Drug Profile, Expanded Targeted Panels

Drug Profile, Expanded Targeted Panel by LC-MS/MS, Serum/Plasma 3004833

Method: Qualitative Liquid Chromatography-Tandem Mass Spectrometry

Drug Profile, Expanded Targeted Panel by LC-MS/MS, Urine 3005060

Method: Qualitative Liquid Chromatography-Tandem Mass Spectrometry

Use to detect drug exposure from among a targeted list of prescriptions, over-the-counter medications, and illicit drugs. Assays are for medical purposes only—not for forensic testing. Not recommended to determine medication compliance or to assess for undisclosed drug/substance use in the context of pain management, substance use disorder treatment, or any other pharmacotherapies involving controlled substances.

In 2020, more than 59 million people in the United States used illicit drugs.  Furthermore, according to recent preliminary data from the Drug Abuse Warning Network (DAWN), opioids, methamphetamine, cannabis, and cocaine were among the top substances involved in emergency room visits.  Other substances, such as prescription medications, are also common factors in the need for emergency medical care. For situations in which the identity or class of one or more drugs is unknown, multidrug analysis may be useful.

Test Interpretation

Sensitivity/Specificity

  • Analytic sensitivity: dependent on the cutoff concentrations for applicable analytes (127 analytes included). The concentration at which a drug or metabolite can be detected varies within a drug class. See below for a complete list of analytes and cutoff concentrations.
  • Specificity: high; mass spectrometric methodology.
Drug Class/Drug/Drug Metabolite Drug Profile, Expanded Targeted Panels Cutoff Concentrations (ng/mL)
Anticoagulants

Apixaban

25

Rivaroxaban

25

Warfarin

100

Anticonvulsants

Brivaracetam

100

Carbamazepine

100

   Carbamazepine-10,11-epoxidea

100

Felbamate

100

Gabapentin

100

Lacosamide

100

Lamotrigine

100

Levetiracetam

100

Oxcarbazepine

   10-hydroxycarbazepinea

100

Pregabalin

100

Primidone

100

Rufinamide

100

Tiagabine

5

Topiramate

100

Zonisamide

100

Antidepressants

Amitriptyline

50

   Nortriptylineab

50

Bupropion

5

   Hydroxybupropiona

5

Citalopram

5

   N-desmethylcitaloprama

5

Clomipramine

50

Desipramine

50

Doxepin

50

   Desmethyldoxepina

50

Duloxetine

50

Fluoxetine

10

   Norfluoxetinea

50

Imipramine

50

   N-desmethyltrimipraminea

50

Mirtazapine

5

Paroxetine

10

Protriptyline

50

Sertraline

20

Trimipramine

50

Venlafaxine

10

   O-desmethylvenlafaxinea

10

Antidiabetics

Glimepiride

50

Glipizide

50

Glyburide

50

Antihistamines

Chlorpheniramine

100

Diphenhydramine

20

Doxylamine

50

Hydroxyzine

5

Pheniramine

5

Antipsychotics

Aripiprazole

50

Clozapine

10

   N-desmethylclozapinea

10

Haloperidol

5

Loxapine

5

Quetiapine

5

Risperidone

5

   9-hydroxyrisperidonea

5

Trazodone

50

Ziprasidone

5

Benzodiazepines

Alprazolam

5

   Alpha-hydroxyalprazolama

20

Chlordiazepoxide

20

Clobazam

20

Clonazepam

5

    7-aminoclonazepama

5

Diazepam

20

   Nordiazepamab

20

   Oxazepamab

20

   Temazepamab

10

Lorazepam

20

Midazolam

5

   Alpha-hydroxymidazolama

20

Zolpidem

5

Cardiac Medications

Atenolol

20

Atropine

5

Diltiazem

10

Disopyramide

100

Flecainide

50

Lidocaine

100

Metoprolol

5

Mexiletine

50

Propafenone

50

Propranolol

10

Sotalol

50

Verapamil

10

   Norverapamila

10

Cough Suppressants

Dextromethorphan

5

Muscle Relaxants

Baclofen

20

Carisoprodol

100

Cyclobenzaprine

5

Meprobamate

100

Nicotine

Cotinine

5

NSAIDs

Acetaminophen

100

Opioids

Buprenorphine

5

   Norbuprenorphinea

5

Codeine

5

Dihydrocodeine

5

Fentanyl

2

   Norfentanyla

5

Heroin

   6-acetylmorphinea

5

Hydrocodone

5

   Hydromorphoneab

5

Meperidine

10

   Normeperidinea

10

Methadone

10

   EDDPa

10

Morphine

5

Naloxone

10

Oxycodone

5

   Oxymorphoneab

5

Tapentadol

5

   N-desmethyltapentadola

5

Tramadol

10

   O-desmethyl-cis-tramadola

100

Sedative-Hypnotics

Ketamine

20

   Norketaminea

20

Stimulants

Amphetamine

10

Cocaine

10

   Benzoylecgoninea

20

   Cocaethylenea

10

Ephedrine

10

Methamphetamine

10

Methylenedioxymethamphetamine (MDMA)

10

Methylphenidate

5

   Ritalinic acida

5

Phencyclidine (PCP)

5

Phentermine

10

Pseudoephedrine

5

aSubstance is a metabolite of the preceding parent drug.

bSubstance can be administered as a prescription drug.

Results

Result Clinical Significance

Detected

One or more drug analytes were detected in the sample

Not detected

No drug analytes were detected

Result does not exclude the possibility of drug use or exposure

Limitations

  • Minimum reporting limits and estimated concentrations are established for each compound, but quantitative results are not reported.
  • Drug concentrations must be greater than or equal to the cutoff to be reported as positive.
  • Drug detection depends on specimen quality and the timing of specimen collection relative to drug exposure.

References