This is a test panel comprising of 15 different tests. Please see individual tests for more information on individual test methodology.

ETG (Alcohol)

Ethyl Glucuronide (ETG) is a direct metabolite of ethanol, formed by enzymatic conjugation of ethanol with glucuronic acid. Alcohol in urine is usually detected for only a few hours, whereas ETG can be detected up to several days after complete elimination of alcohol from the body. The DRI ETG screen in an enzyme immunoassay.

The assay uses specific antibodies that can detect Ethyl Glucuronide without any significant cross-reactivity to other glucuronide compounds. The assay is based on competition between a drug labeled with glucose-6-phosphate dehydrogenase (G6PDH), and a free drug from the urine sample for a fixed amount of specific antibody binding sites. In the absence of free drug from the sample, the specific antibody binds the drug labeled with G6PDH and causes a decrease in enzyme activity. This phenomenon creates a direct relationship between the drug concentration in urine and enzyme activity. Active enzymes convert NAD to NADH resulting in an absorbance change that can be measured spectrophotometrically at 340 nm.

Amphetamine

Amphetamines are synthetic derivatives of ephedrine. The most common amphetamines include d-amphetamine, d-methamphetamine, and d,l-amphetamine. They act as stimulants for the central nervous system. When amphetamine is ingested, it is either rapidly deactivated in the liver or excreted unchanged into the urine. Other ephedrine derivatives such as methamphetamine can be metabolized and excreted in urine as amphetamine. The screening assay uses specific antibodies, which can detect amphetamine and/or methamphetamine in urine with minimal cross-reactivity to various over the counter structurally unrelated compounds. The assay is based on the competition of an enzyme glucose-6-phosphate dehydrogenase (G6PDH) labeled drug and the drug from the urine sample for a fixed amount of specific antibody binding sites. In the absence of free drug from the sample, the specific antibody binds the drug labeled with G6PDH and causes a decrease in enzyme activity. In the presence of free drug, the free drug occupies the antibody binding sites, allowing the drug labeled G6PDH to interact with the substrate, resulting in enzyme activity. This phenomenon creates a direct relationship between drug concentration in urine and enzyme activity. The enzyme activity is determined spectrophotometrically at 340 nm by measuring its ability to convert nicotinamide adenine dinucleotide (NAD) to NADH.

Barbiturates

Drug abusers may abuse various barbiturates, such as short-acting secobarbital and long-acting phenobarbital, through oral ingestion or by intravenous and/or intramuscular injection. Long-term abuse can lead to respiratory depression or, in severe cases, coma. When ingested, a barbiturate is rapidly metabolized and excreted into urine, allowing immunoassays to detect recent use. The barbiturate screening assay uses monoclonal antibodies that detect most barbiturates in urine. The assay is based on the competition of an enzyme glucose-6-phosphate dehydrogenase (G6PDH) labeled drug and the drug from the urine sample for a fixed amount of specific antibody binding sites. In the absence of drug from the sample, the G6PDH labeled drug is bound by the specific antibody and the enzyme activity is inhibited. This phenomenon creates a relationship between drug concentration in urine and enzyme activity. The enzyme G6PDH activity is determined spectrophotometrically at 340 nm.

Benzodiazepine

Benzodiazepines are sedative-hypnotic drugs, which are subject to abuse. Benzodiazepines are structurally similar and include a wide variety of drugs such as alprazolam, chlordiazepoxide, diazepam, lorazepam, oxazepam and triazolam. They are absorbed and metabolized at different rates, resulting in various psychoactive effects. Therefore, the detection of benzodiazepines or their metabolites in urine can be used as an indicator of benzodiazepine abuse. The benzodiazepine screening assay uses a specific antibody which can detect most benzodiazepines and their metabolites in urine. The assay is based on the competition of an enzyme glucose6-phosphate dehydrogenase (G6PDH) labeled drug and the drug from the urine sample for a fixed amount of specific antibody binding sites. In the absence of free drug from the sample, the enzyme-labeled drug is bound by the specific antibody and the enzyme activity is inhibited. This phenomenon creates a relationship between drug concentration in urine and enzyme activity. The enzyme G6PDH activity is determined spectrophotometrically at 340 nm by measuring its ability to convert nicotinamide adenine dinucleotide (NAD) to NADH.

