Cross-reactivity of the CEDIA buprenorphine assay with opiates: an Austrian phenomenon?

Pavlic, Marion; Libiseller, Kathrin; Grubwieser, Petra; Rabl, Walter

doi:10.1007/s00414-005-0544-x

Cited by 26 publications

(18 citation statements)

References 14 publications

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“…Immunoassay [20][21][22][23], high-performance liquid chromatography combined with ultraviolet detection [24], and several gas chromatographic methods [25][26][27][28] have been described. More recent studies were mostly based on liquid chromatography-mass spectrometry [29] or liquid chromatography-tandem mass spectrometry (LC-MS-MS) techniques [30][31][32][33].…”

Section: Introductionmentioning

confidence: 99%

Fatal outcome in a child after ingestion of a transdermal fentanyl patch

et al. 2006

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The case history and toxicological findings of a fatal fentanyl intoxication due to ingestion of a transdermal patch are presented. A 1-year-old otherwise healthy girl was put to bed and 2 h later she was found dead. The autopsy revealed a 25-microg/h (4.2 mg) transdermal fentanyl patch in the stomach. Toxicological analysis by liquid chromatography-tandem mass spectrometry with positive electrospray ionization yielded fentanyl and norfentanyl concentrations in the peripheral blood of 5.6 and 5.9 ng/ml, heart blood 19.0 and 8.9 ng/ml, and liver 235 and 26 ng/g, respectively. The cause of death was determined to be a fentanyl overdose. The investigation established that the child has unintentionally swallowed the patch, which had been lying on the floor.

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Section: Introductionmentioning

confidence: 99%

Fatal outcome in a child after ingestion of a transdermal fentanyl patch

et al. 2006

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“…The remaining specimen screened positive for tramadol, a known ABMC interferent. 6,9 Three CEDIA false positives could not be explained by these previously documented CEDIA interferences. Although the LZ assay missed approximately half of the positive samples, it detected 4 additional low-level positives samples that were missed by ACON POC (Table 3) and, like the ACON, produced no false-positive results ( Table 4).…”

Section: Resultsmentioning

confidence: 81%

Comparison of 3 Point-of-Care and 2 Automated Urine Buprenorphine Assays for Screening Patients Treated for Chronic Pain

Melanson¹,

Snyder²,

Bishop³

et al. 2011

Point of Care: The Journal of Near-Patient Testing &Amp; Technology

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Buprenorphine (BUP), a partial opioid agonist, is used in outpatient settings to treat opioid addiction and manage chronic pain. Patients in these settings are increasingly screened for the presence or absence of BUP in their urine to monitor medication compliance and to detect and deter misuse of this potent drug. We evaluated 3 point-ofcare (POC; ACON, NTB, and ABMC) and 2 automated urine BUP qualitative immunoassays (CEDIA and LZ) for their ability to accurately detect BUP in 52 urine (17 positive/35 negative) samples from patients treated for chronic pain. Sensitivity and specificity of each assay were evaluated in comparison with a liquid chromatographyYtandem mass spectrometry BUP reference method. Overall agreement with liquid chromatographyYtandem mass spectrometry for these 52 samples, many of which contained low levels of BUP and high concentrations of potentially cross-reacting drugs, was 77%, 73%, 65%, 48%, and 85% for ACON, NTB, ABMC, CEDIA, and LZ, respectively. The NTB POC and automated CEDIA assays were able to detect lower BUP levels and had higher sensitivities, 88% and 94%, respectively, compared with the ACON (29%), ABMC (29%), and LZ (53%) assays. However, the NTB POC, CEDIA, and ABMC POC generated a substantial number of false positives, providing considerable lower specificities of 66%, 26%, and 83%, respectively, compared with the ACON POC and automated LZ methods (both 100%). Of the 3 POC assays, ACON demonstrated the best overall performance, allowing reliable detection of BUP above its stated cutoff without interference from other opioid-related compounds.

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“…Another report informed the false positive results in EMIT II Plus monoclonal amphetamine/ methamphetamine immunoassay caused by promethazine metabolite/s [19]. The limitation of on-site drug screening kits has always been brought to discussion [20,21], but this is the first study to identify the responsible compound for a false negative amphetamine result in the Triage® DOA panel. Promethazine and chlorpromazine possess similar phenothiazine structures and it is possible that phenothiazine-associated compounds cross-react in the widely distributed immunoassays, causing a false result in some cases.…”

Section: Reaction Cupmentioning

confidence: 97%

False negative result for amphetamines on the Triage® Drug of Abuse panel?

et al. 2008

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On-site drug screening devices are widely used today for their simple test procedures and instantaneous results. Among other devices, a Triage Drug of Abuse panel is considered to be highly reliable for its high specificity and sensitivity of abused drugs. Although it is known that a false positive amphetamine (AMP) result may be obtained from the urine samples containing putrefactive amines or ephedrine-related compounds, no clinical false negative methamphetamine results have been reported to date. However, a false negative Triage result was obtained from the urine of a fatal methamphetamine poisoning victim taking Vegetamine tablets. Further experimental analyses revealed that the cross-reactivity of methamphetamine and chlorpromazine metabolites, including nor-2-chlorpromazine sulfoxide, was the cause for a false negative Triage reaction for AMP. Forensic scientists and clinicians must be aware of the limitations of on-site drug testing devices and the need for the confirmatory laboratory tests for the precise identification and quantification of drugs in suspicious intoxication cases, as also recommended by the manufacturers.

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Cross-reactivity of the CEDIA buprenorphine assay with opiates: an Austrian phenomenon?

Cited by 26 publications

References 14 publications

Fatal outcome in a child after ingestion of a transdermal fentanyl patch

Fatal outcome in a child after ingestion of a transdermal fentanyl patch

Comparison of 3 Point-of-Care and 2 Automated Urine Buprenorphine Assays for Screening Patients Treated for Chronic Pain

False negative result for amphetamines on the Triage® Drug of Abuse panel?

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