Biomaterial Database

[Urinary toxicological screening: analytical interference between niflumic acid and cannabis]. 2009

A Boucher, and P Vilette, and N Crassard, and N Bernard, and J Descotes

Centre d'évaluation et d'information sur la pharmacodépendance (CEIP), 162 avenue Lacassagne, Lyon cedex 03, France.

One case of analytical interference between cannabis and niflumic acid resulting in a false-positive screening in a 3-year-old girl is described. METHODS The child was hospitalized because of behavioral disturbances of unknown origin. The only noteworthy finding in her medical history was a drug treatment including suppositories of niflumic acid, started 5 days before. The initial urinary toxicological screening was positive for cannabinoids, but the child's parents strongly denied the exposure. Another analysis was performed by the same laboratory on the same urine sample using chromatography and confirmed the absence of any cannabinoids, while clearly identifying the presence of niflumic acid. CONCLUSIONS Immunoanalysis for toxicological analysis has various limitations that must be known. False-positive results of the urinary screening for cannabis in patients treated with niflumic acid are well recognized although seldom reported. All usual screening tests are not concerned by this ill-explained interference with niflumic acid and all formulations can be involved except transcutaneous formulations. Because of the wide use of this nonsteroidal anti-inflammatory drug, particularly in pediatric patients, it is important to know that this type of interference can occur with various screening tests for cannabis so that misleading conclusions can be avoided.

UI	MeSH Term	Description	Entries
D009544	Niflumic Acid	An analgesic and anti-inflammatory agent used in the treatment of rheumatoid arthritis.	Donalgin,Flunir,Niflactol,Niflugel,Nifluril,Acid, Niflumic
D002186	Cannabinoids	Compounds having the cannabinoid structure. They were originally extracted from Cannabis sativa L. The most pharmacologically active constituents are TETRAHYDROCANNABINOL; CANNABINOL; and CANNABIDIOL.	Cannabinoid
D002653	Child Behavior Disorders	Disturbances considered to be pathological based on age and stage appropriateness, e.g., conduct disturbances and anaclitic depression. This concept does not include psychoneuroses, psychoses, or personality disorders with fixed patterns.	Childhood Behavior Disorders,Behavior Disorder, Child,Behavior Disorder, Childhood,Child Behavior Disorder,Childhood Behavior Disorder,Disorder, Childhood Behavior
D002675	Child, Preschool	A child between the ages of 2 and 5.	Children, Preschool,Preschool Child,Preschool Children
D004347	Drug Interactions	The action of a drug that may affect the activity, metabolism, or toxicity of another drug.	Drug Interaction,Interaction, Drug,Interactions, Drug
D005189	False Positive Reactions	Positive test results in subjects who do not possess the attribute for which the test is conducted. The labeling of healthy persons as diseased when screening in the detection of disease. (Last, A Dictionary of Epidemiology, 2d ed)	False Positive Reaction,Positive Reaction, False,Positive Reactions, False,Reaction, False Positive,Reactions, False Positive
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000285	Administration, Rectal	The insertion of drugs into the rectum, usually for confused or incompetent patients, like children, infants, and the very old or comatose.	Anal Drug Administration,Drug Administration, Rectal,Instillation, Rectal,Rectal Drug Administration,Drug Administration, Anal,Rectal Administration,Administration, Anal Drug,Administration, Rectal Drug,Administrations, Anal Drug,Administrations, Rectal,Administrations, Rectal Drug,Anal Drug Administrations,Drug Administrations, Anal,Drug Administrations, Rectal,Instillations, Rectal,Rectal Administrations,Rectal Drug Administrations,Rectal Instillation,Rectal Instillations
D000894	Anti-Inflammatory Agents, Non-Steroidal	Anti-inflammatory agents that are non-steroidal in nature. In addition to anti-inflammatory actions, they have analgesic, antipyretic, and platelet-inhibitory actions. They act by blocking the synthesis of prostaglandins by inhibiting cyclooxygenase, which converts arachidonic acid to cyclic endoperoxides, precursors of prostaglandins. Inhibition of prostaglandin synthesis accounts for their analgesic, antipyretic, and platelet-inhibitory actions; other mechanisms may contribute to their anti-inflammatory effects.	Analgesics, Anti-Inflammatory,Aspirin-Like Agent,Aspirin-Like Agents,NSAID,Non-Steroidal Anti-Inflammatory Agent,Non-Steroidal Anti-Inflammatory Agents,Nonsteroidal Anti-Inflammatory Agent,Anti Inflammatory Agents, Nonsteroidal,Antiinflammatory Agents, Non Steroidal,Antiinflammatory Agents, Nonsteroidal,NSAIDs,Nonsteroidal Anti-Inflammatory Agents,Agent, Aspirin-Like,Agent, Non-Steroidal Anti-Inflammatory,Agent, Nonsteroidal Anti-Inflammatory,Anti-Inflammatory Agent, Non-Steroidal,Anti-Inflammatory Agent, Nonsteroidal,Anti-Inflammatory Analgesics,Aspirin Like Agent,Aspirin Like Agents,Non Steroidal Anti Inflammatory Agent,Non Steroidal Anti Inflammatory Agents,Nonsteroidal Anti Inflammatory Agent,Nonsteroidal Anti Inflammatory Agents,Nonsteroidal Antiinflammatory Agents