Case Studies: CASE ONE

A mother and her daughterapproach the counselingbooth at ABC Pharmacy.The mother is franticallywaving a home drug-testingkit.

The mother explainsto the pharmacist that shebought the test that morning andinsisted that her daughter use the test.Her daughter's best friend had just been expelled from schoolfor possession of illegal drugs. She wanted to make sure herdaughter was not using drugs, too.

As she shows the test to the pharmacist, the mother startsto cry because the test was positive for amphetamines. Thedaughter begins insisting that she does not use drugs andthat the test must be wrong. The mother wants the pharmacistto inform her daughter that these tests are accurate.

In an attempt to sort out the situation, the pharmacistasks if the daughter takes any prescription or OTC medications.The daughter says she takes ibuprofen for menstrualcramps and pseudoephedrine and loratadine for seasonalallergies.

What information about "false positives" can the pharmacistprovide considering the daughter's medications?

Dr. Schlesselman is a clinical pharmacist based in Niantic, Conn.

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Despite the accuracy of these tests, the pharmacist should counsel the mother and daughter that false positives are possible. Urine drugtests for amphetamines can falsely report "positive" in patients taking pseudoephedrine, ephedrine, and certain dietary supplements. If themother and daughter wish, a confirmatory blood screen should be performed at a local laboratory or doctor's office.

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