Amphetamines
Label Mnemonic: AMPU
Epic code: LAB7381
Downtime form: A-1a Doctor/Provider Orders - Pathology Core and Specialty Care Nursery
Chemistry
6240 RCP
356-3527
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 confirmation is needed for amphetamines, call the Laboratory at 
319-356-3527.  Allow up to seven days for confirmatory results.  
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.
CPT Code:
80326
 
See also:
Drugs of Abuse, Urine + Confirm
Drugs of Abuse, Urine