Drugs of Abuse

Name Purpose Principle/Use Methodology Specimen Therapeutic Range

Ethanol Determine level of ADH
Ethanol in blood Ethanol + NAD ----->
CH3CHO + NADH + H
Measure amount of NADH
Reactive Enzyme Assay -Non-hemolyzed serum/ -No measurable
(REA) plasma ( Sodium Fluoride) amount
-Whole blood -QC/CAP req’t: lesson
-Record and interpret topic 3.7
results in mg/dl or gm%

Salicylate Determine level of Commonly used analgesic. FPIA -Non-hemolyzed serum/ < 30 mg/dl
Salicylate in blood Abuse leads to respiratory plasma (heparinized) Toxic > 30 mg/dl
alkalosis -Record and interpret
results in mg/dl

Acetaminophen Determine level of -Commonly used analgesic FPIA -Non-hemolyzed serum/ 10-25 mg/ml
Acetaminophen in blood -Taken as directed, poses plasma (heparinized) Toxic 100-250 mg/ml
no risk -Record and interpret
-Delayed toxicity: liver results in mg/ml
Necrosis 3-4 days post OD
-Toxic agent is metabolite,
not parent drug
-Antidote: N-acetylcysteine
Marijuana, -Pre-employment Screen by EIA, FPIA -Urine Confirmatory (ng/ml)
Cocaine, Opiate -Random testing Confirm by GC/MS -Record and interpret Marijuana 50 15
metabolite -Employees exhibiting results in ng/ml Cocaine 300 150
s/s of abuse -Results over phone with Opiate metabolite
-Forensics strict protocol 300 300

FPIA- Flourescence Polarization Immunoassay

Tx- Therapeutic drug