Limitations of immunoassays for screening of drugs of abuse in urine

Boyd, Jessica M.; Sadrzadeh, S.M. Hossein

doi:10.1016/b978-0-12-813776-5.00014-5

Cited by 9 publications

(2 citation statements)

References 44 publications

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“…Drug testing has played a vital role in drug monitoring, , clinical toxicology, , forensic toxicology, , and antidoping control. , For a long time, immunoassay has been mainly used for drug analysis. − Even though this method is rapid and cost-effective, the poor specificity and sensitivity can sometimes result in false positive results, which makes it just a preliminary screening method. To obtain more accurate and reliable outcomes in confirmatory testing, mass spectrometry (MS) has become a more and more popular approach employed for drug analysis due to its outstanding sensitivity and specificity.…”

Section: Introductionmentioning

confidence: 99%

Swab-in-Capillary Electrospray Ionization and a Miniature Mass Spectrometer for In Situ Drug Analysis

Liu,

Xu,

Zhai

2023

Anal. Chem.

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In situ analysis of drugs has been in increasing demand in many fields. As an updated version of capillary-in-capillary electrospray ionization (CC-ESI) developed previously, a disposable swab-in-capillary electrospray ionization (SC-ESI) source was designed in this study. With a micro medical swab for sampling and an integrated filter membrane for online filtration, SC-ESI was able to directly sample and MS analyze complex samples without the need for pretreatment. Coupled with a miniature mass spectrometer, SC-ESI was applied for direct analysis of effective ingredients in therapeutic drugs (in tablet, capsule, and liquid droplet) and drugs in saliva and quantitation of therapeutic drugs in blood. The limits of detection in absolute amounts were obtained as 1 ng for fentanyl and 0.5 ng for cocaine in saliva. Combining with an internal standard method, SC-ESI acquired linear quantitation ranges of 100−5000 ng/ mL for imatinib in whole blood and 100−2000 ng/mL for clozapine in serum with high accuracies and precisions. The entire analysis process, from sampling to data acquisition, can be completed in less than 2 min. As demonstrated as a cheap, portable, and sampling-effective ionization source, SC-ESI has shown great potential for in situ drug analysis, especially in border drug screening and clinical therapeutic drug monitoring.

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Section: Introductionmentioning

confidence: 99%

Swab-in-Capillary Electrospray Ionization and a Miniature Mass Spectrometer for In Situ Drug Analysis

Liu,

Xu,

Zhai

2023

Anal. Chem.

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“…Depending on the Gaussian distribution of the results at the threshold concentration, there is a risk of classifying positive results as negative and vice versa by the immunoassay methods [5] . Furthermore, false-positive or rarely false-negative test results can be reported due to the interaction of antibodies with molecules with similar structures [6] .…”

Section: Introductionmentioning

confidence: 99%

Reducing the need for repeating urine drug testing with the gray zone determined by the measurement uncertainty

et al. 2023

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Background On an initial urine screening test for illegal substances, if the concentration of a substance is at or above the determined legislative threshold, it is reported as positive. Repeat testing with the same sample to verify before reporting is a common practice of clinical laboratories. This study aimed to determine whether measurement uncertainty (MU) results can be used to detect a gray zone to reduce repeat testing. Materials and Methods A retrospective study using data from … ….. …… ……. laboratory information system between 1.January.2020 and 1.July.2022 was conducted. The MU values for urinary amphetamine, cannabinoid, cocaine, and opioid parameters using ADVIA Chemistry reagents (Siemens Healthcare Diagnostic Inc., Germany) on a Siemens ADVIA 1800 chemical analyzer were calculated. The gray zone was defined as the cut-off value ± MU. Samples that were studied twice within one hour before reporting for the same urine sample were analyzed. Results From a total of 31,839 patients’ (16–65 years), urine samples, 319 amphetamine, 198 cannabinoid, 112 cocaine, and 125 opiate tests were repeated. Mean biases between the repeat test results were -7.64 (95% CI: −13.71 to -1.57) for the amphetamine and 1.16 (95% CI: 0.31 to 2.01) for the cannabinoid results. Ten amphetamine, 12 cannabinoid and 2 cocaine test results changed from positive to negative or negative to positive on retesting, all within the gray zone level defined by the MU value. Conclusions It is necessary to define the gray zone around the cut-off value for each illicit substance based on its MU for repeat testing.

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Ambient ionization mass spectrometry applied to new psychoactive substance analysis

Ena

Cowan

Abbate

2021

Mass Spectrometry Reviews

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In the past decade a plethora of drugs with similar effects to controlled psychoactive drugs, like cannabis, amfetamine (amphetamine), or lysergic acid diethylamide, have been synthesized. These drugs can collectively be classified under the term new psychoactive substances (NPS) and are used for recreational purposes. The novelty of the substances, alongside the rapid rate of emergence and structural variability, makes their detection as well as their legal control highly challenging, increasing the demand for rapid and easy-to-use analytical techniques for their detection and identification. Therefore, interest in ambient ionization mass spectrometry applied to NPS has grown in recent years, which is largely because it is relatively fast and simple to use and has a low operating cost. This review aims to provide a critique of the suitability of current ambient ionization techniques for the analysis of NPS in the forensic and clinical toxicology fields. Consideration is given to analytical performance and ease of implementation, including ionization efficiency, selectivity, sensitivity, quantification, analyte chemistry, molecular coverage, validation, and practicality.

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Limitations of immunoassays for screening of drugs of abuse in urine

Cited by 9 publications

References 44 publications

Swab-in-Capillary Electrospray Ionization and a Miniature Mass Spectrometer for In Situ Drug Analysis

Swab-in-Capillary Electrospray Ionization and a Miniature Mass Spectrometer for In Situ Drug Analysis

Reducing the need for repeating urine drug testing with the gray zone determined by the measurement uncertainty

Ambient ionization mass spectrometry applied to new psychoactive substance analysis

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