False-positive levorphanol (opioid) due to dextromethorphan on urine drug screen by time-of-flight MS

Patricia M. Jones; Khushbu Patel

doi:10.1016/B978-0-12-815846-3.00098-3

False-positive levorphanol (opioid) due to dextromethorphan on urine drug screen by time-of-flight MS

Research output: Chapter in Book/Report/Conference proceeding › Chapter

Abstract

A case of a false-positive levorphanol on an LC-QTOF urine drug screen due to the presence of dextromethorphan is described. Levorphanol is a stereoisomer of dextrorphan, the main metabolite of dextromethorphan. Dextromethorphan does not produce the same analgesic and sedative effects as opioids, which exhibit nervous system and respiratory depression. LC-MS assays are not able to distinguish between stereoisomers, and thus dextrorphan in the sample will be recognized as levorphanol. Only enantiomeric chiral LC-MS/MS analysis can help differentiate the two compounds. The primary caregiver was notified that with dextromethorphan present, the detected levorphanol was most likely the metabolite dextrorphan.

Original language	English (US)
Title of host publication	Toxicology Cases for the Clinical and Forensic Laboratory
Publisher	Elsevier
Pages	497-499
Number of pages	3
ISBN (Electronic)	9780128158463
ISBN (Print)	9780128163733
DOIs	https://doi.org/10.1016/B978-0-12-815846-3.00098-3
State	Published - Jan 1 2020

Keywords

dextromethorphan
LC/Q-TOF mass spectrometry
Levorphanol
opioid

ASJC Scopus subject areas

Medicine(all)

Access to Document

10.1016/B978-0-12-815846-3.00098-3

Cite this

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title = "False-positive levorphanol (opioid) due to dextromethorphan on urine drug screen by time-of-flight MS",

abstract = "A case of a false-positive levorphanol on an LC-QTOF urine drug screen due to the presence of dextromethorphan is described. Levorphanol is a stereoisomer of dextrorphan, the main metabolite of dextromethorphan. Dextromethorphan does not produce the same analgesic and sedative effects as opioids, which exhibit nervous system and respiratory depression. LC-MS assays are not able to distinguish between stereoisomers, and thus dextrorphan in the sample will be recognized as levorphanol. Only enantiomeric chiral LC-MS/MS analysis can help differentiate the two compounds. The primary caregiver was notified that with dextromethorphan present, the detected levorphanol was most likely the metabolite dextrorphan.",

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AU - Patel, Khushbu

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N2 - A case of a false-positive levorphanol on an LC-QTOF urine drug screen due to the presence of dextromethorphan is described. Levorphanol is a stereoisomer of dextrorphan, the main metabolite of dextromethorphan. Dextromethorphan does not produce the same analgesic and sedative effects as opioids, which exhibit nervous system and respiratory depression. LC-MS assays are not able to distinguish between stereoisomers, and thus dextrorphan in the sample will be recognized as levorphanol. Only enantiomeric chiral LC-MS/MS analysis can help differentiate the two compounds. The primary caregiver was notified that with dextromethorphan present, the detected levorphanol was most likely the metabolite dextrorphan.

AB - A case of a false-positive levorphanol on an LC-QTOF urine drug screen due to the presence of dextromethorphan is described. Levorphanol is a stereoisomer of dextrorphan, the main metabolite of dextromethorphan. Dextromethorphan does not produce the same analgesic and sedative effects as opioids, which exhibit nervous system and respiratory depression. LC-MS assays are not able to distinguish between stereoisomers, and thus dextrorphan in the sample will be recognized as levorphanol. Only enantiomeric chiral LC-MS/MS analysis can help differentiate the two compounds. The primary caregiver was notified that with dextromethorphan present, the detected levorphanol was most likely the metabolite dextrorphan.

KW - dextromethorphan

KW - LC/Q-TOF mass spectrometry

KW - Levorphanol

KW - opioid

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BT - Toxicology Cases for the Clinical and Forensic Laboratory

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ER -

False-positive levorphanol (opioid) due to dextromethorphan on urine drug screen by time-of-flight MS

Abstract

Keywords

ASJC Scopus subject areas

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