Clinical and Forensic Toxicology News

September 2016 CFTN

An AACC/CAP Educational Newsletter for Toxicology Laboratories
CFTN is registered with the U.S. Library of Congress, ISSN 2374-9679.

Read the September 2016 issue of CFTN
Welcome to CFTN for September 2016. Clinical & Forensic Toxicology News for September, 2016 is now available online. Articles in this issue are centered on pain management and newer anti-epileptic drugs as well as therapeutic drug monitoring. Send us feedback and let us know what you think.

Suggested citation for CFTN
Author’s last name(s), first and middle initials. (Date of Publication). Title of article. Clinical and Forensic Toxicology News (Quarterly, AACC/CAP), pages. Available from [specific web URL of posting].

Ritchie J (March 2016). Kratom: Herb Gains Popularity as a Gentler Opiate Substitute. Clinical and Forensic Toxicology News (Quarterly, AACC/CAP), 8-10. Available from

Newer Anti-Epileptic Drugs
TDM for Second Generation of AEDs Remains a Work in Progress
By Matthew D. Krasowski, MD, PhD

Medications used to treat and prevent seizures--anti-epileptic drugs (AEDs)--are among the most common drugs for which therapeutic drug monitoring (TDM) is performed (1). The first generation AEDs, including carbamazepine, phenobarbital, phenoytoin, primidone, and valproic acid, were introduced prior to 1990 and are still in use today to varying degrees (2).

NACB Creates Guideline on Tests for Monitoring Pain Management
By Paul J. Jannetto, PhD, and Loralie J. Langman, PhD

The National Academy of Clinical Biochemistry (NACB) recently released a draft of a new laboratory medicine practice guideline (LMPG) on the use of Laboratory tests to monitor drug therapy in pain management patients. The comment period closed on Sept. 6, but the guideline, "Using Clinical Laboratory Tests to Monitor Drug Therapy in Pain Management Patients," can be viewed on the ACC website (1).

Gabapentin and Pregabalin:
Although They Were Thought to Pose Little Risk, their Abuse is Growing
By Christine Snozek, PhD

A study presented at the 2016 AACC annual meeting in Philadelphia highlights a growing concern in pain management patients and other populations: the abuse of nonopioid medications such as the anti-epileptic drugs (AEDs) gabapentin and pregabalin. These drugs, often used to treat neuropathic pain, drug or alcohol withdrawal and other nonsiezure indications, were originally thought to have minimal risk of abuse.

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