Document Detail

Emergency department evaluation of a rapid assay for detection of cocaine metabolites in urine specimens.
MedLine Citation:
PMID:  8859922     Owner:  NLM     Status:  MEDLINE    
We evaluated the Abuscreen ONTRAK assay for cocaine metabolites, a rapid immunoassay for the detection of cocaine metabolites in a pediatric emergency department (ED) setting. The ONTRAK uses a cutoff point of 300 micrograms/L for benzoylecgonine (BEC), cocaine's major urinary metabolite. One hundred and thirty-two urine specimens obtained from infants, children, and adolescents whose clinical findings warranted toxicology screening were evaluated. The ONTRAK identified all 15 specimens with BEC values of 300 micrograms/L, but did not detect seven additional specimens positive for cocaine metabolites at concentrations less than 300 micrograms/L. One third of the positive specimens for cocaine metabolite identified by fluorescent polarization immunoassay (FPIA), cutoff point set at 80 micrograms/L, and confirmed by gas chromatography/mass spectrometry (GUMS), cutoff point 50 micrograms/L, were not detected by the ONTRAK. These false negative specimens were seen exclusively in young children, whose concentration of cocaine metabolite was less than the ONTRAK's cutoff value. The test was sensitive to drug concentration at or around the stated cutoff values. The ONTRAK test for cocaine metabolites, although both a sensitive and specific screening test for adolescents who smoke or snort cocaine, lacks the sensitivity to be a useful screening too[ for detecting cocaine metabolites in young children. Limitations of currently performed toxicology screening tests (ie, stated cutoff levels) may cause emergency physicians to miss most young children whose symptoms may he related to cocaine exposure.
R A Belfer; B L Klein; D A Boenning; S J Soldin
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric emergency care     Volume:  12     ISSN:  0749-5161     ISO Abbreviation:  Pediatr Emerg Care     Publication Date:  1996 Apr 
Date Detail:
Created Date:  1997-04-09     Completed Date:  1997-04-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8507560     Medline TA:  Pediatr Emerg Care     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  113-5     Citation Subset:  IM    
Department of Pediatrics, Children's National Medical Center, The George Washington University, Washington, DC, USA.
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MeSH Terms
Child, Preschool
Cocaine* / metabolism,  urine
Emergency Service, Hospital
Evaluation Studies as Topic
Fluorescence Polarization Immunoassay
Gas Chromatography-Mass Spectrometry
Latex Fixation Tests / methods*
Prospective Studies
Substance Abuse Detection / methods*
Substance-Related Disorders / urine*
Reg. No./Substance:
50-36-2/Cocaine; 519-09-5/benzoylecgonine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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