Clinical toxicology in the laboratory sphere deals with the identification of chemicals, drugs, or toxins that may affect patients and offers a means for clinicians to predict future toxic effects, confirm a diagnosis, or optimize therapy. Drug testing can determine the presence or absence of drugs and/or drug metabolites and may be quantitative (particularly useful for therapeutic drug monitoring) or qualitative to verify compliance with prescribed therapy or identify inappropriate drug use (helpful in pain management). Pharmacogenetic (PGx) testing may be performed to help explain an adverse drug reaction or to help guide selection of drugs for an individual patient. Therapeutic drug management can help to optimize the dose of a therapeutic drug and is complementary to PGx testing.
Biomarkers play an important role in testing for acute and chronic alcohol ingestion and in monitoring abstinence. Each marker has strengths and weaknesses in particular uses.
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Emergency toxicology focuses on the diagnosis, management, and prevention of poisoning due to drugs, occupational and environmental toxins, and biological agents.
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Genetic variations associated with drug response or disposition may predispose a patient to be at risk for drug-related toxicity, nonstandard dose requirements, or lack of therapeutic benefit.
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Timely detection of in utero drug exposure is critical for effective management of withdrawal syndromes and long-term needs (social and medical) for exposed infants.
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The use of nicotine-containing tobacco products is the main preventable cause of disease and death in the United States. Laboratory testing can detect active or passive exposure.
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Drug testing strategies and methods are not well standardized, adding challenges to the selection of the right test and to the interpretation of test results.
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Therapeutic drug monitoring is used to optimize dose therapy to maintain a consistent concentration of drug in the patient’s blood in order to achieve the appropriate therapeutic effect while minimizing the risk for toxicity.
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Essential and nonessential elements can be toxic when levels exceed a certain threshold. Laboratory testing can help evaluate for element toxicity.
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