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December 2012 CFTN

An AACC/CAP Educational Newsletter for Toxicology Laboratories

Read the December 2012 Issue

Oral Fluid Testing
An Alternative Approach to Monitoring Pain Management
By Anne Z. DePriest, PharmD, BCPS, Julie L. Knight, PharmD, Brandi L. Puet, PharmD, David L. Black, PhD, DABFT, FAIC, and Edward J. Cone, PhD

ith the aging population and recognition that treatment of a patient’s pain is a key healthcare objective, more patients are taking pain medications that must be taken consistently to be effective. But at the same time, many of these same medications are subject to abuse. These benefits and dangers drive the need to test for patient compliance.

Immunosuppressive Drug Monitoring
An Update

By Anthony W. Butch

Clinicians must monitor immunosuppressive drug levels in organ transplant patients to optimize their effectiveness and minimize adverse events. As organ transplantation has become more successful and widespread, laboratories that support transplant programs perform therapeutic drug monitoring (TDM) of many immunosuppressive drugs, including cyclosporine A, tacrolimus, sirolimus, mycophenolic acid, and everolimus.

Case History
Desoxypipradrol Intoxication
By Vijay Bhardwaj, MD, and John M. Wilson, PhD
The new “bath salts” and cannabinoid derivatives that have come on the market in recent years illustrate the need for laboratories to constantly update their procedures and databases. Our laboratory experienced this need when a 17-year-old Caucasian boy presented disoriented and hallucinating at our emergency department.

CAP Toxicology Programs
News and Updates
By Glynnis Ingall, MD, PhD
Starting in 2013, the College of American Pathologists (CAP) will offer two new proficiency testing (PT) surveys for therapeutic drug monitoring (TDM) and toxicology—for everolimus and ethanol biomarkers.