphoria
Naturally-derived: Coca-plant
Cocaine
Cocaine
Naturally-derived: _____
Coca-plant
Cocaine
Naturally-derived: Coca-plant (_______)
Erythroxylon coca
NOT considered as True Addictive Drug
Cocaine
Why is Cocaine NOT considered as True Addictive Drug
Because they don’t develop dependance
Cocaine
Enumerate Toxic effects:
→ Overdose
→ Hypertension, arrythmias, seizure, myocardial infarction
→ Uterine malformation
→ Mental retardation
→ Slow mental development
→ Drug dependence (newborns)
→ Sudden death
Cocaine
Toxic effect which causes violent behavior
Overdoise
Cocaine
Toxic effect if parents are taking cocaine
Drug dependence (newborns)
Cocaine
Why is there a drug dependence in newborns as Toxic effect of cocaine?
Because cocaine can cross the placenta
Cocaine
What toxic effect is observed bc cocaine has direct toxicity to myocardium
Sudden death
Cocaine
Sudden death:
Cocaine has direct toxicity to _____
myocardium
Cocaine
Metabolite
benzoylecgonine
T/F: benzoylecgonine is NOT detected in urine
FALSE; CAN be detected in urine
Cocaine
benzoylecgonine:
_____ - single use
for 3 days
Cocaine
benzoylecgonine
_____ - chronic use
For 20 days
Capable of analgesia, sedation and anesthesia
Opiates
Opiates
Capable of _____, _______ and ______.
analgesia
sedation
anesthesia
Types of Opiates:
→ Naturally occurring
→ Chemically modified
→ Synthetic
Opiates
Examples of Naturally occuring Opiates
Opium
Morphine
Codeine
Opiates (Naturally occuring)
Powerful analgesic
Morphine
Opiates (Naturally occurring)
Used for patients who experiencing excruciating pain
Morphine
Opiates (Naturally occurring)
Morphine:
Example of excruciating pain
Burn
Cancer patients
Opiates (Naturally occurring)
Heroin metabolite
Morphine
Opiates (Naturally occurring)
Mild analgesic and antitussive
Codeine
Relieves cough
Antitussive
Opiates
Examples of Chemically modified
○ Heroin
○ Hydromorphone
○ Oxycodone
Opiates (Chemically modified)
What is the brand name of Hydromorphone
Dialudin
Opiates (Chemically modified)
What is the brand name for Oxycodone
Percodan
Opiates
Examples of Synthetic
○ Meperidine
○ Methadone
○ Proxyphene
○ Pentazocine
○ Fentanyl
Opiates (Synthetic)
What is the brand name of Meperidine
Demerol
Opiates (Synthetic)
What is the brand name of Methadone
Dolophine
Opiates (Synthetic)
What is the brand name of Proxyphene
Darvon
Opiates (Synthetic)
What is the brand name of Pentazocine
Talwin
Opiates (Synthetic)
What is the brand name of Fentanyl
Sublimaze
Derived from opium poppy
Opiates
Opiates
Derived from ______
opium poppy
High abuse potentia
Opiates
Opiates
Toxic effect:
respiratory acidosis, myoglobinuria, cardiopulmonary failure, pupillary constriction (pin-point pupils)
Opiates
Antidote
Naloxone
Opiates (Antidote)
Brand name for Naloxone
Narcan
Naloxone are _____ inhibitors
Opiate inhibitors
What is a type of opiates?
