College of American Pathologists

  Press Release


Published on March 1, 2012

Contact: Joe Schramm
Phone: 847-832-7445

CAP Press Releases Clinical Toxicology Testing: A Guide for Laboratory Professionals

Northfield, IL—The College of American Pathologists’ (CAP) has released its newest publication, Clinical Toxicology Testing: A Guide for Laboratory Professionals, a practical guide to setting up, overseeing, and directing hospital toxicology laboratory operations.

The book focuses on the complex issues a laboratory director or pathologist may encounter in clinical toxicology testing. It addresses pharmacological principles, testing menus, methodologies, and clinical test interpretation for specialized areas including the emergency department, the pain clinic, and the autopsy suite. In addition, it serves as an introduction to such topics as workplace drug testing and relevant regulatory issues.

“Our intent was to provide the reader with a comprehensive view of what is needed, and expected, when offering a clinical toxicology service,” said Barbarajean Magnani, PhD, MD, FCAP, Chair and Pathologist-in-Chief, Department of Pathology and Laboratory Medicine at Tufts University School of Medicine, one of the book’s four editors.

The books other editors include: Michael G. Bissell MD, PhD, MPH, FCAP, Professor of Pathology, The Ohio State University, and Director of Clinical Chemistry and Toxicology, Wexner Medical Center at The Ohio State University; Tai C. Kwong, PhD, DABCC, FACB, Professor of Pathology and Laboratory Medicine, and Director, Automated and Toxicology Laboratories at the University of Rochester Medical Center; and Alan H.B. Wu, PhD, DABCC, FACB, Chief, Clinical Chemistry Laboratory, San Francisco General Hospital, and Professor, Laboratory Medicine, The University of California San Francisco.

“This is a comprehensive, yet eminently readable, text on the burgeoning field of clinical toxicology,” said Gary L. Horowitz, MD, FCAP, Medical Director, Clinical Chemistry at Beth Israel Deaconess Medical Center, Boston, MA. “The chapters, though very complete, are relatively short and unintimidating. One can pick up the book to read about offering a new service, for example, supporting a pain service, or to answer a specific question about amphetamines, for example, that the anti-Parkinson’s drug selegiline is metabolized to methamphetamine and amphetamine and thus may cause a true positive ‘amphetamines’ screening immunoassay.”

The publication covers topics including:

  • Organizational aspects of a hospital toxicology laboratory
  • Supporting the emergency department and the pain service
  • Forensic toxicology and chain of custody
  • Medical professional substance abuse and workplace drug testing
  • Adverse drug events and poisonings
  • Analytical methodologies and alternate specimens for testing
  • Drugs of abuse, toxic substances, and overdoses
  • Therapeutic drug monitoring and compliance testing
  • Pharmacokinetic concepts and pharmacogenomic testing

“Individual chapters are devoted to different drug classes, serving as the kind of reference material one can use to answer specific questions as they arise,” Dr. Horowitz said.

“It is written for the pathologist and clinical laboratorian, as it covers essential regulatory issues as well as the medical and analytical issues that are pertinent to toxicology,” said Anthony Killeen, MD, PhD, FCAP, Director of Clinical Laboratories at the University of Minnesota Medical Center. “It should be in the library of every pathologist and laboratory director, and required reading for residents in pathology.”

The book includes templates and charts that can be adapted to any clinical toxicology laboratory, along with a series of frequently asked questions that pathologists may face in their role as laboratory directors.

For more information and to order a copy of Clinical Toxicology Testing: A Guide for Laboratory Professionals, visit or call 800-323-4040, option 1.

The College of American Pathologists (CAP), celebrating 50 years as the gold standard in laboratory accreditation, is a medical society serving more than 18,000 physician members and the global laboratory community. It is the world’s largest association composed exclusively of board-certified pathologists and is the worldwide leader in laboratory quality assurance. The College advocates accountable, high-quality, and cost-effective patient care.