Mayo Test Catalog, (Sorted By Test Name) - Mayo Medical ...

DAUCO
505230
DMETH
505343
triazolam, 7-aminoclonazepam as the metabolite of clonazepam, and 7-amino-flunitrazepam as the
metabolite of flunitrazepam (Rohypnol).
Reference Values:
Negative
EMIT cutoff concentration: 200 ng/mL
Positives are reported with a quantitative GC/MS result.
This report is intended for clinical monitoring and management of patients. It is not intended for use in
employment-related drug testing.
Clinical References: 1. Porter WF, Moyer TP: Clinical toxicology. In Tietz Textbook of Clinical
Chemistry. Second Edition. Edited by CA Burtis, ER Ashwood. Philadelphia, WB Saunders Company,
1994, pp 1155-1235 2. Baselt RC, Cravey RH: Disposition of Toxic Drugs and Chemicals In Man. Third
edition. Chicago, IL, Year Book Medical Publishers, 1989
Drug of Abuse, Cocaine Screen with GC-MS Confirmation, Urine
Clinical Information: Cocaine, a central nervous system stimulant, is a drug of current health
concern because of its proliferation among recreational drug abusers. Cocaine can be taken in a variety of
ways. It can be inhaled, injected intravenously, or the base can be smoked (crack). Freebase and crack
increase the potential for major toxicity. Increasingly, laboratory results are disputed or there are
medical/legal overtones. Therefore, physicians are finding an increased need to confirm positive results
before informing or confronting the patients. Cocaine is almost completely metabolized by the liver, with
only about 1% being excreted unchanged. The rate of excretion depends on the individual and the mode
of administration. Benzoylecgonine is the major metabolite, but some is excreted as ecgonine methyl ester
and ecgonine. Benzoylecgonine can be detected in urine within 4 hours following inhalation and can
remain detectable for as long as 48 hours.
Useful For: Detecting drug abuse involving cocaine
Interpretation: The presence of cocaine, or its major metabolite, benzoylecgonine indicates use within
the past 4 days. Cocaine has a 6-hour half-life, so it will be present in urine for 1 day after last use.
Benzoylecgonine has a half-life of 12 hours, so it will be detected in urine up to 4 days after last use.
Reference Values:
Negative
EMIT cutoff concentration: 150 ng/mL
Positives are reported with a quantitative GC-MS result.
Clinical References: Baselt RC, Cravey RH: Disposition of Toxic Drugs and Chemicals in Man.
Third edition. Chicago, Year Book Medical Publishers, 1989
Drug of Abuse, Methadone Screen with GC-MS Confirmation,
Urine
Clinical Information: Methadone (Dolophine) is a synthetic narcotic with analgesic and
pharmacological properties similar to morphine. It can be administered orally and provides analgesia for
approximately 24 hours. The I-racemate of the drug is active, while the d-racemate has little activity.
Methadone has properties that make it useful for treating heroin addiction. Sedation ensues with higher
doses, which is an undesirable side effect. Administered in small doses of 5 to 20 mg, the drug occupies
the opioid receptor for prolonged periods of time, blocking the action of morphine, precluding the
euphoric effect that heroin addicts seek. Addicts who self-administer heroin while taking methadone
doses do not experience euphoria, only sedation, miosis, respiratory depression, hypotension, and
dry-mouth. Tolerant patients may require doses up to 200 mg per day. Methadone is metabolized by
demethylation (cytochrome P [450] 2D6 [CyP 2D6]) to 2-ethylidene-1, 5-dimethyl-3,
3diphenylpyrrolidine (EDDP) and to 2-ethyl-5-methyl-3, 3-diphenylpyrrolidine (EMDP). Individuals with
genetic deficiencies of CyP 2D6 or coadministered amiodarone, paroxetine protease inhibitor
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