Ketamine and Metabolite Confirmation, Urine
Detection and confirmation of ketamine use
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Ketamine has been used in the United States as an anesthetic induction agent since 1972. The drug acts by noncompetitive antagonism of the N-methyl-D-aspartate (NMDA)-type glutamate receptors.(1,2) Ketamine has become a popular street drug because of its hallucinogenic effects.(3)
Ketamine has a half-life of 3 to 4 hours, and is metabolized to norketamine.(3) The effects from ketamine last from 1 to 5 hours, and ketamine and/or norketamine can be detected in the urine for a period of 1 to 2 days following use.(4)
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.
The presence of ketamine and/or norketamine >25 ng/mL is a strong indicator that the patient has used ketamine.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
A kit including all the materials necessary to complete chain-of-custody is available to ensure that the test results are appropriate for legal proceedings.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Ujhelyi MR, Robert S, Cummings DM, et al: Influence of digoxin immune Fab therapy and renal dysfunction on the disposition of total and free digoxin. Ann Intern Med 1993;119:273-277
2. Goodman and Gilman's: The Pharmacological Basis of Therapeutics. 10th edition. New York. McGraw-Hill Book Company, 2001
3. Baselt RC. Disposition of Toxic Drugs and Chemicals in Man. Seventh edition. Foster City, CA. Biomedical Publications, 2004 pp 1254
4. Mozayani A: Ketamine-Effects on human performance and behavior. Forensic Sci Rev 2002;14:123-131