Clinical Urine Drug Screen with Reflex to Confirmation by LCMSMS

*Metabolite(s)

ⁱMethamphetamine 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.

ⁱⁱ The drug analyte detected in this assay, 9-carboxy THC, is a metabolite of delta-9-tetrahydrahydrocannabinol (THC). Detection of 9-carboxy THC suggests use of, or exposure to, a product containing THC. This test cannot distinguish between prescribed or non-prescribed forms of THC, nor can it distinguish between active or passive use. The 9-carboxy THC metabolite can be detected in urine for several weeks. Normalization of results to creatinine concentration can help document elimination or suggest recent use, when specimens are collected at least one week apart. 11-Nor-9-carboxy-Δ⁹-THC glucuronide is a major urinary metabolite of Δ⁹-THC and is not tested.

INTERPRETIVE DATA: Unanticipated negative findings may be the result of non-compliance, timing of specimen collection relative to drug exposure, inter-individual 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 and drug metabolites are detected by the screen are reflexed to a second more specific confirmatory quantitative procedure by LCMSMS (Liquid Chromatography Tandem Mass Spectrometry). Additional charges may apply.

Interpretive questions should be directed to the laboratory.

ANALYTIC SENSITIVITY:  >99%

TEST LIMITATIONS: Urine creatinine results less than 20 mg/dL may indicate adulterated/ diluted urine. Recollection of urine specimen may be requested and preferably from an early morning clean catch specimen.

INDICATIONS FOR USE: Results are intended to provide physicians/ clients of Saint Francis Health System with clinical interpretation of the results obtained from analysis of a urine specimen for the presence and/or absence of 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: http://www.aruplab.com/pain-management

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ⁱ Methamphetamine Footnote
ⁱⁱ THC-COOH Footnote