title: Diagnostic performance of Triage for benzodiazepines: urine analysis of the dose of therapeutic cases.
abstract: We evaluated the diagnostic performance of Triage for benzodiazepines in 74 urine specimens from outpatients given therapeutic doses of benzodiazepines and compared the results of EMIT assays. Results obtained in all urine samples were confirmed using liquid chromatography-mass spectrometry (LC-MS). Overall agreement between results of Triage and EMIT assays was 73%. All of the Triage-positive samples were also positive by EMIT assays. Results of Triage and EMIT assays were different for 20 samples obtained from patients given thienodiazepines (etizolam, brotizolam, and clotiazepam) and nitrobenzodiazepines (nitrazepam, flunitrazepam, and clonazepam). LC-MS confirmed parent drugs in urine specimens, consistent with the prescriptions of drugs. The low agreement between Triage and EMIT results in this study might be due to low sensitivity of Triage for thienodiazepines. Thienodiazines are frequently prescribed benzodiazepines, and Triage panel is the most frequently used screening kit in Japan. It should be noted that negative results obtained by a Triage test might not mean the absence of thienodiazepines.
authors.affiliation: Department of Legal Medicine, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukushima, Japan. ekuri@fmu.ac.jp
authors.forename: Emiko
authors.initials: E
authors.lastname: Kurisaki
authors.forename: Makiko
authors.initials: M
authors.lastname: Hayashida
authors.forename: Makoto
authors.initials: M
authors.lastname: Nihira
authors.forename: Youkichi
authors.initials: Y
authors.lastname: Ohno
authors.forename: Hirobumi
authors.initials: H
authors.lastname: Mashiko
authors.forename: Takaaki
authors.initials: T
authors.lastname: Okano
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Niwa
authors.forename: Kouichi
authors.initials: K
authors.lastname: Hiraiwa
mesh_terms: D001569:Benzodiazepines / Q000627:therapeutic use / Q000652:urine*; D002853:Chromatography, Liquid; D017248:Enzyme Multiplied Immunoassay Technique; D005188:False Negative Reactions; D006801:Humans; D013058:Mass Spectrometry; D012680:Sensitivity and Specificity
chemical_list: D001569:Benzodiazepines