|Downtime form:||A-1a Doctor/Provider Orders - Pathology Core and Specialty Care Nursery|
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.