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Clinical Chemistry 43: 498-504, 1997;
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(Clinical Chemistry. 1997;43:498-504.)
© 1997 American Association for Clinical Chemistry, Inc.

Articles

Automated liquid-chromatographic analyzer used for toxicology screening in a general hospital: 12 months' experience

Nouredine Sadeg1,2,a, Gilles François1, Brigitte Petit1, Hélène Dutertre-Catella2 and Michel Dumontet1

1 Laboratoire Claude Bernard Hôpital de Pontoise, F-95300 Pontoise, France.
2 Laboratoire de Toxicologie (EA207), Faculté de Pharmacie 4 av. de L'Observatoire, F-75006 Paris, France.
a Author for correspondence. Fax Int + 331 30 75 53 69.

We evaluated the clinical utility of an automated HPLC system (Remedi, Bio-Rad) for identification of drugs and metabolites in biological fluids. Serum or urine or both from 354 consecutive cases of poisoning were analyzed by the system and by a set of fluorescence polarization immunoassay (FPIA, Abbott) and thin-layer chromatographic (TLC) procedures. Antidepressants and most phenothiazines were recognized by the new system. Comparison of Remedi results with final clinical diagnoses yielded diagnostic specificity and sensitivity of 80% and 90%, respectively. Remedi detected 26 additional compounds that were neither reactive in the immunoassay screening tests nor detected by TLC procedures. Because the Remedi expands the range of drugs covered by the immunoassays and provides a rapid, preliminary report in emergency situations, we conclude that this system can be a useful complementary technique in the clinical toxicology laboratory. Although urine toxicological screening seemed adequate for a good toxicological report, blood analysis allows extra toxicokinetic data such as blood concentrations and half-life estimations.


Key Words: indexing terms: drug screening • chromatography, thin- layer • fluorescence polarization immunoassay • urine • gastric lavage




The following articles in journals at HighWire Press have cited this article:


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A Fabbri, S Ruggeri, G Marchesini, and A Vandelli
A combined HPLC-immunoenzymatic comprehensive screening for suspected drug poisoning in the emergency department
Emerg. Med. J., May 1, 2004; 21(3): 317 - 322.
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A Fabbri, G Marchesini, A M Morselli-Labate, S Ruggeri, M Fallani, R Melandri, V Bua, A Pasquale, and A Vandelli
Comprehensive drug screening in decision making of patients attending the emergency department for suspected drug overdose
Emerg. Med. J., January 1, 2003; 20(1): 25 - 28.
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R. L. Fitzgerald, J. D. Rivera, and D. A. Herold
Broad Spectrum Drug Identification Directly from Urine, Using Liquid Chromatography-Tandem Mass Spectrometry
Clin. Chem., August 1, 1999; 45(8): 1224 - 1234.
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Copyright © 1997 by the American Association for Clinical Chemistry.