Introduction: The study evaluates the application of an onsite screening for the detection of illicit drugs in oral fluids with further confirmation analysis by LC/MS/MS, as rapid diagnostic tool in Emergency. Materials and Methods: Oral fluids were collected (by Cozart DDS oral swab) from 110 hospitalized patients at an Anti Poisons Centre, during 2009. Toxicological screening of oral fluid was performed using Cozart onsite immunoassay to reveal the presence of THC, Cocaine, Opiates, Amphetamine, Methamphetamine, BDZ and Methadone. All samples were confirmed by LC/MS/MS. As controls, oral fluid samples from 50 volunteers were analyzed. Results: Results obtained for patients by onsite immunoassay carried out on admission, were constantly confirmed by LC/MS/MS analyses except for THC (only 3 cases not confirmed). All controls from volunteers were negative as with Cozart as by LC/MS/MS. Data about drugs show that the poly drug use regards 38% of in-patients with higher incidence of cocaine/opiates and cocaine/THC association. Cocaine is also the main cause of acute intoxication and concerns, as a single drug taken, 27% of subjects. Conclusions: The results demonstrate that the oral fluid analysis, if rapidly applied on admission in Emergency Department, may lead to a significant improvement in clinical diagnosis and therapeutic management of acute intoxications involving illicit drugs abuse.

Rapid screening and UPLC/MS-MS toxicological analysis of oral fluid for diagnosis of acute intoxication in emergency

CASSANDRO, Paola;CARFORA, Anna;BORRIELLO, Renata
2010

Abstract

Introduction: The study evaluates the application of an onsite screening for the detection of illicit drugs in oral fluids with further confirmation analysis by LC/MS/MS, as rapid diagnostic tool in Emergency. Materials and Methods: Oral fluids were collected (by Cozart DDS oral swab) from 110 hospitalized patients at an Anti Poisons Centre, during 2009. Toxicological screening of oral fluid was performed using Cozart onsite immunoassay to reveal the presence of THC, Cocaine, Opiates, Amphetamine, Methamphetamine, BDZ and Methadone. All samples were confirmed by LC/MS/MS. As controls, oral fluid samples from 50 volunteers were analyzed. Results: Results obtained for patients by onsite immunoassay carried out on admission, were constantly confirmed by LC/MS/MS analyses except for THC (only 3 cases not confirmed). All controls from volunteers were negative as with Cozart as by LC/MS/MS. Data about drugs show that the poly drug use regards 38% of in-patients with higher incidence of cocaine/opiates and cocaine/THC association. Cocaine is also the main cause of acute intoxication and concerns, as a single drug taken, 27% of subjects. Conclusions: The results demonstrate that the oral fluid analysis, if rapidly applied on admission in Emergency Department, may lead to a significant improvement in clinical diagnosis and therapeutic management of acute intoxications involving illicit drugs abuse.
2010
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11591/158811
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