Drug Testing Methods in the Clinical Toxicology Laboratory
Continuing Education Credits
This course presents the screening techniques utilized in drug testing and details the appropriate confirmatory techniques used in the clinical toxicology laboratory. It is important to understand the various factors that contribute to the interpretation of drug testing results. These factors, including drug half-life, are discussed in detail.
Objectives
- Identify the specimens commonly utilized for testing in the clinical toxicology laboratory.
- Distinguish between qualitative and quantitative drug testing methods.
- Recognize initial screening techniques utilized in drug testing.
- Determine appropriate confirmatory techniques used in the clinical toxicology laboratory.
- State the various factors that contribute to the interpretation of drug testing results.
Course Outline
- Drug Testing
- Drug Testing
- Urine is the preferred sample for drug testing for several reasons. Which of the statements below regarding urine is false?
- Drug Testing: Screening and Confirmation
- Initial Screening Methods
- Screening: Point of Care Drug Testing
- Screening: Immunoassays
- Enzyme Multiplied Immunoassay Technique
- Cloned Enzyme Donor Immunoassay
- Enzyme-linked Immunosorbent Assay
- Immunoassay Techniques, continued
- Match the following descriptions with the correct drug testing platform.
- Cross-Reactivity
- Cross-Reactivity, continued
- Which of the following scenarios will most likely give a false negative result?
- Confirmatory Methods
- Confirmatory Testing
- Gas Chromatography/Mass Spectrometry
- Gas Chromatography/Mass Spectrometry, continued
- Electron Ionization
- Mass Analyzer
- Scanning Modes
- Match the GC/MS component to its most appropriate function.
- Liquid Chromatography with Tandem Mass Spectrometry
- Liquid Chromatography
- Electrospray Ionization
- Mass Analysis
- Multiple Reaction Monitoring
- A toxicology laboratory decides to develop an opiate method to be performed by LC/MS/MS. Why would they choose LC/MS/MS over GC/MS?
- An immunoassay drug screen in a clinical laboratory yields a result that is above the cutoff for cocaine. Which of the following is the most appropriate action?
- Drug Half-Life and Interpretation of Results
- Interpretation of Drug Tests in the Clinical Laboratory
- Amphetamine
- Methamphetamine
- Codeine
- MDMA
- Cocaine
- Marijuana
- Heroin
- Morphine
- Hydrocodone
- Hydromorphone
- Oxycodone
- Oxymorphone
- Benzodiazepines
- Barbiturates
- Hydrolysis
- Ever Expanding Testing
- References
- References
Additional Information
Level of Instruction: Intermediate
Intended Audience: Medical laboratory scientists, medical laboratory technicians, pathology residents, MLS students, and other health care personnel who have an interest in this subject matter.
Author Information: Robert E. Moore, MLS(ASCP)CMSCCM, TC(NRCC) is the lead technologist in the toxicology laboratory at Kaiser Permanente in Portland, Oregon, where his responsibilities include methods development and validation, review of QC data, instrument troubleshooting, and employee training/competency assessment. In his career as a medical laboratory scientist, he has been a chemistry supervisor, toxicology supervisor, and laboratory director. He holds a bachelor's degree in Biology from Marshall University.
Reviewer Information:
Kevin F. Foley, PhD, DABCC, MT, SC is the director of clinical pathology for the Kaiser Permanente Northwest region. He also teaches clinical chemistry at Oregon Health Sciences University. Dr. Foley earned his PhD in clinical pharmacology and toxicology at the East Carolina School of Medicine in North Carolina. He received a PhD in clinical pharmacology and toxicology from Brody School of Medicine, Greenville, NC. He has been working in laboratory medicine for over 15 years, starting his career as a medical technologist.
Laurie Bjerklie, MA, MLS(ASCP)CM, is
currently an Education Developer for MediaLab and LabCE. She earned a B.S. in
Medical Laboratory Science from the University of North Dakota and an M.A. in
Curriculum and Instruction from Saint Xavier University. She has over 15 years
of experience in higher education and has held program director and faculty
positions in both MLT and MLS programs.