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Garcia Rivero G, Nadeau C, Cardy C, Crenshaw N, Gonzalez JM. Arm Pain After Walking Up a Flight of Stairs. J Nurse Pract 2023. [DOI: 10.1016/j.nurpra.2022.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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2
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Gaulier JM, Brunet B, Labat L, Eysseric H, Gheddar L, Ameline A, Kintz P. Guide d’interprétation des concentrations salivaires des stupéfiants, proposé par la SFTA. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2022. [DOI: 10.1016/j.toxac.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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3
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Positivity to Cocaine and/or Benzoylecgonine in Confirmation Analyses for On-Road Tests in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105371. [PMID: 34070008 PMCID: PMC8157855 DOI: 10.3390/ijerph18105371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/13/2021] [Accepted: 05/15/2021] [Indexed: 11/16/2022]
Abstract
We are using real-life data in order to determine the prevalence of driving with the presence of cocaine and/or benzoylecgonine (BZE), their concentrations, and their use in combination with other drugs. This study assessed data on Spanish drivers with confirmed drug-positive results recorded by the Spanish National Traffic Agency from 2011-2016. Frequencies of positivity for cocaine and/or BZE and concentration of such substances were obtained. Comparisons and univariate and multivariate regression analyses were performed. Drivers who tested positive for cocaine and/or BZE accounted for 48.59% of the total positive results for drugs. In positive cases for both cocaine and BZE, other substances were detected in 81.74%: delta-9-tetrahydrocannabinol (THC) (68.19%), opioids (20.78%) and amphetamine-like substances (16.76%). In the multivariate logistic regression analysis, the frequency of cocaine and/or BZE positive cases decreased with age (OR:0.97) and were less likely among women (OR:0.63). Concentrations (ng/mL) of cocaine (249.30) and BZE (137.90) were higher when both substances were detected together than when detected alone. Positivity to cocaine represented an important proportion among Spanish drivers who tested positive for drugs, and polysubstance use was especially observed in more than 8 out of 10 positive cases for cocaine and/or BZE.
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Hampson AJ, Schroeder JR, Ellefsen KN, Yammine L, Epstein DH, Preston KL, Huestis MA, Verrico CD. Subtherapeutic Acetazolamide Doses as a Noninvasive Method for Assessing Medication Adherence. Clin Pharmacol Ther 2020; 108:1203-1212. [PMID: 32496573 PMCID: PMC7669583 DOI: 10.1002/cpt.1929] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 05/12/2020] [Indexed: 12/17/2022]
Abstract
Adherence monitoring is a vital component of clinical efficacy trials, as the regularity of medication consumption affects both efficacy and adverse effect profiles. Pill-counts do not confirm consumption, and invasive plasma assessments can only assist post hoc assessments. We previously reported on the pharmacokinetics of a potential adherence marker to noninvasively monitor dosage consumption during a trial without breaking a blind. We reported that consumption cessation of subtherapeutic 15 mg acetazolamide (ACZ) doses showed a predictable urinary excretion decay that was quantifiable for an extended period. The current study describes the clinical implementation of 15 mg ACZ doses as an adherence marker excipient in distinct cohorts taking ACZ for different "adherence" durations. We confirm that ACZ output did not change (accumulate) during 18-20 days of adherence, and developed and assessed urinary cutoffs as nonadherence indicators. We demonstrate that whereas an absolute concentration cutoff (989 ng/mL) lacked sensitivity, a creatinine normalized equivalent (1,376 ng/mg ACZ) was highly accurate at detecting nonadherence. We also demonstrate that during nonadherent phases of three trials, creatinine-normalized urinary ACZ elimination was reproducible within and across trials with low variability. Excretion was first order, with a decay half-life averaging ~ 2.0 days. Further, excretion remained quantifiable for 14 days, providing a long period during which the date of last consumption might be determined. We conclude that inclusion of 15 mg ACZ as a dosage form adherence marker excipient, provides a reliable and sensitive mechanism to confirm medication consumption and detect nonadherence during clinical efficacy trials.
