Confirming drug exposure involving amphetamines such as amphetamine and methamphetamine, phentermine, pseudoephedrine/ephedrine, methylenedioxyamphetamine (MDA), and methylenedioxymethamphetamine (MDMA).
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Amphetamines
Ecstasy
MDA (Methylenedioxyamphetamine)
MDMA (Methylenedioxymethamphetamine)
Methamphetamines (Desoxyn)
Methylenedioxyamphetamine (MDA) Metabolite for Methylenedioxyethylamphetamine (MDEA) and Methylenedioxymetamphetamine (MDMA)
Speed (Amphetamines)
Urine
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.
If urine creatinine is required or adulteration of the sample is suspected, the following test should also be ordered, ADULT / Adulterants Survey, Urine.
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.
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.
0.5 mL
Gross hemolysis | OK |
Gross icterus | OK |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Urine | Refrigerated (preferred) | 28 days | |
Ambient | 28 days | ||
Frozen | 28 days |
Confirming drug exposure involving amphetamines such as amphetamine and methamphetamine, phentermine, pseudoephedrine/ephedrine, methylenedioxyamphetamine (MDA), and methylenedioxymethamphetamine (MDMA).
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.
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
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.
Over-the-counter sympathomimetics such as ephedrine and
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
The urine sample is diluted and then analyzed by liquid chromatography tandem mass spectrometry for the presence of amphetamines.(Unpublished Mayo method)
Monday through Friday
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.
80325
80359
G0480 (if appropriate)
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
AMPHU | Amphetamines Confirmation, U | 97161-4 |
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.
|
---|---|---|
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 |