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2021, Number 4

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Rev Cubana Farm 2021; 54 (4)

Ketoprofen as a cause of false positive in the detection of Δ9-etrahydrocannabinol in urine

Bonalde AR, Morales OA, Vicuña-Fernández N, Colmenares RS, Saravia M, Losno R, Valderrama-Wong M, Muñoz AM, Tito AA

Language: Spanish
References: 26
Page: 1-13
PDF size: 581.96 Kb.


ABSTRACT

Introduction: Ketoprofen is one of the nonsteroidal anti-inflammatory drugs most used in the population, and has an epitope similar to 11-nor-Δ9- tetrahydrocannabinol-9-carboxylic acid, so it can be a cause of false positives to marijuana.
Objective: Assess whether ketoprofen at therapeutic doses is a cause of false positive in the detection of Δ9-tetrahydrocannabinol in urine by immunoassay.
Methods: A cross-sectional, experimental uncontrolled two-phase sampling, convenience sampling and prospective recruitment study included 40 volunteers (26 female and 14 male) over 18 years old. The Advanced Quality One Step Cannabinoid (THC) test was used. 50 mg of ketoprofen were administered, after 7 days 100 mg of the same drug was administered, in both phases at a single dose, orally, fasting and with 250 mL of water. Urine samples were collected at 0, 1, 2, 4, 6, 9 and 12 hours.
Results: At doses of 50 mg of ketoprofen, false positives were observed in urine samples from the first hour in women, and from 2 hours (female n = 16; 61.5 %; male n = 9; 64.3 %) to 6 hours in both sexes; at doses of 100 mg of the same drug, false positives were observed, from the first (female n = 21; 80.8 %; male n = 9; 64.3 %) to the sixth hour, in both sexes. Urine samples were false positive at 6 hours (100%) for both sexes and at the two doses studied.
Conclusions: Ketoprofen induces cross-reactivity of false positives to the doseindependent Advanced Quality One Step Cannabinoid (THC) test, and in case of requiring a test for Δ9-tetrahydrocannabinol, it should be known if the subject has previously consumed ketoprofen, to perform the test in a time not less than 9 hours of having consumed the drug. At the same time, all positive screening tests for Δ9-tetrahydrocannabinol should be confirmed by more accurate techniques.


REFERENCES

  1. Pomilio AB, Vitale AA. Técnicas para determinación cuali/cuantitativa dedrogas de abuso en fluidos biológicos. Acta Bioquím Clín Latinoam. 2006 [acceso 22/06/2021];40:347-382. Disponible en:http://www.scielo.org.ar/pdf/abcl/v40n3/v40n3a10.pdf

  2. National Center for Biotechnology Information. PubChem Compound Summaryfor CID 3825, Ketoprofen. EE. UU.: PubChem; 2021. [acceso 22/06/2021]Disponible en: https://pubchem.ncbi.nlm.nih.gov/compound/Ketoprofen

  3. Magallanes L, Lorier M, Ibarra M, Guevara N, Vázquez M, Fagiolino P. Sex andFood Influence on Intestinal Absorption of Ketoprofen GastroresistantFormulation. Clin Pharmacol Drug Dev. 2016;5(3):196-200. DOI:10.1002/cpdd.208

  4. Siepsiak-Połom M, Szałek E, Porażka J, Karbownik A, Grabowski T, Mziray M,et al. Ketoprofen and tramadol pharmacokinetics in patients with chronicpancreatitis. Eur Rev Med Pharmacol Sci. 2019;23(9):4044-4051. DOI:10.26355/eurrev_201905_17835

  5. Hanuš LO, Meyer SM, Muñoz E, Taglialatela-Scafati O, Appendino G.Phytocannabinoids: a unified critical inventory. Nat Prod Rep. 2016;33(12):1357-92. DOI: 10.1039/c6np00074f

  6. Goggin MM, Janis GC. Using measured cannabidiol and tetrahydrocannabinolmetabolites in urine to differentiate marijuana use from consumption ofcommercial cannabidiol products. Clin Toxicol (Phila). 2021;59(6):506-14. DOI:10.1080/15563650.2020.1827148

  7. Wong SS, Wilens TE. Medical Cannabinoids in Children and Adolescents: ASystematic Review. Pediatrics. 2017;140(5):e20171818. DOI: 10.1542/peds.2017-1818

  8. Wang GS, Bourne DWA, Klawitter J, Sempio C, Chapman K, Knupp K, et al.Disposition of oral delta-9 tetrahydrocannabinol (THC) in children receiving cannabis extracts for epilepsy. Clin Toxicol (Phila). 2020;58(2):124-28. DOI:10.1080/15563650.2019.1616093

  9. Amin MR, Ali DW. Pharmacology of medical Cannabis. Adv Exp Med Biol.2019;1162:151-65. DOI: 10.1007/978-3-030-21737-2_8

  10. Huestis MA. Pharmacokinetics and metabolism of the plant cannabinoids,delta9-tetrahydrocannabinol, cannabidiol and cannabinol. Handb Exp Pharmacol.2005;(168):657-90. DOI: 10.1007/3-540-26573-2_23

