Resolving Erroneous Reports in Toxicology and Therapeutic Drug Monitoring : A Comprehensive Guide

**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. Content: Chapter 1 An Introduction to Tests Performed in Toxicology Laboratories (pages 1–30): Chapter 2 Challenges in Drugs of Abuse Testing (pages 31–51): Chapter 3 False?Positive Results Using Immunoassays for Drugs of Abuse Testing (pages 53–66): Chapter 4 True?Positive Drugs of Abuse Test Results Due to Use of Prescriptions and Nonprescription Drugs (pages 67–83): Chapter 5 When Toxicology Report Is Negative in a Suspected Overdosed Patient: The World of Designer Drugs (pages 85–100): Chapter 6 Abuse of Magic Mushrooms, Peyote Cactus, Khat, and Solvents: No Readily Available Laboratory Tests (pages 101–120): Chapter 7 Limitations of Blood Alcohol Measurements Using Automated Analyzers and Breath Analyzers (pages 121–137): Chapter 8 Role of the Laboratory in Detecting Other Poisoning, Including Pesticides, Ethylene Glycol, and Methanol (pages 139–160): Chapter 9 Poisoning with Warfarin and Superwarfarin: What Can Laboratory Testing Do? (pages 161–184): Chapter 10 Plant Poisoning and the Clinical Laboratory (pages 185–211): Chapter 11 Sources of Erroneous Results in Therapeutic Drug Monitoring Due to Preanalytical Errors, High Bilirubin, Hemolysis, and Lipids (pages 213–235): Chapter 12 Challenges in Therapeutic Drug Monitoring of Digoxin Using Immunoassays (pages 237–263): Chapter 13 Interference in Immunoassays Used for Monitoring Anticonvulsants and the Usefulness of Monitoring Free Anticonvulsants (pages 265–291): Chapter 14 Interference in Immunoassays Used to Monitor Tricyclic Antidepressants (pages 293–322): Chapter 15 Therapeutic Drug Monitoring of Immunosuppressants: Limitations of Immunoassays and the Need for Chromatographic Methods (pages 323–353): Chapter 16 Effect of Drug–Herb Interactions on Therapeutic Drug Monitoring (pages 355–384): Chapter 17 Pharmacogenomics and the Toxicology Laboratory (pages 385–409): Chapter 18 Approaches for Eliminating Interference/ Discordant Specimens in Therapeutic Drug Monitoring and Drugs of Abuse Testing (pages 411–427): An introduction to tests performed in toxicology laboratories and methodologies available for such testings Challenges in drugs of abuse testing False positive results in immunoassays for drugs of abuse testing True positive drugs of abuse test results due to prescription and non-prescription drugs When toxicology report is negative in a suspected overdosed patient : the world of designer drugs Abuse of magic mushroom, peyote cactus and solvent : no readily available laboratory tests False positive alcohol tests using breath analyzers and automated analyzers Role of laboratory in detecting other poisoning including pesticides, ethylene glycol, and methanol Poisoning with warfarin and superwarfarin : what laboratory can do? Plant poisoning and clinical laboratory Sources of erroneous results in therapeutic drug monitoring due to pre-analytical errors, high bilirubin, hemolysis, and heterophilic antibody Interferences in immunoassays used for digoxin monitoring Interferences in immunoassays used for monitoring anticonvulsants and usefulness of monitoring free anticonvulsants in certain patients Interferences in immunoassays used for monitoring tricyclic antidepressant Therapeutic drug monitoring of immunosuppressant drugs : limitations of immunoassays and need for chromatographic methods Effect of drug-herb interactions on therapeutic drug monitoring Pharmacogenomics and toxicology laboratory Approaches for eliminating interference/discordant specimen in therapeutic drug monitoring and drugs of abuse testing. This easy-to-use guide provides toxicologists and scientists involved in toxicology tests with clear, concise instructions on how to quickly identify, interpret, and ultimately resolve erroneous results in toxicology and therapeutic drug monitoring. A handy resource of up-to-date methods, techniques, technologies, scenarios, and practical tips for toxicology labs, the book also discusses challenges in testing such as false positives, unexpected negative reports, and specific interferences. Chapters on genetic analysis and other pharmacogenomics platforms as well as drug-herb interactions are also included.