Confirmation of LSD intoxication by analysis of serum and urine.

Serum and urine specimens of 31 patients with suspected lysergic acid diethylamide (LSD) intoxication were analyzed for LSD by both radioimmunoassay (RIA) and high-pressure liquid chromatography (HPLC). The RIA assay, using 0.1 ng/mL as the limit of detection instead of the manufacturer's recommendation of 0.

Estimation of theophylline clearance during intravenous aminophylline infusions.

The utility of predicting theophylline clearance (CL) from two serum concentrations obtained during continuous intravenous aminophylline infusion was examined in 16 stable, adult patients. Blood for theophylline measurement was obtained 0, 6, and 12 h after starting infusions and, thereafter, at 12-h intervals. EMIT was used to assay samples in multiple runs as they were obtained.

Detection of phencyclidine usage by radioimmunoassay of saliva.

Paired serum and saliva samples, obtained from 100 emergency department patients suspected of phencyclidine (PCP) intoxication, were analyzed using a specific PCP radioimmunoassay (RIA). Seventy-four of the 100 saliva samples and 75 of the paired serum samples were positive for PCP. The final clinical diagnosis was PCP intoxication in 79 cases.

Quantitation of phencyclidine in serum by enzyme immunoassay: results in 405 patients.

Phencyclidine (PCP) in serum (5 ng/mL and higher) was quantitated by a homogeneous enzyme immunoassay procedure. Precision and accuracy data indicate that the procedure meets the requirements for a clinical assay. The short turnaround time for the assay makes it superior to other available methods for the emergency determination of PCP in serum.

Quantitation of phencyclidine in urine by enzyme immunoassay.

The EMIT phencyclidine assay was modified to permit quantitative results to be obtained on urine from patients intoxicated from ingestion of phencyclidine (PCP). Additional calibrators and a clinical processor for calculating the data are required. Precision and accuracy of the quantitative procedure was determined from urine spiked with PCP.

Rapid assessment of lidocaine in cardiac patients by enzyme immunoassay.

Lidocaine, a drug commonly used via intravenous infusion for the treatment of cardiac arrhythmias, is frequently effective but has the hazard of potential toxicity. Avoidance of toxicity and better control of therapy are shown to be markedly enhanced by a new method of rapidly measuring blood levels of lidocaine by enzyme immunoassay. Examples of the use of this technique, for drug monitoring in the settings of suspected toxicity, prospective therapy, dose response assessment, and the study of pharmacokinetics are presented.

DAWN: Drug Abuse Warning Network or Data About Worthless Numbers?

This report presents further data about toxicologic results in 1008 "mentions" to the DAWN (Drug Abuse Warning Network) System from Los Angeles County/USC Medical Center in 1977. Details from some of the blood concentrations found in that retrospective study are presented here for the most commonly reported drugs, both alone and in combination with alcohol. The data suggests caution about inferring drug abuse trends from DAWN data is presently collected.

Lidocaine efficacy and toxicity assessed by a new, rapid method.

Lidocaine (L) levels were measured by gas chromatography (GC) and a new technique of direct measurement by enzyme immunoassay (EMIT) in 50 consecutive patients admitted to the Coronary Care Unit who received L. There was no significant difference between the levels by the two techniques. There was eradication of most ventricular arrhythmias in 78% of patients, partial effectiveness in 16%, and no improvement in 6%.

The Drug Abuse Warning Network (DAWN) Program. Toxicologic verification of 1,008 emergency room 'mentions'.

One thousand eight emergency room patient records from which reports were contributed to the federal Drug Abuse Warning Network (DAWN) system from the Los Angeles County/University of Southern California Medical Center in 1977 were studied. The drugs reported to DAWN for these patients were compared with the available toxicology laboratory reports for some of these same patients. The purpose was to test the validity of the data reported to DAWN.

California Association of Toxicologists proficiency testing program.

A proficiency testing program that has been conducted by the California Association of Toxicologists for 10 years is described. The purpose of the program is to allow each participant the opportunity to evaluate their methodology and efficiency on a qualitative as well as quantitative basis with other laboratories in the organization. The program is conducted entirely on a volunteer basis with the sample prepared by a different member each time.

Clinical evaluation of the EMIT procainamide and N-acetylprocainamide assay.

Procainamide and its major metabolite, N-acetylprocainamide, were measured by the homogeneous enzyme immunoassay technique (EMIT). The reagents for the EMIT assays were supplied as a separate matched set for each assay. There is no cross-reactivity by procainamide in the assay for N-acetylprocainamide or by N-acetylprocainamide in the assay for procainamide.

Toxicology test-ordering patterns in a large urban general hospital during five years: an update.

Analytical data from the clinical toxicology laboratory of a large urban hospital, the Los Angeles County--University of Southern California Medical Center, are reported for the year 1976 and are compared to similar data previously documented for the year 1972. Drugs assayed, number of tests requested, and number of positive results are collated. Data on 58 assays show that the overwhelming majority of the requests continue to be for those tests that were originally classified as tests with 4-h turn-around time in the patient-focused concept for a clinical toxicology service in 1972.