Key result
The homogeneous enzyme immunoassay (EMIT) yielded 25% higher quinidine values than liquid chromatography due to cross-reactivity, but is acceptable for clinical use as the metabolites are active.
Why the study?
Does the homogeneous enzyme immunoassay (EMIT) accurately measure serum quinidine levels compared to liquid chromatography and fluorescence spectroscopy in cardiac patients?
Observational (n=67)
Does the homogeneous enzyme immunoassay (EMIT) accurately measure serum quinidine levels compared to liquid chromatography and fluorescence spectroscopy in cardiac patients?
The EMIT assay for quinidine overestimates levels by 25% compared to liquid chromatography due to cross-reactivity with active metabolites, but remains acceptable for clinical use.
Answers are grounded in this paper and cite their sources.
May support continued EMIT use for quinidine; leaves open assay standardization needs in research.
Sera from 67 cardiac patients being treated with quinidine were analyzed for this drug by both a homogeneous enzyme immunoassay (EMIT) and a fluorescence procedure (double-extraction method). Of these samples, 47 were also analyzed for quinidine and its major metabolite in serum, (3s)-3-hydroxyquinidine, by liquid chromatography. Results by the EMIT procedure correlated well with those by both the chromatographic and fluorescence procedures, but EMIT gave, on the average, 25% higher values for quinidine than did the chromatographic procedure. The EMIT procedure is therefore not totally specific. (3s)-3-Hydroxyquinidine and dihydroquinidine (a contaminant present in standard quinidine formulations) each show cross reactivity in the EMIT assay for quinidine. Nevertheless, the EMIT assay for quinidine is acceptable for clinical use because these two compounds are also pharmacologically active.
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Drayer et al. (1981) conducted an observational in Cardiac patients treated with quinidine (n=67). Homogeneous enzyme immunoassay (EMIT) vs. Liquid chromatography and fluorescence spectroscopy was evaluated on Quinidine levels in serum. The homogeneous enzyme immunoassay (EMIT) yielded 25% higher quinidine values than liquid chromatography due to cross-reactivity, but is acceptable for clinical use as the metabolites are active.
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