mayo medical laboratories · bobbi pritt, m.d. – program planning committee cara schmidt –...

1

© MFMER© MFMER

Mayo Medical Laboratories

Virtual Lectures

©2014 MFMER

© MFMER

Virtual Lectures Planning Committee Disclosure Summary As a provider accredited by ACCME, College of Medicine, Mayo Clinic (Mayo School of CPD) must ensure balance, independence, objectivity and scientific rigor in its educational activities. Course Director(s), Planning Committee Members, Faculty, and all others who are in a position to control the content of this educational activity are required to disclose all relevant financial relationships with any commercial interest related to the subject matter of the educational activity. Safeguards against commercial bias have been put in place. Faculty also will disclose any off label and/or investigational use of pharmaceuticals or instruments discussed in their presentation. Disclosure of these relevant financial relationships will be published in activity materials so those participants in the activity may formulate their own judgments regarding the presentation.

Listed below are individuals with control of the content of this program who have disclosed…

Relevant financial relationship(s) with industry:None

No relevant financial relationship(s) with industry:Paul Jannetto, Ph.D. – program presenterCurtis Hanson, M.D. – program planning committeeSharon Preuss – program planning committeeBobbi Pritt, M.D. – program planning committeeCara Schmidt – program planning committee

References to off-label and/or investigational usage(s) of pharmaceuticals or instruments in their presentation:

None

2

© MFMER

©2014 MFMER

© MFMER

Disclosure

• Relevant Financial Relationships:• None

• Off Label Usage:• None

©2014 MFMER

3

© MFMER

Objectives

• Discuss the clinical utility and limitations of urine screening assays and definitive tests for drugs of abuse and opioids.

• Identify the challenges of correctly interpreting urine drug testing results and discuss the use of alternative specimen types for monitoring controlled substances.

• Describe how laboratory testing can be used to identify recent vs. chronic marijuana use and the challenges with identifying prescribed vs. recreational marijuana.

©2014 MFMER

© MFMER

©2014 MFMER

4

© MFMER

©2014 MFMER

© MFMER

©2014 MFMER

5

© MFMER

©2014 MFMER

© MFMER

©2014 MFMER

Jung B. and Reidenberg MM. Physicians being Deceived, Pain Medicine, 2007,8(5)

6

© MFMER

©2014 MFMER

© MFMER

©2014 MFMER

7

© MFMER

©2014 MFMER

© MFMER

©2014 MFMER

8

© MFMER

©2014 MFMER

© MFMER

©2014 MFMER

9

© MFMER

©2014 MFMER

http://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx#3; accessed 4-20-16

© MFMER

©2014 MFMERPharmacotherapy 2013;33(2):195-09

10

© MFMER

©2014 MFMER

Natonal Institute on Drug Abuse. Marijuana Retrieved from http://www.drugabuse.gov/publications/drugfacts/marijuanaon April 2, 2016 Pharmacotherapy 2013;33(2):195-09

© MFMER

©2014 MFMER

Porter WH. Clinical Toxicology Figure 34-29 In Tietz Textbook of Clinical Chemistry andMolecular Diagnostics 4th edition.

11

© MFMER

©2014 MFMER

Mule SJ. et al. Active and realistic passive marijuana exposure tested by three immunoassaysand GC/MS in urine. J. Anal Toxicol 1988;12:113-16.Elsohly MA. Drug testing in the workplace: Could a positive test for one of the mandated drugsbe for reasons other than illicit use of the drug? J. Anal Toxicol 1995;19:450-58.

© MFMER

©2014 MFMER

12

© MFMER

©2014 MFMER

© MFMER

ElSohly MA. et al. Delta9-tetrahydrocannabivarin as a marker for the ingestion of marijuana versus Marinol: results

of a clinical study J Anal Toxicol 2001;25:565-71.Wertlake PT and Henson MD. A urinary test procedure for identification

13

© MFMER

©2014 MFMER

© MFMER

Smith ML. et al. Identifying new cannabis use with urine creatinine normalized THCCOOHconcentrations and time intervals between specimen collections J Anal Toxicol 2009;33:185-89.

Schwilke EW. et al. Differentiating new cannabis use from residual urinary cannabinoid excretion inchronic, daily users. Addiction 2010;106:499-506.

14

© MFMER

Huestis MA and Cone EJ. Differentiating new marijuana use from residual drug excretion inoccasional marijuana users. J Anal Toxicol 1998;22:445-54.

Smith ML. et al. Identifying new cannabis use with urine creatinine normalized THCCOOHconcentrations and time intervals between specimen collections J Anal Toxicol 2009;33:185-89.

© MFMER

©2014 MFMERSmith ML. et al. Identifying new cannabis use with urine creatinine normalized THCCOOHconcentrations and time intervals between specimen collections J Anal Toxicol 2009;33:185-89.

15

© MFMER

©2014 MFMER

© MFMER

©2014 MFMER

16

© MFMER

©2014 MFMER

© MFMER

©2014 MFMER

17

© MFMER

Castaneto MS et al. Drug and Alcohol Dependence 2014;144:12-41Su M et al. Metabolism of classical cannabinoids and the synthetic cannabinoid JWH-018 Clin

Pharmacol Ther 2015;

© MFMER

http://www.designerdrugtrends.org/documents/trendsreport2014_2.pdf ©2014 MFMER

18

© MFMER

©2014 MFMER

© MFMER

©2014 MFMER

19

© MFMER

©2014 MFMER

© MFMER

©2014 MFMER

20

© MFMER

©2014 MFMER

© MFMER

©2014 MFMER

21

© MFMER

©2014 MFMER

© MFMER

©2014 MFMER

22

© MFMER

©2014 MFMER

© MFMER

©2014 MFMER

23

© MFMER

©2014 MFMER

© MFMER

©2014 MFMER

24

© MFMER

©2014 MFMER

© MFMER

©2014 MFMER

mayo medical laboratories · bobbi pritt, m.d. – program planning committee cara schmidt –...

Documents