Why Combine Point of Care Testing with Laboratory Confirmation? Medication Monitoring

Why Combine Point of Care Testing with Laboratory Confirmation? Medication Monitoring

Medication Monitoring
Why Combine Point of Care Testing
with Laboratory Confirmation?
Benefits of POCT confirmation
» Although
Point of Care Testing (POCT)
usage is expanding in clinical settings,
certain drugs such as Fentanyl, Soma,
Tapentadol, Meperidine, Methylphenidate,
and many others cannot be detected by
POCT devices.
» Confirmation testing identifies the presence
or absence of a specific drug and/or its
metabolite(s); whereas POCT may only
show a presumptive result for a class of
drugs such as Opiates or Benzodiazines.
» Interferences can arise with antibody-based
screens including POCT, thus false-positive
results are possible. Laboratory confirmation is the best way to rule-out potential false
positive results.
» Confirmation testing via LC/MS/MS is a more
sensitive detection method than POCT, so
false negative results can be avoided.
» Alere Toxicology assures specimen validity
with objective measurements of pH, Creatinine, Specific Gravity, and Oxidants.
Test Comparison by Cutoff Level
Test Options
Typical POCT Cutoff
LC/MS/MS Cutoff
50 mg/dL1
Alcohol
Ethyl Glucuronide
500 ng/mL
Ethyl Sulfate
125 ng/mL
Amphetamine
1000 ng/mL
100 ng/mL
Barbiturates
300 ng/mL
200 ng/mL2
Benzodiazepines
300 ng/mL
Alprazolam (Alpha-hydroxyalprazolam)
50 ng/mL
Clonazepam (7-aminoclonazepam)
50 ng/mL
Diazepam (Nordiazepam)
50 ng/mL
Lorazepam
50 ng/mL
Oxazepam
50 ng/mL
Temazepam
50 ng/mL
Buprenorphine
10 ng/mL
Norbuprenorphine
25 ng/mL
Carisoprodol
50 ng/mL
Meprobamate
Cocaine (Benzoylecgonine)
Fentanyl
Norfentanyl
Gabapentin
10 ng/mL
50 ng/mL
300 ng/mL
25 ng/mL
2 ng/mL
10 ng/mL
50 ng/mL
Continued on back
Medication Monitoring
Test Options
Typical POCT Cutoff
Ketamine
LC/MS/MS Cutoff
100 ng/mL
Norketamine
100 ng/mL
MDMA
500 ng/mL
100 ng/mL
MDA
100 ng/mL
Meperidine
50 ng/mL
Normeperidine
50 ng/mL
Methamphetamine
1000 ng/mL
Methamphetamine Isomer Analysis
100 ng/mL
100 ng/mL
Methylphenidate
50 ng/mL
Ritalinic Acid
50 ng/mL
Methadone
300 ng/mL
EDDP
Opiate Panel
100 ng/mL
100 ng/mL
300 or 2000 ng/mL
Heroin (6-MAM)
10 ng/mL
Codeine
50 ng/mL
Hydrocodone
50 ng/mL
Norhydrocodone
50 ng/mL
Hydromorphone
50 ng/mL
Morphine
50 ng/mL
Oxycodone
50 ng/mL
Oxymorphone
50 ng/mL
Noroxycodone
Phencyclidine (PCP)
50 ng/mL
25 ng/mL
Pregabalin
Propoxyphene
50 ng/mL
300 ng/mL
Norpropoxyphene
THC (THC-COOH)
Tramadol
O-desmethyltramadol
100 ng/mL
100 ng/mL
Tapentadol
Tricyclic Antidepressants (TCA)
5 ng/mL
50 ng/mL
1000 ng/mL
300 ng/mL2
50 ng/mL
10 ng/mL
50 ng/mL
50 ng/mL
1. EA (Enzyme Assay) 2. EIA (Enzyme Immunoassay)
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