[Toxicological screening of medicines and drugs of abuse in emergency cases].
BACKGROUND
In some situations, and particularly when intoxications are suspected, it would be advantageous if medicines and drugs of abuse could be swiftly detected in serum or urine.


METHODS
The Department of Clinical Pharmacology at St. Olav University Hospital has since 2004 been developing a comprehensive toxicology service (at all hours 7-days/week) for immediate quantitative analysis of between 80 and 90 substances. We here present the service in further detail and evaluate its usefulness during its first full year, 2005. Two case reports are presented to further illustrate the possible benefits of this service.


RESULTS
Urgent testing was requested for a total of 390 samples; 351 serum and 39 urine samples. The most common indications for requesting such analyses were suspected acute intoxication (46%) and suspected therapeutic failure/adverse drug reaction (31%). 88% of the serum samples obtained for acute intoxications were positive, and 48 different substances were detected. The substances most often found were various benzodiazepines, various antiepileptic drugs, ethanol, carisoprodol, lithium, and other psychotropic drugs. In urine, amphetamine and zopiclone were the substances most often detected.


CONCLUSIONS
The service seems to be used according to its intentions, and the high number of samples received indicate that clinicians consider the service to be useful. An early and continuous dialogue between the clinician and the laboratory physician is a prerequisite for rational use of the service.
Helland
Arne
A
Avdeling for klinisk farmakologi, St. Olavs Hospital, 7006 Trondheim.
Espnes
Ketil Arne
KA
Reimers
Arne
A
Aamo
Trond
T
Zahlsen
Kolbjørn
K
Rygnestad
Tarjei
T
Spigset
Olav
O
D000293:Adolescent; D000328:Adult; D000435:Alcoholic Intoxication / Q000097:blood / Q000175:diagnosis / Q000652:urine; D000927:Anticonvulsants / Q000097:blood / Q000506:poisoning / Q000652:urine; D001569:Benzodiazepines / Q000097:blood / Q000506:poisoning / Q000652:urine; D004636:Emergency Service, Hospital; D005260:Female; D053593:Forensic Toxicology / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D011041:Poisoning / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D011619:Psychotropic Drugs / Q000097:blood / Q000506:poisoning / Q000652:urine; D015813:Substance Abuse Detection / Q000379:methods / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000097:blood / Q000175:diagnosis* / Q000652:urine
D000927:Anticonvulsants; D011619:Psychotropic Drugs; D001569:Benzodiazepines