In vitro drug interference with home blood-glucose-measurement systems

Rice, Gary K.; Galt, Kimberly A.

doi:10.1093/ajhp/42.10.2202

Cited by 3 publications

(4 citation statements)

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“…Hence, dye color development is incomplete, resulting in falsely lower glucose readings. 16 With different indicator dyes, such as the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5diphenyl-2H-tetrazolium bromide) used in the HemoCue B-Glucose analyzer, 17 ascorbic acid increases the glucose reading instead of decreasing it. This suggests that the ascorbic acid interference may be indicator dye-dependent.…”

Section: Interference Trends and Their Mechanismsmentioning

confidence: 99%

“…37,38 On the basis of reports of the Rocky Mountain Poison Control Center, at least 1 to 2 cases of acetaminophen poisoning occur daily in the United States. 39 Acetaminophen affects the results of not only handheld glucose meters, 16,21,22,36,40 but also wholeblood bench analyzers. 19,41 In the patients with an overdose, the acetaminophen blood concentrations were as high as 534 and 680 µg/mL (3,535 and 4,502 µmol/L).…”

Section: Clinical Relevancementioning

confidence: 99%

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Effects of Drugs on Glucose Measurements With Handheld Glucose Meters and a Portable Glucose Analyzer

Tang

Louie

et al. 2000

American Journal of Clinical Pathology

201

145

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Thirty drugs used primarily in critical care and hospital settings were tested in vitro to observe interference on glucose measurements with 6 hand-held glucose meters and a portable glucose analyzer. Paired differences of glucose measurements between drug-spiked samples and unspiked control samples were calculated to determine bias. A criterion of +/- 6 mg/dL was used as the cutoff for interference. Ascorbic acid interfered with the measurements on all glucose devices evaluated. Acetaminophen, dopamine, and mannitol interfered with glucose measurements on some devices. Dose-response relationships help assessment of drug interference in clinical use. High dosages of these drugs may be given to critically ill patients or self-administered by patients without medical supervision. Package inserts for the glucose devices may not provide adequate warning information. Hence, we recommend that clinicians choose glucose devices carefully and interpret results cautiously when glucose measurements are performed during or after drug interventions.

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Section: Interference Trends and Their Mechanismsmentioning

confidence: 99%

Section: Clinical Relevancementioning

confidence: 99%

Effects of Drugs on Glucose Measurements With Handheld Glucose Meters and a Portable Glucose Analyzer

Tang

Louie

et al. 2000

American Journal of Clinical Pathology

201

145

View full text Add to dashboard Cite

show abstract

“…Blood glucose testing should therefore be considerably less susceptible to drug interference than urine glucose testing. However, a recent well-designed investigation of in vitro drug interference with several SMBG systems documented falsely decreased blood glucose results due to ascorbic acid, aspirin (but not gentisic acid), and acetaminophen (71). Clinically important decreases of >20% compared with control values were observed at moderate to high drug concentrations.…”

Section: Group C Drugsmentioning

confidence: 99%

Review of Drug Interference With Urine Glucose Tests

Rotblatt¹,

Koda-Kimble²

1987

Diabetes Care

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Many drugs have been reported to interfere with copper-reduction or glucose oxidase tests used to measure urine glucose. However, only a few drugs or drug classes have been well documented to clinically interfere with these tests. The interfering drugs include ascorbic acid, beta-lactam antibiotics (e.g., cephalosporins and penicillins), levodopa, and salicylates. Several other drugs may also interfere with certain urine glucose tests, but the interactions are poorly documented. These drugs include chloral hydrate, hyaluronidase, nalidixic acid, nitrofurantoin, p-aminosalicylic acid, phenazopyridine, probenecid, and X-ray contrast media. Drugs or their metabolites that are strong reducing substances produce false-positive results by the copper-reduction method and false-negative results by the glucose oxidase method. The beta-lactam antibiotics interfere with copper-reduction tests by producing copper compounds of various colors that confuse interpretation of test results. Tables are provided that summarize the drug interferences discussed.

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“…Drugs such as paracetamol, salicylic acid, ascorbic acid, dopamine, and mannitol have been demonstrated to interact with these glucose reagents and can interfere with the performance of such glucose meters. The meters will produce falsely high blood glucose readings, significantly so when the drug concentration in the blood is high 1,2 . Similarly, high paracetamol levels have been reported to interfere with blood glucose readings in some older wholeblood bench analysers when such reagents are used 3,4 .…”

mentioning

confidence: 99%

Correspondence

2003

Anaesth Intensive Care

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Is allergy to rocuronium a high probability cross-reaction with suxamethonium? Recently we investigated the suspected anaphylaxis of a 35-year-old female patient. She was given atropine, fentanyl, propofol, suxamethonium and vecuronium for an operation and became hypotensive (BP 70/-mmHg) with SpO 2 80% on 100% oxygen. She recovered rapidly after adrenaline 100 µg intravenously and two litres of crystalloid infused intravenously as quickly as possible. Mast cell tryptase taken at the time was later found to be 22.4 µg/l (N<13.5). Eight weeks later she was tested with intradermal injections. These results were (wheal/flare): N saline negative, atropine 1/100 negative, fentanyl 1/100 negative, vecuronium 1/100 negative, propofol 1/100 negative, suxamethonium 1/100 15/25, rocuronium 1/100 12/20, atracurium 1/1000 negative. These results are consistent with an anaphylactic reaction to suxamethonium but the reaction to rocuronium was puzzling. The patient had had four previous anaesthetics. One anaesthetic recorded in 1997 used vecuronium and in 1988 one used pancuronium. Prior to this there were two previous anaesthetics for tonsils and wisdom teeth but no documentation was available. The two earlier procedures may well have included suxamethonium. However, as rocuronium was only approved for anaesthetic use in 1996 (manufacturer's data), the patient could not have had previous exposure. Thus the positive intradermal skin reaction to rocuronium must have been a cross-reactivity from suxamethonium. Rocuronium has become a muscle relaxant commonly associated with anaphylaxis. This has been explained as simply the result of the high usage 1 , but an additional explanation is that it has a strong crossreactivity with suxamethonium, a drug already recognized as having a substantial frequency of allergic reactions. The fact that neither vecuronium nor atracurium showed a positive response in this patient is strong evidence that the allergy is not simply triggered by the quaternary ammonium complex in the molecules as has been suggested. If this were true, then vecuronium and atracurium would also trigger the allergic response. Possibly the three dimensional map of rocuronium and suxamethonium have substantial spatial similarities around one quaternary nitrogen and acetyl complex. If there were such a

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In vitro drug interference with home blood-glucose-measurement systems

Cited by 3 publications

References 0 publications

Effects of Drugs on Glucose Measurements With Handheld Glucose Meters and a Portable Glucose Analyzer

Effects of Drugs on Glucose Measurements With Handheld Glucose Meters and a Portable Glucose Analyzer

Review of Drug Interference With Urine Glucose Tests

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