Energy Guide

cardiac dysrhythmias. The pattern of psychosis which may appear at half-life of about 15 hours and is
excreted in urine as amphetamine and oxidized as deaminated and hydroxylated derivatives. However, 40%
of methamphetamine is excreted unchanged. Thus the presence of the parent compound in the urine
indicates methamphetamine use.
Morphine (MOP)
The opiates such as heroin, morphine, and codeine are derived from the resin of opium poppy. The principal
metabolites of opiates are morphine, morphine-3-glucuronide normorphine and codeine with a half-life of
about 3 hours. Heroin is quickly metabolized to morphine. Thus, morphine and morphine glucuronide might
both be found in the urine of a person who has taken only heroin. The body also changes codeine to morphine.
Thus, the presence of morphine (or the metabolite, morphine glucuronide) in the urine indicates heroin,
morphine and/or codeine use.
The test for Morphine (MOP) of the CLIA Screen Multi-Drug Urine Test Cup yields a positive result when the
morphine in urine exceeds 300ng/mL.
Methadone (MTD)
Methadone is a synthetic analgesic drug that is originally used in the treatment of narcotic addicts. Among the
psychological effects induced by using methadone are analgesia, sedation and respiratory depression.
Overdose of methadone may cause coma or even death. It is administered orally or intravenously and is
metabolized in the liver and excreted in urine as methadone, EDDP, EMDA and methadol. The kinneys are a
major route of methadone excretion. Methadone has a biological half-life of 15 to 60 hours.
Opiate (OPI)
Opiate refers to any drug that is derived from the opium poppy, including the natural products, morphine and
codeine, and the semi-synthetic drugs such as heroin. Opioid is more general, referring to any drug that acts
on the opioid receptor. Opioid analgesics comprise a large group of substances which cont
rol pain by
depressing the central nervous system. Large doses of morphine can produce higher tolerance levels,
physiological dependency in users, and may lead to substance abuse. Morphine is excreted unmetabolized,
and is also the major metabolic product of codeine and heroin. Morphine is detectable in the urine for several
days after an opiate dose.
The test for Morphine 2000 (OPI) of the CLIA Screen Multi-Drug Urine Test Cup yields a positive result when
the morphine in urine exceeds 2000 ng/mL.
Oxycodone (OXY)
Oxycodone is known as Oxycontin and Roxicodone. It is an ingredient of Percodan, Percocet, Roxicet and
Tylox. Oxycodone is a semi-synthetic opiates derived from opium. Like other opiates, Oxycodone is
characterized by its analegestic properties, and the tendency for users to form a physical dependency and
develop tolerance with extended use. Oxycodone is usually administered in combination with non-opiate
analegesics such
as acetaminophen and salicylates for the relief of moderate to severe pain. Oxycodone is a
central nervous system depressant that may cause drowsiness, dizziness, lethargy, weakness and confusion.
Toxicity in an overdose of Oxycodone can lead to stupor, coma, muscle flaccidity, severe respiratory
depression, hypotension, and cardiac arrest.
Oxycodone is metabolized by N- and O-demethylation. One of the metabolites, oxymorphone, is a potent
narcotic analgesic, while the other, n
oroxycodone, is relatively inactive. Between 33 to 61% of a single dose of
Oxycodone is excreted in a 24 hour urine collection and consists of 13-19% free Oxycodone, 7-29%
glucuronide conjugated Oxycodone, 13-14% glucuronide conjugated oxymorphone and an unknown amount
of noroxycodone. The detection time window of Oxycodone is 1-3 days following use.
Phencyclidine (PCP)
Phencyclidine is an arylcyclohexylamine that was originally used as an anesthetic agent and a veterinary
tranquilzer. Phencyc
lidine can produce hallucinations, lethargy, disorientation, loss of coordination, trance-like
ecstatic states, a sense of euphoria and visual distortions. It has many street names, such as “angel dust” and
“crystal cyclone,” etc. phencyclidine can be administered orally, by nasal ingestion, smoking, or by intravenous
injection. It is metabolized in the liver and excreted through the kidneys in urine in unchanged form and
oxidized metabolites with a half life of about 12 hours. Suction and urinary acidification in the treatment of
overdose typically reduces its half-life from three days to one day.
