Millennium Research Institute, CA, USA.
J Anal Toxicol. 2013 Mar;37(2):83-9. doi: 10.1093/jat/bks096. Epub 2013 Jan 11.
In addition to illicit methamphetamine, there are prescription and over-the-counter medications that, if ingested, may yield positive methamphetamine (MAMP) results on laboratory urine drug tests. The purpose of the study is to estimate the prevalence of medicinal and illicit MAMP in the pain population using chiral analysis to determine the relative amounts of the d and l-MAMP enantiomers. This retrospective analysis included the LC-MS/MS results and prescriber provided medication histories of 485,889 de-identified urine specimens from patients treated for pain. Two groups of 100 specimens each were subjected to chiral analysis. Group 1 contained specimens that were MAMP positive and amphetamine negative. Group 2 contained randomly selected MAMP positive specimens. The overall MAMP positivity rate of the 485,889 specimens tested was 1.6%. The prevalence of MAMP medications based on reported medications and detection of l-MAMP in Group 1 and Group 2 was 44% and 6%, respectively. These data indicate that the use of both illicit and medicinal MAMP is found in this patient population, and that medicinal use is underreported in clinical histories. Therefore, clinical laboratories should provide on request chiral analysis to aid in differentiating illicit and medicinal MAMP.
除了非法的甲基苯丙胺，还有一些处方和非处方药物，如果摄入，可能会导致实验室尿液药物检测呈阳性甲基苯丙胺（MAMP）结果。该研究的目的是使用手性分析来估计疼痛人群中药用和非法 MAMP 的流行率，以确定 d 和 l-MAMP 对映体的相对含量。这项回顾性分析包括 485889 份来自接受疼痛治疗的患者的匿名尿液样本的 LC-MS/MS 结果和处方医生提供的用药史。每组 100 份样本进行手性分析。第 1 组包含 MAMP 阳性和安非他命阴性的样本。第 2 组包含随机选择的 MAMP 阳性样本。在测试的 485889 份样本中，MAMP 阳性率总体为 1.6%。根据报告的用药情况和第 1 组和第 2 组中 l-MAMP 的检测结果，MAMP 药物的流行率分别为 44%和 6%。这些数据表明，在该患者人群中发现了非法和药用 MAMP 的使用，并且在临床病史中报告的药用使用不足。因此，临床实验室应根据要求提供手性分析，以帮助区分非法和药用 MAMP。
