探討醫療藥物影響DRIR及TDxR免疫試劑檢測尿中嗎啡及甲基安非他命   全文下載

Interference of Selected Clinical Medicines on DRIR and TDxR Immunoassays of Morphine and Methamphetamine in Urine

本實驗篩選國內醫療常用藥品分別類屬於抗組織胺、非類固醇抗發炎藥、維他命製劑等共十一種藥物進行體外試驗，評估該等藥品對DRIR及TDxR免疫試劑檢測尿液中嗎啡與甲基安非他命干擾之可能性，同時探究DRIR試劑受干擾現象之原因。實驗結果顯示tolmetin於紫外線波長340nm有強吸收導致造成偽陰性結果；diphenhydramine、pheniramine、trimethobenzamide三者可能與DRIR試劑之抗體具親和力引起交叉反應；至於chlorpromazine造成偽陽性反應之可能原因包括：於紫外線波長340nm有吸收及與DRIR試劑之抗體具親和力兩者，ascorbic acid於溶液中濃度大於2%時有可能抑制G6PDH酵素引起DRIR試劑偽陰性反應。

Eleven commonly used antihistamines, nonsteroidal anti-inflammatory drugs, and vitamins were evaluated in vitro for potential interference with DRIR and TDxR immunoassay reagents for opiates and amphetamines. Mechanisms for the observed interference were also explored. DRIR reagents appear to be more susceptible to interference by the compounds studied. Regarding mechanistic aspects, tolmetin was found to be strongly absorbent at the detection wavelength (340 nm) causing a false negative response; diphenhydramine, pheniramine, and trimethobenzamide appeared to cause false positive interference through their affinity to the antibodies used in the DRIR reagents; while chlorpromazine was found to positively interfere with the assay through both cross reaction and UV absorption. Ascorbic acid, when in high concentrations (>2%, w/v), may inhibit the enzyme (G6PDH) activity and result in a false negative response. 本實驗篩選國內醫療常用藥品分別類屬於抗組織胺、非類固醇抗發炎藥、維他命製劑等共十一種藥物進行體外試驗，評估該等藥品對DRIR及TDxR免疫試劑檢測尿液中嗎啡與甲基安非他命干擾之可能性，同時探究DRIR試劑受干擾現象之原因。實驗結果顯示tolmetin於紫外線波長340nm有強吸收導致造成偽陰性結果；diphenhydramine、pheniramine、trimethobenzamide三者可能與DRIR試劑之抗體具親和力引起交叉反應；至於chlorpromazine造成偽陽性反應之可能原因包括：於紫外線波長340nm有吸收及與DRIR試劑之抗體具親和力兩者，ascorbic acid於溶液中濃度大於2%時有可能抑制G6PDH酵素引起DRIR試劑偽陰性反應。