What the lab can and cannot do: clinical interpretation of drug testing results.

Abstract:

:Urine drug testing is one of the objective tools available to assess adherence. To monitor adherence, quantitative urinary results can assist in differentiating "new" drug use from "previous" (historical) drug use. "Spikes" in urinary concentration can assist in identifying patterns of drug use. Coupled chromatographic-mass spectrometric methods are capable of identifying very small amounts of analyte and can make clinical interpretation rather challenging, specifically for drugs that have a longer half-life. Polypharmacy is common in treatment and rehabilitation programs because of co-morbidities. Medications prescribed for comorbidities can cause drug-drug interaction and phenoconversion of genotypic extensive metabolizers into phenotypic poor metabolizers of the treatment drug. This can have significant impact on both pharmacokinetic (PK) and pharmacodynamic properties of the treatment drug. Therapeutic drug monitoring (TDM) coupled with PKs can assist in interpreting the effects of phenoconversion. TDM-PKs reflects the cumulative effects of pathophysiological changes in the patient as well as drug-drug interactions and should be considered for treatment medications/drugs used to manage pain and treat substance abuse. Since only a few enzyme immunoassays for TDM are available, this is a unique opportunity for clinical laboratory scientists to develop TDM-PK protocols that can have a significant impact on patient care and personalized medicine. Interpretation of drug screening results should be done with caution while considering pharmacological properties and the presence or absence of the parent drug and its metabolites. The objective of this manuscript is to review and address the variables that influence interpretation of different drugs analyzed from a rehabilitation and treatment programs perspective.

journal_name

Crit Rev Clin Lab Sci

authors

Kapur BM,Aleksa K

doi

10.1080/10408363.2020.1774493

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

548-585

issue

8

eissn

1040-8363

issn

1549-781X

journal_volume

57

pub_type

杂志文章
  • Relevant issues in the monitoring and the toxicology of antidepressants.

    abstract::This review provides specific information concerning the interpretation and usefulness of antidepressant drug monitoring. Fifteen antidepressants (ADs) were selected based on their importance in the 7 major markets (Japan, USA, France, United Kingdom, Italy, Spain, Germany) according to the Cognos Plus Study #11. Lite...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.1080/10408360701713112

    authors: Wille SM,Cooreman SG,Neels HM,Lambert WE

    更新日期:2008-01-01 00:00:00

  • Using transferrin saturation as a diagnostic criterion for iron deficiency: A systematic review.

    abstract::Iron deficiency is the most common micronutrient deficiency in the world and represents a major challenge for public health, notably in terms of morbidity and mortality. It remains largely under-diagnosed due to the low level of exploration and the absence of international harmonization for biological tests and thresh...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章

    doi:10.1080/10408363.2019.1653820

    authors: Cacoub P,Vandewalle C,Peoc'h K

    更新日期:2019-12-01 00:00:00

  • Applications of mid-infrared spectroscopy in the clinical laboratory setting.

    abstract::Fourier transform mid-infrared (MIR-FTIR) spectroscopy is a nondestructive, label-free, highly sensitive and specific technique that provides complete information on the chemical composition of biological samples. The technique both can offer fundamental structural information and serve as a quantitative analysis tool...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.1080/10408363.2017.1414142

    authors: De Bruyne S,Speeckaert MM,Delanghe JR

    更新日期:2018-01-01 00:00:00

  • The calcium-sensing receptor in normal physiology and pathophysiology: a review.

    abstract::The discovery of a G protein-coupled, calcium-sensing receptor (CaR) a decade ago and of diseases caused by CaR mutations provided unquestionable evidence of the CaR's critical role in the maintenance of systemic calcium homeostasis. On the cell membrane of the chief cells of the parathyroid glands, the CaR "senses" t...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.1080/10408360590886606

    authors: Tfelt-Hansen J,Brown EM

    更新日期:2005-01-01 00:00:00

  • Exploring the role of programmed cell death protein 1 and its ligand 1 in eye diseases.

