Test Catalog

Test Id : TSPU

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Targeted Stimulant Screen, Random, Urine

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Determining compliance or identifying illicit stimulant drug use

 

This test is not intended for employment-related testing.

Highlights

This test uses high-resolution accurate mass spectrometry to identify 11 different stimulants for situations when immunoassays are not adequate.

Profile Information
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.

Test Id Reporting Name Available Separately Always Performed
LPPS List prescribed stimulants No Yes
TSTIM Targeted Stimulant Screen, U No Yes

Method Name
A short description of the method used to perform the test

Liquid Chromatography-Tandem Mass Spectrometry, High Resolution Accurate Mass (LC-MS/MS HRAM)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Targeted Stimulant Screen, U

Aliases
Lists additional common names for a test, as an aid in searching

Adderall (Amphetamine)

ADHD

Adipex-P (Phentermine)

Adzenys ER (Amphetamine)

Angel Dust (Phencyclidine)

Amphetamines

Concerta (Methylphenidate)

Desoxyn (Methamphetamine)

Dexedrine (Amphetamine)

Dyanavel XR (Amphetamine)

Ecstacy

Killer Weed (Phencyclidine)

Lomaira (Phentermine)

MDA (Methylenedioxyamphetamine)

MDMA (Methylenedioxyamphetamine)

Methamphetamines

Methylenedioxyamphetamine (MDA) Metabolite for Methylenedioxyethylamphetamine (MDEA) and Methylenedioxymetamphetamine (MDMA)

PCP (Phencyclidine)

Qsymia (Phentermine)

Ritalin (Methylphenidate)

Rocket Fuel (Phencyclidine)

Speed (Amphetamines)

Sudafed (Pseudoephedrine)

Super Weed

TCP (Phencyclidine)

Vyvanse (Amphetamine)

Specimen Type
Describes the specimen type validated for testing

Urine

Additional Testing Requirements

In most cases, no additional testing is needed after the qualitative targeted stimulant test is performed if the parent drug or metabolites found are consistent with the patients prescribed medications. However, if unexpected stimulant is found, confirmatory testing can be requested at an additional charge.

ORDER QUESTIONS AND ANSWERS

Question ID Description Answers
LPPS List prescribed stimulants

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Supplies: Sarstedt 5 mL Aliquot Tube (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

Forms

If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

0.5 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis OK
Gross icterus Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 14 days
Frozen 28 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

Determining compliance or identifying illicit stimulant drug use

 

This test is not intended for employment-related testing.

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Stimulants are sympathomimetic amines that stimulate the central nervous system activity and, in part, suppress the appetite. Amphetamine and methamphetamine are also prescription drugs used in the treatment of narcolepsy and attention-deficit disorder/attention-deficit hyperactivity disorder (ADHD). Methylphenidate is another stimulant used to treat ADHD. Phentermine is indicated for the management of obesity. All of the other amphetamines (eg, methylenedioxymethamphetamine: MDMA) are Drug and Enforcement Administration (DEA) scheduled Class I compounds. Due to 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
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Not detected

 

Cutoff concentrations:

Methamphetamine: 100 ng/mL

Amphetamines: 100 ng/mL

3,4-Methylenedioxymethamphetamine (MDMA): 100 ng/mL

3,4-Methylenedioxy-N-ethylamphetamine (MDEA): 100 ng/mL

3,4-Methylenedioxyamphetamine (MDA): 100 ng/mL

Ephedrine: 100 ng/mL

Pseudoephedrine: 100 ng/mL

Phentermine: 100 ng/mL

Phencyclidine (PCP): 20 ng/mL

Methylphenidate: 20 ng/mL

Ritalinic acid: 100 ng/mL

Interpretation
Provides information to assist in interpretation of the test results

If a stimulant or its corresponding metabolite is identified (present), it indicates that the patient has used the respective stimulant in the recent past (typically 1-3 days). The absence of the expected stimulant or its metabolites may indicate noncompliance, inappropriate timing of specimen collection relative to drug administration, poor drug absorption, diluted or adulterated urine, or limitations of testing. The concentration of the drug must be greater than or equal to the cutoff to be reported as present. If a specific drug concentration is required, the laboratory must be contacted within 2 weeks of specimen collection/testing to request quantification by a second analytical technique at an additional charge.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

No significant cautionary statements

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Jannetto PJ, Bratanow NC, Clark WA, et al: Executive Summary: American Association of Clinical Chemistry Laboratory Medicine Practice Guideline-using clinical laboratory tests to monitor drug therapy in pain management patients. J Appl Lab Med. 2018 Jan 1;2(4):489-526

2. Langman LJ, Bechtel L, Meier BM, Holstege CP: Clinical toxicology. In: Rifai N, Horwath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:832-887

3. McMillin GA, Marin SJ, Johnson-Davis KL, Lawlor BG, Strathmann FG: A hybrid approach to urine drug testing using high-resolution mass spectrometry and select immunoassays. Am J Clin Pathol. 2015 Feb;143(2):234-240

4. Paterson SM, Moore GA, Florkowski CM, George PM: Determination of methylphenidate and its metabolite ritalinic acid in urine by liquid chromatography/tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci. 2012 Jan 15;881-882:20-26

5. Cone EJ, Caplan YH, Black DL, Robert T, Moser F: Urine drug testing of chronic pain patients: licit and illicit drug patterns. J Anal Toxicol. 2008 Oct;32(8):530-543

6. Cheze M, Deveaux M, Martin C, Lhermitte M, Pepin G: Simultaneous analysis of six amphetamines and analogues in hair, blood and urine by LC-ESI-MS/MS. Application to the determination of MDMA after low ecstasy intake. Forensic Sci Int. 2007 Aug 6;170(2-3):100-104

7. Concheiro M, dos Santos Sadler Simoes SM, Quintela O, et al: Fast LC–MS/MS method for the determination of amphetamine, methamphetamine, MDA, MDMA, MDEA, MBDB and PMA in urine. Forensic Sci Int. 2007 Aug 24;171(1):44-51. doi: 10.1016/j.forsciint.2006.10.004

8. Chronic Pain in America: Roadblocks to Relief, survey conducted for the American Pain Society, The American Academy of the Pain Medicine and Janssen Pharmaceutical; 1999

9. Bost RO: 3,4-Methylenedioxymethamphetamine (MDMA) and other amphetamine derivatives. J Forensic Sci. 1988 Mar;33(2):576-587

Method Description
Describes how the test is performed and provides a method-specific reference

The urine sample is diluted with internal standard and clinical laboratory reagent water and then analyzed by liquid chromatography-tandem mass spectrometry using a high resolution-accurate mass orbi-trap detector.(Unpublished Mayo method)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Saturday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

3 to 4 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

80326

G0480 (if appropriate)

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
TSPU Targeted Stimulant Screen, U 99107-5
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.
610273 Methamphetamine 19554-5
610274 Amphetamine 19343-3
610275 3,4-methylenedioxymethamphetamine (MDMA) 19568-5
610276 3,4-methylenedioxy-N-ethylamphetamine (MDEA) 59844-1
610277 3,4-methylenedioxyamphetamine (MDA) 19565-1
610278 Ephedrine 99108-3
610279 Pseudoephedrine 99109-1
610280 Phentermine 19674-1
610281 Phencyclidine (PCP) 19659-2
610282 Methylphenidate 19577-6
610283 Ritalinic acid 99110-9
610284 Stimulant Interpretation 54247-2
LPPS List prescribed stimulants 29305-0

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | PHP Pdf | CMS Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports