Drug test positive for pcp

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Try out PMC Labs and tell us what you think. Learn More. reports describe false positive urine immunoassay screens for phencyclidine PCP associated with use of tramadol, dextromethorphan, or diphenhydramine. The likelihood of these false positives is unknown. We sought to find the relative frequency of false-positive PCP screens associated with these medications and to look for any other Drug test positive for pcp with similar associations. In an IRB-approved study, we retrospectively reviewed charts of all ED encounters with positive urine screens for PCP in our hospital from throughinclusive.

We recorded all medications mentioned in the chart as current medications or medications given before the urine sample. We compared frequencies of tramadol, dextromethorphan, diphenhydramine, and other medications between the two groups. Tramadol, dextromethorphan, alprazolam, clonazepam, and carvedilol all were ificantly more frequent among the false positive group.

Diphenhydramine was more frequently recorded among the false positive group, but this was not statistically ificant. False positive urine screens for PCP are common with tramadol, dextromethorphan, alprazolam, clonazepam, and carvedilol and may also occur with diphenhydramine.

Urine drug screening in the ED usually involves immunoassay testing for major classes of drugs of abuse. Most hospitals do not routinely perform secondary testing to confirm positive screen. Therefore, the true rate of false positive urine drug screens is unknown. False positive drug screens for illicit drugs can lead Drug test positive for pcp an incorrect treatment, prejudice from nursing and physician staff, increased healthcare expenditures, and adverse legal or employment action. However, the frequency of such false positive is unknown.

The objective of this study was to determine the frequency of false positive urine screens for PCP in association with reported use of medications. Structures of PCP, tramadol, diphenhydramine, and dextromethorphan. The approach for this IRB-approved, retrospective study was very similar to a study of false positive urine drug screens for amphetamines associated with the use of bupropion by Casey et al.

We recorded documented use of tramadol, diphenhydramine, and dextromethorphan, as well as any other medications that frequently appeared. The null hypothesis of each comparison was that the frequency of a given medication would be the same in both groups.

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Before starting the data extraction phase of the project, researchers met to clearly define variables and standardize data collection. Weekly meetings were scheduled to discuss progress and to ensure uniform handling of data that were conflicting, missing, or ambiguous. The rater was not blinded to the purpose of the study. Between January 1 st and December 31 st33, urine drug screens were performed by the laboratory at Barnes-Jewish Hospital on patients presenting to the ED.

Out of 33, urine screens, 1. Of those Among the confirmed positives, patient charts reflected documented use of tramadol in 32 patients 8. Among the 88 who failed to confirm, records reflected documented use of tramadol in 19 patients Alprazolam, clonazepam, and carvedilol unexpectedly were also ificantly overrepresented among patients with PCP screens which failed confirmation.

Of the confirmed positives, four patients had documented use of alprazolam 1. The 88 patients with PCP screens that failed Drug test positive for pcp confirm included nine patients with recorded use of alprazolam All three of the medications suggested by case reports had higher proportions in the non-confirmed group than among the confirmed positive group. However, these differences were ificantly different for tramadol and dextromethorphan but not for diphenhydramine, which showed a non-ificant trend for positive PCP screens which failed confirmation by GC-MS.

Unexpected drugs with ificant disproportion of false positive PCP screens included alprazolam, clonazepam, and carvedilol. This finding may be due to the fact that these medications share structural similarity with PCP, each with Drug test positive for pcp six-member rings that are one atom apart Figure 4. Structures of PCP, alprazolam, clonazepam, and carvedilol. As with most retrospective studies, a limitation of our study is the assumption that the information recorded in patient's chart was correct, complete, and accurate.

Also, this was a single-center study, of which the might not be generalizable to other patient populations. The investigator who abstracted data from the charts was not blinded to the purpose of the study. Identifying the presence or absence of the data elements in a given chart was objective, so we believe that unblinded data abstraction did not appreciably bias the.

Another potential limitation is that we did not stratify our sample based upon renal or hepatic function.

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We did not record serum concentrations of creatinine or hepatic enzymes because most patients were missing one or both. We believe that any hepatic or renal abnormalities would be equally distributed among both of our study groups.

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Tramadol, dextromethorphan, alprazolam, clonazepam, and carvedilol were ificantly associated with false positive urine screens for phencyclidine. Diphenhydramine showed a non-ificant trend and was among the most frequently identified medications among patients with false positive screens for phencyclidine.

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Louis on February 16, The authors have no conflicts to disclose. National Center for Biotechnology InformationU. Clin Toxicol Phila. Author manuscript; available in PMC Apr 3. Arvind Rengarajan and Michael E. MullinsMD. Author information Copyright and information Disclaimer. Corresponding author: Michael E. Mullins MD, ude. Euclid Avenue, Campus BoxSt. Louis, MO Copyright notice. The publisher's final edited version of this article is available at Clin Toxicol Phila.

See other articles in PMC that cite Drug test positive for pcp published article. Abstract Background reports describe false positive urine immunoassay screens for phencyclidine PCP associated with use of tramadol, dextromethorphan, or diphenhydramine.

Objective We sought to find the relative frequency of false-positive PCP screens associated with these medications and to look for any other medications with similar associations. Methods In an IRB-approved study, we retrospectively reviewed charts of all ED encounters with positive urine screens for PCP in our hospital from throughinclusive.

Conclusion False positive urine screens for PCP are common with tramadol, dextromethorphan, alprazolam, clonazepam, and carvedilol and may also occur with diphenhydramine. Open in a separate window. Figure 1. Methods The approach for this IRB-approved, retrospective study was very similar to a study of false positive urine drug screens for amphetamines associated with the use of bupropion by Casey et al. Discussion All three Drug test positive for pcp the medications suggested by case reports had higher proportions in the non-confirmed group than among the confirmed positive group.

Figure 4. Conclusion Tramadol, dextromethorphan, alprazolam, clonazepam, and carvedilol were ificantly associated with false positive urine screens for phencyclidine. Figure 2. Figure 3. Table 1 Demographics of patients with confirmed and non-confirmed positive PCP screens. References 1. Postmortem urine immunoassay showing false-positive phencyclidine reactivity in a case of fatal tramadol overdose. Am J Forensic Med Pathol. False-positive urine phencyclidine immunoassay screen result caused by interference by tramadol and its metabolites.

Ann Emerg Med. Immunochromatographic tests: false-positive for methadone and phencyclidine after acute poisoning with tramadol and dextropropoxyphene. Acta Clinica Belgica. Schier J, Diaz JE. Avoid unfavorable consequences: dextromethorpan can bring about a false-positive phencyclidine urine drug screen.

J Emerg Med. Budai B, Iskandar H. Dextromethorphan can produce false positive phencyclidine testing with HPLC. Am J Emerg Med. Are false-positive phencyclidine immunoassay instant-view multi-test caused by overdose concentrations of ibuprofen, metamizol, and dextromethorphan? Ther Drug Monitor. Effects of diphenhydramine on immunoassay of phencyclidine in the urine.

Clin Chem. Commonly prescribed medications and potential false-positives urine drug screens. Am J Hosp Pharm. Incidence of false positive amphetamine due to bupropion in the Syva Emit II urine drug screens. J Med Toxicol. Support Center Support Center.

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Drug test positive for pcp

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False positive phencyclidine result on urine drug testing: a little known cause