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HelpTest Code SOFT: Z0544 Amphetamines Confirmation, Random, Urine
Additional Codes
| Ordering Mnemonic | Mayo Test ID |
|---|---|
| EPIC NAME: AMPHETAMINES, URINE, CONFIRMATION | AMPHU |
EPIC CODE: LAB20424
Reporting Name
Amphetamines Confirmation, UUseful For
Confirming drug exposure involving amphetamines such as amphetamine and methamphetamine, phentermine, pseudoephedrine/ephedrine, methylenedioxyamphetamine (MDA), and methylenedioxymethamphetamine (MDMA).
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
UrineOrdering Guidance
For situations where chain of custody is required, a Chain of Custody Kit (T282) is available. For chain-of-custody testing, order AMPHX / Amphetamines Confirmation, Chain of Custody, Random, Urine.
Additional drug panels and specific requests are available; call 800-533-1710.
Additional Testing Requirements
If urine creatinine is required or adulteration of the sample is suspected, the following test should also be ordered, ADULT / Adulterants Survey, Urine.
Specimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (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
Additional Information:
1. No specimen substitutions.
2. STAT requests are not accepted for this test.
3. Submitting less than 1 mL will compromise our ability to perform all necessary testing.
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Urine | Refrigerated (preferred) | 28 days | |
| Ambient | 28 days | ||
| Frozen | 28 days |
Reject Due To
| Gross hemolysis | OK |
| Gross icterus | OK |
Reference Values
Negative
Cutoff concentrations by liquid chromatography tandem mass spectrometry:
Amphetamine: <25 ng/mL
Methamphetamine: <25 ng/mL
Phentermine: <25 ng/mL
Methylenedioxyamphetamine: <25 ng/mL
Methylenedioxymethamphetamine: <25 ng/mL
Pseudoephedrine/ephedrine: <25 ng/mL reported as negative
Day(s) Performed
Monday through Friday
CPT Code Information
80325
80359
G0480 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| AMPHU | Amphetamines Confirmation, U | 97161-4 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 2934 | Amphetamine-by LC-MS/MS | 20410-7 |
| 29278 | Phentermine-by LC-MS/MS | 20557-5 |
| 2550 | Methamphetamine-by LC-MS/MS | 16235-4 |
| 29279 | Pseudoephedrine/Ephedrine-by LC-MS/MS | 58707-1 |
| 29280 | MDA (Ecstasy metabolite)-by LC-MS/MS | 20545-0 |
| 29281 | MDMA (Ecstasy)-by LC-MS/MS | 18358-2 |
| 21197 | Amphetamines Interpretation | 69050-3 |
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.Clinical Information
Amphetamines are sympathomimetic amines that stimulate the central nervous system activity and, in part, suppress the appetite. Phentermine, amphetamine, and methamphetamine are prescription drugs for weight loss. All other amphetamines are Class I (distribution prohibited) compounds. In addition to their medical use as anorectic drugs, they are used in the treatment of narcolepsy, attention-deficit disorder/attention-deficit hyperactivity disorder and minimal brain dysfunction.
Because of 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.
Interpretation
The presence of amphetamines in urine is a strong indicator that the patient has used one of these drugs within the past 3 days.
Methamphetamine has a half-life of 9 to 24 hours and is metabolized by hepatic demethylation to amphetamines. Consequently, a sample containing methamphetamine usually also contains amphetamine. Amphetamine has a half-life of 4 to 24 hours.
Amphetamine is not metabolized to methamphetamine; absence of methamphetamine in the presence of amphetamine indicates the primary drug of abuse is amphetamine. However, trace amounts of methamphetamine can be detected in amphetamine-based prescription drugs (eg, Adderall), but the concentrations are typically less than 1% of the amphetamine concentrations.
3,4-Methylenedioxymethamphetamine (Ecstasy, MDMA) is metabolized to 3,4-methylenedioxyamphetamine (MDA).
Methylenedioxyethylamphetamine (MDEA) is also metabolized to MDA.
The detection interval in urine for amphetamine type stimulants is typically to 3 to 5 days after last ingestion.
This test will produce true-positive results for urine specimens collected from patients who are administered Adderall and Benzedrine (contain amphetamine); Desoxyn and Vicks Inhaler (contain methamphetamine); Selegiline, and famprofazone (metabolized to methamphetamine and amphetamine); and clobenzorex, fenproporex, mefenorex, and fenethylline, which are amphetamine pro-drugs and metabolized to amphetamine.
Cautions
Over-the-counter sympathomimetics such as ephedrine and phenylpropanolamine are occasionally detected in the screening immunoassay.
Clinical Reference
1. Baselt RC. Disposition of Toxic Drugs and Chemicals in Man. 10th ed. Biomedical Publications; 2014
2. Langman LJ, Bechtel LK, Holstege CP. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT eds Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 43
Method Description
The urine sample is diluted and then analyzed by liquid chromatography tandem mass spectrometry for the presence of amphetamines.(Unpublished Mayo method)
Report Available
3 to 5 daysSecondary ID
8257Specimen Retention Time
14 daysForms
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.