Painful Poster Revised Sjm Edits

Evaluation of Immunalysis Enzyme Immunoassays for Detection of Buprenorphine, Oxycodone, Meperidine, and Tramadol in Urine Natalie N. Rasmussen 1 * JoEtta M. Juenke 2 , Stephanie J. Marin 2 , Miles Merrell 1 , Gwendolyn A. McMillin 2,3 1 ARUP Laboratories, Salt Lake City, UT, USA; 2 ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT, USA; 3 Dept of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA Introduction Use and abuse of narcotics is a significant social concern. Patients of pain management and rehabilitation/abstinence programs must often submit to urine drug testing to verify compliance with prescribed therapy. Testing to detect drugs beyond the traditional SAMHSA panel is necessary due to the common use and potential for abuse of many synthetic or semi-synthetic opioid analgesics. (1,2) Materials Results Method Conclusions Acknowledgements Here Homogeneous Enzyme Immunoassay kits (HEIA) (Immunalysis Corporation, Pomona, CA) to detect buprenorphine oxycodone, tramadol, and meperidine were evaluated. The HEIA kits are comparable in design and performance to Enzyme Multiplied Immunoassay Technique kits (EMIT, Siemens Healthcare Diagnostics, Deerfield, IL). Calibrators and quality control materials were prepared in-house and target concentrations verified by LC-MS/MS. All calibrators and controls were within ±10% of the target concentrations. De-identified urine samples that previously confirmed positive by LC-MS/MS for oxycodone (n=29, at concentrations from 40 ng/mL to > 5000 ng/mL) or buprenorphine (n=21, at concentrations from 9.8 ng/mL to > 2000 ng/mL) as well as prepared urine samples containing meperidine (n=25) and tramadol (n=25) at concentrations ranging from 50% below the cutoff to ten times above the cutoff were analyzed. ,[object Object],[object Object],[object Object],Immunalyisis Corporation Dr. Michael Vincent Rochelle Timbang The Immunalysis HEIA kits successfully detected buprenorphine, oxycodone, meperidine, and tramadol in fortified samples and patient specimens. Further studies are required to better understand specificity of the buprenorphine reagents and define precision at the cutoff concentrations for all assays. Samples were tested in accordance with manufacturer instructions using an Olympus AU400e (Olympus America, Center Valley, PA). No sample preparation or dilution was necessary. Two of the samples had high enough concentrations of other opioids to cross-react with oxycodone. Five of the others screened positive for oxycodone but failed to confirm. It has been recently reported that naloxone has been shown to cause a false positive result for oxycodone by HEIA (3). Some preparations of buprenorphine contain naloxone to discourage illicit use. This could be the cause of the five false positive results ,[object Object],[object Object],Buprenorphine Results ,[object Object],References ,[object Object],[object Object],[object Object],O.D. of oxycodone in buprenorphine samples LC/MS/MS Confirmation for opioids 184 (Cutoff = 100) 6-AM = 710 ng/mL Morphine = 2887 ng/mL Hydromorphone = 11 ng/mL Codeine = 26 ng/mL 186 Morphine = 65 ng/mL Hydromorphone = 4344 ng/mL 124 Morphine = 11 ng/mL 144 None detected 161 Morphine = 35 ng/mL 157 None detected 152 None detected

Painful Poster Revised Sjm Edits

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