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Affiliation(s)
- Aidan J Hampson
- Division of Therapies and Medical Consequences, National Institute on Drug Abuse, Rockville, Maryland, USA
| | - Jennifer R Schroeder
- Intramural Research Program, National Institute on Drug Abuse, Baltimore, Maryland, USA
| | - Kayla N Ellefsen
- Intramural Research Program, National Institute on Drug Abuse, Baltimore, Maryland, USA
- Travis County Medical Examiner's Office, Austin, Texas, USA
| | - Luba Yammine
- McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - David H Epstein
- Intramural Research Program, National Institute on Drug Abuse, Baltimore, Maryland, USA
| | - Kenzie L Preston
- Intramural Research Program, National Institute on Drug Abuse, Baltimore, Maryland, USA
| | - Marilyn A Huestis
- Intramural Research Program, National Institute on Drug Abuse, Baltimore, Maryland, USA
- Institute on Emerging Health Professions, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Christopher D Verrico
- Department of Psychiatry, Baylor College of Medicine, Houston, Texas, USA
- Research Service Line, Department of Veterans Affairs, Michael E. DeBakey VA Medical Center, Houston, Texas, USA
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5
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Scherer J, Schuch J, Rabelo-da-Ponte F, Silvestrin R, Ornell R, Sousa T, Limberger R, Pechansky F. Analytical reliability of four oral fluid point-of-collection testing devices for drug detection in drivers. Forensic Sci Int 2020; 315:110434. [DOI: 10.1016/j.forsciint.2020.110434] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 12/21/2022]
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6
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Lizot LDLF, da Silva ACC, Bastiani MF, Maurer TF, Hahn RZ, Perassolo MS, Antunes MV, Linden R. Simultaneous Determination of Cocaine and Metabolites in Human Plasma Using Solid Phase Micro-Extraction Fiber Tips C18 and UPLC-MS/MS. J Anal Toxicol 2020; 44:49-56. [PMID: 31095712 DOI: 10.1093/jat/bkz042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/10/2019] [Indexed: 11/14/2022] Open
Abstract
The determination of cocaine (COC) and its metabolites ecgonine methyl ester (EME), benzoylecgonine (BZE), norcocaine (NCOC) and cocaethylene (CE) in human plasma is relevant in clinical and forensic toxicology. An efficient extraction and clean-up of plasma specimens for the simultaneous determination of BZE along with COC and basic metabolites is challenging due to their widely different polarities and ionization characteristics. Recently, biocompatible SPME LC tips C18 became commercially available. We applied SPME LC tips C18 to the simultaneous extraction of COC, BZE, EME, NCOC, and CE by direct immersion of the fiber in plasma diluted with a buffer at pH 8.0. Analytes were desorbed from the fiber to methanol containing formic acid and injected into a UPLC-MS/MS system. The assay was linear from 5 to 500 ng mL-1. Precision assays presented CV% in the range of 2.22 to 10.54%, and accuracy was in the range of 93.4-108.1%. The assay requires minimal quantities of plasma and organic solvents, allowing multiple extractions in parallel. Biocompatible SPME is a promising alternative for preparing biological samples prior to drug measurement by UPLC-MS/MS.
