Journal Article

Comparison of an Automated and Point-of-Care Immunoassay to GC-MS for Urine Oxycodone Testing in the Clinical Laboratory

Christine A. Haller, Judith Stone, Vicki Burke, Jean Branch, Kathy Chen and Susan Gross

in Journal of Analytical Toxicology

Volume 30, issue 2, pages 106-111
Published in print March 2006 | ISSN: 0146-4760
Published online March 2006 | e-ISSN: 1945-2403 | DOI: http://dx.doi.org/10.1093/jat/30.2.106
Comparison of an Automated and Point-of-Care Immunoassay to GC-MS for Urine Oxycodone Testing in the Clinical Laboratory

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OxyContin® a controlled-release formulation of oxycodone, is increasingly abused. Monitoring patient compliance by urine drug testing may deter illegal diversion of OxyContin. Two urine immunoassays were evaluated with a 100 ng/ml cutoff for oxycodone. The Microgenics Corporation Oxycodone DRI on the Bayer ADVIA 1650 and a point-of-care (POC) immunoassay, Monitect Oxycodone POC from Branan Medical Corporation, were compared to gas chromatography-mass spectrometry (GC-MS) with a detection limit of 50 ng/mL free oxycodone. Between-day precision for DRI yielded coefficients of variation from 3.9% to 7.0% at 75 and 125 ng/mL. Fifty-two positive and 52 negative urines were tested. The DRI had a 100% agreement with GC-MS. Two positive specimens had free oxycodone < 50 ng/mL, but oxycodone metabolites, oxymorphone and oxycodone glucuronide > 100 ng/mL, were identified by GC-MS analysis. The POC assay had two false positives and 15 indeterminate (±) results. Codeine or hydrocodone was present in all but one of these samples. There was no interference with DRI from morphine, codeine, hydrocodone, hydromorphone, dihydrocodeine, or 6-monoacetyl morphine. Four-hundred and ninety urine samples were subsequently tested with DRI to estimate the oxycodone-positive rate at our hospital, and 47 (9.4%) were positive. The confirmation rate with GC-MS for free oxycodone, not including metabolites, was 93%. The Microgenics DRI offers good performance for oxycodone urine testing and is a better choice for the clinical laboratory than the POC assay. Confirmation of screened positive samples requires a method that can detect total oxycodone and oxymorphone.

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Subjects: Medical Toxicology ; Toxicology (Non-medical)

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