Propoxyphene (PPX)
Propoxyphene, a synthetic opiate agonist, is structurally similar to methadone. Propoxyphene is a narcotic
analgesic used to relieve mild to moderate pain. The principal metabolites are nordextropropoxyphene. The
combination usage of propoxyphene, aspirin, acetaminophen or other sedatives can lead cooperative
int
eraction. Abuse of propoxyphene can lead nausea, vomit, astriction, illusion, hallucination, heart poisoning,
lung dropsy and even death. Propoxyphene is metabolized in the liver and excreted in urine as
nordextropropoxyphene. Thus the presence of the propoxyphene or its metabolites in the urine indicates
propoxyphene use.
Notriptyline (TCA)
TCA (Tricyclic Antidepressants) are commonly used for the treatment of depressive disorders. TCA overdoses
can result in profound central nervous sy
stem depression, cardiotoxicity and anticholinergic effects. TCA
overdose is the most common cause of death from prescription drugs. TCAs are taken orally or sometimes by
injection. TCAs are metabolized in the liver. Both TCAs and their metabolites are excreted in urine mostly in
the form of metabolites for up to ten days.
Cannabinoids (THC)
Cannabinoids is a hallucinogenic agent derived from the flowering portion of the hemp plant. The active
ingredients in Cannabinoids, THC & Cannabinol can be metabolized and excreted as 11-nor- Δ
9-tetrahydrocannabinol-9-carboxylic acid with a half-life of 24 hours. It can be detected for 1 to 5 days after
use. Smoking is the primary method of use of Cannabinoids/cannabis. Higher doses used by abusers produce
central nervous system effects, altered mood and sensory perceptions, loss of coordination, impaired
short-term memory, anxiety, paranoia, depression, confusion, hallucinations and increased heart rate. A
tolerance to the cardiac and psychotropic effects can occur, and withdrawal syndrome produces restlessness,
insomnia, anorexia and nausea.
PRINCIPLE
When the test is activate, the urine is absorbed into the device by capillary action, mixes with the respective
drug monoclonal antibody conjugate, and flows across the pre-coated membrane. When sample drug levels
are zero or below the target cutoff (the detection sensitivity of the test), respective drug monoclonal antibody
conjugate binds to the respective drug-protein (duck egg) conjugate immobilized in the Test Region (T) of the
device. This produ
ces a colored Test line that, regardless of its intensity, indicates a negative result.
When sample drug levels are at or above the target cutoff, the free drug in the sample binds to the respective
drug monoclonal antibody conjugate preventing the respective drug monoclonal antibody conjugate from
binding to the respective drug-protein conjugate immobilized in the Test Region (T) of the device. This
prevents the development of a distinct colored band in the test region, indicating a potentially positive result.
To serve as a procedure control, a colored line will appear at the Control Region (C), where the Goat anti
mouse IgG polyclonal antibody immobilized in, if the test has been performed properly.
SPECIMEN COLLECTION AND PREPARATION
1. Collect the urine sample. Remove the test cup from the foil pouch by tearing at the notch and use it as
soon as possible. Open the cap of the test cup and urinate directly into the test cup. The minimum
sample volume is 25mL (See the Minimum Fill Volume scale on the cup label).
2. The technician replaces and seals the cap. Check the cap for a tight seal.
3. The technician observes temperature strip affixed on the test cup between 2 to 4 minute
s to see if the
urine is diluted by water or liquid other than urine. The temperature range from 32°C-38°C
(90ºF-100ºF) is acceptable.
4. Technician dates and signs the names of the donor and the operator on the cap label.
5. Technician dates and initials the security seal and attaches the security seal over the cup cap.
QUALITY CONTROL
Users should follow the appropriate federal, state, and local guidelines concerning the frequency of assaying
external quality control materials.
Even though there is an internal procedural control line in the test device in the Control Region, the use of
external controls is strongly recommended as good laboratory testing practice to confirm the test procedure
and to verify proper test performance. Positive and negative controls shoul
d give the expected results. When
testing the positive and negative controls, the same assay procedure should be adopted. External Control
(positive and negative) should be run with each new lot of test received, each new shipment, each new
operator and monthly to determine that tests are working properly. This will ensure that the end user has clear
understanding of when to perform quality control testing.
PERFORMANCE CHARACTERISTICS
ADULTERATION CONTROL:
The CLIA Screen Multi-Drug Urine Test Cup is a competitive immunoassay that is used to screen for the
presence of drugs of abuse in urine. It is chromatographic absorbent device in which drugs in a sample
competitively combined to a limited number of drug monoclonal antibody (mouse) conjugate binding sites.