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Affiliation(s)
- Lilian de Lima Feltraco Lizot
- Laboratory of Analytical Toxicology, Feevale University, Novo Hamburgo, Brazil.,National Institute of Science and Technology in Forensic Sciences (INCT Forense), Brazil.,Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo-RS, Brazil
| | - Anne Caroline Cezimbra da Silva
- Laboratory of Analytical Toxicology, Feevale University, Novo Hamburgo, Brazil.,Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo-RS, Brazil
| | - Marcos Frank Bastiani
- Laboratory of Analytical Toxicology, Feevale University, Novo Hamburgo, Brazil.,National Institute of Science and Technology in Forensic Sciences (INCT Forense), Brazil.,Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo-RS, Brazil
| | | | - Roberta Zilles Hahn
- Laboratory of Analytical Toxicology, Feevale University, Novo Hamburgo, Brazil
| | - Magda Susana Perassolo
- Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo-RS, Brazil
| | - Marina Venzon Antunes
- Laboratory of Analytical Toxicology, Feevale University, Novo Hamburgo, Brazil.,Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo-RS, Brazil
| | - Rafael Linden
- Laboratory of Analytical Toxicology, Feevale University, Novo Hamburgo, Brazil.,National Institute of Science and Technology in Forensic Sciences (INCT Forense), Brazil.,Graduate Program on Toxicology and Analytical Toxicology, Universidade Feevale, Novo Hamburgo-RS, Brazil
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7
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Fiorentin TR, Scherer JN, Marcelo MCA, Sousa TRV, Pechansky F, Ferrão MF, Limberger RP. Comparison of Cocaine/Crack Biomarkers Concentrations in Oral Fluid, Urine and Plasma Simultaneously Collected From Drug Users. J Anal Toxicol 2018; 42:69-76. [PMID: 29140478 DOI: 10.1093/jat/bkx085] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 10/23/2017] [Indexed: 11/14/2022] Open
Abstract
The use of oral fluid (OF) as an alternative specimen for drug analysis has become very popular in forensic toxicology. Many clinical studies have evaluated the correlations between concentrations of cocaine and its metabolites in OF and other matrices, but results have shown high variability. In addition, there are no data available regarding the correlations between biomarkers of crack-cocaine use in different matrices. This study evaluated the relationship between concentrations of cocaine/crack-cocaine biomarkers in OF, urine and plasma samples collected from cocaine users. All samples were analyzed for the presence of cocaine (COC), benzoylecgonine (BZE) and anhydroecgonine (AEC) by a validated liquid chromatography-mass spectrometry method. Median COC, BZE and AEC concentrations ranged from 4.20 to 33.26 ng/mL, from 13.03 to 3,615.86 ng/mL and from 7.40 to 1,892.5 ng/mL across matrices, respectively. The relationship between drug concentrations in OF versus plasma (OF/P) and OF versus urine (OF/U) was evaluated by their coefficients of determination (R2). Least-squares regression analyses demonstrated significant correlations between OF/P and OF/U for cocaine and BE (P < 0.05), with R2 = 0.17, 0.07 for cocaine and R2 = 0.73, 0.45 for BE, respectively. The correlation coefficients (r) found for BZE, COC and AEC in OF/P and OF/U were 0.85 and 0.67 (P < 0.05); 0.41 and 0.26 (P < 0.05); and 0.30 and -0.37 (P > 0.05), respectively. Many factors contribute to the variability of drug correlation ratios in studies involving random samples, including uncertainty about the time of last administration and dosage. Overall, we found significant R2 values for COC and BZE in OF/P and OF/U, but not for AEC. Despite the good correlations found in some cases, especially for BZE, the large variation in drug concentrations seen in this work suggests that OF concentrations should not be used to estimate concentrations of COC, BZE or AEC in plasma and/or urine.
