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Drug interactions occur when the pharmacological effect of one drug is altered by another substance, either enhancing or diminishing its activity. The drug whose activity is altered is known as the object drug, and the substance causing the alteration is called the agent drug or the precipitant. The net effects of these interactions are mostly undesirable, leading to decreased effectiveness or increased adverse effects. In rare cases, interactions can be beneficial, such as the enhanced...
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Common Interferences in Drug Testing.

Michael P Smith1, Martin H Bluth2

  • 1Oakland University William Beaumont School of Medicine, Rochester, MI, USA; Toxicology and Therapeutic Drug Monitoring Laboratory, Beaumont Laboratories, Beaumont Hospital-Royal Oak, 3601 West 13 Mile Road, Royal Oak, MI 48073, USA.

Clinics in Laboratory Medicine
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Summary

Laboratory toxicology testing interferences can lead to inaccurate drug screening results, causing false positives or false negatives. Understanding these common issues is crucial for correct interpretation and patient care.

Keywords:
DrugsFalse negativeFalse positiveForensicLaboratoryToxicologyWorkplace

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Area of Science:

  • Clinical Toxicology
  • Laboratory Medicine

Background:

  • Laboratory toxicology testing is essential for drug screening.
  • Discrepancies between initial drug screens and confirmatory tests are common.

Purpose of the Study:

  • To define and categorize interferences in laboratory toxicology testing.
  • To highlight the impact of these interferences on test results and patient management.

Main Methods:

  • Review of common causes of discrepancies in toxicology testing.
  • Categorization of interferences into false positive and false negative results.

Main Results:

  • Interferences arise from methodology, reagent cross-reactivity, detection limits, and sample issues.
  • False positives occur when screening is positive, but confirmation is negative.
  • False negatives occur when screening is negative despite substance ingestion.

Conclusions:

  • Awareness of potential interferences is vital for accurate interpretation of toxicology results.
  • Proper understanding aids in effective patient management and clinical decision-making.