Amphetamines

Label Mnemonic:	AMPU
Epic code:	LAB7381
Order form:	Laboratory Requisition
Supply order:	Supply Order Form
Billing:	Billing Policies
CPT code:	80326

Specimen(s):

Urine Screen

Collection Medium:

Clear top tube

Alternate Collection Media:

Urine (Random)-BD Vacutainer^®, no additive yellow top

Minimum:

5 mL random urine

Rejection Criteria:

Test cannot be added to a urine sample previously utilized for urinalysis testing (LAB1160, LAB1164, LAB8379).

Testing Schedule:

24 hrs/day, 7 days a week, including holidays.

Turn Around Time:

1 hour (upon receipt in laboratory)

Reference Range:

None

Interpretive Data:

Drug of abuse screening tests are to be used for medical purposes only and not for non-medical purposes (e.g., employee, competitive athlete, or forensic testing).

Comments:

Screen includes amphetamines only.  For full drug of abuse-urine 
panel, see "Drug of Abuse Screen".

If  quantitative confirmation is needed for amphetamines, call 
UIDL Client Services at 1-866-844-2522.  Allow up to seven days for 
confirmatory results.  

Quantitative confirmation is at an additional charge.

Additional information on approximate cut-offs for individual drugs or 
drug metabolites in the specific assays


AMPHETAMINES ASSAY
Drug                       Approximate cut-off for
                           amphetamines assay (ng/mL)
-------------------------------------------------------------
d-Amphetamine                        981
d-Methamphetamine                    998
MBDB                               1,175
MDA                                  771
MDEA                               1,553
MDMA ("Ecstasy")                     509
PMMA                                 690
PMA                                  908
Labetalol metabolite               5,116
Phendimetrazine*                 138,000
Phentermine*                     239,000
d-Pseudoephedrine*               261,000
Ephedrine*                       308,000

Abbreviations for the "designer" amphetamine and methamphetamine 
derivatives:
   MBDB - methylbenzodioxolylbutanamine ("Eden")
   MDA - 3,4-methylenedioxyamphetamine
   MDEA - 3,4-methylenedioxy-N-ethylamphetamine ("Eve")
   MDMA - 3,4-methylenedioxymethamphetamine ("Ecstasy")
   PMA - para-Methoxyamphetamine
   PMMA - para-Methoxymethamphetamine 

* The concentrations of these compounds needed to trigger a positive
  amphetamines screen are very high and likely only achievable in large
  overdose.

New amphetamines assay instituted 7/7/10.  
Unlike the assay used prior to 7/7/10, the new assay has very good 
cross-reactivity for MDMA (Ecstasy) and some designer amphetamines 
(MDA, MBDB, MDEA, PMA, PMMA).  The older assay did not cross-react 
well with amphetamines other than amphetamine and methamphetamine. The 
new assay has low cross-reactivity with non-amphetamine drugs 
(ephedrine, pseudoephedrine, phentermine, etc.).

Patients on labetalol can have a false positive amphetamines screen 
due to a metabolite of labetalol (APB, 1-Methyl-3-phenylpropylamine)
structurally resembling amphetamine. In these cases, confirmatory 
testing will be negative.

References:

Belson MG, Simon HK, Sullivan K, Geller RJ.  The Utility of 
Toxicologic Analysis in Children with Suspected Ingestion.  Pediatr 
Emerg Care 1999;15:383-387.

Bast RP, Helmer SD, Henderson SR, Rogers MA, Shapiro WM, Smith RS.  
Limited Utility of Routine Drug Screening in Trauma Patients.  South 
Med J 2000;93:397-399.

Hammett-Stabler CA, Pesce AJ, Cannon DJ.  Urine Drug Screening in the 
Medical Setting.  Clinica Chimica Acta 2002;315:125-135.

Schiller MJ, Shumway M, Batki SL.  Utility of Routine Drug Screening 
in a Psychiatric Emergency Setting.  Psychiatric Services 2000;51:474-
478.

Sugarman JM, Rodgers GC, Paul RI.  Utility of Toxicology Screening in 
a Pediatric Emergency Department.  Pediatric Emergency Care.  
Pediatric Emergency Care 1997;13(3):194-197.

Gilbert RB, Peng PI, Wong D.  A labetalol metabolite with analytical 
characteristics resembling amphetamines.  J Anal Toxicol 1995;19(2):84-
86.

Test Limitations:

There is the possibility that other substances and/or factors may interfere with the test and cause erroneous results (e.g., technical or procedural errors). Call the lab at 319-356-3527 for additional information.

Methodology:

Assay is based on the kinetic interaction of microparticles in a solution (KIMS) as measured by changes in light transmission.

Sample Processing:

Submit urine in leak-proof plastic container.

Sample Storage:

Refrigerate.

Transport Instructions:

Place labeled specimen into zip-lock type biohazard bag; seal bag.
Place completed requisition into outside pocket of bag.
Transport in cooler with refrigerated coolant packs.

See also:
Drugs of Abuse, Urine
Drugs of Abuse, Urine + Confirm