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, salicylatestricyclics 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.

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