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Mayo Test ID AMPHU Amphetamines Confirmation, Random, Urine


Ordering 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.


Useful 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)

Reporting Name

Amphetamines Confirmation, U

Specimen Type

Urine

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

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.

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

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)

Day(s) Performed

Monday through Friday

Report Available

3 to 5 days

Specimen Retention Time

14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

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.

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