5 mL random urine

None

Drugs 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).

Screen includes amphetamines, benzodiazepines, cocaine, fentanyl, opiates, and oxycodone/oxymorphone. A presumptive positive result for any of the tested drugs indicates the possible presence of the drug or metabolites in the urine but does not measure the level of

intoxication.

If quantitative confirmation is needed for amphetamines, benzodiazepines, cocaine, fentanyl, opiates, or oxycodone/oxymorphone, call the Laboratory at 356-3527. Allow up to seven days for confirmatory results.

Quantitative confirmation is at an additional charge.

The individual components of the drug of abuse-urine screen can also be ordered individually, if desired (see links at end).

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

AMPHETAMINES ASSAY

Abbreviations for the "designer" amphetamine and methamphetamine derivatives:

* 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.

BENZODIAZEPINES ASSAY

*In patients taking typical therapeutic doses of these benzodiazepines for medical purposes, the benzodiazepines screen can be negative due to the low concentrations of these drugs and their metabolites excreted in urine relative to the cut-offs.

Assay with improved detection of glucuronidated benzodiazepines implemented 05-21-2024.

COCAINE ASSAY

*In general, local anesthetics do not cross-react with the cocaine immunoassay.

FENTANYL ASSAY

OPIATES ASSAY

 OXYCODONE ASSAY*

 *The oxycodone assay does not cross-react with opiates other than oxycodone or oxymorphone (e.g., codeine, heroin, hydrocodone, hydromorphone, morphine) or with synthetic opioids (e.g., fentanyl, meperidine, methadone, propoxyphene).

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.

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.

All assays except oxycodone and fentanyl are based on the kinetic interaction of microparticles in a solution (KIMS) as measured by changes in light transmission. The oxycodone and fentanyl screens are based on the competition between a drug labeled with glucose-6-phosphate dehydrogenase (G6PDH), and free drug from the urine sample for a fixed amount of specific antibody binding sites. In the absence of free drug from the sample, the specific antibody binds the drug labeled with G6PDH and causes a decrease in enzyme activity. This phenomenon creates a direct relationship between the drug concentration in urine and enzyme activity. The enzyme activity is determined spectrophotometrically at 340 nm by measuring the conversion of nicotinamide adenine dinucleotide (NAD) to NADH.