Clinical Urine Drug Screen with Reflex to Confirmation by LCMSMS

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CLINICAL URINE DRUG SCREEN WITH REFLEX TO CONFIRMATION BY LCMSMS

SAMPLE REPORTS: 
 
Clinical UDS with Reflex to Confirmation a
 
TURNAROUND TIME:   2 - 3 days
 
PERFORMED :  Monday through Friday  
 
TESTING METHODOLOGY:
High Performance Liquid Chromatography Triple Quadrupole Mass Spectrometer (LC/MSMS).
 
SPECIMEN REQUIREMENTS:
  • Collect: 20 mLs random urine collected in sterile cup.  Transfer 10 mL into two vaccuette urine containers with no additives or preservatives.
  • Min. Collection: Two vaccuette urine containers with 2.0 mL each.
  • Transport:  Room Temperature; Store refrigerated if analysis is not performed immediately.
  • Stability: Ambient:  5 days; Refrigerated: 2 weeks; Frozen: 2 months.
  • Unacceptable Conditions:  Specimen exposed to repeated freeze/thaw cycles or transferred into a tube or cup containing additives or preservatives.
REFERENCE INTERVAL:
For a complete list of prescription drugs detected refer to the Clinical Drug Monitoring Information Guide link to Analyte Medication List.
 
Analyte / Metabolite Positive Cutoffs for Screen and Confirmation Testing:
Barbiturates
ng/ mL
Amobarbital/ Pentobarbital
50
Butalbital
50
Phenobarbital
50
Secobarbital
50
Benzodiazepines
ng/ mL
Alprazolam
25
a-OH-Alprazolam
25
Clonazepam
25
7-amino-Clonazepam
25
Diazepam
25
Nordiazepam
25
Flunitrazepam
25
7-amino-Flunitrazepam
25
Flurazepam
25
Des-alkyl-Flurazepam
25
Lorazepam
25
Lorazepam Glucuronide
25
Midazolam
25
Oxazepam
25
Oxazepam Glucuronide
25
Temazepam
25
Triazolam
25
a-OH-Triazolam
25
Opiates/ Opioid Agonists
ng/ mL
Codeine
25
Fentanyl
10
Norfentanyl
25
Diacetylmorphine (6-MAM)
(Heroin Metabolite)
25
Hydrocodone
25
Hydromorphone
25
Meperidine
25
Normeperidine
25
Methadone
25
EDDP (Methadone Metabolite)
25
Morphine
25
M-3-G
25
M-6-G
25
Oxycodone
25
Oxymorphone
25
Tapentadol
25
N-desmethyltapentadol
25
Tramadol
25
Opioid Partial Agonist
ng/ mL
Buprenorphine
2
Norbuprenorphine
2
Opioid Antagonists
ng/ mL
Naltrexone
25
Naloxone
25
Stimulants
ng/ mL
Pseudoephedrine
50
Methamphetamine
50
Amphetamine
50
Methylphenidate
50
Ritalinic Acid
50
Phentermine
50
Other
ng/ mL
Methylenedioxyethamphetamine
(MDEA) (Ecstacy-Like)
50
Methylenedioxyamphetamine
(MDA) (Ecstasy-Like)
50
Methylenedioxymethamphetamine
(MDMA) (Ecstasy)
50
Ketamine
50
Diphenhydramine
50
Carisoprodol
25
Meprobamate
25
Phenylcyclidine (PCP)
25
Lysergic Acid Diethylamide (LSD)
0.5
2-Oxo-3-OH-LSD
25
Cannabinoid
ng/ mL
THC-COOH
20
Cocaine
ng/ mL
Benzoylecgonine (BE)
50
 
INTERPRETATIVE DATA:
 
Unanticipated negative findings may be the result of noncompliance, timing of specimen collection relative to drug exposure, interindividual variations in pharmacokinetics, testing limitations, and or diluted or adulterated urine.
 
Drug metabolism or exposure to multiple drugs can lead to detection of multiple analytes in urine.  Pharmaceutical manufacturing impurities can result in low concentrations of an anticipated analyte in the presence of large concentrations of another related analyte.
 
Specimens for which drugs or drug metabolites are detected by the screen are reflexed to a second specific confirmatory quantitative procedure by LCMSMS (Liquid Chromatography Tandem Mass Spectrometry).  Additional charges will apply.
 
Interpretive questions should be directed to the laboratory.
 
For the most accurate interpretation of the results, a Clinical Urine Drug Screen with Reflex to Confirmation Test Requisition form should be submitted with the specimen.
 
ANALYTIC SENSITIVITY: >99%
 
TEST LIMITATIONS:
Urine creatinine results less than 20mg/dL may indicate adulterated/diluted urine.  Recollection of urine specimen may be requested and preferably from an early morning clean catch collection.
 
Methamphetamine exists in the d- and l- isomeric forms.  Illegal, street-manufactured methamphetamine is the d-isomer, or a racemic mixture of the d and l, with the d- isomer being present at 20-100%.  The d- isomer also comes from the prescription drugs Desoxyn and Didrex.  L-methamphetamine occurs in the Vick’s inhaler, and as a metabolite of the Parkinson’s drug Eldepryl.  This test does not distinguish between d- and l- isomers.  If isomer separation is desired, contact the laboratory. 
 
INDICATIONS FOR USE:
Results are intended to provide the physicians/ clients of Saint Francis Health System with clinical interpretation of the results obtained from the analysis of a urine specimen for the presence and/ or absence of prescribed drugs and their metabolites.  This test is not intended to be used as a pre-employment screening assay or for legal forensic purposes.
 
 
ADDITIONAL RESOURCES: