Kuyeza Mankhwala Osokoneza Bongo

Akuyezetsa mankhwalandi kusanthula kwaukadaulo kwa chitsanzo chachilengedwe, mwachitsanzo mkodzo, tsitsi, magazi, mpweya, thukuta, kapena madzi amkamwa/malovu—kuti adziwe kupezeka kapena kusakhalapo kwa mankhwala odziwika omwe amabadwa kapena ma metabolites awo.Ntchito zazikulu zoyezetsa mankhwala osokoneza bongo zimaphatikizapo kuzindikira kukhalapo kwa ma steroids owonjezera pamasewera, olemba anzawo ntchito ndi oyang'anira parole/probation officer kuyang'ana mankhwala oletsedwa ndi lamulo (mongacocaine, methamphetamine, ndi heroin) ndi apolisi kuyesa kukhalapo ndi kuchuluka kwa mowa (ethanol) m'magazi omwe amadziwika kuti BAC (mowa wamagazi).Mayeso a BAC nthawi zambiri amaperekedwa kudzera pa breathalyzer pamene urinalysis imagwiritsidwa ntchito poyesa mankhwala ambiri pamasewera ndi kuntchito.Njira zina zambiri zokhala ndi milingo yolondola yosiyana, kukhudzika (kuzindikira polowera / kudulidwa), komanso nthawi yodziwira.
Kuyezetsa mankhwala kungatanthauzenso kuyesa komwe kumapereka kusanthula kwamankhwala kwamankhwala osaloledwa, omwe cholinga chake ndikuthandizira kugwiritsa ntchito bwino mankhwala.[1]

Kusanthula mkodzo kumagwiritsidwa ntchito makamaka chifukwa cha mtengo wake wotsika.Kuyeza mankhwala a mkodzondi imodzi mwa njira zoyesera zomwe zimagwiritsidwa ntchito.Kuyeza kwa chitetezo chamthupi chochulukitsidwa ndi ma enzyme ndi njira yomwe imagwiritsidwa ntchito pafupipafupi.Madandaulo akhala akunenedwa za kuchuluka kwa anthu omwe ali ndi bodza pogwiritsa ntchito mayesowa.[2]
Mayeso a mankhwala a mkodzo amawunika mkodzo ngati pali mankhwala kapena ma metabolites ake.Mulingo wamankhwala kapena ma metabolites ake sadziwiratu za nthawi yomwe mankhwalawa adamwedwa kapena kuchuluka kwa momwe wodwalayo adagwiritsa ntchito.

Kuyeza mankhwala a mkodzondi immunoassay yozikidwa pa mfundo yomangiriza mpikisano.Mankhwala omwe angakhalepo mumkodzo amapikisana motsutsana ndi mankhwala omwe amalumikizana nawo kuti amangire ma antibodies awo.Pakuyesa, chitsanzo cha mkodzo chimasunthira mmwamba ndi capillary action.Mankhwala, ngati alipo m'chitsanzo cha mkodzo m'munsi mwa mkodzo wake, sangakhutitse malo omwe amamangiriza ma antibody ake enieni.Anti-antibody idzachitapo kanthu ndi conjugate ya protein-protein ndipo mzere wowoneka bwino udzawonekera pagawo loyesa la mzere wa mankhwalawo.

