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Lesson 12: Drug Testing and POCT (Order: Answers/Questions) With Complete Solutions DRUG TESTING Highest level of modern biotechnoly the production of therapeutic proteins and other drugs through genetic engineering What is the most prominent area of biotechnology?
- Because drug testing can have an important role in occupations where we, the public, are entitled to expect especially high levels of safety and security.
- For example, bodyguards must have regular drug testing.
- For medical tests, the forensic standard Why does workplace drug testing meets the highest standard? Recent drug use What does drug testing detects? o Impairment o Addiction o Abuse o Dependence Drug tetsing does not detect what?
-Act as deterrent to future drug use -Identify folks who need treatment -Identify participants who are maintaining abstinence -Identify participants who have relapsed -Rapid intervention àAdjunct to treatment frames sanction decisions (because it is part of the court's order) What are the goals of drug testing? Urine Hair Oral Fluid Sweat Breath -for alcohol only now Common specimens for Drug Testing: Saliva (oral fluids) Drug Detection times (specimen): 7 to 14 days depending on the product used Urine Drug Detection times (specimen): 1 to 7 days Hair Follicle
To eliminate the risk of passive exposure Why are there cut-offs? Marijuana Cocaine Amphetamine Morphine PCP Standard 5-panel drug screen - a single kit can detect 5 drugs; what are these drugs FALSE; differently TRUE OR FALSE: Alcohol affects everyone the same 0.02-0.05 g/dL Diminished fine motor coordination 0.05-0.1 g/dL Impaired judgment, coordination 0.1-0.15 g/dL Difficulty with gait and balance 0.15-0.25 g/dL Lethargy, difficulty sitting upright without assistance
0.25-0.30 g/dL Coma in the non-habituated drinker 0.30-0.40 g/dL Respiratory depression Heroin It is a white or brown powder, or a black, sticky goo opioid drug made from morphine (a natural substance in the seedpod of the Asian poppy plant) Miscarriages, heart infections, and death from overdose. People who inject the drug also risk getting infectious diseases, including HIV/AIDS and hepatitis. Heroin causes what Restlessness Muscle and Bone pain Diarrhea and Vomiting Codes Flashes with goosebumps Sudden withdrawal causes death Withdrawal Symptoms due to heroin use: Cocaine tropane alkaloid and stimulant drug Cocaine
marijuana green, brown, or gray mix of dried crumbled parts from a ___________plant
- smoking it like a cigarette or cigar
- mixing it in food and eating it (pot cookie)
- brewing it as a tea
- smoking oils from the plant (dabbing)
- using electronic vaporizers (vaping) How do people use marijuana?
- Altered senses (seeing brighter colors)
- Altered sense of time (minutes seems hours)
- Changes in mood
- Problems with body movement
- Trouble with thinking, problem-solving, and memory
- Increased appetite While you are high WIwith marijuana, you may experience: specimen collection The most important part of drug testing is the
Urine sample collection most common and often preferred test substance because of its ease of collection urine
Concentrations of drugs and metabolites also tend to be high in _______________ allowing longer detection times than concentrations in the serum allow. to stop donors from using toilet water as a sample Why do collectors add bluingagentto the toilet and taps faucet lids? Donor What do you call someone who will be tested for urine drug testing? Witnessed and Unwitnessed Two types of collection for urine specimen Collection witnessed collection Collector goes inside the stall itself and observes the urination. unwitnessed collection Collector observes the donor from outside the stall.
