PART 3 / CH 17
Urine Toxicology (MGH)
| Drug Class or Drug | Duration of Positive Result | Comments |
|---|---|---|
| Amphetamines | 1-3 days post use | -false (+) possible: chlorpromazine, buproprion, propranalol, chloroquine, ephedrine, pseudoephedrine, phenylpropanolamine (Dexatrim), selegiline, tranylcypromine, tyramine |
| Barbiturates | 2-20d: depends on drug | -short acting agents detectable ~24hrs -long acting up to 3 wks |
| Benzodiazepines | 1-14 days | |
| Cannabanoids | 2-7 days if use 4x/week, up to 10 days with daily use | (May be positive up to 1 month in case of chronic use) |
| Opiates/ Metabolites (codeine, morphine) may detect high concentrations of meperidine, oxycodone, oxymorphone | 2-3 days after use | -may yield more true positives than serum tox -not specific to heroin or illicit opiods -naloxone, propoxyphene, nalbuphine, methadone fentanyl, propofol do not cross-react -false (+) with poppyseeds |
| Cocaine Metabolite | Peak 4 hrs post exposure, (+) 2-4 days post use | (May be positive for 7-22 days after use in chronic high-dose abusers) |
| Phencyclidine | 10-20 days post use | more true (+) vs serum tox, but false (+) may occur with dextromethorphan |
Serum Toxicology (MGH)
| Drugs Included | Therapeutic Range | Toxic Range | |
|---|---|---|---|
| Tox Panel 1 | ethanol isopropanol methanol | not defined not defined not defined | >1000 >400 >200 |
| Tox Panel 2 | acetominophen salicylate theophylline | 10-25 100-200 10-20 | >120 >300 >25 |
| Tox Panel 3 | butalbital carbamazepine ibuprofen pentobarbital phenobarbital phenytoin secobarbital | 5-10 4-12 20-70 not defined 15-20 10-20 not defined | >20 >15 >100 >15 >60 >25 >10 |
| Tox Panel 4 | alprazolam chlordiazepoxide clonazepam demoxepam diazepam desalkyflurazepam flurazepam glutethimide lidocaine lorazepam methaqualone norchlordiazepoxide nordiazepam oxazepam quinidine temazepam trazodone 4-OH-glutethimide | 19-55 1000-3000 10-70 not defined 100-1000 20-110 10-100 2000-6000 1500-5000 50-240 not defined 1000-3000 100-800 200-1400 1200-4000 190-540 800-1600 not defined | not defined >5000 >80 not defined >5000 >500 >200 >7000 >6000 not defined >10000 >5000 >5000 >5000 >5000 not defined not defined >15000 |
Tox Panel 5
amitriptyline
chlorpheniramine
chlorpromazine
clomipramine
clozapine
cocaethylene
cocaine
cyclobenzaprine
D-pseudoephedrine
desipramine
desmethylsertraline
dextromethorphan
diphenhydramine
disopyramide
doxepin
doxylamine
fluoxetine
fluvoxamine
imipramine
maprotilene
MCPP
meperidine
mesoridazine
methadone
metoprolol
norclomipramine
nordoxepin
norfluoxetine
normaprotilene
normeperidine
norpropoxyphene
nortriptyline
norverapamil
oxycodone
paroxetine
pentazocine
promazine
propoxyphene
propranolol
pyrilamine
sertraline
thioridazine
trifluoperazine
trimipramine
venlafaxine
verapamil
120-250
5-20
50-500
150-450
150-500
not defined
not defined
20-30
36-80
150-300
not defined
not defined
not defined
2000-5000
150-250
not defined
50-450
12-240
150-250
180-450
not defined
70-500
150-1000
50-800
20-340
not defined
150-250
50-450
not defined
not defined
100-1500
50-150
not defined
10-40
20-190
50-200
100-500
100-400
50-100
not defined
40-160
250-1250
not defined
50-200
not defined
100-400
>500
not defined
>1000
not defined
not defined
not defined
not defined
not defined
>2000
>500
not defined
not defined
>200
>8000
>500
not defined
not defined
not defined
>500
>800
not defined
>1000
not defined
>2000
not defined
not defined
>500
not defined
>800
not defined
>2000
>500
not defined
not defined
not defined
>1000
>1000
>500
not defined
not defined
not defined
>1000
not defined
not defined
not defined
>400