Heroin
Major drug of abuse (1960’s - 70’s)
Heroin
Heroin
Major drug of abuse (_______)
Major drug of abuse (1960’s - 70’s)
Enumerate the forms of Heroin
→ No. 4 (China white)
→ No. 3 (Brown sugar)
→ No. 2 and 1
Forms of heroin
Purest form
No. 4 (China white)
Forms of Heroin
Used for smoking
No. 3 (Brown sugar)
Forms of heroin
unprocessed heroin
No. 2 and 1
Heroin
Major metabolite
→ N-acetylmorphine
→ Morphine
Heroin
Major metabolite:
Heroin metabolite
Morphine
Heroin
Methods
Immunoassays (screening)
GC-MS (confirmatory)
Heroin (Methods)
Used to detect morphine, and codeine
Immunoassays (Screening)
Heroin (Methods)
Immunoassay
Used to detect ______, and _____
morphine
codeine
Phenycyclidine
A.k.a
Angel dust
angel hair
peace dust
Illicit drug with stimulant, depressant, anesthetic, and hallucinogenic properties
Phencyclidine
Phencyclidine
Illicit drug with _____, _____, _____, and ______ properties
stimulant
depressant
anesthetic
hallucinogenic
Lipophilic drug (slow elimination)
Phencyclidine
During elimination: 10-15% of administered drugs are eliminated and unchanged
Phencyclidine
Phencyclidine
During elimination: _____ of administered drugs are eliminated and unchanged
10-15%
Phencyclidine
Enumerate the adverse effect
agitation
hostility
paranoia
Phencyclidine
Enumerate the overdose effects
Stupor
Coma
Phencyclidine
Methods
→ Immunoassay (screening)
→ GC-MS (confirmatory)
Detection of Parent Drugs itself
Phenylcyclidine
Phencyclidine
detected in urine for up to 30 days after abstinence
Chronic user
Phencyclidine
Chronic user – detected in urine for up to ____ after abstinence
30 days
Tranquilizers
Sedative-Hypnotics
Sedative-Hypnotics a.k.a
Tranquilizers
CNS depressant
Sedetives-Hypnotics
Sedative-Hypnotics
Enumerate the overdose effects
lethargy
slurred speech
coma
respiratory depression
Sedatives-Hypnotics (Overdose)
The most serious toxicity of sedative-hypnotics because it may result to deaath
Respiratory depression
Most common type of Sedatives-Hypnotics
→ Barbiturates
→ Benzodiazepines
Sedatives-Hypnotics (Types)
Condensation products of urea and malonic acid
Barbituates
Sedatives-Hypnotics (Types)
Barbiturates:
Condensation products of ___ and ______
urea
malonic acid
Sedatives-Hypnotics (Types)
Have higher abuse potential than benzodiazepine
Barbiturates
Example of Barbiturates
✓ Phenobarbital
✓ Amobarbital
✓ Secobarbital, Pentobarbital
Barbiturates (Examples)
long acting /Tranquilizers
Phenobarbital
Barbiturates (Examples)
Intermediate acting
Amobarbital
Barbiturates (Examples)
Short acting
Secobarbital
Pentobarbital
Sedatives-Hypnotics (Types)
Treatment for cocaine addiction
Benzodiazepines
Sedatives-Hypnotics
Benzodiazepines:
Treatment for _______
Cocaine addiction
Sedatives-Hypnotics
More commonly found in abused and overdosed situation
Benzodiazepines
Benzodiazepines:
More commonly found in _____ and _____ situation
abused
overdosed
Sedatives-Hypnotics (Types)
Most widely available
Benzodiazepines
Benzodiazepines
Enumerate examples:
✓ Diazepam
✓ Chlordiazepoxide
✓ Lorazepam
Benzodiazepines (Examples)
Brand name of Diazepam
Valium
Benzodiazepines (Examples)
Minor tranquilizer
Diazepam (Valium)
Benzodiazepines (Examples)
Rapid control of acute seizure activity
Diazepam (Valium)
Benzodiazepines (Examples)
Diazepam (Valium):
Rapid control of _______
acute seizure activity
Sedatives-Hypnotics
Methods used
→ Immunoassay (screening)
→ GC-MS (confirmatory)
Enumerate the other drugs of abuse
a. Lysergic Acid Diethylamide (LSD)
b. Methaqualone (Quaalude)
c. Piperazines
d. Tryptamines
Other drugs of abuse
LSD, Lysergide
Lysergic Acid Diethylamide (LSD)
Other drugs of abuse
Hallucinogen
Lysergic Acid Diethylamide (LSD)
Methaqualone (Quaalude)
Other drugs of abuse
Most potent pharmacologic material
Lysergic Acid Diethylamide (LSD)
Other drugs of abuse
Methaqualone a.k.a
Quaalude
Other drugs of abuse
2,3-disubstituted quinazoline with anesthetic, antihistamine, and antitussive properties
Methaqualone (Quaalude)
Other drugs of abuse
