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Phencyclidine Assay Metabolites, and Primarily As Unidentified Compounds

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Phencyclidine Assay Metabolites, and Primarily As Unidentified Compounds 2 SUmmARy Phencyclidine, also known as PCP and “angel dust,” is a synthetic drug that was orginally developed for its anesthetic properties but is now a drug of abuse used solely for its potent hallucinogenic effects. It may be self-administered in a variety of ways, including ingestion, inhalation, and intravenous injection. Phencyclidine is absorbed well and quickly, and concentrates in the brain and fatty tissues.2 Excretion patterns vary widely, ranging from several hours to a couple of weeks. Phencyclidine is excreted in the urine unchanged, as conjugated Phencyclidine Assay metabolites, and primarily as unidentified compounds. The Emit® II Plus Phencyclidine Assay tests for phencyclidine in human urine. It also detects August 2010 9J052.4D_C the analog 1-[1-(2-thienyl)-cyclohexyl]piperidine (TCP). High concentrations of several phencyclidine metabolites and analogs can also produce positive results in the assay. Positive results for specimens containing other compounds structurally unrelated to phencyclidine usually have not been observed. Methods historically used for detecting phencyclidine in biological fluids include thin-layer chromatography,3 gas chromatography,4 ultraviolet spectroscopy, enzyme immunoassay, and radioimmunoassay.5, 6 While confirmation techniques other than GC/MS may be adequate for some drugs of abuse, GC/MS is generally accepted as a vigorous confirmation technique for all drugs, since it provides the best level of confidence in the result.1 Catalog Quantity/ Number Product Description Volume 3 mEThODOLOgy OSR9J229 Emit® II Plus Phencyclidine Assay The Emit® II Plus Phencyclidine Assay is a homogeneous enzyme immunoassay technique OSR9J618 R1 (Antibody/Substrate Reagent 1) 2 x 27 mL used for the analysis of specific compounds in human urine.6 The assay is based on competition between drug in the specimen and drug labeled with the enzyme glucose-6-phosphate OSR9J648 R2 (Enzyme Reagent 2) 2 x 13 mL dehydrogenase (G6PDH) for antibody binding sites. Enzyme activity decreases upon binding to 9A509UL Emit® Calibrator/Control Level 0* 1 x 14 mL the antibody, so the drug concentration in the specimen can be measured in terms of enzyme 9A549UL Emit® Calibrator/Control Level 2 (12.5)* 1 x 14 mL activity. Active enzyme converts nicotinamide adenine dinucleotide (NAD) to NADH, resulting 9A569UL Emit® Calibrator/Control Level 3 (25)* 1 x 14 mL in an absorbance change that is measured spectrophotometrically. Endogenous serum G6PDH 9A589UL Emit® Calibrator/Control Level 4 (75)* 1 x 14 mL does not interfere because the coenzyme NAD functions only with the bacterial (Leuconostoc 9A609UL Emit® Calibrator/Control Level 5 (100)* 1 x 14 mL mesenteroides) enzyme employed in the assay. *Required for calibrating the Emit® II Plus Phencyclidine Assay. Sold separately. To determine the appropriate calibrators required for use, see Table 1. 4 REAgENTS Note: Reagents and calibrators/controls are shipped ready to use in liquid form. No reconstitution is required. Reagents contain the following substances: Note: Reagents 1 and 2 are provided as a matched set. They should not be interchanged with Sheep polyclonal antibodies to phencyclidine (0.2 µg/mL), glucose-6-phosphate (5.5 mM), components of kits with different lot numbers. nicotinamide adenine dinucleotide (3.5 mM), bovine serum albumin, phencyclidine labeled Note: These reagents are qualified for use with these calibrators only. However, other with G6PDH (0.47 U/mL), Tris buffer, preservatives, and stabilizers. material may be used for quality control purposes. Precautions Table 1 — Emit® Calibrators/Controls for Use in Qualitative or Semiquantitative Analysis • For in vitro diagnostic use. Qualitative Analysis Semiquantitative Analysis • Reagent 1 contains nonsterile sheep antibodies. Required Concentration Required Concentration • Reagent 2 contains nonsterile mouse antibodies. Cal/Control of Phencyclidine Cal/Control of Phencyclidine • Reagents 1 and 2 contain nonsterile bovine serum albumin. Level (ng/mL) Level (ng/mL) • Do not use after expiration date. Level 0 0 Level 0 0 Level 3 25 Level 2 12.5 • Turbid or yellow reagents may indicate contamination or degradation and must be discarded. Level 5 100 Level 3 25 Level 4 75 Preparation of Reagents Level 5 100 The Emit® II Plus Phencyclidine Assay reagents are provided ready to use; no preparation is necessary. Note: The Emit® Calibrators/Controls contain the stated concentrations of phencyclidine listed in Table 1. Emit® Calibrator/Control Levels 2, 3, 4, and 5 contain additional drugs of Storage of Assay Components abuse that do not affect the assay. A calibrator/control is used either as a calibrator or