And troubleshooting

Surprises are fun when hosting birthday parties or when one wins a sweepstakes. They are not enjoyable when encountered in the laboratory. By taking time to include the evaluation of a few pre-analytical characteristics when considering new analytes or methods, one can minimize later surprises. In addition to assessing the effects of hemolysis, lipemia, and icterus remember to evaluate the tubes and devices used in the sample collection, storage, or preparation. The pharmaceutical literature is often a good place to start. Descriptions of the stability (or lack thereof) of a drug in a pharmaceutical solution often provide insight into the stability of the drug in our samples. When considering changes in vendors of established materials, remember to obtain supplies in advance to assess comparability. Make sure your purchasing agent does not have the authority to make changes in sources without approval and validation. Our laboratory has found that the recording of lot of changes facilitates troubleshooting. This is not easy to do, but it is amazing how often a lot of buffer or solvent is found to be the culprit.

Although I have focused on the samples used in TDM, the lessons are applicable to those used in toxicology as well. Because of forensic needs, for example, the need to be able to replicate results with retesting at later dates, the stabilities of these analytes are probably better documented than most therapeutically monitored drugs.

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