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Published:
Journal of Analytical Toxicology,
ISSN 0146-4760,
Volume 32, Number 6, July/August,
pp.402-407
Urine Monitoring
of Diazepam Abuse— New Intake or Not?
Roland Lennestål1, Hans-Åke
Lakso2, Mats Nilsson3,
and Tom Mjörndal1
1Division of Clinical Pharmacology, Department of Pharmacology
and Clinical Neuroscience, Norrland University Hospital, Umeå,
Sweden;
2Laboratory Medicine, Norrland University Hospital,
Umeå,
Sweden;
3The Academy of Healthcare, County Council, Jönköping,
Sweden
Testing for drugs-of-abuse in urine is requested
for multiple reasons, including legal and workplace policies.
Two cases were studied in which there was a suspicion that the
patients continued to abuse diazepam, because of repeatedly positive
urine samples. In these cases, diazepam metabolites were measured
in urine samples by gas or liquid chromatography coupled to mass
spectrometry. The concentrations of diazepam metabolites were
subsequently creatinine correlated. Very long elimination times
were found in the described cases. None of them had in fact ingested
diazepam again during the study period. By the use of pharmacogenetic
typing, one of the subjects was found to have a slow metabolism
for CYP2C9 as well as for CYP2C19. In the second case, there
was a possible drug interaction between diazepam and zolpidem.
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