title: [The false positive reaction of the Triage panel drug-of-abuse by herbal drugs ma-huang (Ephedra sinica (Ephedraceae))].
abstract: We investigated false-positive reactions obtained from a drug screening test using a Triage panel. We detected 2 cases giving false-positive reaction for AMP (amphetamine, methamphetamine) during the screening of 187 normal subjects. Subsequent follow up testing by high-performance liquid chromatography (HPLC), showed both to be false-positive reactions. As both cases have a history of ingesting the herbal drug, Ma-huang (Ephedra sinica (Ephedraceae)), containing ephedrine, we examined the relationship between false-positive reactions on Triage and Ma-huang. All urine samples collected from 7 healthy volunteers following administration of Ma-huang indicated AMP positive on Triage. Also a high ratio of AMP positives was observed in the patients who were administered Ma-huang-containing drugs at the hospital. However, none of them were identified as true-positives by HPLC or gas chromatography mass spectrometry (GC/MS) analysis. The extract of Ma-huang contained in herbal drugs, which otherwise contain neither amphetamine nor its derivatives, gives (AMP) positive indications on Triage. We speculate that unidentified components of Ma-huang cause the false-positive reactions. We suggest that follow-up tests by GC/MS or HPLC are needed wherever a positive result is obtained from a screening test by Triage. Furthermore, it will be established to continue collecting information on prescribed and non-prescribed drugs.
authors.affiliation: Department of Legal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Nishiguchi
authors.forename: H
authors.initials: H
authors.lastname: Kinoshita
authors.forename: K
authors.initials: K
authors.lastname: Higasa
authors.forename: T
authors.initials: T
authors.lastname: Taniguchi
authors.forename: H
authors.initials: H
authors.lastname: Ouchi
authors.forename: T
authors.initials: T
authors.lastname: Minami
authors.forename: S
authors.initials: S
authors.lastname: Marukawa
authors.forename: K
authors.initials: K
authors.lastname: Yoshinaga
authors.forename: J
authors.initials: J
authors.lastname: Yamauchi
authors.forename: S
authors.initials: S
authors.lastname: Aoki
authors.forename: S
authors.initials: S
authors.lastname: Hishida
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002851:Chromatography, High Pressure Liquid; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D029790:Ephedra sinica / Q000737:chemistry*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007211:Indoles / Q000652:urine; D008297:Male; D008875:Middle Aged; D015813:Substance Abuse Detection / Q000379:methods*; D019966:Substance-Related Disorders / Q000175:diagnosis*
chemical_list: D004365:Drugs, Chinese Herbal; D007211:Indoles; C055673:amphethinile