Nonfatal tramadol overdose may cause false-positive phencyclidine on Emit-II assay

• Published in: The American journal of emergency medicine Vol. 31; no. 2; pp. 444.e5 - 444.e9
• Main Authors: King, Andrew M., MD, Pugh, Jennifer L., MD, Menke, Nathan B., MD, PhD, Krasowski, Matthew D., MD, PhD, Lynch, Michael J., MD, Pizon, Anthony F., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-02-2013; Elsevier Limited
• Subjects: Adult; Analgesics, Opioid - adverse effects; Analgesics, Opioid - urine; Bipolar disorder; Blood pressure; Child, Preschool; Chromatography; Diagnosis, Differential; Drug Overdose - diagnosis; Drug Overdose - urine; Emergency; Emergency medical care; Enzyme Multiplied Immunoassay Technique; False Positive Reactions; Female; Gas chromatography; Gas Chromatography-Mass Spectrometry; Hallucinogens - urine; Heart rate; Humans; Immunoassay; Ingestion; Male; Mass spectrometry; Metabolites; Nicotine; Overdose; Patients; Phencyclidine - urine; Phencyclidine Abuse - diagnosis; Substance Abuse Detection; Tramadol - adverse effects; Tramadol - urine
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2012.05.028

A comprehensive gas chromatography/mass spectrometry qualitative urine drug screen demonstrated valproic acid metabolites, nicotine, gabapentin, benztropine, and a large peak of tramadol. A comprehensive gas chromatography/mass spectrometry qualitative urine drug screen demonstrated valproic acid metabolites, nicotine, gabapentin, benztropine, and a large peak of tramadol (Fig. 1). Seizure activity may have been prevented in our adult patient by the antiepileptic properties of her bipolar medications (valproic acid and gabapentin); the time course of her ingestion may explain her normal vital signs.