    abstract::Programmed death receptor-1 (PD-1) and its ligand, PD-L1, as negative co-stimulatory molecules, are indispensable for regulating both physiological and pathological immune responses. The PD-1/PD-L1-mediated signaling pathway has been studied extensively in cancer research and has become a hotspot for biopharmaceutical...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.1080/10408363.2018.1522292

    authors: Wang X,Wu M,Cao Y,Zhang Z,Guo F,Li X,Zhang Y

    更新日期:2019-01-01 00:00:00

  • Clinical use of laboratory tests for the identification of secondary forms of arterial hypertension.

    abstract::The prevalence of secondary hypertension can be underestimated if appropriate tests are not performed. The importance of selecting patients with a high pre-test probability of secondary forms of hypertension is first discussed. The laboratory tests currently used for seeking a cause of hypertension are critically revi...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.1080/10408360600931831

    authors: Rossi GP,Seccia TM,Pessina AC

    更新日期:2007-01-01 00:00:00

  • Laboratory diagnosis of acute pancreatitis: in search of the Holy Grail.

    abstract::Acute pancreatitis is an acute inflammatory condition of the pancreas, which might extend to local and distant extrapancreatic tissues. The global incidence varies between 17.5 and 73.4 cases per 100,000 and the pathogenesis recognizes alcohol exposure and biliary tract disease as the leading causes, ahead of post-end...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.3109/10408363.2012.658354

    authors: Lippi G,Valentino M,Cervellin G

    更新日期:2012-01-01 00:00:00

  • Review of isoelectric focusing for Gc, PGM1, Tf, and Pi subtypes: population distributions.

    abstract::Isoelectric focusing (IEF) as a method for differentiating macromolecules with minor differences in isoelectric points has demonstrated an increase in the degree of genetic polymorphisms of the blood. Studies over the last 5 to 6 years have shown that genetic marker systems such as transferrin (TF), phosphoglucomutase...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.3109/10408368409165772

    authors: Dykes DD,Polesky HF

    更新日期:1984-01-01 00:00:00

  • Control of vascular tone in the syndromes of Bartter and Gitelman.

    abstract::Bartter's and Gitelman's syndromes can be used as models to gain insight into the mechanisms responsible for maintaining/controlling vascular tone. In fact, the study of patients with these syndromes provides important insights into mechanistic details of the most relevant pathways of vascular tone. So far, several ex...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.1080/10408360091174295

    authors: Calò L,Davis PA,Semplicini A

    更新日期:2000-12-01 00:00:00

  • Non-alcoholic fatty liver disease.

    abstract::Non-alcoholic fatty liver disease (NAFLD) refers to the accumulation of hepatic steatosis not due to excess alcohol consumption. The prevalence of NAFLD is up to 30% in developed countries and nearly 10% in developing nations, making NAFLD the most common liver condition in the world. The pathogenesis of NAFLD is rela...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.3109/10408363.2011.596521

    authors: Smith BW,Adams LA

    更新日期:2011-05-01 00:00:00

  • Pterostilbene: Biomedical applications.

    abstract::Resveratrol and its naturally dimethylated analog, pterostilbene, show similar biological activities. However, the higher in vivo bioavailability of pterostilbene represents a fundamental advantage. The main focus of this review is on biomedical applications of pterostilbene. The metabolism and pharmacokinetics of thi...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.3109/10408363.2013.805182

    authors: Estrela JM,Ortega A,Mena S,Rodriguez ML,Asensi M

    更新日期:2013-05-01 00:00:00

  • Analyte stability in clinical chemistry quality control materials.

    abstract::Maximum stability of analytes in chemistry control materials is desired. Stability testing is customarily performed by manufacturers, both prior to distribution of products and during the period following distribution when the products are in the field. Users and evaluators of such materials periodically have reported...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.3109/10408368209107031

    authors: Lawson NS,Haven GT,Williams GW

    更新日期:1982-01-01 00:00:00

  • Small-pool high-yield factor VIII production.

    abstract::Hemophilia care depends on several factors for the production of purified FVIII: plasma procurement, plasma logistics, production method, and efficacy. The latter two are restrictive factors, both for the supply and the safety of FVIII preparations. Conventional production methodology unavoidably recovers only 10 to 2...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.3109/10408368609111596

    authors: Smit Sibinga CT

    更新日期:1986-01-01 00:00:00

  • Clinical implications of estrone sulfate measurement in laboratory medicine.

