scholarly journals Urine drug screens: Considerations for the psychiatric pharmacist

2016 ◽  
Vol 6 (1) ◽  
pp. 42-47
Author(s):  
G. Lucy Wilkening ◽  
Genevieve M. Hale ◽  
Clint Ross
Keyword(s):  
False Positive ◽  
False Negative ◽  
Ease Of Use ◽  
Psychiatric Evaluation ◽  
Drug Screen ◽  
Stabilizing Agents ◽  
Drug Test ◽  
Urine Drug ◽  
Masking Agents ◽  
Positive Results

Abstract Introduction Proper psychiatric evaluation of patients necessitates that the clinician be vigilant in ruling out secondary causes of symptoms, such as substance-induced symptoms. Immunoassay-type urine drug screens (UDSs) offer clinicians rapid drug screen results, ease of use, and inexpensive cost. Unfortunately, these screens are not without their limitations. This review aims to outline the nuances and limitations of immunoassay UDSs and to provide the clinician with information that facilitates more accurate interpretation of UDS results. Specifically, false positive results associated with psychiatric medications and the availability and methods for acquisition of commercialized UDS masking agents will be reviewed. Methods A literature review was conducted to identify false positive UDSs associated with psychiatric medications. References for each article identified were also reviewed. Additionally, a Google® search was conducted to identify commercially available preparations used to mask UDS results and the methods of acquisition of these products. Results A total of 14 articles were identified using PubMed. No articles for mood stabilizing agents were identified. Entering the phrase how to pass a drug test into Google® search yielded about 12.6 million results, and select references were reviewed based on relevance and user reviews. Discussion Several psychiatric medications are documented as potential sources of false positive UDSs. Additionally, several agents are available for consumer purchase that may result in false negative UDSs. The clinician must be vigilant in interpreting immunoassay UDS results and should utilize more advanced forms of testing as clinically appropriate.

scholarly journals Does Lidocaine Cause False Positive Results on Cocaine Urine Drug Screen?

2019 ◽  
Vol 15 (4) ◽  
pp. 255-261 ◽  
Author(s):  
Eungjae Kim ◽  
Brian Patrick Murray ◽  
Maryam Salehi ◽  
Tim P. Moran ◽  
Joseph E. Carpenter ◽  
...  
Keyword(s):  
False Positive ◽  
Drug Screen ◽  
Urine Drug Screen ◽  
Urine Drug ◽  
Positive Results

Reduced Interference by Phenothiazines in Amphetamine Drug of Abuse Immunoassays

2006 ◽  
Vol 130 (12) ◽  
pp. 1834-1838
Author(s):  
Stacy E. F. Melanson ◽  
Elizabeth Lee-Lewandrowski ◽  
David A. Griggs ◽  
William H. Long ◽  
James G. Flood
Keyword(s):  
Emergency Department ◽  
False Positive ◽  
Massachusetts General Hospital ◽  
Parent Compound ◽  
Drug Screen ◽  
Urine Drug Screen ◽  
Drug Of Abuse ◽  
Positive Urine ◽  
Urine Drug ◽  
Positive Results

Abstract Context.—Emergency department physicians frequently request urine drug screens, but many are unaware of their limitations, including the potential for false-positive results. Promethazine, a phenothiazine derivative, is used for the treatment of allergies, agitation, nausea, and vomiting. Many patients taking promethazine are subject to urine drug screens and any potential interferences are important to recognize. Design.—During an 11-month period, all patients presenting to the Massachusetts General Hospital emergency department who had a finding of promethazine in their serum drug screen, and who also had a urine drug screen performed, were selected for inclusion in the study. The urine drug screen results (n = 22 patients/samples) were then studied. Objective.—To determine if promethazine use can cause false-positive urine amphetamine results in widely used drug of abuse immunoassays. Results.—Thirty-six percent of patients taking promethazine had false-positive test results for urine amphetamines using the EMIT II Plus Monoclonal Amphetamine/Methamphetamine Immunoassay. Sixty-four percent of patients showed cross-reactivity greater than 20% higher than the blank calibrator rate. In a separate, related study, no promethazine-induced false-positive results were seen with the EMIT II Plus, Triage, and TesTcard 9 amphetamine assays, or the Triage methamphetamine assay. Reduced chlorpromazine interference was also seen with these other assays. Conclusions.—False-positive urine amphetamine results can be obtained in patients taking promethazine. Promethazine metabolite(s), and not the parent compound, are the likely cause of these urine false-positive results obtained with EMIT II Plus Monoclonal Amphetamine/Methamphetamine Immunoassay. Immunoassays from different manufacturers can have very different “interference” profiles, which the pathologist and laboratory scientist must understand and relay to clinicians.