Cotinine (Nicotine)

Tobacco smoking or passive inhalation of tobacco smoke results in the absorption of nicotine through the lungs and mucus membranes of the mouth. When nicotine is absorbed, it is readily metabolized into cotinine as its major metabolite. Cotinine is detectable in the urine of smokers even several days after the termination of smoking. Several methods, including the measurement of thiocyanate, carbon monoxide and cotinine, can be used to determine an individual’s smoking status. Measurement of either carbon monoxide or thiocyanate can give a false indication of tobacco use, as they may come from other environmental sources. Cotinine, on the other hand, can only be derived from the metabolism of nicotine, and is therefore the best indicator of smoking status. The cotinine screening assay is based on competition between cotinine labeled with glucose-6-phosphate dehydrogenase (G6PDH) enzyme and free cotinine in the sample for a fixed amount of cotinine-specific antibody binding sites. The enzyme G6PDH activity is determined spectrophotometrically at 340 nm.

Cocaine

Cocaine (benzoylmethylecgonine) is derived from the plant species Erythroxylon coca, which is widely grown in South America. Cocaine is a very common illicit drug and is popularly abused in the US. Cocaine abuse can produce euphoria, arousal, garrulousness, alertness, anxiety, insomnia, hyperactivity, paranoia, severe psychosis, and even suicide. Cocaine is rapidly metabolized, with less than 5% excreted unchanged in the urine. The two major metabolites, which result from enzymatic and nonenzymatic hydrolysis, are benzoylecgonine and ecgonine methyl ester. The metabolites may be detectable in urine for up to 3 weeks after long term, heavy use of cocaine. The cocaine screening assay uses a specific antibody, which can detect benzoylecgonine in urine. The assay is based on the competition of an enzyme glucose-6-phosphate dehydrogenase (G6PDH) labeled drug and the drug from the urine sample for a fixed amount of specific antibody binding sites. In the presence of free drug from the sample, the free drug occupies the antibody binding sites, allowing the drug labeled G6PDH to interact with the substrate, resulting in enzyme activity. In the absence of drug from the sample, the specific antibody binds to the drug labeled with G6PDH and the enzyme activity is inhibited. This phenomenon creates a direct relationship between the drug concentration in the urine and the enzyme activity. The enzyme G6PDH activity is determined spectrophotometrically at 340 nm by measuring the ability to convert nicotinamide adenine dinucleotide (NAD) to NADH.

Methadone

Methadone, a synthetic opioid, has been used in the treatment of heroin addiction. Methadone compliance is essential and can be effectively monitored by urine screening for methadone or its metabolite. When methadone is ingested, it is rapidly metabolized in the liver. The primary methadone metabolite is formed by N-demethylation to normethadone. However, normethadone is rarely detected as it readily dehydrates to form 2-ethylidene-1, 5-dimethyl-3, 3-diphenylpyrrolidine, commonly known as EDDP. Both TLC and GC methods are laborious and subject to interference. The methadone screening assay uses specific antibodies, which can detect methadone in urine. The assay is based on the competition of an enzyme glucose-6-phosphate dehydrogenase (G6PDH) labeled drug and the drug from the urine sample for a fixed amount of specific antibody binding sites. In the absence of drug from the sample, the specific antibody binds to the drug labeled with G6PDH and the enzyme activity is inhibited. This phenomenon creates a direct relationship between the drug concentration in the urine and the enzyme activity. The enzyme G6PDH activity is determined spectrophotometrically at 340 nm by measuring its ability to convert nicotinamide adenine dinucleotide (NAD) to NADH.