Methaqualone (Quaalude):
_______________ with anesthetic, antihistamine, and antitussive properties
2,3-disubstituted quinazoline
Other drugs of abuse
Methaqualone (Quaalude):
2,3-disubstituted quinazoline with _____, _____ , and _______ properties
anesthetic
antihistamine
antitussive
Other drugs of abuse
Shows the same pleasant feeling as amphetamines (euphoria)
Piperazines
Other drugs of abuse
Piperazine:
Shows the same pleasant feeling as______ (euphoria)
amphetamines
Other drugs of abuse
Piperazine:
Enumerate the Major Derivatives
→ N-benzylpiperazines (BZP)
→ Phenylpiperazines
Other drugs of abuse
Piperazine:
Enumerate the Minor Derivatives
→ 1-(3,4-methylene-dioxybenzyl) piperazine (MDMP)
→ 1-(3- trifluoromethylphenyl) piperazine (TFMPP/Molly)
Other drugs of abuse
Piperazines
Major derivatives: most popular
N-benzylpiperazines (BZP)
Other drugs of abuse
Piperazines
Minor derivatives: most popular
1-(3- trifluoromethylphenyl) piperazine (TFMPP/Molly)
Other drugs of abuse
Serotonin derivative
Tryptamines
Other drugs of abuse
Tryptamines
______ derivatives
Serotonin
Other drugs of abuse
Examples of Tryptamines
→ N,N-dimethyltryptamine (DMT)
→ Psilocin
→ Ayahuasca
Tryptamines (Example)
a.k.a businessman’s lunch
N,N-dimethyltryptamine
Tryptamines (Examples)
Short term hallucinogen
N,N-dimethyltryptamine
Tryptamines (Examples)
Hallucinogen
Psilocin
Tryptamines (Examples)
Component of magic mushroom (psilocybe)
Psilocin
Tryptamines (Examples)
Tea
Ayahausca
R.A 916T
a.k.a
The Comprehensive Dangerous Drugs Acts of 2002
The Comprehensive Dangerous Drugs Acts of 2002
a.k.a
R.A 9165
SCREENING AND CONFIRMATORY DRUG TESTING LABORATORY ORGANIZATION
Head of the Laboratory:
Pathologist
Doctor
A doctor can be the head of laboratory IF ______
they undergo training under DOH for laboratory management
SCREENING AND CONFIRMATORY DRUG TESTING LABORATORY ORGANIZATION
Analysts
→ Medical technologist
→ Pharmacist
→ Chemist
→ Nurses
The aforementioned analyst are eligible for the position IF:
they all undergone training in drug testing reference laboratory of the Philippines
What is the drug testing reference laboratory of the Philippines?
East Avenue Medical Center
Enumerate the Authorized Specimen Collector
College undergraduates
Give the purpose of Authorized Specimen Collector
○ Observe specimen collection
○ Assess collected specimen
SPECIMEN COLLECTION
What are the types of Collection Site
a. Within the Laboratory
b. Remote Collection Site
Collection site
What are the requirements for Within the Laboratory type
Clean, adequate space, private secured area for specimen/documents
Collection site
Within the Laboratory:
For ________
For mandatory drug testing, except criminals
Collection site
Type of collection site where it is done in Workplace, school, jail, rehabilitation facility, site of crime
Remote collection site
Collection site
Where is Remote Collection Site performed?
Workplace
school
jail
rehabilitation facility
site of crime
Collection site
Remote collection site are for _____
Critically ill/disable
Collection site
Remote Collection Site is Required to have a permit from _____ __ days prior
BHFS-CHD
10
T/F: All collection site should NOT have a water source
True
Why all collection sites should NOT have a water source?
To prevent specimen tampering or contamination
Collection procedure
What are the accepted specimens
Urine
Saliva
Blood
Hair
Sweat
Clippings
Among all the accepted specimens, which is most commonly used?
Urine
Types of Collection Procedure
a. Observed Collection
b. Unobserved Collection
Collection Procedure
Collection of specimens in the presence of authorized specimen collector (ASC)
Observed Collection
T/F: In observed collection, gender does not matter between the patient and ASC
FALSE; If the patient is a woman, ASC should also be a woman. And vice versa
Collection Procedure
Prevent adulteration of specimen
Observed Collection
Collection Procedure
During collection, the things should be outside the collection area.
Observed Collection
Enumerate the substances used to tamper urine specimens
●Water
●Liquid soap
●Bleach
●Salt (second most common)
●Vinegar
●Ammonia
●Baking soda
●Glutaraldehyde
●Potassium Nitrate
●Lemon juice
●Cologne
Among all substances used to tamper urine specimens, which is the most commonly used?
Water
Among all the substances used to tamper urine specimens, which is the second most commonly used?
Salt
Collection procedure
In the absence of ASC
Unobserved Collection
Collection Procedure
Submitted specimen
Unobserved Collection
Collection Procedure
Subjected to Validity test
Unobserved Collection
Unobserved Collection
If urine; subjected to ______
urine validity testing
Unobserved Collection (Urine Validity Testing)
Urine is adulterated IF:
✓ Urine creatinine - _______
✓ Specific gravity - ________
✓ Urine creatinine - <20 mg/dL
✓ Specific gravity - <1.003 (no longer a urine)
Unobserved Collection
Detection of urinary constituents
Microscopy
Unobserved Collection
Examples of urinary constituents detected in Microscopy
✓ Epithelial cells
✓ Amorphous crystals
Laboratory Analyses
Rapid identification of drugs or drugs present in clinical specimens
Screening Tests
Laboratory Analyses
Qualitative
Screening Tests
Laboratory Analyses
High sensitivity, lack sensitivity
Screening Test
Laboratory Analyses
Screening Tests
High _______, lack ______
High sensitivity, lack sensitivity
T/F: Positive screening requires confirmatory
True
Laboratory Analyses
Enumerate the Screening Tests Methods
→ Thin-layer Chromatography
→ Gas-liquid Chromatography
→ Colorimetric “spot” test
Screening Tests (Methods)
Can be used as confirmatory test for drugs detected by TLC
Gas-liquid Chromatography
Screening Tests (Methods)
Relies on the analyst’s vision
Colorimetric “spot” test
Screening Tests (Methods)
Subjective
Colorimetric “spot” test
Laboratory Analyses
To confirm, quantify drugs found in patient’s serum or urine using screening methods
Confirmatory Tests
Laboratory Analyses (Confirmatory Tests)
T/F: Specimen used that yields a positive result in the screening test must be the same specimen to be used in confirmatory testing
True
Laboratory Analyses
Confirmatory Tests:
T/F: Shouldered by the patient
FALSE; Shouldered by the testing laboratory
Laboratory Analyses
Enumerate the Confirmatory Test Methods
→ Enzyme Multiplied Immunoassay technique
→ Gas-Chromatography/Mass Spectrometry
Confirmatory Tests (Methods)
Utilized antibodies to detect drugs
Enzyme Multiplied Immunoassay technique
Confirmatory Tests (Methods)
Antigen-antibody reaction
Enzyme Multiplied Immunoassay technique
Confirmatory Tests (Methods)
1st line confirmatory
Gas-Chromatography/Mass Spectrometry
Confirmatory Tests (Methods)
Reference Method
Gas-Chromatography/Mass Spectrometry
T/F: GC/MS can detect low levels of drugs
TRUE
GC/MS is a ____ method
Coupled Method
GC/MS
detects presence of specific compound
GC
GC/MS
quantitate the compound detected
MS
GC/MS
According to _______: In the absence of GC/MS, any method is valid provided that it is completely (similar/different) from the ________ used.
R.A 9165
different
screening method
What is only detected by confirmatory tests
Drug cut-off levels
What is the sign in Drug cut-off levels in Urine
ng/mL
DRUG CUT-OFF LEVELS (ng/mL) IN URINE
Amphetamines
EMIT: _____
GC-MS: ______
EMIT: 500
GC-MS: 250
DRUG CUT-OFF LEVELS (ng/mL) IN URINE
Marijuana
EMIT: _____
GC-MS: ______
EMIT: 50
GC-MS: 25
DRUG CUT-OFF LEVELS (ng/mL) IN URINE
Cocaine
EMIT: _____
GC-MS: ______
EMIT: 150
GC-MS: 100
DRUG CUT-OFF LEVELS (ng/mL) IN URINE
Opiates
EMIT: _____
GC-MS: ______
EMIT: 2000
GC-MS: 2000
DRUG CUT-OFF LEVELS (ng/mL) IN URINE
Phencyclidine
EMIT: _____
GC-MS: ______
EMIT: 25
GC-MS: 25