Malingaliro olakwika odziwika bwino ndi akuti kuyesa kwa mankhwala omwe akuyesa gulu la mankhwala, mwachitsanzo, opioids, adzazindikira mankhwala onse a gululo.Komabe, mayeso ambiri a opioid sangazindikire modalirika oxycodone, oxymorphone, meperidine, kapena fentanyl.Momwemonso, mayeso ambiri a benzodiazepine sangazindikire lorazepam modalirika.Komabe, zowonetsera za mankhwala a mkodzo zomwe zimayesa mankhwala enaake, osati gulu lonse, nthawi zambiri zimapezeka.
Wolemba ntchito akapempha kuti amuyezetse mankhwala kwa wogwira ntchito, kapena dokotala akapempha kuti amuyezetse mankhwala kwa wodwala, wogwira ntchitoyo kapena wodwala amalangizidwa kuti apite kumalo osungira zinthu kapena kunyumba kwawo.Mkodzo umadutsa mu 'chain of custody' yodziwika bwino kuti uwonetsetse kuti sunasokonezedwe kapena kuthetsedwa kudzera mu labu kapena zolakwika za ogwira ntchito.Mkodzo wa wodwalayo kapena wogwira ntchito umasonkhanitsidwa pamalo akutali m'kapu yotetezedwa mwapadera, yosindikizidwa ndi tepi yosagwira ntchito, ndikutumizidwa ku labotale yoyezetsa kuti akawone ngati ali ndi mankhwala osokoneza bongo (makamaka gulu 5 la Kugwiritsa Ntchito Mankhwala Osokoneza Bongo ndi Mental Health Services Administration 5).Gawo loyamba pamalo oyesera ndikugawa mkodzo kukhala ma aliquots awiri.Aliquot imodzi imawunikiridwa koyamba ndi mankhwala pogwiritsa ntchito analyzer yomwe imapanga immunoassay ngati chophimba choyambirira.Kuti muwonetsetse kukhulupirika kwachitsanzocho komanso kuti muwone zomwe zingathe kuchita chigololo, magawo owonjezera amayesedwa.Ena amayesa mkodzo wabwinobwino, monga, creatinine ya mkodzo, pH, ndi mphamvu yokoka inayake.Zina zimapangidwira kugwira zinthu zomwe zimawonjezeredwa mumkodzo kuti zisinthe zotsatira zoyesa, monga, oxidants (kuphatikizapo bleach), nitrites, ndi gluteraldehyde.Ngati chithunzi cha mkodzo chili chabwino ndiye kuti aliquot ina ya chitsanzocho imagwiritsidwa ntchito kutsimikizira zomwe zapezedwa ndi gas chromatography-mass spectrometry (GC-MS) kapena liquid chromatography - mass spectrometry methodology.Ngati atapemphedwa ndi dokotala kapena abwana, mankhwala ena amafufuzidwa payekha;Awa kawirikawiri ndi mankhwala omwe ali mbali ya gulu la mankhwala omwe, pazifukwa zambiri, amaganiziridwa kuti ndi chizolowezi kapena chodetsa nkhawa.Mwachitsanzo, oxycodone ndi diamorphine akhoza kuyesedwa, onse ochepetsa ululu.Ngati kuyesedwa koteroko sikunapemphedwe mwachindunji, kuyesa kowonjezereka (m'nkhani yapitayi, kuyesa kwa opioid) kudzazindikira mankhwala ambiri a m'kalasi, koma olemba ntchito kapena dokotala sangakhale ndi phindu lachidziwitso cha mankhwalawo. .
Zotsatira za mayeso okhudzana ndi ntchito zimatumizidwa ku ofesi yowunikira zachipatala (MRO) komwe dokotala amawunika zotsatira.Ngati zotsatira za chinsaluzo zili zoipa, MRO imadziwitsa bwanayo kuti wogwira ntchitoyo alibe mankhwala odziwika mumkodzo, nthawi zambiri mkati mwa maola 24.Komabe, ngati zotsatira za mayeso a immunoassay ndi GC-MS sizili zoipa ndipo zikuwonetsa kuchuluka kwa mankhwala a makolo kapena metabolite pamwamba pa malire omwe akhazikitsidwa, MRO amalumikizana ndi wogwira ntchitoyo kuti adziwe ngati pali chifukwa chilichonse chovomerezeka-monga chithandizo chamankhwala. mankhwala kapena mankhwala.

[1] "Ndinakhala kumapeto kwa sabata ndikuyesa mankhwala paphwando".The Independent.July 25, 2016. Adabwezedwanso May 18, 2017.
[2] US Department of Transportation: National Highway Traffic Safety Administration (DOT HS 810 704).Mayeso Oyendetsa Njira Zatsopano Zofufuza Zamsewu Zakuyendetsa Bwino Kwambiri.Januware, 2007.