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Affiliation(s)
- Taís Regina Fiorentin
- Graduate Program in Pharmaceutical Sciences, Federal University of Rio Grande do Sul, Av. Ipiranga, 2752, 90610-000 Porto Alegre, RS, Brazil
| | - Juliana Nichterwitz Scherer
- Center for Drug and Alcohol Research, Collaborating Center on Alcohol and Drugs-HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020 Porto Alegre, RS, Brazil
| | - Marcelo Caetano Alexandre Marcelo
- Graduate Program in Chemistry, Federal University of Rio Grande do Sul, Av. Bento Gonçalves, 9500, 90650-001 Porto Alegre, RS, Brazil
| | - Tanara Rosângela Vieira Sousa
- Center for Drug and Alcohol Research, Collaborating Center on Alcohol and Drugs-HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020 Porto Alegre, RS, Brazil
| | - Flavio Pechansky
- Center for Drug and Alcohol Research, Collaborating Center on Alcohol and Drugs-HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvaro Alvim, 400, 90420-020 Porto Alegre, RS, Brazil
| | - Marco Flôres Ferrão
- Graduate Program in Chemistry, Federal University of Rio Grande do Sul, Av. Bento Gonçalves, 9500, 90650-001 Porto Alegre, RS, Brazil
| | - Renata Pereira Limberger
- Graduate Program in Pharmaceutical Sciences, Federal University of Rio Grande do Sul, Av. Ipiranga, 2752, 90610-000 Porto Alegre, RS, Brazil
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Ferrari D, Manca M, Premaschi S, Banfi G, Locatelli M. Toxicological investigation in blood samples from suspected impaired driving cases in the Milan area: Possible loss of evidence due to late blood sampling. Forensic Sci Int 2018; 288:211-217. [DOI: 10.1016/j.forsciint.2018.04.038] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 02/24/2018] [Accepted: 04/19/2018] [Indexed: 12/15/2022]
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Chantada–Vázquez MP, de–Becerra–Sánchez C, Fernández–del–Río A, Sánchez–González J, Bermejo AM, Bermejo–Barrera P, Moreda–Piñeiro A. Development and application of molecularly imprinted polymer – Mn-doped ZnS quantum dot fluorescent optosensing for cocaine screening in oral fluid and serum. Talanta 2018; 181:232-238. [DOI: 10.1016/j.talanta.2018.01.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 01/04/2018] [Accepted: 01/07/2018] [Indexed: 11/17/2022]
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10
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Di Fazio V, Wille SMR, Toennes SW, van Wel JHP, Ramaekers JG, Samyn N. Driving under the influence of cocaine: Quantitative determination of basic drugs in oral fluid obtained during roadside controls and a controlled study with cocaine users. Drug Test Anal 2018; 10:1285-1296. [PMID: 29524342 DOI: 10.1002/dta.2379] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 02/27/2018] [Accepted: 02/27/2018] [Indexed: 11/06/2022]
Abstract
Using the Belgian Drugs and Driving procedure, 36% of the cocaine-positive oral fluid (OF) screening results were not confirmed in plasma. This study investigates the impact of the choice of screening devices and confirmation matrix on the detection of cocaine use. An ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method quantifying cocaine, benzoylecgonine (BZE), and other basic drugs in OF was developed and validated. This method monitored OF samples obtained either from a roadside (n = 12) or a double-blind controlled study with cocaine users (n = 10) who were given either a capsule containing 300 mg of cocaine-HCl or a placebo. The OF data were compared to plasma concentrations to obtain concentration-time profiles. In addition, the sensitivity and accuracy of the Drugwipe5S® was assessed. A significant difference between the OF volume collected at baseline/placebo (median 0.93 mL [range 0.43-1.92 mL]) or after cocaine-HCL intake (0.79 mL [0.30-1.21 mL]) was observed. The median OF/Plasma at the 3 collection time points were 10.7, 13.8, 6.7 for cocaine and 0.8, 1.7, 0.8 for BZE, respectively. The Drugwipe5S® detected cocaine use until at least 4 hours after intake. When applying the Belgian legal confirmation decision limit of 10 ng/mL in OF, an accuracy of 75%-98% was observed, depending on the study setting. Cocaine concentrations in OF were much higher and were detected longer as compared to plasma, when applying the same decision limit. From a toxicological viewpoint, the longer detection window with the higher sensitivity of Cocaine and BZE is beneficial to detect drivers in the crash/fatigue phase.