scholarly journals Amphetamine Positive Urine Toxicology Screen Secondary to Atomoxetine

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Joshua L. Fenderson ◽  
Amy N. Stratton ◽  
Jennifer S. Domingo ◽  
Gerald O. Matthews ◽  
Christopher D. Tan
Keyword(s):  
Positive Result ◽  
False Positive ◽  
Clonic Seizure ◽  
Gas Chromatography Mass Spectrometry ◽  
Drug Screen ◽  
Urine Drug Screen ◽  
First Case ◽  
Positive Urine ◽  
Urine Drug ◽  
Positive Results

The aim of this paper is to report the first case of atomoxetine leading to false-positive urine drug screen. An otherwise healthy 27-year-old female with a history of attention deficit hyperactivity disorder (ADHD) treated with atomoxetine had an acute onset tonic-clonic seizure. On arrival to the hospital, a urine toxicological drug screen with immunochemical cloned enzyme donor immunoassay (CEDIA) was performed. Results were positive for amphetamines; however, the presence of these substances could not be confirmed with urine gas chromatography-mass spectrometry (GC-MS). She denied any illicit drug use, herbal medications, or supplements, and her other prescription medications have not been previously known to cause a false-positive result for amphetamines. While stimulant treatments for ADHD could certainly result in a positive result on urine screen for amphetamines, there have been no reports of false-positive results for amphetamines secondary to patients using atomoxetine. We implicate atomoxetine, and/or its metabolites, as a compound or compounds which may interfere with urine drug immunoassays leading to false-positive results for amphetamines CEDIA assays.

Critical Evaluation of Impedance Phlebography for the Diagnosis of Deep Vein Thrombosis

1974 ◽  
Vol 31 (02) ◽  
pp. 273-278
Author(s):  
Kenneth K Wu ◽  
John C Hoak ◽  
Robert W Barnes ◽  
Stuart L Frankel
Keyword(s):  
Deep Vein Thrombosis ◽  
False Positive ◽  
False Negative ◽  
Critical Evaluation ◽  
Original Method ◽  
Vein Thrombosis ◽  
Negative Results ◽  
False Negative Results ◽  
Deep Vein ◽  
Positive Results

SummaryIn order to evaluate its daily variability and reliability, impedance phlebography was performed daily or on alternate days on 61 patients with deep vein thrombosis, of whom 47 also had 125I-fibrinogen uptake tests and 22 had radiographic venography. The results showed that impedance phlebography was highly variable and poorly reliable. False positive results were noted in 8 limbs (18%) and false negative results in 3 limbs (7%). Despite its being simple, rapid and noninvasive, its clinical usefulness is doubtful when performed according to the original method.

