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Emergency and Overdose Drug Testing

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Also known as: Drug Testing; Drug Screen; Poison Testing; Toxicology Assays
Formal name: Emergency and Overdose Drug Testing

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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used. To access online sources, copy and paste the URL into your browser.

Sources Used in Current Review

2016 review performed by Adetoun A. Ejilemele, MB.ChB., DABCC, Clinical & Technical Consultant, Kaiser Permanente Regional Laboratory.

(August 3, 2015) Rhyee SH, Traub SJ & Grayzel J. General Approach to Drug Poisoning in Adults. UpToDate. Available online at http://www.uptodate.com/contents/general-approach-to-drug-poisoning-in adults?source=search_result&search=general+approach+to+drug+poisoning&selectedTitle=1~150. Accessed on 2/2/2016.

Erdmann A, Werner D, Hugli O & Yersin B. Focused Use of Drug Screening in Overdose Patients Increases Impact on Management. Swiss Med Wkly. 2015; 145w14242. Available online at http://www.smw.ch/content/smw-2015-14242/. Accessed 2/1/2016.

Henry's Clinical Diagnosis and Management by Laboratory Methods. McPherson RA & Pincus MR, eds 22nd Edition: Elsevier, St Louis, MO. Pp 329–364.

Tietz Textbook of Clinical Chemistry & Molecular Diagnostics. Burtis CA, Ashwood ER & Bruns DE, eds. 5th Edition: Elsevier Saunders, Philadelphia, PA. Pp 1057–1107, 1109–1188.

(Aug 17, 2015) Centers for Disease Control and Prevention. Effects of Blood Alcohol Concentration. Available online at http://www.cdc.gov/motorvehiclesafety/impaired_driving/bac.html. Accessed 2/2/2016.

(August 27, 2015) Sivilotti MLA, Traub SJ, Grayzel J. Initial Management of the Critically Ill Adult with an Unknown Overdose. UpToDate. Available online at http://www.uptodate.com/contents/initial-management-of-the-critically-ill-adult-with-an-unknown-overdose?source=search_result&search=general+approach+to+drug+poisoning&selectedTitle=2~150. Accessed 2/2/2016.

Sources Used in Previous Reviews

Pagana, K. D. & Pagana, T. J. (© 2007). Mosby's Diagnostic and Laboratory Test Reference 8th Edition: Mosby, Inc., Saint Louis, MO. Pp 361-364, 684-685.

Clarke, W. and Dufour, D. R., Editors (© 2006). Contemporary Practice in Clinical Chemistry: AACC Press, Washington, DC. Pp 469-475.

Wu, A. (© 2006). Tietz Clinical Guide to Laboratory Tests, 4th Edition: Saunders Elsevier, St. Louis, MO. Pp 1238-1239, 1266-1273, 1284-1285, 1334-1355, 1344-1345, 1388, 1398-1401, 1428, 1436, 1456-1457, 1490-1491, and 1506-1507.

Olson, K., Editor (© 2004). Poisoning & Drug Overdose 4th Edition: McGraw-Hill Companies, Inc., U.S.A. Pp 66-69, 90-93, 148-150, 155-157, 190-193, 194-198, 207-209, 243-246, 283-286, 331-333, 354-356, 362-364, 486-487.

Wu, A. and McKay, C., Editors (© 2003). Recommendations For The Use Of Laboratory Tests To Support Poisoned Patients Who Present To The Emergency Department. The National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines [On-line information]. Available online through http://www.aacc.org.

Anthony S. Manoguerra, A. et. al. (© 2006). Valproic Acid Poisoning: an Evidence-Based Consensus Guideline for Out-of-Hospital Management. American Association of Poison Control Centers [On-line information]. PDF available for download at http://www.aapcc.org/archive/FinalizedPMGdlns/Valproic%20Acid%20Poisoning%20Final.pdf.

Woolf, A. et. al. (2006 July 20). Tricyclic antidepressant poisoning: an evidence-based consensus guideline for out-of-hospital management. Clinical Toxicology (2007) 45, 203-233. [On-line information]. PDF available for download at http://www.aapcc.org/archive/FinalizedPMGdlns/TCA%20guideline%20for%20AAPCC.pdf.

Chyka, P. et. al. (2006 June 6). Salicylate poisoning: An evidence-based consensus guideline for out-of-hospital management. Clinical Toxicology 45:2, 95-131. [On-line information]. PDF available for download at http://www.aapcc.org/archive/FinalizedPMGdlns/Salicylate%20guideline%20for%20AAPCC%202006-5-23.pdf.

Caravati, E. et. al. (19 April 2006). Long-acting anticoagulant rodenticide poisoning: An evidence-based consensus guideline for out-of-hospital management. Clinical Toxicology 45:1, 1-22. [On-line information]. PDF available for download at http://www.aapcc.org/archive/FinalizedPMGdlns/LAAR%20guideline%202006-4-19%20for%20Clin%20Toxicol.pdf.

Dart, R. et. al. (© 2006). Acetaminophen Poisoning: an Evidence-Based Consensus. Guideline for Out-of-Hospital Management. Clinical Toxicology 44:1-18, 2006 [On-line information]. PDF available for download at http://www.aapcc.org/archive/FinalizedPMGdlns/APAP%20-%20final%20guideline%209.9.05.pdf.

Caravati, E. et. al. (© 2005). Ethylene Glycol Exposure: an Evidence-Based Consensus. Guideline for Out-of-Hospital Management. Clinical Toxicology 43:327-345, 2005 [On-line information]. PDF available for download at http://www.aapcc.org/archive/FinalizedPMGdlns/ethylene%20glycol%20guideline.pdf.

Acetaminophen and children: Why dose matters. Mayo Clinic. Available online at http://www.mayoclinic.com/health/acetaminophen/HO00002. Last updated June 18, 2011. Accessed October 2, 2013.

Matthew D. Krasowski, MD, PhD. Toxic Alcohols: Practical Challenges in Laboratory Diagnosis of Ingestions. Clinical Laboratory News. Available online at http://www.aacc.org/publications/cln/2012/February/Pages/ToxicAlcohols.aspx. Published February 2012. Accessed October 7, 2013.

Phenobarbital. MedlinePlus. Available online at http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682007.html. Last updated May 15, 2013. Accessed October 7, 2013.

Phenytoin. MedlinePlus. Available online at http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682022.html. Last updated May 1, 2009. Accessed October 7, 2013.

Theophylline. MedlinePlus. Available online at http://www.nlm.nih.gov/medlineplus/druginfo/meds/a681006.html. Last updated December 21, 2011. Accessed October 7, 2013.

Valproic Acid. MedlinePlus. Available online at http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682412.html. Last updated September 15, 2013. Accessed October 7, 2013.

Drug Overdose. National Coalition Against Prescription Drug Abuse. Available online at http://ncapda.org/index.php?option=com_content&view=article&id=79:drug-overdose&catid=33:students&Itemid=7. Copyright 2013. Accessed October 7, 2013.

Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Burtis CA, Ashwood ER, Bruns DE, eds. 4th edition, St. Louis: Elsevier Saunders; 2006, Pp 1288-1314, 1317-1348.

Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL eds (2005). Harrison's Principles of Internal Medicine, 16th Edition, McGraw Hill, Pp 1840-1841.