Opiates

Opiate compounds, such as morphine and codeine, are naturally occurring alkaloids of opium and are widely used as analgesics. Although drug abusers may abuse morphine and codeine, another opiate compound, heroin, is synthesized from morphine and is the most commonly abused opiate. When ingested or injected, heroin is metabolized to the molecule, 6-Monoacetyl morphine (6-AM or 6-MAM), which is hydrolyzed back to morphine. Opiates are rapidly metabolized by the body and excreted in urine, allowing immunoassays to detect recent use of morphine, codeine, and/or heroin. The opiate screening assay uses monoclonal antibodies that detect opiates in urine. The assay is based on the competition between an enzyme glucose-6-phosphate dehydrogenase (G6PDH) labeled drug and the free drug from the urine sample for a fixed amount of specific antibody binding sites. In the absence of free drug from the sample, the specific antibody binds the drug labeled G6PDH and the enzyme activity is inhibited. This phenomenon creates a direct relationship between drug concentration in urine and the enzyme activity. The enzyme G6PDH activity is determined spectrophotometrically at 340 nm by measuring its ability to convert nicotinamide adenine dinucleotide (NAD) to NADH.

Oxycodone

Oxycodone is a semi-synthetic opioid prescribed for pain management in patients with moderate to severe pain. It is like codeine and morphine in its analgesic properties, but it is more potent than morphine and has higher dependence potential. The drug oxycodone is supplied as OxyContin® (Oxycodone HCl) or in combination with aspirin (Percodan®) or acetaminophen (Percocet®). Drug abusers crush the pills into powder and snort them for faster effect which may result in a potentially fatal outcome. Oxymorphone, noroxycodone and noroxymorphone are the only known metabolites of oxycodone. The metabolite, oxymorphone, is a potent narcotic analgesic, while the other two metabolites are relatively inactive. From 33-61% of a single dose of oxycodone is excreted in urine within 24 hours as unconjugated oxycodone (13-19%), conjugated oxycodone (7-29%), and conjugated oxymorphone (13-14%). The oxycodone screening assay uses specific antibodies that can detect oxycodone and oxymorphone without any significant cross-reactivity to other opiate compounds. The assay is based on competition between a drug labeled with glucose-6-phosphate dehydrogenase (G6PDH), and a free drug from the urine sample for a fixed amount of specific antibody binding sites. In the absence of free drug from the sample, the specific antibody binds the drug labeled with G6PDH and causes a decrease in enzyme activity. This phenomenon creates a direct relationship between the drug concentration in urine and enzyme activity. The enzyme activity is determined spectrophotometrically at 340 nm by measuring the conversion of nicotinamide adenine dinucleotide (NAD) to NADH.

THC (Cannabinoids)

The principal active agent in marijuana and/or hashish that produces hallucinogenic and other biological effects is generally accepted to be ∆9 -tetrahydrocannabinol (∆9 -THC). ∆9 -THC is rapidly absorbed and almost completely metabolized by inhalation or through the gastrointestinal tract. The major metabolites of ∆9 -THC (i.e. 11-nor-∆9 -THC-9-carboxylic acid) becomes detectable in plasma, feces and urine within hours after exposure. Passive inhalation of marijuana smoke can result in an elevation of urine THC concentration as high as 10-40 ng/mL. In chronic users, THC may accumulate in fatty tissue faster than it can be excreted. This leads to longer detection times in urine for chronic users than for occasional users. The cannabinoid screening assay uses specific monoclonal antibody which can detect the major metabolite of ∆9 -THC in urine. The assay is based on the competition of a drug labeled with enzyme, glucose6-phosphate dehydrogenase (G6PDH), and the drug from the urine sample for a fixed amount of specific antibody binding sites. In the absence of drug from the sample, the specific antibody binds the drug labeled with G6PDH and the enzyme activity is inhibited. This phenomenon creates a direct relationship between the drug concentration in urine and the enzyme activity. The G6PDH activity is determined spectrophotometrically at 340 nm by measuring the conversion of nicotinamide adenine dinucleotide (NAD) to NADH.

