Determining compliance or identifying illicit stimulant drug use
This test is not intended for employment-related testing.
This test uses high-resolution accurate mass spectrometry to identify 11 different stimulants for situations when immunoassays are not adequate.
Test Id | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
LPPS | List prescribed stimulants | No | Yes |
TSTIM | Targeted Stimulant Screen, U | No | Yes |
Liquid Chromatography-Tandem Mass Spectrometry, High Resolution Accurate Mass (LC-MS/MS HRAM)
Adderall (Amphetamine)
ADHD
Adipex-P (Phentermine)
Adzenys ER (Amphetamine)
Angel Dust (Phencyclidine)
Amphetamines
Concerta (Methylphenidate)
Desoxyn (Methamphetamine)
Dexedrine (Amphetamine)
Dyanavel XR (Amphetamine)
Ecstacy
Killer Weed (Phencyclidine)
Lomaira (Phentermine)
MDA (Methylenedioxyamphetamine)
MDMA (Methylenedioxyamphetamine)
Methamphetamines
Methylenedioxyamphetamine (MDA) Metabolite for Methylenedioxyethylamphetamine (MDEA) and Methylenedioxymetamphetamine (MDMA)
PCP (Phencyclidine)
Qsymia (Phentermine)
Ritalin (Methylphenidate)
Rocket Fuel (Phencyclidine)
Speed (Amphetamines)
Sudafed (Pseudoephedrine)
Super Weed
TCP (Phencyclidine)
Vyvanse (Amphetamine)
Urine
In most cases, no additional testing is needed after the qualitative targeted stimulant test is performed if the parent drug or metabolites found are consistent with the patients prescribed medications. However, if unexpected stimulant is found, confirmatory testing can be requested at an additional charge.
Question ID | Description | Answers |
---|---|---|
LPPS | List prescribed stimulants |
Supplies: Sarstedt 5 mL Aliquot Tube (T914)
Collection Container/Tube: Plastic urine container
Submission Container/Tube: Plastic, 5-mL tube
Specimen Volume: 1 mL
Collection Instructions:
1. Collect a random urine specimen.
2. No preservative
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.
0.5 mL
Gross hemolysis | OK |
Gross icterus | Reject |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Urine | Refrigerated (preferred) | 14 days | |
Frozen | 28 days |
Determining compliance or identifying illicit stimulant drug use
This test is not intended for employment-related testing.
Stimulants are sympathomimetic amines that stimulate the central nervous system activity and, in part, suppress the appetite. Amphetamine and methamphetamine are also prescription drugs used in the treatment of narcolepsy and attention-deficit disorder/attention-deficit hyperactivity disorder (ADHD). Methylphenidate is another stimulant used to treat ADHD. Phentermine is indicated for the management of obesity. All of the other amphetamines (eg, methylenedioxymethamphetamine: MDMA) are Drug and Enforcement Administration (DEA) scheduled Class I compounds. Due to their stimulant effects, the drugs are commonly sold illicitly and abused. Physiological symptoms associated with very high amounts of ingested amphetamine or methamphetamine include elevated blood pressure, dilated pupils, hyperthermia, convulsions, and acute amphetamine psychosis.
Not detected
Cutoff concentrations:
Methamphetamine: 100 ng/mL
Amphetamines: 100 ng/mL
3,4-Methylenedioxymethamphetamine (MDMA): 100 ng/mL
3,4-Methylenedioxy-N-ethylamphetamine (MDEA): 100 ng/mL
3,4-Methylenedioxyamphetamine (MDA): 100 ng/mL
Ephedrine: 100 ng/mL
Pseudoephedrine: 100 ng/mL
Phentermine: 100 ng/mL
Phencyclidine (PCP): 20 ng/mL
Methylphenidate: 20 ng/mL
Ritalinic acid: 100 ng/mL
If a stimulant or its corresponding metabolite is identified (present), it indicates that the patient has used the respective stimulant in the recent past (typically 1-3 days). The absence of the expected stimulant or its metabolites may indicate noncompliance, inappropriate timing of specimen collection relative to drug administration, poor drug absorption, diluted or adulterated urine, or limitations of testing. The concentration of the drug must be greater than or equal to the cutoff to be reported as present. If a specific drug concentration is required, the laboratory must be contacted within 2 weeks of specimen collection/testing to request quantification by a second analytical technique at an additional charge.
No significant cautionary statements
1. Jannetto PJ, Bratanow NC, Clark WA, et al: Executive Summary: American Association of Clinical Chemistry Laboratory Medicine Practice Guideline-using clinical laboratory tests to monitor drug therapy in pain management patients. J Appl Lab Med. 2018 Jan 1;2(4):489-526
2. Langman LJ, Bechtel L, Meier BM, Holstege CP: Clinical toxicology. In: Rifai N, Horwath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:832-887
3. McMillin GA, Marin SJ, Johnson-Davis KL, Lawlor BG, Strathmann FG: A hybrid approach to urine drug testing using high-resolution mass spectrometry and select immunoassays. Am J Clin Pathol. 2015 Feb;143(2):234-240
4. Paterson SM, Moore GA, Florkowski CM, George PM: Determination of methylphenidate and its metabolite ritalinic acid in urine by liquid chromatography/tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci. 2012 Jan 15;881-882:20-26
5. Cone EJ, Caplan YH, Black DL, Robert T, Moser F: Urine drug testing of chronic pain patients: licit and illicit drug patterns. J Anal Toxicol. 2008 Oct;32(8):530-543
6. Cheze M, Deveaux M, Martin C, Lhermitte M, Pepin G: Simultaneous analysis of six amphetamines and analogues in hair, blood and urine by LC-ESI-MS/MS. Application to the determination of MDMA after low ecstasy intake. Forensic Sci Int. 2007 Aug 6;170(2-3):100-104
7. Concheiro M, dos Santos Sadler Simoes SM, Quintela O, et al: Fast LC–MS/MS method for the determination of amphetamine, methamphetamine, MDA, MDMA, MDEA, MBDB and PMA in urine. Forensic Sci Int. 2007 Aug 24;171(1):44-51. doi: 10.1016/j.forsciint.2006.10.004
8. Chronic Pain in America: Roadblocks to Relief, survey conducted for the American Pain Society, The American Academy of the Pain Medicine and Janssen Pharmaceutical; 1999
9. Bost RO: 3,4-Methylenedioxymethamphetamine (MDMA) and other amphetamine derivatives. J Forensic Sci. 1988 Mar;33(2):576-587
The urine sample is diluted with internal standard and clinical laboratory reagent water and then analyzed by liquid chromatography-tandem mass spectrometry using a high resolution-accurate mass orbi-trap detector.(Unpublished Mayo method)
Monday through Saturday
This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.
80326
G0480 (if appropriate)
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
TSPU | Targeted Stimulant Screen, U | 99107-5 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
610273 | Methamphetamine | 19554-5 |
610274 | Amphetamine | 19343-3 |
610275 | 3,4-methylenedioxymethamphetamine (MDMA) | 19568-5 |
610276 | 3,4-methylenedioxy-N-ethylamphetamine (MDEA) | 59844-1 |
610277 | 3,4-methylenedioxyamphetamine (MDA) | 19565-1 |
610278 | Ephedrine | 99108-3 |
610279 | Pseudoephedrine | 99109-1 |
610280 | Phentermine | 19674-1 |
610281 | Phencyclidine (PCP) | 19659-2 |
610282 | Methylphenidate | 19577-6 |
610283 | Ritalinic acid | 99110-9 |
610284 | Stimulant Interpretation | 54247-2 |
LPPS | List prescribed stimulants | 29305-0 |