Compliance or Abuse? Detectable hydromorphone in patients taking oxycodone
نویسندگان
چکیده
Abstract A middle-aged woman with recent cervical diskectomy spinal fusion at C3-C4 suffered a mechanical fall bilateral upper extremity paresthesia requiring admission but no surgical intervention. Patient was seen by orthopedic service and recommended to continue using Aspen collar oxycodone for pain. Following discharge, drug urine screen test performed, showed positive immunoassay. Confirmatory liquid chromatography-tandem mass spectrometry (LC-MS/MS) detectable oxycodone, oxymorphone hydromorphone. In patients treated opioid therapy chronic pain, monitoring is an important tool ensure that are adhering the prescribed medication. Hydrocodone hydromorphone not metabolites of oxycodone. However, hydrocodone can be present in preparations estimated impurity <1%. metabolized into hydromorphone, although, there literature reporting patients’ only. This case resulted quality improvement project where we evaluated detection samples LC-MS/MS. We analyzed 322 samples. Twenty-one (6%) had and/or below 100 ng/mL. Twelve out 21 were from taking medication other than last week, 33.3% showing 75% ng/dL. The calculated hydrocodone/oxycodone (HC/OC) hydromorphone/oxycodone (HM/OC) ratios on average 0.26% HC/OC = (0.05-0.69% SD 0.002; HM/OC (0.18-0.37% 0.001)] each (<1%). Patients opioids >1% [HC/OC 168% (3-563% 2.53; 699% (1.09-6585% 15.96)] higher detected levels (>100 ng/mL). Pain management very challenging; therefore, laboratory testing provides objective assessment exposure adherence treatment. Cut-off values considering may change interpretation tests Using cutoff (100 ng/mL) (<1%) useful determine these components due formulation.
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ژورنال
عنوان ژورنال: American Journal of Clinical Pathology
سال: 2022
ISSN: ['0002-9173', '1943-7722']
DOI: https://doi.org/10.1093/ajcp/aqac126.008