as a • Improper storage of reagents can affect assay performance. control when the assay is used for qualitative analysis. When a calibrator/control is used as a calibrator, the other level calibrators/controls (above or below it, as listed above) are used as • When not in use, store reagents upright at 2–8°C and with screw caps tightly closed. controls. See the Emit® Calibrators/Controls instructions for use. • Unopened reagents are stable until the expiration date printed on the label if stored upright at 2–8°C. 1 INTENDED USE • Do not freeze reagents or expose them to temperatures above 32°C. The Emit® II Plus Phencyclidine Assay is a homogeneous enzyme immunoassay with a 25 ng/mL cutoff (SAMHSA initial test cutoff level). The assay is intended for use in the qualitative and 5 SPECImEN COLLECTION AND PREPARATION semiquantitative analyses of phencyclidine in human urine. These reagents are packaged specifically for use on a variety of AU® Clinical Chemistry Systems. • Urine specimens may be collected in plastic (ie, polypropylene, polycarbonate, polyethylene) or glass containers. Some plastics can adsorb certain drugs. The Emit® II Plus Phencyclidine Assay provides only a preliminary analytical test result. A more specific alternative chemical method must be used to obtain a confirmed analytical • If not analyzed immediately, specimens may be stored unrefrigerated for up to 7 days result. Gas chromatography/mass spectrometry (GC/MS) is the preferred confirmatory following collection. After 7 days, specimens should be stored frozen. 1 method. Other chemical confirmation methods are available. Clinical consideration and • Frozen specimens must be thawed and mixed thoroughly prior to analysis. professional judgment should be applied to any drug-of-abuse test result, particularly when preliminary positive results are used. • Specimens with high turbidity should be centrifuged before analysis. • The recommended pH range for urine specimens is 3.0–10.0. • Adulteration of the urine specimen may cause erroneous results. If adulteration is suspected, obtain another specimen. • Human urine specimens should be handled and treated as if they are potentially infectious. 6 PROCEDURE Table 2 — Within-Run and Total Precision for the Emit® II Plus Phencyclidine Assay Within-Run Precision Total Precision materials Provided Phencyclidine Emit® II Plus Phencyclidine Assay 25 ng/mL Cutoff Control Control Cutoff Control Control Reagent 1 Cutoff Cal 75% 125% Cal 75% 125% Reagent 2 mean 441 417 471 441 417 471 materials Required But Not Provided (mAU/min) Emit® Calibrators/Controls SD 3.9 2.9 4.0 5.3 4.2 5.7 Commercially available controls (see Quality Control, Semiquantitative Analysis) %CV 0.9 0.7 0.8 1.2 1.0 1.2 Refer to the instrument User’s Guide for appropriate instrument checks and maintenance instructions. Comparative Analysis Calibration Clinical urine specimens were analyzed using Emit® II Plus Phencyclidine Assay on the Qualitative Analysis AU400/AU600 Clinical Chemistry System and using Emit® II Phencyclidine Assay on the Run the Emit® Calibrator/Control Level 3 (25 ng/mL Cutoff) in duplicate. Validate the calibration SYVA®-30R Biochemical System. Specimens positive by either method contained phencyclidine by running controls (see Quality Control). Refer to the analyzer User’s Guide or the Application ranging from 14.9 ng/mL to 78.5 ng/mL. Table 3 summarizes the number of positive/negative Sheet for instrument settings. Recalibrate as indicated by control results. results identified and the percent agreement with the SYVA®-30R Biochemical System. Semiquantitative Analysis Prepare a calibration curve by running a reagent blank (blue rack) and the Table 3 — Summary of Comparative Analysis Emit® Calibrators/Controls Level 2 (12.5 ng/mL), Level 3 (25 ng/mL), Level 4 (75 ng/mL), and Assay Positive Negative % Agreement Level 5 (100 ng/mL). Validate the calibration by running controls (see Quality Control). Refer to the instrument User’s Guide or the Application Sheet for instrument settings. Recalibrate as Phencyclidine 49 54 99 indicated by control results. Analytical Recovery Quality Control Negative human urine specimens were spiked with known concentrations of phencyclidine. Qualitative Analysis Specimens spiked with drug concentrations lower than the cutoff concentration and tested Validate the calibration by assaying controls. Ensure that the result from the qualitatively were correctly identified as negative 100% of the time. Specimens spiked with drug Emit® Calibrator/Control (Level 0 [0 ng/mL] or Level 5 [100 ng/mL]) relates appropriately to concentrations greater than the cutoff were correctly identified as positive 100% of the time. the cutoff calibrator (Emit® Calibrator/Control Level 3 [25 ng/mL]) result. Once calibration is Table 4 summarizes the results on semiquantitative analysis of the specimens. validated,
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