Drug Adherence Assessment Report

Transcription

1 Prescribed Medications: Drug Adherence Assessment Report FENTANYL, OXYCODONE CONSISTENT RESULTS - REPORTED MEDICATION DETECTED (PARENT DRUG AND/OR METABOLITE) REPORTED ANTICIPATED TEST PRESCRIPTION (S) FENTANYL Fentanyl 1 day FENTANYL rfentanyl 1 day OXYCODONE Oxycodone OXYCODONE roxycodone OXYCODONE Oxymorphone INCONSISTENT RESULTS - REPORTED MEDICATION NOT DETECTED (NEITHER PARENT DRUG NOR METABOLITE) REPORTED ANTICIPATED TEST PRESCRIPTION (S) N/A N/A N/A N/A INCONSISTENT RESULTS - ANALYTE DETECTED BUT NO CORRESPONDING PRESCRIPTION REPORTED DETECTED ILLICIT MEASURED CUTOFF TEST ANALYTE RESULT Buprenorphine 250 rbuprenorphine 500 Caffeine days 1-10 days 1-5 days TEST SPECIMEN VALIDITY TESTING TEST MEASURED RESULT REFERENCE RANGE Glucose rmal <20 (Max >500) Bilirubin rmal <1.8 (Max >4) Ketone rmal <3 (Max >80) Leukocytes rmal <15 (Max >500) Blood rmal <0.02 (Max >1) Protein rmal <20 (Max >500) Urobilinogen rmal <1.6 (Max >4) Nitrite rmal 00 <0.04 ph rmal Specific Gravity rmal Color rmal 0 Yellow/Amber/RGB Clarity rmal 0 Clear/Cloudy/Turbid Ascorbic Acid rmal <17 (Max >40) rbup-bup-ratio rmal >0.02 >.02 ADDITIONAL MEDICATIONS REPORTED BUT NOT TESTED FOR IN THIS REPORT Page 1 of 5

2 Urinalysis (UA) Glucose rmal <20 (Max >500) mg/dl Bilirubin rmal <1.8 (Max >4) mg/dl Ketone rmal <3 (Max >80) mg/dl Leukocytes rmal <15 (Max >500) WBCs/uL Blood rmal <0.02 (Max >1) mg/dl Protein rmal <20 (Max >500) mg/dl Urobilinogen rmal <1.6 (Max >4) mg/dl Nitrite rmal 00 <0.04 mg/dl ph rmal Specific Gravity rmal Color rmal 0 Yellow/Amber/RGB Clarity rmal 0 Clear/Cloudy/Turbid Ascorbic Acid rmal <17 (Max >40) mg/dl Acetaminophen Alprazolam Alphahydroxyalprazola m Amitriptyline Amphetamine Aripiprazole Buprenorphine Positive 250 rbuprenorphine Positive 500 Bupropion Caffeine Positive 2693 Carbamazepine Carisoprodol Meprobamate Chlorpromazine Citalopram Clozapine Clonazepam 7-Aminoclonazepam Clozapine_N_oxide Codeine Cocaine Benzoylecgonine Cyclobenzaprine Diazepam rdiazepam Doxepin Duloxetine Fentanyl Positive 25 rfentanyl Positive 150 Fluoxetine Page 2 of 5

3 Fluphenazine Gabapentin Hydrocodone rhydrocodone Hydromorphone Lamotrigine Levetiracetam Levorphanol Lorazepam MDA MDEA MDMA Meperidine Mephedrone Methadone EDDP Methamphetamine Mirtazapine Morphine 6-MAM Methylphenidate Ritalinic Acid Naloxone <50 ng/ml Oxazepam Oxcarbazepine Dihydro-10-Hydr oxycarbamazepine Oxycodone Positive 2500 roxycodone Positive >5000 Oxymorphone Positive >5000 Paroxetine PCP Pregabalin Propoxyphene rpropoxyphene Quetiapine Sertraline Tapentadol ng/ml Temazepam THC <125 ng/ml (Tetrahydrocannabinol) HU-210 (Spice AM2201 (Spice Page 3 of 5

4 JWH-019 (Spice JWH Hydroxybutyl (Spice JWH-081 (Spice JWH-122 (Spice JWH-18-5-pentanoic acid (Spice JWH-18-5-pentanyl (Spice JWH-250-5OH-pentany l (Spice Tiagabine Thioridazine Tramadol O-Desmethyl-Tramadol N-Desmethyl-Tramadol Trazodone Venlafaxine O-Desmethyl-Venlafaxi ne Ziprasidone Zolpidem Zonisamide rbup-bup-ratio rmal >0.02 >.02 Ratio Page 4 of 5

5 Morphine is a commonly detected metabolite among patients taking codeine. An active molecule of Opana, Oxymorphone is a commonly detected metabolite among patients taking Oxycodone. Opana (Oxymorphone) will not metabolize to roxycodone or Oxycodone. Hydromorphone is a commonly detected metabolite among patients taking Hydrocodone and Morphine. Oxazepam is commonly detected metabolite among patients taking Diazepam, r-diazepam or Temazepam. Temazepam and r-diazepam are commonly detected metabolites among patients taking Diazepam. Alprazolam, Alpha-OH-Alprazolam, Clonazepam, and 7-amino-Clonazepam are not detected in patients taking Diazepam, r-diazepam, Lorazepam, Oxazepam, and Temazepam. Meprobamate is a commonly detected metabolite among patients taking Carisoprodol and its presence is consistent with the use of Carisoprodol. An active (drug) or metabolite may be listed as a Outcome, however, if either the active or any metabolite(s) are present (Positive), then the result is listed as Consistent for that reported prescribed medication. Metabolites can remain longer in the body than the parent drug. Sometimes only the metabolite may be detected in the urine and not the parent drug. In case of patients consuming HYDROCODONE-containing medications: rhydrocodone is the major metabolite of Hydrocodone indicating presence of Hydrocodone in the urine. While Hydrocodone can also be metabolized to Hydromorphone, identification of just Hydromorphone by itself is not a confirmation of Hydrocodone being present, since recent studies suggest that urine specimens of patients taking Hydrocodone always show presence of Hydrocodone or rhydrocodone in combination with Hydromorphone. FOR PATIENT RESULTS INDICATING JUST THE PRESENCE OF HYDROMORPHONE: THIS MAY BE DERIVED FROM MORPHINE-CONTAINING PRESCRIPTION DRUGS OR HYDROMORPHONE-ONLY PRESCRIPTIONS (FOR EXAMPLE, DILAUDID). Further reading: Valtier,S. and Bebarta,V.S. (2012) Excretion profile of hydrocodone, hydromorphone and norhydrocodone in urine following single dose administration of hydrocodone to healthy volunteers. J. Anal. Toxicol., 36, and Barakat,N.H., Atayee,R.S., Best,B.M. and Ma,J.D. (2014) Observations of Urinary Hydrocodone and Metabolite Distributions in Pain Patients. J. Anal. Toxicol., 38, ) Reviewed By: Tagwerker, Christian Urinalysis (UA) (2/22/2017 1:45 PM) (2/22/2017 1:45 PM) Page 5 of 5