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Interpretive Handbook

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Test 505337:
Drug of Abuse, Benzodiazepine Screen with GC-MS Confirmation, Urine

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

The benzodiazepines are central nervous system depressants composed of over 20 parent compounds. The structure of the benzodiazepines varies mainly by substitution of the benzodiazepine ring.

 

Benzodiazepines are minor tranquilizers, often referred to as anxiolytics (drugs used to control anxiety). Benzodiazepines also are prescribed as muscle relaxants, anesthetic adjuncts, anticonvulsants, and as

treatment for obsessive-compulsive disorders. Due to their wide availability and distribution, a high potential for benzodiazepine abuse exists.

 

Benzodiazepine mode of action is primarily to enhance gamma-aminobutyric acid (GABA)-mediated transmission. The benzodiazepines are extensively metabolized with half-lives ranging from 2 to 100 hours. Urine level variation is due to individual parent excretion rates as well as metabolic rates.

Useful For Suggests clinical disorders or settings where the test may be helpful

Confirmation of drug abuse involving benzodiazepines such as alprazolam, chlordiazepoxide, diazepam, flurazepam, lorazepam, and triazolam.

Interpretation Provides information to assist in interpretation of the test results

This test screens for the presence of common metabolites of benzodiazepines. The presence of a benzodiazepine metabolite indicates recent use within the past 3 days of the fast-acting drugs such as alprazolam, flurazepam, or triazolam. Chlordiazepoxide and diazepam are cleared very slowly-the presence of their metabolites indicates use sometime within the past 30 to 40 days. This test detects nordiazepam, oxazepam, and temazepam as common metabolites of either chlordiazepoxide or diazepam, lorazepam as the parent drug, hydroxyethylflurorazepam as the metabolite of flurazepam, alpha-hydroxyalprazolam as the metabolite of alprazolam, alpha-hydroxytriazolam as the metabolite of triazolam, 7-aminoclonazepam as the metabolite of clonazepam, and 7-amino-flunitrazepam as the metabolite of flunitrazepam (Rohypnol).

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

No significant cautionary statements.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Negative

EMIT cutoff concentration: 200 ng/mL

Positives are reported with a quantitative GC/MS result.

This report is intended for clinical monitoring and management of patients. It is not intended for use in employment-related drug testing.

Clinical References Provides recommendations for further in-depth reading of a clinical nature

1. Porter WF, Moyer TP: Clinical toxicology. In Tietz Textbook of Clinical Chemistry. Second Edition. Edited by CA Burtis, ER Ashwood. Philadelphia, WB Saunders Company, 1994, pp 1155-1235

2. Baselt RC, Cravey RH: Disposition of Toxic Drugs and Chemicals In Man. Third edition. Chicago, IL, Year Book Medical Publishers, 1989