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Sorted By Test Name - Mayo Medical Laboratories

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FMETF<br />

91418<br />

MTDNU<br />

83129<br />

3-8 years: 186-980 mcg/g creatinine<br />

9-12 years: 110-582 mcg/g creatinine<br />

13-17 years: 78-412 mcg/g creatinine<br />

18-29 years: 131-467 mcg/g creatinine<br />

30-39 years: 147-523 mcg/g creatinine<br />

40-49 years: 164-585 mcg/g creatinine<br />

50-59 years: 184-655 mcg/g creatinine<br />

60-69 years: 206-733 mcg/g creatinine<br />

> or =70 years: 230-821 mcg/g creatinine<br />

Clinical References: 1. Ito Y, Obara T, Okamoto T, et al: Efficacy of single-voided urine<br />

metanephrine and normetanephrine assay for diagnosing pheochromocytoma. World J Surg<br />

1998;22:684-688 2. Hernandez FC, Sanchez M, Alvarez A, et al: A five-year report on experience in the<br />

detection of pheochromocytoma. Clin Biochem 2000;33:649-655 3. Pacak K, Linehan WM, Eisenhofer<br />

G, et al: Recent advances in genetics, diagnosis, localization, and treatment of pheochromocytoma. Ann<br />

Intern Med 2001;134:315-329 4. Sawka AM, Singh RJ, Young WF Jr: False positive biochemical testing<br />

for pheochromocytoma caused by surreptitious catecholamine addition to urine. Endocrinologist<br />

2001;11:421-423<br />

Metformin, Serum/Plasma<br />

Reference Values:<br />

Reporting limit determined each analysis<br />

Synonym(s): Glucophage<br />

Therapeutic range: Approximately 1-2 mcg/mL. Metformin<br />

associated lactic acidosis generally has been associated<br />

with Metformin plasma concentrations exceeding 5 mcg/mL.<br />

<strong>Test</strong> Performed <strong>By</strong>: NMS Labs<br />

3701 Welsh Road<br />

P.O. Box 433A<br />

Willow Grove, PA 19090-0437<br />

Methadone Confirmation, Urine<br />

Clinical Information: Methadone (Dolophine) is a synthetic opioid, a compound that is structurally<br />

unrelated to the natural opiates but is capable of binding to opioid receptors. These receptor interactions<br />

create many of the same effects seen with natural opiates, including analgesia and sedation. However,<br />

methadone does not produce feelings of euphoria and has substantially fewer withdrawal symptoms than<br />

opiates such as heroin.(1) Methadone is used clinically to relieve pain, to treat opioid abstinence<br />

syndrome, and to treat heroin addiction in the attempt to wean patients from illicit drug use. Metabolism<br />

of methadone to inactive forms is the main form of elimination. Oral delivery of methadone makes it<br />

subject to first-pass metabolism by the liver and creates interindividual variability in its bioavailability,<br />

which ranges from 80% to 95%. The most important enzymes in methadone metabolism are CYP3A4 and<br />

CYP2B6.(1-4) CYP2D6 appears to have a minor role, and CYP1A2 may possibly be involved.(1-5)<br />

Methadone is metabolized to a variety of metabolites, the primary metabolite is<br />

2-ethylidene-1,5-dimethyl1-3,3-diphenylpyrrolidine (EDDP).(1-4) The efficiency of this process is prone<br />

to wide inter- and intraindividual variability, due both to inherent differences in enzymatic activity as well<br />

as enzyme induction or inhibition by numerous drugs. Excretion of methadone and its metabolites<br />

(including EDDP) occurs primarily through the kidneys.(1,4) Patients who are taking methadone for<br />

therapeutic purposes excrete both parent methadone and EDDP in their urine. Clinically, it is important to<br />

measure levels of both methadone and EDDP. Methadone levels in urine vary widely depending on<br />

factors such as dose, metabolism, and urine pH.(5) EDDP levels, in contrast, are relatively unaffected by<br />

the influence of pH and are, therefore, preferable for assessing compliance with therapy.(5) Some patients<br />

Current as of January 4, 2013 7:15 pm CST 800-533-1710 or 507-266-5700 or <strong>Mayo</strong><strong>Medical</strong><strong>Laboratories</strong>.com Page 1193

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