Evaluation of EMIT®-TOX Enzyme Immunoassay for the Analysis of Benzodiazepines in Serum: Usefulness and Limitations in an Emergency Laboratory

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Abstract
The EMIT®-Enzyme immunoassay for benzodiazepines was evaluated. Reproducibility, linearity, accuracy, sensitivity, and interferences were tested and found to be in good agreement with the manufacturer's specifications. Furthermore, the reactivity of 15 benzodiazepines were studied. According their differential reactivity, the 15 benzodiazepines can be classified into three groups: 1) good reactivity similar to diazepam (potassium clorazepate, prazepam, estazolam, medazepam, flunitrazepam, nitrazepam); 2) medium reactivity (clobazam, clonazepam, bromazepam, chlordiazepoxide, triazolam); and 3) low reactivity (oxazepam, ethyl ioflazepate, iorazepam). A possible structure/reactivity relationship is discussed. It is concluded that this kit is well adapted for the rapid detection of most benzodiazepines, but in no way can the EMIT technique permit quantitative results without clinical information.