Evaluation of the REMEDi drug profiling system.

One hundred and sixteen samples for toxicological analysis (78 urines and 38 stomach contents) were analysed both with the Bio-Rad REMEDi Drug Profiling System and with a set of immunoassays and standard chromatographic procedures (HPLC, GC/NPD and GC/MS). As a screening method, REMEDi performed only moderately well, compared with immunoassays. Amphetamines and tricyclic antidepressants were detected by REMEDi in 80% and 68%, respectively, of the positive immunoassay results. Positive immunoassay screening tests were more often confirmed by the conventional chromatographic methods (80%) than by REMEDi (35%). The highest confirmation score for REMEDi was observed in the amphetamine group (9 of 12), while low scores were obtained for barbiturates (1 of 7) and benzodiazepines (13 of 75). However, in these samples REMEDi detected 53 additional compounds, which were neither reactive in the immunoassay screening tests, nor detected by the standard chromatographic procedures. These results clearly demonstrate that REMEDi can be a useful complementary technique in the clinical toxicology laboratory, since it expands the range of drugs covered by the immunoassays and provides a rapid, preliminary report in emergency situations.