    abstract::Estrone sulfate (E1S) is the most abundant circulating estrogen and it has the potential to be used as a biomarker in certain conditions where estimation of low levels of estrogen or changes in relative levels of estrogens are important. This review will critically consider the role of estimating E1S for clinical labo...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.1080/10408363.2016.1252310

    authors: Rezvanpour A,Don-Wauchope AC

    更新日期:2017-03-01 00:00:00

  • Complement in the pathophysiology and diagnosis of human diseases.

    abstract::Complement is a humoral effector system composed of 21 plasma proteins that was identified initially because of its cytolytic effects. In addition to cytolysis, complement has a number of different functions related to inflammatory and other host defense processes. The description of the reaction mechanism includes: (...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.3109/10408368609110272

    authors: Dalmasso AP

    更新日期:1986-01-01 00:00:00

  • Role of vitamin D in cytotoxic T lymphocyte immunity to pathogens and cancer.

    abstract::The discovery of vitamin D receptor (VDR) expression in immune cells has opened up a new area of research into immunoregulation by vitamin D, a niche that is distinct from its classical role in skeletal health. Today, about three decades since this discovery, numerous cellular and molecular targets of vitamin D in the...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.3109/10408363.2015.1094443

    authors: Sarkar S,Hewison M,Studzinski GP,Li YC,Kalia V

    更新日期:2016-01-01 00:00:00

  • Alpha-fetoprotein: a review.

    abstract::Alpha fetoprotein (AFP) is the major protein of fetal serum and most resembles albumen, which replaces it shortly after birth. It is produced by fetal liver and passes into the amniotic fluid (AF) via fetal urine. A small amount crosses the membranes into the maternal circulation. Excluding fetal blood contamination, ...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.3109/10408368109105870

    authors: Crandall BF

    更新日期:1981-01-01 00:00:00

  • The coagulopathy of cardiopulmonary bypass.

    abstract::There have been numerous publications on the coagulopathy of cardiopulmonary bypass (CPB). This review provides an introduction to the history and main components of current CPB circuits and summarizes the current knowledge of pathogenesis, prevention, and treatment of the CPB coagulopathy. It encompasses an overview ...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.3109/10408363.2010.549291

    authors: Besser MW,Klein AA

    更新日期:2010-12-01 00:00:00

  • Biochemistry and clinical role of human cystatin C.

    abstract::Low molecular-mass plasma proteins play a key role in health and disease. Cystatin C is an endogenous cysteine proteinase inhibitor belonging to the type 2 cystatin superfamily. The mature, active form of human cystatin C is a single non-glycosylated polypeptide chain consisting of 120 amino acid residues, with a mole...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.1080/10408360490504934

    authors: Mussap M,Plebani M

    更新日期:2004-01-01 00:00:00

  • Immunology of head and neck cancers.

    abstract::Despite the ever growing collection of data concerning the function of the immune system in patients with epidermoid carcinoma of the head and neck, the precise mechanism by which these tumors effect the body's surveillance against foreign antigen is as yet unidentified. If these specific immunological characteristics...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.3109/10408368309165758

    authors: Newbill ET,Johns ME

    更新日期:1983-01-01 00:00:00

  • Biochemistry and clinical role of trypsinogens and pancreatic secretory trypsin inhibitor.

    abstract::Trypsinogens and PSTI/TATI/SPINK1 are expressed, usually together, at high levels by the pancreas but also by many other normal and malignant tissues. The present review describes studies on the expression and putative functions of trypsinogens and PSTI/TATI/SPINK1 in the human body. The clinical aspects are discussed...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.1080/10408360500523852

    authors: Paju A,Stenman UH

    更新日期:2006-01-01 00:00:00

  • The spleen: diagnosis of splenic diseases using radiolabeled tracers.

    abstract::The coupling of hematologic data with radionuclide studies of the spleen has provided information as to the functioning of the organ in a variety of disease states. The major radionuclide studies have been presented in terms of the type of information derivable and the various conditions that can result in fairly simi...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.3109/10408368909105717

    authors: Spencer RP,Gupta SM

    更新日期:1989-01-01 00:00:00

  • Hypophosphatasia and the extracellular metabolism of inorganic pyrophosphate: clinical and laboratory aspects.