  11. Spindle TR, Cone EJ, Schlienz NJ, Mitchell JM, Bigelow GE, Flegel R, et al.Acute pharmacokinetic profile of smoked and vaporized Cannabis in human bloodand oral fluid. J Anal Toxicol. 2019;43(4):233-58. DOI: 10.1093/jat/bky104

  12. Watanabe K, Yamaori S, Funahashi T, Kimura T, Yamamoto I. CytochromeP450 enzymes involved in the metabolism of tetrahydrocannabinols andcannabinol by human hepatic microsomes. Life Sci. 2007;80(15):1415-19. DOI:10.1016/j.lfs.2006.12.032

  13. Patilea-Vrana GI, Anoshchenko O, Unadkat JD. Hepatic Enzymes Relevant tothe Disposition of (-)-Δ9-Tetrahydrocannabinol (THC) and Its PsychoactiveMetabolite, 11-OH-THC. Drug Metab Dispos. 2019;47(3):249-56. DOI:10.1124/dmd.118.085548

  14. Mazur A, Lichti CF, Prather PL, Zielinska AK, Bratton SM, Gallus-Zawada A, etal. Characterization of human hepatic and extrahepatic UDPglucuronosyltransferaseenzymes involved in the metabolism of classiccannabinoids. Drug Metab Dispos 2009;37(7):1496-1504. DOI:10.1124/dmd.109.026898

  15. Grotenhermen F. Pharmacokinetics and pharmacodynamics of cannabinoids.Clin Pharmacokinet. 2003;42(4):327-360. DOI: 10.2165/00003088-200342040-00003

  16. McGilveray IJ. Pharmacokinetics of cannabinoids. Pain Res Manag. 2005Autumn;10 Suppl A:15A-22A. DOI: 10.1155/2005/242516

  17. Kapur BM. False positive drugs of abuse immunoassays. Clin Biochem2012;45(9):603-04. DOI: 10.1016/j.clinbiochem.2012.05.004

  18. Connors N, Kosnett MJ, Kulig K, Nelson LS, Stolbach AI. ACMT PositionStatement: Interpretation of Urine for Tetrahydrocannabinol Metabolites. J MedToxicol. 2020;16(2):240-42. DOI: 10.1007/s13181-019-00753-8

  19. Saitman A, Park HD, Fitzgerald RL. False-positive interferences of commonurine drug screen immunoassays: a review. J Anal Toxicol. 2014;38(7):387-96.DOI: 10.1093/jat/bku075

  20. Garro-Zamora LD, Zavaleta-Monestel E. Falsos positivos en pruebas dedetección de drogas de abuso en orina asociados a consumo de medicamentos. Rev. Colegio de Microb. Quim. Clin. Costa Rica. 2015;21(2):34-44. [acceso23/06/2021]. Disponible en:http://omextad.salud.gob.mx/contenidos/investigaciones/Falsospositivos.pdf

  21. Quiroga PN, Mirson DJE, Ridolfi AS, Fuentes S, De Cristófano M, Navoni J, etal. Metabolitos del efavirenz como probable causa de falsos-positivos en testinmunológico para benzodiacepinas en orina. Acta Toxicol Argent 2007;15(2): 44-50.[acceso 23/06/2021]. Disponible en:http://www.scielo.org.ar/pdf/ata/v15n2/v15n2a03.pdf

  22. Krasowski MD, Pizon AF, Siam MG, Giannoutsos S, Iyer M, Ekins S. Usingmolecular similarity to highlight the challenges of routine immunoassay-baseddrug of abuse/toxicology screening in emergency medicine. BMC Emerg Med.2009;9:5. DOI: 10.1186/1471-227X-9-5

  23. Le J. Metabolismo de los fármacos. Manual MSD. USA: Merck Sharp & DohmeCorp., Kenilworth, NJ; 2020. [acceso: 24/06/2021]. Disponible en:https://www.msdmanuals.com/es-pe/professional/farmacolog%C3%ADacl%C3%ADnica/farmacocin%C3%A9tica/metabolismo-de-los-f%C3%A1rmacos

  24. Pacifici R, Pichini S, Pellegrini M, Tittarelli R, Pantano F, Mannocchi G, et al.Determination of cannabinoids in oral fluid and urine of "light cannabis"consumers: a pilot study. Clin Chem Lab Med 2019;57(2):238-43. DOI:10.1515/cclm-2018-0566

  25. Saravia M, Losno R, Valderrama-Wong M, Muñoz AM, Bendezú M, García J, etal. Interacciones farmacocinéticas de la azitromicina e implicación clínica.Revista Cubana de Medicina Militar. 2021 [acceso 26/10/2021];50(3):e02101284.Disponible en: http://revmedmilitar.sld.cu/index.php/mil/issue/view/25

  26. Alvarado AT, Muñoz AM, Loja B, Miyasato M, García JA, Cerro RA, et al.Estudio de las variantes alélicas CYP2C9*2 y CYP2C9*3 en muestras de poblaciónmestiza peruana. Biomédica. 2019;39(3):601-10. DOI: 10.7705/biomedica.4636




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