title: Comparison of urine and serum testing for early detection of acetaminophen ingestion.
abstract: Acetaminophen is a common ingestant that is routinely screened for, with serum testing, after overdoses. We compared a modified, qualitative, colorimetric, o-cresol urine test for acetaminophen with the standard laboratory serum immunoassay. Twenty-nine adult volunteers were given 975 mg of acetaminophen, and then serum and urine samples were tested at predefined intervals for up to 4 hours. The presence of acetaminophen in the urine samples was determined with a modified o-cresol assay by two independent reviewers and was verified by using high-performance liquid chromatography. Compared with the acetaminophen serum immunoassay, the acetaminophen urine test had specificity of 97% (95% confidence interval, 80-100%) and sensitivity of 100% (95% confidence interval, 81-100%) at 45 minutes. Further studies to improve and to accelerate processing of the qualitative colorimetric o-cresol urine test could allow the test to be used in specific military and civilian clinical scenarios.
authors.affiliation: Baptist Health System, Emergency Physician Affiliates, San Antonio, TX 78258, USA.
authors.forename: Joe
authors.initials: J
authors.lastname: MacDaniel
authors.forename: Vikhyat S
authors.initials: VS
authors.lastname: Bebarta
authors.forename: Harvey A
authors.initials: HA
authors.lastname: Schwertner
authors.forename: James F
authors.initials: JF
authors.lastname: Martin
mesh_terms: D000082:Acetaminophen / Q000009:adverse effects / Q000097:blood* / Q000652:urine*; D000293:Adolescent; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects / Q000097:blood* / Q000652:urine*; D002851:Chromatography, High Pressure Liquid; D062787:Drug Overdose; D042241:Early Diagnosis; D006801:Humans; D007118:Immunoassay; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D008889:Military Personnel; D015813:Substance Abuse Detection / Q000379:methods*; D013997:Time Factors
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen