-1739993209.png){kind=logo}
Home
HelpTest Code AMPMX Amphetamine-Type Stimulants Confirmation, Chain of Custody, Meconium
Additional Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| COCH | Chain of Custody Processing | No | Yes |
Specimen Type
MeconiumSpecimen Required
Supplies: Chain of Custody Meconium Kit (T653) includes the specimen containers, seals, and documentation required.
Specimen Volume: 1 g (approximately 1 teaspoon)
Collection Instructions: Collect entire random meconium specimen.
Additional Information:
1. Specimen that arrives with a broken seal does not meet the chain of custody requirements.
2. The laboratory recommends sending chain-of-custody specimens by overnight shipment.
Specimen Minimum Volume
0.3 g (approximately 1/4 teaspoon)
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Meconium | Frozen (preferred) | 28 days |
| Ambient | 28 days | |
| Refrigerated | 28 days |
Reject Due To
| Grossly bloody | Reject; Pink OK |
| Stool; Diapers |
Reject |
Clinical Information
Several stimulants and hallucinogens chemically related to phenylethylamine are referred to collectively as the amphetamine-type stimulants (amphetamines). Generally, this refers to the prescription and illicit amphetamines including amphetamine; methamphetamine; 3,4-methylenedioxymethamphetamine (MDMA, Ecstasy); 3,4-methylenedioxyamphetamine (MDA); and 3,4-methylenedioxyethylamphetamine (MDEA).(1) Methamphetamine has become a drug of choice among stimulant abusers because of its availability and ease of production.
The metabolism of amphetamine consists of hydroxylation and deamination followed by conjugation with glucuronic acid. Methamphetamine is metabolized to amphetamine; both should be present in urine after methamphetamine use. Both MDMA and MDEA are metabolized to MDA.(1)
The disposition of drug in meconium, the first fecal material passed by the neonate, is not well understood. The proposed mechanism is that the fetus excretes drug into bile and amniotic fluid. Drug accumulates in meconium either by direct deposition from bile or through swallowing of amniotic fluid.(2) The first evidence of meconium in the fetal intestine appears at approximately the 10th to 12th week of gestation, and slowly moves to the colon by the 16th week of gestation.(3) Therefore, the presence of drugs in meconium has been proposed to be indicative of in utero drug exposure up to 5 months before birth, a longer historical measure than is possible by urinalysis.(2)
Intrauterine drug exposure to amphetamines has been associated with maternal abruption, prematurity, and decreased growth parameters, such as low birthweight.(4) Some intrauterine amphetamine-exposed infants may develop hypertonia, tremors, and poor feeding and abnormal sleep patterns.(5)
Chain of custody is a record of the disposition of a specimen to document who collected it, who handled it, and who performed the analysis. When a specimen is submitted in this manner, analysis will be performed in such a way that it will withstand regular court scrutiny.
Reference Values
Negative
Positives are reported with a quantitative liquid chromatography tandem mass spectrometry (LC-MS/MS) result.
Cutoff concentrations for LC-MS/MS testing:
Amphetamine: 20 ng/g
Methamphetamine: 20 ng/g
3,4-Methylenedioxyamphetamine: 20 ng/g
3,4-Methylenedioxyethylamphetamine: 20 ng/g
3,4-Methylenedioxymethamphetamine: 20 ng/g
Day(s) Performed
Monday through Sunday
Report Available
2 to 3 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
80324
80359
G0480 (if appropriate)
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Forms
1. Chain of Custody Request is included in the Chain-of-Custody Meconium Kit (T653).
2. If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.