NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Monitoring oxycodone therapy
Routine drug monitoring is not indicated in all patients. Because drug diversion (use of prescription drugs for recreational purposes) is a possibility, compliance monitoring is indicated in patients being treated for chronic pain requiring high doses (>40 mg twice a day)
Gas Chromatography-Mass Spectrometry Using Selected Ion Monitoring (GC-MS SIM)
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Oxycodone (Oxycontin, Percodan)
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Container/Tube: Red top
Specimen Volume: 5 mL
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Mild OK; Gross reject
Mild OK; Gross reject
Mild OK; Gross reject
Serum gel tube
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
|Serum Red||Refrigerated (preferred)||14 days|
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Oxycodone hydrochloride is an opioid analgesic with several actions qualitatively similar to those of morphine. The clearance half-life of oxycodone is approximately 3 to 6 hours.(1)
Although its own strong analgesic activity precludes oxycodone from being considered a prodrug, it is also converted to a highly active metabolite, oxymorphone, through the activity of the cytochrome P450 enzyme CYP2D6.(2) This conversion appears to be less of a concern for CYP2D6 poor metabolizers, since oxycodone itself still provides analgesia, than for ultra-rapid metabolizers who could be at increased risk for adverse effects.(3)
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 minimal effective peak serum concentration of oxycodone for analgesia is 10 ng/mL from a dose of 5 to 10 mg of regular release oxycodone (Percodan).(1,4) Patients develop tolerance to oxycodone and may require larger doses for effective management of chronic pain.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Monitor patients carefully if drugs inhibiting CYP2D6 are coadministered.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Baselt RC: Oxycodone. In Dispositition of Toxic Drugs and Chemical in Man. Eighth edition. Edited by RC Baselt. Foster City, CA, Biomedical Publications, 2008, pp1166-1168
2. Riley J, Eisenberg E, Muller-Schwefe G, et al: Oxycodone: a review of its use in the management of pain. Curr Med Res Opin 2008;24:175-192
3. de Leon J, Dinsmore L, Wedlund P: Adverse drug reactions to oxycodone and hydrocodone in CYP2D6 ultrarapid metabolizers. J Clin Psychopharmacol 2003;23:420-421
4. Gutstein HB, Akil H: Chapter 21: Opioid analgesics. In Goodman and Gilman's The Pharmacological Basis of Therapeutics. 11th edition. Edited by LL Brunton, JS Lazo, KL Parker. New York, McGraw-Hill Inc, 2006. Available at: http://www.accessmedicine.com/content.aspx?aID=940653
Method Description Describes how the test is performed and provides a method-specific reference
Oxycodone is extracted from the serum specimen by solid-phase chromatography, derivatized, and then analyzed by gas chromatography-mass spectrometry using selected ion monitoring.(Unpublished Mayo method)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
|Result ID||Reporting Name||LOINC Code|