Three Years of Experience With Random Urinary Homovanillic and Vanillylmandelic Acid Levels in the Diagnosis of Neuroblastoma

PEDIATRICS ◽  
1987 ◽  
Vol 79 (2) ◽  
pp. 203-205
Author(s):  
Mendel Tuchman ◽  
Margaret L. R. Ramnaraine ◽  
William G. Woods ◽  
William Krivit
Keyword(s):  
False Positive ◽  
Homovanillic Acid ◽  
False Negative ◽  
False Negative Rate ◽  
Urine Samples ◽  
Vanillylmandelic Acid ◽  
Test Results ◽  
Upper Limit ◽  
Positive Results ◽  
Rule Out

During the last 3 years, random urine samples from 408 patients were tested for elevated homovanillic acid (HVA) and vanillylmandelic acid (VMA) levels to rule out the diagnosis of neuroblastoma. Thirty-seven of these patients had elevated HVA and/or VMA levels, and neuroblastoma was subsequently diagnosed. In three additional patients with negative test results (normal HVA and VMA levels), tumors were subsequently diagnosed (false-negative rate of 7.5%). Ten percent of the patients with neuroblastoma had normal HVA and 27.5% had normal VMA levels at the time of diagnosis. Only one patient (2.5%) with neuroblastoma had elevated VMA levels in the presence of normal HVA levels. More than 60% of the patients with neuroblastoma had urinary HVA and/or VMA levels higher than twice the upper limit of normal. No false-positive results were encountered. Age and stage distributions of the patients are shown, and the significance of the results is discussed.

N.B.T. TEST—FALSE-NEGATIVE AND FALSE-POSITIVE RESULTS

The Lancet ◽  
1972 ◽  
Vol 299 (7764) ◽  
pp. 1341-1342 ◽  
Author(s):  
RonaldP. Ng ◽  
T.K. Chan ◽  
D. Todd
Keyword(s):  
False Positive ◽  
False Negative ◽  
Positive Results

Thyroid Screening for Early Discharged Infants

PEDIATRICS ◽  
1996 ◽  
Vol 98 (1) ◽  
pp. 41-44
Author(s):  
Judy G. Saslow ◽  
Ernest M. Post ◽  
Carol A. Southard
Keyword(s):  
New Jersey ◽  
Congenital Hypothyroidism ◽  
False Positive ◽  
False Negative ◽  
Negative Results ◽  
Thyroid Screening ◽  
False Negative Results ◽  
Positive Results

Objective. As neonatal discharge before 24 hours of life becomes commonplace, the rejection of congenital hypothyroidism (CH) screening specimens obtained too early has created the need for numerous additional tests. We sought to determine whether the specimens obtained before 24 hours could be used safely. Methods. During a 31-day period we measured thyrotropin in all thyroid-screening specimens that had been obtained before 24 hours. We also examined the early specimens from every infant diagnosed in New Jersey with CH during 1993 or 1994. Results. Among the 663 specimens, those obtained at or before 12 hours and those from infants with birth weights less than 2500 g had too many low thyroxine results to be useful. Among the 515 specimens obtained at more than 12 to 24 hours from newborns weighing 2500 g or more, 37 (7%) had low thyroxine levels and 12 (2.3%) had thyrotropin levels of 20 µIU/mL (mU/L) or higher. Four hundred seventy-one of the 515 infants had subsequent specimens obtained at more than 24 hours, and none of the results were abnormal. There was no child weighing more than or equal to 2500 g who was diagnosed with CH in 1993 and 1994 whose specimen obtained at 24 hours or less was normal. Conclusions. Accepting specimens obtained at more than 12 to 24 hours from infants weighing 2500 g or more would have resulted in more than the usual number of false-positive results but no false-negative results. This would have decreased the requests for additional specimens by more than 90%.

scholarly journals Factors associated with false negative and false positive results of prostate-specific antigen (PSA) and the impact on patient health

Medicine ◽  
2019 ◽  
Vol 98 (40) ◽  
pp. e17451 ◽  
Author(s):  
Mari Carmen Bernal-Soriano ◽  
Lucy A. Parker ◽  
Maite López-Garrigos ◽  
Ildefonso Hernández-Aguado ◽  
Juan P. Caballero-Romeu ◽  
...  
Keyword(s):  
Prostate Specific Antigen ◽  
False Positive ◽  
False Negative ◽  
Specific Antigen ◽  
Factors Associated ◽  
Patient Health ◽  
The Impact ◽  
Positive Results
Sign in / Sign up

Export Citation Format

Share Document