LQCL2202 - CMLE - LIMITATIONS OF IMMUNOASSAYS AND LIQUID CHROMATOGRAPHY– TANDEM MASS SPECTROMETRY SCREEN AND CONFIRM TESTING-LIMITATIONS OF IMMUNOASSAYS AND LIQUID CHROMATOGRAPHY– TANDEM MASS SPECTROMETRY SCREEN AND CONFIRM TESTING

LIMITATIONS OF IMMUNOASSAYS AND LIQUID CHROMATOGRAPHY– TANDEM MASS SPECTROMETRY SCREEN AND CONFIRM TESTING

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The document discusses a case study of a 21-year-old man who presented to the emergency department after ingesting cocaine and methaqualone. The patient's urine drug screen confirmed cocaine and tetrahydrocannabinol use but did not detect methaqualone. It delves into the limitations of immunoassays and liquid chromatography–tandem mass spectrometry (LC-MS/MS) in detecting novel illicit drugs. It explains the importance of broad-spectrum urine drug screening in identifying unknown drugs and the role of high-resolution mass spectrometry (HRMS) in differentiating compounds. The case study highlights the process of identifying "unknown unknown" drugs in patient samples, using mass spectrometry techniques. Additionally, it details the challenges of separating coeluting compounds to identify specific drugs accurately. The study emphasizes the importance of utilizing advanced analytical techniques to identify novel compounds and assist clinicians in treating patients effectively. Overall, the document underscores the significance of high-resolution mass spectrometry in clinical toxicology and the evolving landscape of drug screening methods to adapt to emerging designer drugs.

Keywords

21-year-old man

emergency department

cocaine

methaqualone

urine drug screen

immunoassays

liquid chromatography–tandem mass spectrometry

broad-spectrum urine drug screening

high-resolution mass spectrometry

clinical toxicology