Given the structural similarity between agents, such as ephedrine and amphetamine, this finding was not unexpected, and such cross-reactivity has been previously reported. Īmphetamine or methamphetamine was the most commonly reported false-positive UDS result. Specific immunologic reagent tests have been identified with these reactions, and, in some cases, the concentrations needed to elicit the reaction were provided.Įxamples of specific medications with false-positive reports are listed in Table 1 and included brompheniramine, bupropion, chlorpromazine, clomipramine, dextromethorphan, diphenhydramine, doxylamine, ibuprofen, naproxen, promethazine, quetiapine, quinolones (ofloxacin and gatifloxacin ), ranitidine, sertraline, thioridazine, trazodone, venlafaxine, verapamil, and a nonprescription nasal inhaler. The potential for false-positive UDS results was identified for the following medication classes on the clinic formulary: antihistamines, antidepressants, antibiotics, analgesics, antipsychotics, and nonprescription agents. Reports of false-positive UDS results were found for 25 (21.5%) of 116 formulary medications.
In addition, the references for each medication with a reported false-positive UDS were reviewed. Truncation was employed for a maximum number of results. When possible, MeSH terms were used and expanded upon. The search strategy was developed by a medical librarian combining the terms false positive results, urine, and substance abuse testing and the generic names of 116 medications. The English-language literature was reviewed, utilizing databases for Ovid MEDLINE, International Pharmaceutical Abstracts, the Excerpta Medica Database, the Cochrane Database of Systematic Reviews, ACP Journal Club, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Health Technology Assessment Database, and NHS Economic Evaluation Database.
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A comprehensive literature review was conducted for all medications on the formulary of Bedlam Clinic, a free evening clinic for the medically indigent or working poor, offered by the University of Oklahoma School of Community Medicine in Tulsa.
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