The modern toxicology laboratory can play an important role in the evaluation of poisoning. In order to appreciate the nature and extent of this role, several essential elements necessary to an acute care toxicology service should be considered. When an ongoing and effective dialogue between clinicians and the toxicology laboratory staff is established, and a broadly based analytical approach is applied to the analysis of the appropriate biological fluids, a dynamic and viable toxicology service will result. How these elements work together to facilitate this service will be discussed, based primarily on experience in a large teaching hospital. This experience indicates that if the elements necessary to provide laboratory support in the investigation of an alleged poisoning are in place, the toxicology laboratory plays an important role in ensuring optimum and effective patient care.

Clinical Laboratory Techniques↗

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Testing for basic drugs in biological fluids by solvent extraction and dual capillary GC/NPD.

Basic drugs were extracted from 1 mL of serum, urine, or other biological fluids under alkaline conditions into hexane:isoamyl alcohol (98:2). The drugs were back-extracted into acid and re-extracted into 50 microL of chloroform:isoamyl alcohol (95:5) after the acid had been alkalinized. An aliquot of the chloroform:isoamyl alcohol was injected onto a temperature programmed gas chromatograph equipped with two nitrogen phosphorus detectors and two fused silica capillary columns fitted into a single injector. Results obtained from 388 serum samples (from suspected overdose patients) tested using this procedure are presented. The same extraction applied to a variety of body fluids proved reliable for quantitations of several of the basic drugs when a packed column was used.

Body Fluids↗

PubMedDate not supplied

Comparison of a TLC method with EMIT and GC/MS for detection of cannabinoids in urine.

Urine specimens were analyzed in parallel with a new TLC method, an EMIT assay, and a reference GC/MS method. At a 9-carboxy-THC cutoff of 20 ng/mL, the TLC method correctly identified 92% of the positive urines and 97% of the negative urines. In contrast, only 63% of the urine specimens shown by GC/MS to contain greater than 20 ng/mL of 9-carboxy-THC were identified as positive by the EMIT d.a.u. assay at the 100-ng/mL cannabinoid cutoff.

Cannabinoids↗