West Robert E, Guevara Maria G, Mikel Charles, Gamez Ruben
Millennium Health LLC, San Diego, California.
Ther Drug Monit. 2017 Feb;39(1):88-90. doi: 10.1097/FTD.0000000000000365.
A retrospective analysis of oral fluid drug testing results using LC-MS/MS was performed to determine the prevalence rates in oral fluid for codeine (COD) and 3 COD metabolites-morphine (MOR), norhydrocodone (NHC), and hydrocodone (HCOD). Oral fluid samples were collected using Quantisal oral fluid collection device (Immunalysis Inc.) and submitted to Millennium Health, LLC for the routine drug analysis by LC-MS/MS. Consistent with previously published literature, COD was the primary analyte detected in oral fluid after the use of COD. In COD-positive samples, HCOD, MOR, and NHC were detected at rates of 68.4%, 18.4%, and 6.3%, respectively. Concentration ranges of these analytes were 1.0 to >2000 ng/mL for COD, 1.0-20.2 ng/mL for MOR, 1.0-740.0 ng/mL for HCOD, and 2.1-47.5 ng/mL for NHC. In contrast to urine, where HCOD is typically detected as a minor metabolite of COD, HCOD was the most commonly detected metabolite in oral fluid in samples testing positive for COD with reported prescriptions for COD. This observation suggests that care should be taken when interpreting HCOD positives in oral fluid results, and that the use of COD should be considered as one possible explanation for HCOD positives.
使用液相色谱 - 串联质谱法（LC-MS/MS）对口腔液药物检测结果进行回顾性分析，以确定口腔液中可待因（COD）及其3种代谢物——吗啡（MOR）、去甲氢可酮（NHC）和氢可酮（HCOD）的流行率。使用Quantisal口腔液采集装置（Immunalysis公司）采集口腔液样本，并提交给千禧健康有限责任公司，通过LC-MS/MS进行常规药物分析。与先前发表的文献一致，使用COD后，COD是口腔液中检测到的主要分析物。在COD阳性样本中，HCOD、MOR和NHC的检出率分别为68.4%、18.4%和6.3%。这些分析物的浓度范围为：COD为1.0至>2000 ng/mL，MOR为1.0 - 20.2 ng/mL，HCOD为1.0 - 740.0 ng/mL，NHC为2.1 - 47.5 ng/mL。与尿液不同，在尿液中HCOD通常被检测为COD的次要代谢物，而在有COD处方报告的COD阳性口腔液样本中，HCOD是最常检测到的代谢物。这一观察结果表明，在解释口腔液检测结果中的HCOD阳性时应谨慎，并且应将COD的使用视为HCOD阳性的一种可能解释。
