Resolving Erroneous Reports in Toxicology and Therapeutic Drug Monitoring. a Comprehensive Guide

Description

The tools for detecting false positives, false negatives, and interference in interactions when testing and monitoring therapeutic drug use

For physicians monitoring a patient's progress, efficacy of treatment is often linked to a patient's response to medication. Determining whether a patient is taking the prescribed amount, the drug or dosage is effective, or the prescribed medication is interacting with other drugs can be determined through drug testing. Written as a guide for toxicologists, chemists, and health professionals involved in patient care, Resolving Erroneous Reports in Toxicology and Therapeutic Drug Monitoring provides an up-to-date introduction to the tests and methodologies used in a toxicology lab as well as the sources of testing error that can lead to false positives, false negatives, and unreliable conclusions of drug abuse or under use.

Covering a host of common therapeutic drugs as well as specific types of interference in immunoassays used in drug testing, the book details a number of possible testing scenarios and problems as well as solutions:

• False positive results in immunoassays for drugs in abuse testing
• Interferences in immunoassays used for monitoring anticonvulsants, tricyclic antidepressants, and digoxin
• False positive alcohol tests using breath analyzers and automated analyzers
• When a toxicology report is negative in a suspected overdose patient: the world of designer drugs
• Effects of drug-herb interactions on therapeutic drug monitoring
• Pharmacogenomics and the general principles of genetic analysis
• Approaches for eliminating interference/discordant specimen in therapeutic drug monitoring and drugs in abuse testing
• What to do in case there is no readily available method for testing

Complete with easy-to-read tables and flowcharts, this book helps toxicologists, clinical chemists, clinical pathologists, and forensic pathologists develop accurate, unbiased drug monitoring and toxicology reports. Health care professionals involved in patient care, especially of critically ill patients, will find this guide indispensable in making sure lab tests are reliable enough to provide high-quality care. An indispensable handbook to the entire suite of toxicology lab tests, as well as all the possible sources of testing error, Resolving Erroneous Reports in Toxicology and Therapeutic Drug Monitoring offers clear remedies for eliminating and preventing testing error.

Table of Contents

• Chapter 1. An introduction to tests performed in toxicology laboratories and methodologies available for such testings
• Chapter 2. Challenges in drugs of abuse testing
• Chapter 3. False positive results in immunoassays for drugs abuse testing
• Chapter 4. True positive drugs of abuse test results due to prescription and non-prescription drugs
• Chapter 5. When toxicology report is negative in a suspected overdosed patient: The world of designer drugs
• Chapter 6. Abuse of magic mushroom, peyote cactus and solvent: No readily available laboratory tests
• Chapter 7. False positive alcohol tests using breath analyzers and automated Analyzers
• Chapter 8. Role of laboratory in detecting other poisoning including pesticides, ethylene glycol and methanol
• Chapter 9. Poisonin with warfarin and superwarfarin: what laboratory can do?
• Chapter 10. Plant poisoning and clinical laboratory
• Chapter 11. Sources of erroneous results in therapeutic drug monitoring due to pre-analytical errors, high bilirubin, hemolysis and heterophilic antibody
• Chapter 12. Interferences in immunoassays used for digoxin monitoring
• Chapter 13. Interferences in immunoassays used for monitoring anticonvulsants and usefulness of monitoring free anticonvulsants in certain patients
• Chapter 14. Interferences in immunoassays used for monitoring tricyclic antidepressant
• Chapter 15. Therapeutic drug monitoring of immunosuppressant drugs: Limitations of immunoassays and need for chromatographic methods
• Chapter 16. Effect of drug-herb interactions on therapeutic drug monitoring
• Chapter 17. Pharmacogenomics and Toxicology Laboratory
• Chapter 18. Approaches for Eliminating Interference/Discordant Specimen in Therapeutic Drug Monitoring and Drugs of Abuse Testing

Author

AMITAVA DASGUPTA is a Professor in the Department of Pathology and Laboratory Medicine at the University of Texas Medical School at Houston and the director of clinical chemistry, toxicology, and point of care testing at the Memorial Hermann Hospital. He is the author of Herbal Supplements and Pharmacogenomics in Clinical Therapeutics, both published by Wiley.