    abstract::Hypophosphatasia is a rare inherited disorder in which the activity of the bone/liver/kidney or tissue nonspecific form of alkaline phosphatase (ALP) is reduced. The clinical expression of the disease is highly variable, but in early life the severity tends to reflect the age of onset. Accordingly, the disease is ofte...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.3109/10408369109106862

    authors: Caswell AM,Whyte MP,Russell RG

    更新日期:1991-01-01 00:00:00

  • Intestinal bacteria and inflammatory bowel disease.

    abstract::Crohn's disease (CD) and ulcerative colitis (UC) are the two principal forms of inflammatory bowel disease (IBD). Animal studies show that bacteria are involved in the etiology of IBD, and much is now known about the inflammatory processes associated with CD and UC, as well as the underlying genetic, environmental, an...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.1080/10408360802485792

    authors: Macfarlane S,Steed H,Macfarlane GT

    更新日期:2009-01-01 00:00:00

  • Osteocalcin: diagnostic methods and clinical applications.

    abstract::Osteocalcin is a small (Mr 5800), very interesting bone specific protein, synthesized by osteoblasts and measured in plasma as a biochemical indicator of bone formation. Many immunoassays for osteocalcin have been developed, including radio- and enzymoimmunoassays, with the use of monoclonal and polyclonal antibodies....

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.3109/10408369109106867

    authors: Power MJ,Fottrell PF

    更新日期:1991-01-01 00:00:00

  • The role of soluble receptor for advanced glycation end-products (sRAGE) in the general population and patients with diabetes mellitus with a focus on renal function and overall outcome.

    abstract::Isoforms of the receptor for advanced glycation end-product (RAGE) protein, which lack the transmembrane and the signaling (soluble RAGE or sRAGE) domains are hypothesized to counteract the detrimental action of the full-length receptor by acting as a decoy, and they provide a potential tool to treat RAGE-associated d...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章

    doi:10.1080/10408363.2020.1791045

    authors: Steenbeke M,De Bruyne S,De Buyzere M,Lapauw B,Speeckaert R,Petrovic M,Delanghe JR,Speeckaert MM

    更新日期:2020-07-15 00:00:00

  • Methylated DNA for monitoring tumor growth and regression: how do we get there?

    abstract::A wide range of protein cancer biomarkers is currently recommended in international guidelines for monitoring the growth and regression of solid tumors. However, a number of these markers are also present in low concentrations in blood obtained from healthy individuals and from patients with benign diseases. In contra...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.3109/10408363.2014.893279

    authors: Kristiansen S,Nielsen D,Sölétormos G

    更新日期:2014-06-01 00:00:00

  • Problems with measurements caused by high concentrations of serum solids.

    abstract::There have been numerous reports of spectrophotometric and volume problems caused by elevated levels of lipids in blood. The offending lipids, primarily triglycerides, not only cause turbidity leading to optical aberrations when added to analytical reagents, but also result in short-sampling errors leading to the meas...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.3109/10408368709105876

    authors: Artiss JD,Zak B

    更新日期:1987-01-01 00:00:00

  • Molecular biomarkers for cancer detection in blood and bodily fluids.

    abstract::Cancer is a major and increasing public health problem worldwide. Traditionally, the diagnosis and staging of cancer, as well as the evaluation of response to therapy have been primarily based on morphology, with relatively few cancer biomarkers currently in use. Conventional biomarker studies have been focused on sin...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.1080/10408360600922632

    authors: Feng Q,Yu M,Kiviat NB

    更新日期:2006-01-01 00:00:00

  • Variability and function of family 1 uridine-5'-diphosphate glucuronosyltransferases (UGT1A).

    abstract::The substrate spectrum of human UDP-glucuronosyltransferase 1A (UGT1A) proteins includes the glucuronidation of non-steroidal anti-inflammatory drugs, anticonvulsants, chemotherapeutics, steroid hormones, bile acids, and bilirubin. The unique genetic organization of the human UGT1A gene locus, and an increasing number...

    journal_title:Critical reviews in clinical laboratory sciences

    pub_type: 杂志文章,评审

    doi:10.1080/10408360802374624

    authors: Strassburg CP,Kalthoff S,Ehmer U

    更新日期:2008-01-01 00:00:00