Interpretation Guide: Broad Spectrum Urine Toxicology Screen

Interpretation Guide: Broad Spectrum Urine Toxicology Screen

January 2016

The Broad Spectrum Urine Toxicology Screen provided by Dynacare incorporates liquid chromatography and tandem mass spectrometry (LC-MS/MS) for the targeted identification of sixty-three (63) different drugs, drug metabolites and preparation ingredients. All urine specimens undergo enzymatic hydrolysis prior to testing, to yield additional free/unconjugated drug and thereby improve detection.

We note that the ability to detect any drug or metabolite in urine is dependent on many factors, including: the dose ingested the analytical method used the positive/negative cut-off concentration selected the individual's metabolic variability - genetic factors, age, gender, etc. the individual's physical condition ? most notably kidney and liver disease the amount of fluid ingested the method and frequency of dosing the time the drug was ingested relative to the time the urine sample was collected

Dynacare Broad Spectrum Urine Toxicology screen is targeted for the specific drug, drug metabolite and preparation ingredients listed below. It will not identify every licit and/or illicit drug that might be in a urine sample. If the drug of interest is not listed in the table below it will not be detected by this screen, at this time.

If a listed analyte was detected in the urine and its concentration exceeded its defined positive/negative cut-off concentration, the specimen will be reported positive for that specific analyte.

A positive result indicates that the analyte is present in the patient's urine at a minimum concentration above its defined screening threshold. A positive result does not indicate the analytes route of administration, ingested dose, concentration in the urine or the patient's level of intoxication.

A negative result may not necessarily mean that the urine is drug free. Negative results can obtained when the drug is present in the urine, but at a concentration that is below the positive/negative cut-off threshold. Negative results may also be obtained if the specific analyte of interest is not included in Dynacare Broad Spectrum Urine Toxicology screen.

We suggest you review the Ontario Association of Medical Laboratories (OAML) guideline entitled "Guidelines for Ordering Urine Testing for Drugs-of-Abuse: Targeted and Screening Tests (CLP013)", found at . Contact Dynacare if additional information is required.

Drug, Drug Metabolite or Preparation Ingredient

Anesthetic Ketamine Anticonvulsant Gabapentin Antidepressants Bupropion mCPP Benzodiazepines

Alprazolam -hydroxyalprazolam

Clonazepam 7-Aminoclonazepam

Diazepam Nordiazepam

Flunitrazepam 7-Aminoflunitrazepam

Flurazepam Desalkylflurazepam

Lorazepam Nitrazepam

7-Aminonitrazepam Oxazepam Phenazepam

Interpretation Guide: Broad Spectrum Urine Toxicology Screen

Common Trade Names

Interpretive Notes

Positive/ Negative Cut-off (ng/mL)

Urine Detection Time

Ketalar

Ketamine detected after use

100 ng/mL

Neurontin

Gabapentin detected after use

500 ng/mL

Wellbutrin, Zyban

Bupropion detected after use Trazodone metabolite; designer drug

250 ng/mL 250 ng/mL

Apo-Alpraz, Xanax

Clonapam Diastat, Diazemuls, Valium Rohypnol

Dalmane, SOM-PAM Ativan Mogadon

Novoxapam, Oxpam

Metabolized to alpha-hydroxyalprazolam; both may be detected after use Alprazolam metabolite Metabolized to 7-aminoclonazepam; metabolite primarily detected after use Clonazepam metabolite Metabolized to nordiazepam, temazepam and oxazepam; all may be detected after use Diazepam metabolite Metabolized to 7-aminoflunitrazepam; metabolite primarily detected after use Flunitrazepam metabolite Metabolized to desalkylflurazepam; metabolite primarily detected after use Flurazepam metabolite Lorazepam detected after use Metabolized to 7-aminonitrazepam; both may be detected after use Nitrazepam metabolite Oxazepam detected after use; nordiazepam and temazepam metabolite Phenazepam detected after use

100 ng/mL 100 ng/mL 100 ng/mL 100 ng/mL 100 ng/mL 100 ng/mL 100 ng/mL 100 ng/mL 100 ng/mL 100 ng/mL 100 ng/mL 100 ng/mL 100 ng/mL 100 ng/mL 100 ng/mL

2-4 days 2-4 days 2-7 days 1-4 days 1-2 days 5-7 days 1-4 days 2-7 days

Interpretation Guide: Broad Spectrum Urine Toxicology Screen

Drug, Drug Metabolite or

Common Trade Names

Interpretive Notes

Preparation Ingredient

Temazepam

Restoril

Metabolized to oxazepam; both may be detect after use; diazepam metabolite

Triazolam

Triazolam detected after use

Cannabinoids

THCA

Cannabinoid metabolite

JWH-200

Synthetic Cannabinoid

JWH-018

Synthetic Cannabinoid

Opioids and Related Drug Preparation Ingredients

Buprenorphine Norbuprenorphine

Buprenorphine/ Naloxone, Butrans, Suboxone

Metabolized to norbuprenorphine; both may be detected after use; Suboxone and Buprenorphine/Naloxone preparations also include naloxone Buprenorphine metabolite

Tylenol with Codeine

Codeine

No. 2, No. 3 and No. 4; included in many other preparations

Metabolized to norcodeine, morphine and hydrocodone; all may be detected after use

Norcodeine

Codeine metabolite

Fentanyl

Abstral, Duragesic Mat, Metabolized to norfentanyl; both may be detected

Fentanyl Patch

after use

Norfentanyl

Fentanyl metabolite

Heroin 6-Acetylmorphine

Metabolized to 6-acetylmorphine, metabolite primarily detected after use Heroin metabolite

Hydrocodone

Hydrocan, Novahistex DH, Novahistine DH, Tussionex

Metabolized to norhydrocodone, dihydrocodeine and hydromorphone; all may be detected after use; codeine metabolite

Norhydrocodone

Hydrocodone metabolite

Dihydrocodeine

Hydrocodone metabolite

Hydromorphone

Dilaudid, Hydromorph Contin, Jurnista

Hydromorphone detected after use; hydrocodone and morphine metabolite

Positive/ Negative Cut-off 100 ng/mL 100 ng/mL

40 ng/mL 40 ng/mL 20 ng/mL

15 ng/mL

15 ng/mL

100 ng/mL

100 ng/mL 25 ng/mL 25 ng/mL

10 ng/mL 100 ng/mL 100 ng/mL 100 ng/mL 100 ng/mL

Urine Detection Time

1-4 days 1-45 days

2-3 days 1-3 days ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download