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Clinical Toxicology Testing

The CLS Toxicology Laboratory offers a wide range of toxicology analysis:
         Rapid screening for Drugs of Abuse by immunassay techniques 
         Quantitaitve Comprehensive Testing by Gas-Chromatography Mass Spectrometry (GCMS) methodology.

For Rapid Turn-Around the urine Drugs of Abuse Screen is appropriate for all emergency and non-emergency situations, i.e. Emergency Dept, Psychiatry, all other locations, Community. Drugs of Abuse is performed either to determine compliance with drug rehabilitation programs or to detect drug abuse in asymptomatic patients. The immunoassay screen is sufficiently sensitive to detect classes of drugs or drug metabolites in symptomatic patients. Specific agents within a drug class are not identified. It provides qualitative results for barbiturates, benzodiazepines, cocaine metabolite, cannabinoids, opiates and amphetamines.

Confirmation of Positive screens (amphetamines, cannabinoids, barbiturates, opiates and cocaine metabolite) is performed by GCMS at CLS Toxicology Laboratory upon request.

Periods of detection are estimates and will vary with individual user's dose, metabolism and elimination.

All results are intended for medical purposes (i.e. treatment) only.

Other STAT Toxicology tests: acetaminophen, salicylates, tricyclics and ethanol.
 
Test requests from Patient Service Centres and Extra-regional Laboratories are analyzed by the CLS Toxicology Laboratory. 

 
A. Immunoassays - Drugs of Abuse Screen - Urine

Results are reported as presumptive positive or negative according to the cut-off values clinically determined. Presumptive positive results only indicate the presence of the drug or metabolite in urine and do not indicate or measure intoxication or efficacy of elimination. Slight variations in immunoassay reactivity may be seen due to changes in antibody and tracer lots. Negative results reflect concentrations that fall below the cut off and do not necessarily exclude the presence of the drug or metabolite. Confirmation testing is not routinely performed on substances in this screen. It is not intended to monitor substance abuse or to detect neonatal drug exposure. Adulteration of the urine sample may cause erroneous results.

For further detailed information, see Characteristics of the Urine Drug Screening Tests used by Calgary Laboratory Services.

 Amphetamines: Reported as a class  Amephetamine
 Methamphetamine
 Methylenedioxyamphetamine (MDA)
 Methylenedioxymethamphetamine (MDMA)
 Barbiturates: Reported as a class  Amobarbital
 Butabarbital
 Butalbital
 Pentobarbital
 Phenobarbital
 Secobarbital
 Benzodiazepines: Reported as a class   Alprazolam
 Bromazepam
 Chordiazepoxide
 Clonazepam
 Diazepam
 Flunitrazepam
 Flurazepam
 Lorazepam
 Midazolam
 Nitrazepam
 Oxazepam
 Temazepam
 Triapolam
  
 Cannabinoids   
 Cocaine Metabolites   
 Opiates: Reported as a class  Codeine
 Hydrocodone
 Hydromorphone
 Morphine

B.  Volatile Analysis

     
For more information please see Volatile Screen.

C.  Gas-Chromatography Mass Spectrometry (GCMS) - Drug Screen, Comprehensive - Urine

There is a large menu of drugs, which can be identified by Gas Chromatography/Mass Spectrophotometry (GCMS).  Please note that our method is highly selective and optimized for neutral and basic drugs.

Following is a list of drugs, which can be identified. This list is not all inclusive.

 Acetaminophen  Fentanyl  Pentazocine
 Amantadine  Fenfluramine  Pentobarbital
 Amitriptyline  Fluconazole  Pentoxyphylline
 Amobarbital  Flunitrazepam  Perphanizine
 Amoxapine  Fluoxetine  Pethidine
 Amephetamine  Flurazepam  Phencyclidine
 Atomoxetine  Guaifenesin  Pheniramine
 Anileridine  Heroin  Phenobarbitol
 Benzocaine  Hydrocodone  Phentermine
 Benzoylecgonine  Hydrocortisone  Phenylpropanolamine
 Benztropine  Hydromorphone  Phenytoin
 Bromazepam  Hydroxyzine  Prednisolone
 Brompheniramine  Ibuprofen  Primidone
 Bupivacaine  Imipramine  Procainamide
 Bupropion  Ketamine  Procaine
 Buspirone  Lamotrigine  Prochlorperazine
 Butacaine  Lidocaine  Procyclidine
 Butalbital  Loratidine  Promethazine
 Butorphanol  Lorazepam  Propoxyphene
 Caffeine  Loxapine  Propranolol
 Canrenone  Maprotiline  Psilocin
 Carbamazepine  MDA  Pseudoephedrine
 Carisoprodol  MDMA  Pyrilamine
 Chlorcyclizine  Meclizine  Quetiapine
 Chlordiazepoxide  Memantine  Quinapril
 Chlorophenylpiperazine  Meperidine  Quinidine
 Chloroquine  Mepivacaine  Quinine
 Chlorpromazine  Meprobamate  Ranitidine
 Citalopram  Methadone  Rofecoxib
 Clobazam  Methamphetamine  Ropivacaine
 Clomipramine  Methaqualone  Secobarbital
 Clonazepam  Methocarbamol  Seroquel
 Clonidine  Methotrimeprazine  Sertraline
 Clozapine  Methylphenidate  Sildenafil
 Cocaethylene  Methyprylon  Starnoc
 Cocaine  Metoclopramide  Strychnine
 Codeine  Metoprolol  Theophylline
 Cotinine  Metronidazole  Thiopental
 Cyclobenzaprine  Midazolam  Thioridazine
 Desethylchloroquine  Mirtazepine  Thymol
 Desipramine  Moclobemide        Topiramate
 Dextromethorphan  6-monoacetylmorphine  Tramadol
 Diacetylmorphine  Morphine  Tranylcypromine
 Diazepam  Naltrexone  Trazodone
 Diclofenac  Naproxen  Triamterene
 Diethylpropion  Naratriptan  Triazolam
 Diltiazem  Nefazodone  Trihexyphenidyl
 Diphenhydramine  Nevirapine  Trimeprazine
 Dilantin  Nicotine  Trimethoprim
 Disopyramide  Nitrazepam  Trimipramine
 Doxepin  Nizatidine  Tripelennamine
 Doxylamine  Nordiazepam  Tripolidine
 Ecgonine methyl ester  Nortriptyline  Venlafaxine
 EDDP  Olanzapine  Verapamil
 Emetine  Ondansetron  Xylometazoline
 Enalapril  Orphenadrine  Zaleplon
 Ephedrine/Pseudoephedrine       Oxazepam  Zimelidine
 Erythromycin  Oxybenzone  Zolpidem
 Ethanol  Oxycodone  Zopiclone  
 Ethosuximide  Paroxetine