iowa methodist medical center drug screening. tests available drug screen, limited, urine drug...
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Iowa Methodist Medical Center
Drug Screening
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Tests available Drug Screen, Limited, Urine
Drug Screen, Urine,
Monitoring
Sympathomimetic Amines (Amphetamine/ Methamphetamine)
X X
Ecstasy (MDMA,MDA,MDEA) X X
Barbiturates X X
Benzodiazepines X X
Cocaine X X
Opiates X X
Oxycodone (OxyContin, Percocet) X X
6-AM (Heroin) X X
PCP X X
Marijuana X X
Methadone X X
Propoxyphene X
Other Fentanyl, Buprenorphine and Tramadol sent to MedTox
IMMC Drug Screening
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Screening cut offs
Screening cut off (ng/mL)Sympathomimetic Amines (Amphetamine/
Methamphetamine)300
Ecstasy (MDMA,MDA,MDEA) 500Barbiturates 200
Benzodiazepines 200Cocaine 150Opiates 300
Oxycodone (OxyContin, Percocet) 300
6-AM (Heroin) 10PCP 25
Marijuana 20Methadone 300
Propoxyphene 300
IMMC Drug Screening
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Confirmation Testing Confirmation testing
performed automatically at IMMC
Confirmation testing available upon request (Sent to MedTox
Laboratory)
Sympathomimetic Amines (Amphetamine/ Methamphetamine)
X
Ecstasy (MDMA,MDA,MDEA) X
Barbiturates X Benzodiazepines X
Cocaine X Opiates X
Oxycodone (OxyContin, Percocet) X
6-AM (Heroin) XPCP X
Marijuana X Methadone X
Propoxyphene X
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Drug Screen, Prescription/OTC, Urine
• Performed at MedTox Laboratory• Detection and identification of prescription
or over the counter drugs frequently found in drug overdose or used with a suicidal intent. This test is designed to qualitatively identify drugs present in the specimen
IMMC Drug Screening
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Other individually orderable tests of
interest
• Methylphenidate (Ritalin®), • Adderall • Almost any Benzo you can think of…
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Possible causes for false positive and negative results
Screening Assay Commonly Detects False Negatives False Positives
Sympathomimetic Amines
(Amphetamine/ Methamphetamine)
Amphetamine, Methamphetamine
PseudoephedrinePhentermineEphedrinel-Amphetaminel-Methamphetamine
Ranitidine
Ecstasy MDMA,MDA,MDEA N/A DiphenhydramineBuproprionTrazodone
Barbiturates AmobarbitalButalbitalPentobarbitalPhenobarbitalSecobarbital
BarbitalHexobarbital MephobarbitalMetharbital
N/A
Benzodiazepines DiazepamNordiazepamOxazepamTemazepam
AlprazolamClonazepamLorazepam
Oxaprozin
IMMC Drug Screening
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Possible causes for false positive and negative results
IMMC Drug Screening
Screening Assay Commonly Detects
False Negatives False Positives
Cocaine Benzoylecgonine CocaineEcgonine Methyl EsterCocaethyleneEcgonine
N/A
Opiates MorphineCodeineHydrocodoneHydromorphone
OxycodoneOxymorphone
LevofloxacinOfloxacinOxycodone
Oxycodone OxymorphoneNoroxycodoneOxycodone
N/A N/A
6-Acetylmorphine 6AM N/A Morphine Codeine Methadone
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Possible causes for false positive and negative results
IMMC Drug Screening
Screening Assay Commonly Detects
False Negatives
False Positives
PCP PCP N/A DextromethorphanMarijuana Delta 9
Carboxy THCN/A Marinol
Niflumic AcidMethadone EDDP Methadone
EDMPN/A
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DRI® Opiate Cross-Reactivity Tables
IMMC Drug Screening
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• And many, many more
IMMC Drug Screening
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DRI® Benzodiazepine Cross-Reactivity Tables
IMMC Drug Screening
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What does a “positive” urine drug test result on an immunoassay actually mean?
• the patient was compliant and took the prescribed drug as directed.
• the patient was only partially compliant and just took 1 dose prior to collection.
• the patient could have directly spiked/added the drug into the urine sample after collection.
• the patient took another medication that cross-reacted with the immunoassay causing a false-positive result.
False-positive results are one of the limitations of using an immunoassay.
IMMC Drug Screening
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What does a “negative” urine drug test result on an immunoassay really mean?
• the patient is not compliant with their prescribed medication• the patient was partially compliant and maybe missed a few doses,
or took less medication. • the patient is well hydrated and the urine is dilute or possibly
adulterated. • the wrong test might have been ordered and the test may not cross-
react with the patient’s medications. • the drug may actually be present, but it is below the cutoff or
detection limit of the assay leading to a false-negative result.
False-negative results can happen as easily as a false-positive result with immunoassays. Therefore, it is important to look at the assay cutoff or detection limit when interpreting test results.
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Other information of value
• timing between when the patient last took their medication and when the urine sample was collected.
• Specimen validity testing can also be used to help determine the integrity and quality of the patient’s sample.
IMMC Drug Screening