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Availability of urine toxicologic screening tests in the emergency department: focused on illegal drugs
Se Kyu Lee, Sangchun Choi
J Korean Soc Clin Toxicol. 2021;19(1):24-30.   Published online June 30, 2021
DOI: https://doi.org/10.22537/jksct.2021.19.1.24
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  • 1 Citations
AbstractAbstract PDF
Purpose: In Korea, it is predicted that the proportion of drug abusers among patients visiting the emergency room will soon increase. Several emergency medical institutions in Korea are conducting field urine screening tests for poisoning. In this study, we investigated the characteristics and usefulness of urine toxicology screening tests. Methods: The medical records of patients with positive results for tetrahydrocannabinol and methamphetamine from urine toxicology screening tests at a tertiary university hospital from August 2016 to August 2019 were reviewed retrospectively. The subjects were classified into positive and false-positive groups, and their clinical characteristics were compared and analyzed. Results: Of the 2,026 patients surveyed, 823 patients (40.6%) tested positive for one or more drugs. Among them, 12 cases (0.6%) were positive for methamphetamine and 40 cases (2.0%) were positive for tetrahydrocannabinol. The positive and the false-positive rates for methamphetamine were 66.7% and 33.3%, respectively. The positive and the false-positive rates for tetrahydrocannabinol were 2.5% and 97.5%, respectively. Conclusion: Methamphetamine showed a relatively low false-positive rate in our study. Therefore, this test seemed to assist in diagnosing methamphetamine poisoning when considered together with the present illness and physical examination results. On the other hand, the high false-positive rate for tetrahydrocannabinol tests indicates that this test was unlikely to assist in diagnosing tetrahydrocannabinol poisoning. However, considering the growing trend of illegal drug abusers in Korea, it may still be useful as a diagnostic tool for identifying drug users.

Citations

Citations to this article as recorded by  
  • Retrospective Analysis Study of False-Positive Amphetamine Immunoassay Cases and Negative Cases after Withdrawal while Taking Herbal Medicine-Containing Ephedra Sinica Confirmed in a Korean Medicine Obesity Clinic
    Byungsoo Kang, Suyong Shin, Jungsang Kim, Minwhee Kang, Donghoon Lee, Seonghyeon Jeon, Minwoo Bang
    Journal of Korean Medicine for Obesity Research.2024; 24(1): 94.     CrossRef
Survival after Cardiac Arrest due to Acute Methamphetamine Poisoning: A Case Report
You Ho Mun, Jung Ho Kim
J Korean Soc Clin Toxicol. 2018;16(2):176-180.   Published online December 31, 2018
DOI: https://doi.org/10.22537/jksct.2018.16.2.176
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AbstractAbstract PDF
Drug abuse and its related problems are increasing continuously in Korea. One of the most frequently abused drugs is methamphetamine, but there are few medical report in Korea. This is the first report of the identification of methamphetamine in the blood of a patient who had a return of spontaneous circulation after cardiac arrest and survived discharge. A 33-year-old male arrived at the emergency department presenting with chest pain and dyspnea. He had ingested methamphetamine and alcohol approximately 7 hours before arrival. One hour after arrival, he had seizure followed by cardiac arrest. Spontaneous circulation was recovered after 4 minutes of CPR. An analysis of the National Forensic Service identified plasma methamphetamine with an estimated average concentration of plasma methamphetamine at the time of arrival of 0.6 mg/L, a lethal dose. He had rhabdomyolysis and acute kidney injury but survived after continuous renal replacement therapy. Since then, he has suffered chronic kidney disease, and he is being followed up at the out-patient department. In Korea, although drug abuse is still uncommon, it is on the increase. Therefore, emergency physicians should be aware of the clinical characteristics of methamphetamine poisoning.
A Clinical Review of Patients Who Visited Emergency Medical Center with Positive Methamphetamine Tests: A Single Institute Study
Young Bin Ok, Jin Yong Kim, Kyeong Ryong Lee, Dae Young Hong, Kwang Je Baek, Sang O Park, Jong Won Kim, Sin Young Kim
J Korean Soc Clin Toxicol. 2018;16(1):25-32.   Published online June 30, 2018
DOI: https://doi.org/10.22537/jksct.2018.16.1.25
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AbstractAbstract PDF
Purpose: Methamphetamine is an ongoing illegal drug problem worldwide, and its use in South Korea has spread over the last few years. In this study, a clinical review of patients who visited emergency medical centers with positive methamphetamine tests was conducted. Methods: Patients underwent methamphetamine screening based on physician suspicion over a period of 13 years. Their patient characteristics, clinical features, and drug administration properties were described. Results: A total of 297 patients were included, with 19 positive methamphetamine results. Patient age ranged from 21 to 84, with a mean of 37.52. Additionally, 13 were male and 6 were female. The mean BP, PR, RR were 131/82 mmHg, 94/min, 20/min. Saturation levels were all over 95%. Five patients had a psychiatric history. Patient showed varied symptoms ranging from mental changes to chest discomfort. In addition, seven showed abnormal electrocardiography findings and one showed elevated cardiac enzyme levels. Other laboratory results revealed no significantly abnormal results. Six patients also suffered from related trauma. The majority of patients consumed the methamphetamine orally, with unknown motivation at unknown locations. Most were transported by 119 and six patients co-ingested other drugs. Conclusion: Patients who showed positive results to a methamphetamine screening test in Korea visited the emergency medical center mostly by 119 and were unaware of or reluctant to reveal the fact that they had ingested methamphetamine. Emergency physicians should be more aware of the possibility that a patient may have consumed methamphetamine.
Neurobiological Effects of Methamphetamine Abuse on Neurotransmitters: A Review
Tae Kyung Lee, E. Grant Jon, Suck Won Kim, Dong Yul Oh
J Korean Soc Clin Toxicol. 2003;1(1):21-26.   Published online June 30, 2003
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AbstractAbstract PDF
Methamphetamine (MA) is a major drug of abuse in Korea. Currently preliminary evidence suggests that MA dependence may cause long-term neural damage in human. Repeated exposure to psychostimulants such as methamphetamine results in behavioral sensitization, a paradigm thought to be relevant to drug craving and addiction in human. Sensitization alters neural circuitry involved in normal processes of incentrive, motivation, and reward. However the precise mechanism of this behavioral sensitization has not yet been fully elucidated. Repeated use of high dose MA causes neurotoxicity which is characterized by a long-lasting depletion of striatal dopamine (DA) and tyrosin hydroxylase activity of DA, DA-transporter binding sites in the striatum. The loss of DA transporters correlates with memory problems and lack of motor coordination. DA fuels motivation and pleasure, but it' s also crucial for learning and movement. This selective review provides a summary of studies that assess the neurobiological mechanisms of MA.

JKSCT : Journal of The Korean Society of Clinical Toxicology