Download Cocaine Reagent

TEST UPDATE
Pathology & Laboratory Medicine
TEST CHANGE
Notification
Date
Effective
Date
COCAINE URINE DRUG SCREEN REAGENT CHANGE
10/10/2013
10/14/2013
MEDICAL DIRECTOR
CHEMISTRY
Greg Sharp M.D.
Phone: 847-5115
Assay information:
Due to a reagent recall, the Chemistry laboratory changed to a new
vendor for urine cocaine screens. On October 14, 2013, we will begin
using a ThermoFisher DRI Microgenics cocaine metabolite assay reagent to perform all urine cocaine screens. The assay will be performed
on the Ortho Clinical Diagnostics Vitros 5600 platform. The Microgenics assay uses a 300 ng/ml cut-off and has been tested to ensure
comparable performance to the discontinued Ortho Clinical Diagnostics assay. If you have questions regarding this testing change, please
contact Dr. Greg Sharp in the Chemistry Laboratory at 847-5115 or via
email at [email protected].
Clinical Application:
CONTACT INFORMATION
NEWSLETTER EDITOR
Lynn Bryan, lab Manager
Monica Sullivan, Lab Manager
Colleen Williams, Lab Communication Strategist
PATHOLOGY & LABORATORY
MEDICINE
111 Colchester Avnue-233MP1
Burlington, VT, 05401
PHONE
(800) 847-5121 | (800) 991-2799
FAX
(802) 847-5905
Cocaine (benzoylmethylegonine), is derived from the plant 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.
Method:
The DRI Cocaine Metabolite Assay is a homogeneous enzyme immunoassay using ready-to-use liquid reagents. The assay uses a specific antibody,
which can detect benzoylecgonine in urine. The assay is based on the comparison 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 in 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 dinucleiotide (NAD) to NADH.
LABORATORY CUSTOMER SERVICE: 847-5121 OR 1 (800) 991.2799
WEB SITE: WWW.FLETCHERALLEN.ORG/LABS
2
TEST UPDATE—October, 2013
Limitations:
 A positive result from this assay indicates only the presence of cocaine metabolite and does not necessari-
ly correlate with the extent of physiological and psychological effects.
 A positive result by this assay should be confirmed by another nonimmunological method such as GC or
GC/MS.
 The test is designed for human use only.
 It is possible that other substances and/or factors (technical or procedural) other than those investigated
in the specificity study may interfere with the test and cause false results.
Ordering and Sample Information
Test Name
Cocaine Screen, Urine
Test Code
COCA
FAHC Translation Code FAH5574
PRISM Code
LAB278
Sample Requirements
Collect 50 mL freshly voided urine specimens should be collected in a clean previously unused glass or plastic container, minimum volume 10 mL. Specimens should
be refrigerated if testing is not performed within 4 hours of collection. Specimens are
stable for 48 hours if refrigerated. Specimens should be frozen if longer storage is
required.
Expected Value
Negative Screen
Days Performed
Daily
Analytical time
Same day
Price
No change, please contact Laboratory Customer Service (847-5121 or 1-800-9912799) for pricing information.
CPT Code
80101
Test Note
The Fletcher Allen Health Care laboratory stores positive urine specimens for one
week frozen in case confirmatory testing is requested by the ordering clinician.
Effective Date
Monday October 14, 2013
LABORATORY CUSTOMER SERVICE: 847-5121 OR 1 (800) 991.2799
WEB SITE: WWW.FLETCHERALLEN.ORG/LABS