- Stall is not completely closed to the door. Slightly opened. Depends on the laboratory protocols. 32.5-37.7 degrees Celsius Temp of freshly collected urine Confirmatory Test
negative or positive Screening test results shall be reported as ____________ presence or absence , while your confirmatory tests shall be reported with the __________ and identify the drug or metabolite tested as well as its concentration TRUE TRUE OR FALSE: The original copy of the test result form shall be given to the donor immediately after its completion Confirmatory test Used to identify and quantify the presence of a specific drug or metabolite Point-of-care-testing (POCT) Other names: near patient, bed-side, physician's office, extra- laboratory, decentralized, ancillary, alternate site testing
- Basically, conducting a test using a device or test kit in the presence of the patient and without the need to send a sample to a laboratory
- Specialized area of the hospital (ER, ICU, Wards, Private rooms)
- Home Health Care
- Physician's office/clinic
- Health Fairs
- Out Patient Clinics Locations where POCT can be performed: o Decreased TAT (turnaround time) and sample volume o Faster because it is performed in the bedside o Elimination of sample transport o Can be very tricky o Example: Some specimens need ice for transport, and POCT removes that completely/eliminates it o Mobility o Smaller instrumentation than the machines used in the lab Reduced medical cost Advantages of POCT o Capturing and documentation of results
- Pretty hard compared if it's in the lab o Charging and billing mechanisms in hospitals o Incorrect handling of analyzers by nontrained staff Inadequate or absent calibrations or QC Disadvantages of POCT Pre-Examination Phase Examination Phase Post-Examination Phase
GLUCOMETER
-For Glucose Testing -Used to monitor patients with diabetes mellitus (DM) -To determine whether their diet and insulin are maintaining an acceptable level of glucose whole blood POCT in for glucose testing is performed in what blood? 10-15% lower The estimation of whole blood glucose levels are usually ___________ than your plasma glucose alone FALSE; lower TRUE OR FALSE: The glucometer gives out a higher glucose value than when you test blood glucose in the lab 60-115 mg/dl Normal values glucometer would be_________ in fasting sample hypoglycemic below 60 mg/dl in glucose testing would be _________ 100mg/dl
prediabetic 126 mg/dl Diabetic photometric measurement of the intensity of light electrochemical the conversion of electrical energy from the battery to chemical energy reflectance employ a dry reagent technology using special reagent strip (the reagents are embedded in the strip already) Bilirubinometer Detects and monitors hyperbilirubinemia hyper; emia "_________" meaning increased bilirubin and the suffix "_________" meaning in the blood POCT FOR TRANSCUTAENEOUS BILIRUBIN (BILIRUBINOMETER) Used creening for hemolytic disease of the new born (HDN) and premature birth bilurbinemia
Principle for POCT FOR HEMOGLOBIN Reagents in the microcuvette lyse the RBCs to release hemoglobin which is converted to azide methemoglobin by sodium nitrite and sodium azide to produce a color reaction. (Reagents: sodium nitrite and sodium azide àcovert hemoglobin to methemoglobin) How does it measure hemoglobin? Plastic strips to which are affixed several reagent areas for chemical, colorimetric and reflectance tests POCT FOR URINE PRINCIPLE Glucose Double sequential enzyme reaction Bilirubin Diazo-coupling Diazo-coupling This means pairing or a reaction TRUE TRUE OR FALSE: Bilirubin, if it is present in the urine and the diazo dye to produce a color change in the strip Ketone Nitroprisside and acetoacetic acid reaction
Nitroprusside It is the reagent Acetoacetic acid Itis the specific ketone that is tested. When this reacts with the reagent, a new color will form in the strip. Specific gravity The concentration of solutes in the urine Urine _____________is made up of water and solutes Specific gravity Measures how much solute are in the urine PKA change of polyelectrolytes The principle of specific gravity is ________________ Specific gravity The color will change depending on how much ions are present Blood Pseudoperoxidase activity of hemoglobin not true Pseudo means _________, so they are not real peroxides
TRUE
TRUE OR FALSE: The more proteins are present, the more color is changed by the indicators Urobilinogen Modified Ehrlich's reaction Ehrlich's reaction it is a reaction of B-dimethyl-amino-benzaldehyde and urobilinogen that produces a pink color Nitrite Nitrate to Nitrite conversion by gram negative bacteria has high concentrations in the urine. E. coli are the most common causes of UTI TRUE TRUE OR FALSE: If a lot of them are present, the nitrite in the reactions in the strip will be very dark pink. Leukocyte esterase Granulocytic leukocytes contain esterase that catalyze hydrolysis of reagents Leukocyte esterase
this enzyme helps the reagents react with the WBCs in the samples to detect how much WBCs are present in the sample. TRUE TRUE OR FALSE: for Leukocyte esterase, The more analytes are present, the darker the colors of the strips will be Occult blood It is a test for blood in the stool that you cannot see. Pregnancy Tests Detect the presence of your HCG or human chorionic gonadotropin hormone in a woman's urine Pregnancy Tests The kit has an anti-HCG antibody embedded through it or attached to it. attach to the antibodies and forms a complex If there is an HCG in the urine, the HCG will ____________________. o Control Line o Test line
- 2 lines mean that the girl is pregnant 10 days