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Affiliation(s)
- Vincent Di Fazio
- National Institute of Criminalistics and Criminology, Laboratory of Toxicology, Brussels, Belgium
| | - Sarah M R Wille
- National Institute of Criminalistics and Criminology, Laboratory of Toxicology, Brussels, Belgium
| | - Stefan W Toennes
- University of Frankfurt, Institute of Legal Medicine, Frankfurt, Germany
| | - Janelle H P van Wel
- Maastricht University, Neuropsychology & Psychopharmacology, Maastricht, Netherlands
| | - Johannes G Ramaekers
- Maastricht University, Neuropsychology & Psychopharmacology, Maastricht, Netherlands
| | - Nele Samyn
- National Institute of Criminalistics and Criminology, Laboratory of Toxicology, Brussels, Belgium
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11
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Negus SS, Banks ML. Pharmacokinetic-Pharmacodynamic (PKPD) Analysis with Drug Discrimination. Curr Top Behav Neurosci 2018; 39:245-259. [PMID: 27571746 PMCID: PMC5446801 DOI: 10.1007/7854_2016_36] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Discriminative stimulus and other drug effects are determined by the concentration of drug at its target receptor and by the pharmacodynamic consequences of drug-receptor interaction. For in vivo procedures such as drug discrimination, drug concentration at receptors in a given anatomical location (e.g., the brain) is determined both by the dose of drug administered and by pharmacokinetic processes of absorption, distribution, metabolism, and excretion that deliver drug to and from that anatomical location. Drug discrimination data are often analyzed by strategies of dose-effect analysis to determine parameters such as potency and efficacy. Pharmacokinetic-Pharmacodynamic (PKPD) analysis is an alternative to conventional dose-effect analysis, and it relates drug effects to a measure of drug concentration in a body compartment (e.g., venous blood) rather than to drug dose. PKPD analysis can yield insights on pharmacokinetic and pharmacodynamic determinants of drug action. PKPD analysis can also facilitate translational research by identifying species differences in pharmacokinetics and providing a basis for integrating these differences into interpretation of drug effects. Examples are discussed here to illustrate the application of PKPD analysis to the evaluation of drug effects in rhesus monkeys trained to discriminate cocaine from saline.
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Affiliation(s)
- S Stevens Negus
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, 23298, USA.
| | - Matthew L Banks
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, 23298, USA
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12
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Alcohol and illicit drugs in drivers involved in road traffic crashes in the Milan area. A comparison with normal traffic reveals the possible inadequacy of current cut-off limits. Forensic Sci Int 2018; 282:127-132. [DOI: 10.1016/j.forsciint.2017.11.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 11/02/2017] [Accepted: 11/04/2017] [Indexed: 01/24/2023]
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13
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Bouhlal S, Ellefsen KN, Sheskier MB, Singley E, Pirard S, Gorelick DA, Huestis MA, Leggio L. Acute effects of intravenous cocaine administration on serum concentrations of ghrelin, amylin, glucagon-like peptide-1, insulin, leptin and peptide YY and relationships with cardiorespiratory and subjective responses. Drug Alcohol Depend 2017; 180:68-75. [PMID: 28881319 PMCID: PMC5654385 DOI: 10.1016/j.drugalcdep.2017.07.033] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 07/27/2017] [Accepted: 07/28/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Food intake and use of drugs of abuse like cocaine share common central and peripheral physiological pathways. Appetitive hormones play a major role in regulating food intake; however, little is known about the effects of acute cocaine administration on the blood concentrations of these hormones in cocaine users. METHODS We evaluated serum concentrations of six appetitive hormones: ghrelin (total and acyl-ghrelin), amylin, glucagon-like peptide-1 (GLP-1), insulin, leptin and peptide YY (PYY), as well as acute cardiorespiratory and subjective responses of 8 experienced cocaine users who received 25mg intravenous (IV) cocaine. RESULTS Serum concentrations of GLP-1 (p=0.014) and PYY (p=0.036) were significantly decreased one hour following IV cocaine administration; there was a trend towards a decrease for insulin (p=0.055) and amylin (p=0.063) concentrations, while no significant IV cocaine effect was observed for ghrelin (total or acyl-ghrelin) or leptin concentrations (p's≫>0.5). We also observed associations between hormone concentrations acutely affected by IV cocaine (GLP-1, PYY, insulin, amylin) and some cocaine-related cardiorespiratory and subjective responses (e.g., increased heart and respiratory rates; feeling high and anxious). DISCUSSION These findings show a significant effect of acute IV cocaine administration on some appetitive hormones and suggest potential associations between these hormones and cocaine-related cardiorespiratory and subjective responses. Additional research is needed to further investigate the potential mechanisms underlining these associations.
