Establishing a reliable clinical toxicology program for the Lincoln, Nebraska area hospitals.

Abstract

A clinical laboratory toxicology section was established for a large midwestern pathology laboratory service. Methods of analysis of drugs of abuse and therapeutically monitored drugs in biological materials are discussed. Assay methods were established for the anticonvulsant drugs, phenytoin, primidone and phenobarbital, the cardiac drugs, digoxin and quinidine, and for theophyl line, an antlasthmatic drug. A screening procedure was also developed for detecting the presence of approximately twenty drugs of abuse, such as amphetamines, barbiturates, morphine, darvon, demerol and the benzodiazepams. The procedures covered include direct screening tests, various extraction techniques, UV spectrophotometry, thin-layer chromatography, gaschromatography and enzyme Immunoassays. The main advantages and disadvantages of the methods are discussed. The organization of the request and report forms as well as other factors involved In establishlng a working Toxicology Department are also included in the discussion.