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Test Code TSPU Targeted Stimulant Screen, Random, 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 patient's prescribed medications. However, if an unexpected stimulant is found, confirmatory testing can be requested at an additional charge.



Specimen Required


Supplies: Sarstedt Aliquot Tube 5 mL (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


Useful For

Determining compliance or identifying illicit stimulant drug use

 

This test is not intended for employment-related testing.

Profile Information

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

Method Name

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

Reporting Name

Targeted Stimulant Screen, U

Specimen Type

Urine

Specimen Minimum Volume

0.5 mL

Specimen Stability Information

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

Reference Values

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

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.

Clinical Reference

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;2(4):489-526

2. Langman LJ, Bechtel LK, Holstege CP. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 43

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;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;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;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;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;171(1):44-51. doi:10.1016/j.forsciint.2006.10.004

8. Rovine T, Ferrero CL, American Pain Society. Chronic Pain in America: Roadblocks to Relief. Roper Starch Worldwide, Inc; 1999. Updated October 2, 2001. Accessed July 16, 2024. Available at http://accurateclinic.com/wp-content/uploads/2016/04/Chronic-Pain-In-America-Roadblocks-To-Relief-1999.pdf

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

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

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

80326

G0480 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
TSPU Targeted Stimulant Screen, U 99107-5

 

Result ID Test Result Name Result LOINC Value
610273 Methamphetamine 19554-5
LPPS List prescribed stimulants 29305-0
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

Day(s) Performed

Monday through Sunday

Report Available

3 to 4 days

Forms

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