Fentanyl

Fentanyl [N-(1-(2-phenylethyl)-4-piperidinyl)-N-phenylpropanamide] is a synthetic opioid narcotic analgesic similar to morphine. Fentanyl is 50-100 times more potent than morphine and is prescribed for patients with chronic pain and is used to manage pain after surgery or for treatment of breakthrough pain in cancer patients. Fentanyl is prescribed in various forms: by injection (intravenous or intramuscular), transdermal patch, and orally (transmucosal lozenge or film). Fentanyl such as the transdermal system can be abused in a manner like other opioid agonists, legal or illicit. Fentanyl has high potency and short duration of action, and it is abused for its intense euphoric effects. It is very dangerous when substituted illicitly for other opioids because of its potency and overdoses can lead to respiratory depression and death. It is a Schedule II substance under the U.S. Controlled Substances Act. The test is not intended to differentiate between drugs of abuse and prescription use of fentanyl. There are no uniformly recognized drug levels for fentanyl in urine. The primary metabolism of fentanyl leads to the time-dependent urinary excretion of fentanyl and norfentanyl and the half-life of fentanyl may range 3 - 12 hours. Fentanyl is exclusively metabolized by N-dealkylation and hydroxylation. More than 90% of the dose is eliminated as norfentanyl and hydroxylated metabolites. Less than 7% of the dose is excreted unchanged in the urine. The fentanyl screening assay is based on competition between drug in the specimen and drug labeled with recombinant glucose-6-phosphate dehydrogenase (rG6PDH) for antibody binding sites. As the latter binds the antibody, enzyme activity decreases. In the presence of drug from the specimen, enzyme activity increases and is directly related to the drug concentration. Active enzymes convert nicotinamide adenine dinucleotide (NAD) to NADH in the presence of glucose-6-phosphate (G6P), resulting in an absorbance change that is measured spectrophotometrically. Endogenous G6PDH does not interfere because the coenzyme NAD functions only with the bacterial enzyme used in the assay.

Buprenorphine

Buprenorphine is a semi-synthetic opioid analgesic derived from thebaine, a component of opium. Buprenorphine resembles morphine structurally but has both antagonist and agonist properties. Buprenorphine has a longer duration of action than morphine and can be administered sublingually as an analgesic. Subutex®, a higher dose buprenorphine formulation, is widely used in Europe and elsewhere as a substitution treatment for opiate addiction. Recently, the FDA has approved the use of Subutex and Suboxone® containing buprenorphine as active drug, for the treatment of opiate dependence in the US. The antagonist potency was reported as equivalent to naltrexone. Subutex and Suboxone are the first narcotic drugs available under the US Drug Abuse Treatment Act (DATA) of 2003 for the treatment of opiate dependence that can be prescribed in the US in a physician’s workplace. It has also been shown that buprenorphine has abuse potential and may itself cause dependency. In addition, a number of deaths have been recorded as a result of overdose with intravenously injected buprenorphine in conjunction with other psychotropic drugs such as benzodiazepines. Buprenorphine is metabolized primarily by N-dealkylation to form norbuprenorphine and by conjugation to form glucuronide-buprenorphine and glucuronide-norbuprenorphine. The buprenorphine screening assay is based on the bacterial enzyme -galactosidase, which has been genetically engineered into two inactive fragments. These fragments spontaneously re-associate to form fully active enzymes that, in the assay format, cleave a substrate, generating a color change that can be measured spectrophotometrically. In the assay, the analyte in the sample competes with analyte conjugated to one inactive fragment (enzyme donor) of -galactosidase for a limited number of antibody binding sites. If analyte is present in the sample, it binds to antibody, leaving the inactive enzyme fragment free to form active enzyme. If the analyte is not present in the sample, the antibody binds to analyte conjugated on the inactive fragment, inhibiting the re-association of inactive -galactosidase fragments, and no active enzyme is formed. The amount of active enzyme formed, and resultant absorbance change are directly proportional to the amount of analyte present in the sample.