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Affiliation(s)
- Sofia Bouhlal
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, National Institutes of Health, 10 Center Drive (10CRC/15330), Bethesda, MD 20892, United States
| | - Kayla N. Ellefsen
- Chemistry and Drug Metabolism Section, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, United States
| | - Mikela B. Sheskier
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, National Institutes of Health, 10 Center Drive (10CRC/15330), Bethesda, MD 20892, United States
| | - Erick Singley
- Clinical Core Laboratory, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892, United States
| | - Sandrine Pirard
- Chemistry and Drug Metabolism Section, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, United States
| | - David A. Gorelick
- Chemistry and Drug Metabolism Section, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, United States
| | - Marilyn A. Huestis
- Chemistry and Drug Metabolism Section, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, United States
| | - Lorenzo Leggio
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Alcohol Abuse and Alcoholism and National Institute on Drug Abuse, National Institutes of Health, 10 Center Drive (10CRC/15330), Bethesda, MD 20892, United States; Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI 02906, United States.
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14
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Scherer JN, Fiorentin TR, Borille BT, Pasa G, Sousa TRV, von Diemen L, Limberger RP, Pechansky F. Reliability of point-of-collection testing devices for drugs of abuse in oral fluid: A systematic review and meta-analysis. J Pharm Biomed Anal 2017; 143:77-85. [PMID: 28577420 DOI: 10.1016/j.jpba.2017.05.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 05/06/2017] [Accepted: 05/11/2017] [Indexed: 11/18/2022]
Abstract
Point-of-collection testing (POCT) devices for drugs of abuse are used to screen for the presence of psychoactive substances (PAS) in different types of settings and environments. However, these quick and advantageous tools also present disadvantages, including low-reliability measures in comparison to chromatographic assays. Therefore, this article presents a systematic review and meta-analysis of studies evaluating the reliability of measurements of PAS detection in oral fluid using POCT devices. The reliability measures for detection of the five most important drug classes - cocaine, amphetamines, benzodiazepines, cannabinoids and opioids, are reported. The article also presents a subgroup analysis considering the reliability estimates for the different POCT devices that were evaluated by the studies contemplated in the review. A discussion considering the strengths and limitations of POCT techniques was performed in order to guide policymakers, traffic agents and other professionals who also conduct such tests. The use of POCT devices often involves legal and moral aspects of the subjects tested, which demands critical evaluation of these devices before they are implemented in different settings.
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Affiliation(s)
- Juliana Nichterwitz Scherer
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvar Alvim, 400, 90420-020, Porto Alegre, RS, Brazil.
| | - Taís Regina Fiorentin
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Rio Grande do Sul, Av. Ipiranga, 2752, 90610-000, Porto Alegre, RS, Brazil
| | - Bruna Tassi Borille
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Rio Grande do Sul, Av. Ipiranga, 2752, 90610-000, Porto Alegre, RS, Brazil
| | - Graciela Pasa
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvar Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Tanara Rosangela Vieira Sousa
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvar Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Lisia von Diemen
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvar Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
| | - Renata Pereira Limberger
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Rio Grande do Sul, Av. Ipiranga, 2752, 90610-000, Porto Alegre, RS, Brazil
| | - Flavio Pechansky
- Center for Drug and Alcohol Research and Collaborating Center on Alcohol and Drugs - HCPA/SENAD, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Rua Professor Álvar Alvim, 400, 90420-020, Porto Alegre, RS, Brazil
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