Benzodiazepines Glucuronidation and Its Impact on Drug Screening

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Benzodiazepines (e.g., Valium (diazepam) and Librium (chlordiazepoxide)) are commonly prescribed minor tranquilizers, sedatives, and anticonvulsants. They are a large class of compounds and also undergo extensive metabolism, with glucuronida-tion often being the last step in the biotransformation. Most immunoassays for benzodiazepines involve antibodies raised against a common benzodiazepine metabolite, oxazepam. However, because most oxazepam excreted into the urine is actually oxazepam glucuronide, the immunoassay does not always perform well. The antibody has less reactivity with the oxazepam glucuronide, the actual metabolite present in urine. Some research has shown that pretreatment of the urine specimen with glucuronidase, which liberates the metabolite from binding with glucuronide, improves the sensitivity of the method.

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