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Reliability of the toxic screen in drug overdose
Author(s) -
Ingelfinger Joseph A,
Isakson Gordon,
Shine Daniel,
Costello Catherine E,
Goldman Peter
Publication year - 1981
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.1981.79
Subject(s) - clinical toxicology , drug overdose , urine , clinical pharmacology , drug , replicate , reliability (semiconductor) , medicine , toxicology , emergency medicine , pharmacology , poison control , biology , statistics , mathematics , power (physics) , physics , quantum mechanics
To determine the reliability of the laboratory in detecting drugs taken by overdosed patients, we evaluated laboratory performance on an unbiased sample of actual clinical specimens. Replicate serum and urine samples from a series of 20 consecutive clinically overdosed patients were sent to three commercial laboratories and one academic research laboratory for identification and quantification of intoxicating agents. All laboratories used the advanced analytical techniques of gas chromatography–mass spectrometry. The results suggest that laboratories do not reliably identify drugs in the serum of overdosed patients, partly because of technical limitation, partly because of laboratory error, and possibly because of inadequate specimens. Drugs judged responsible for the overdose were identified in only 50% to 70% of the cases, depending on the laboratory. Reported concentrations sometimes varied over a 10‐fold range. Clinical Pharmacology and Therapeutics (1981) 29, 570–575; doi: 10.1038/clpt.1981.79