PCP

Phencyclidine (PCP) was originally made available as a surgical anesthetic agent, but it was removed from clinical use due to undesirable side effects both during surgery and in recovery. The illicit use of the drug produces clinical symptoms ranging from confusion, disorientation, stupor, coma, and death in cases of overdose. The PCP screening assay is based on the competition of a drug labeled with enzyme, glucose-6- phosphate dehydrogenase (G6PDH), and the drug from the urine sample for a fixed amount of specific antibody binding sites. In the absence of drug from the sample, the specific antibody binds the drug labeled with G6PDH and the enzyme activity is inhibited. This phenomenon creates a direct relationship between the drug concentration in urine and the enzyme activity. The G6PDH activity is determined spectrophotometrically at 340 nm by measuring its ability to convert nicotinamide adenine dinucleotide (NAD) to NADH.

EDDP

EDDP is the primary metabolite of methadone. Methadone is a synthetic opiate agonist that is often used in detoxification programs as an oral substitute for heroin or other morphine-like drugs to suppress withdrawal symptoms and/or to maintain chronic relapsing heroin addicts. Measurement of EDDP instead of methadone for compliance can detect those individuals on the compliance program selling their methadone into the illicit drug market and spike their urine with a small quantity of methadone to cover their diversion. Their urine may test positive for methadone but would not test positive for EDDP, since the drug was not ingested and therefore never metabolized. The EDDP assay uses recombinant DNA technology to produce a unique homogeneous enzyme immunoassay system. The assay is based on the bacterial enzyme β-galactosidase, which has been genetically engineered into two inactive fragments. These fragments spontaneously reassociate to form fully active enzyme that, in the assay format, cleaves a substrate, generating a color change that can be measured spectrophotometrically. In the assay, the drug in the sample competes with drug conjugated to one inactive fragment of β-galactosidase for antibody binding site. If drug is present in the sample, it binds to antibody, leaving the inactive enzyme fragments free to form active enzyme. If a drug is not present in the sample, the antibody binds to drug conjugated on the inactive fragment, inhibiting the reassociation of inactive β-galactosidase fragments, and no active enzyme is formed. The amount of active enzyme formed, and resultant absorbance change are directly proportional to the amount of drug present in the sample.

Methamphetamine

Methamphetamine (USAN) also known as metamfetamine (INN), meth, ice, speed, crystal, glass, tik, N-methylamphetamine, methylamphetamine, and desoxyephedrine, is a psychostimulant of the phenethylamine and amphetamine class of psychoactive drugs.

Methamphetamine increases alertness, concentration, energy, and in high doses, can induce euphoria, enhance self-esteem, and increase libido. Methamphetamine has a high potential for abuse and addiction, activating the psychological reward system by triggering a cascading release of dopamine in the brain. Methamphetamine is metabolized in the liver with the main metabolites being amphetamine (active) and 4-hydroxymethamphetamine (pholedrine).

The Immunalysis Methamphetamine Urine Enzyme Immunoassay is homogeneous

enzyme immunoassay with a dual cutoff of 500ng/mL and 1000ng/mL. The assay is

intended for use in laboratories for the qualitative and semi-quantitative analysis of

Methamphetamine in human urine with automated clinical chemistry analyzers. This assay is calibrated against Methamphetamine. This in-vitro diagnostic device is for prescription use only. The assay provides only a preliminary analytical test result.

A more specific alternate chemical method must be used in order to obtain a confirmed analytical result. GC-MS or Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is the preferred confirmatory method. Clinical consideration and professional judgment should be applied to any drug of abuse test result, particularly when preliminary positive results are used. This assay uses Methamphetamine recombinant antibody.

The assay is based on the competition of Methamphetamine labeled enzyme glucose-6-phosphate dehydrogenase (G6PDH) and the free drug in the urine sample for the fixed amount of antibody binding sites. In the absence of the free drug in the sample, the antibody binds the drug enzyme conjugate and enzyme activity is inhibited. This creates a dose response relationship between drug concentration in the urine and enzyme activity. The enzyme G6PDH activity is determined at 340 nm spectrophotometrically by the conversion of NAD to NADH.