Department

Toxicology Heartlands Biochemistry Laboratory Biochemistry

Preferred Sample Type

Suitable Specimen Types

Plain Spot Urine
Serum
EDTA Whole Blood
EDTA Plasma
Li Hep Plasma

1 mL (smaller sample sizes can be utilized where sample collection is not easy).

Specimen Transport

First class post

Sample Processing in Laboratory

Take to toxicology laboratory immediately

Sample Preparation

Avoid use of Gel Separator tubes

Turnaround Time

24 hrs (Can be 2-4 hours if urgent and laboratory contacted)

Sample Stability

4 ºC

Toxicology Screen (Urine & Serum)

General Information

A toxicology screen may be requested when a patient presents with symptoms (such as seizures, coma or abnormal behavoir) suggestive of excessive drug use. However such investigations are typically not required as patient management in these situations is often supportive with knowledge of the causative agent of little utility in the acute setting. If a toxicology screen is required, the following information will be of use.

At the Heartlands Hospital Toxicology Laboratory, toxicology screens are performed using the latest analytical techniques, primarily Liquid Chromatography Time of Flight Mass Spectrometry (LC QTof-MS). Urine and blood may be tested but urine is the preferred matrix

The range of screening by this procedure includes but is not limited to; tricyclic and tetracyclic antidepressants, venlafaxine, sertraline, trazodone, paroxetine, fluoxetine and related antidepressants, amfetamines (including MDMA and related drugs), antihistamines, opiates (e.g. morphine, codeine and dihydrocodeine), fentanyl and some fentanyl analogues, gabapentin and pregabalin, opioids (e.g. methadone and dextropropoxyphene), ketamine, cocaine, benzodiazepines (e.g. diazepam), b-blockers, zopiclone, antipsychotic drugs (e.g. olanzapine), paracetamol, barbiturates, non-steroidal anti-inflammatory drugs (including ibuprofen), salicylates, antiepileptics (including carbamazepine and phenytoin), sulphonylurea drugs and novel psychoactive substances

Relevant drugs and analytes which will not be detected by this routine screen include gamma hydroxybutyrate (GHB) and related compounds, synthetic cannabinoids and trace elements (including lithium). These can be detected but require specific investigations. If these are required, please contact the laboratory.

For more information please contact the Toxicology Laboratory on 0121 424 3707 or the Duty Biochemist on Bleep 2506

Please note, if you are investigating possible illict drug use, a urinary drugs of abuse screen may be a more appropriate test.

Patient Preparation

First pass urine / blood sample taken as soon as possible from onset of symptoms.

Notes

Please refer all requests to either:

Duty Toxicologist (0121 424 1392)

Duty Biochemist (bleep 2506)

Urine is the prefered specimen but serum may be analysed if a urine is unable to be obtained.

As much information as possible should be obtained about the suspected toxic substance ingested.

Analysis of drugs in urine and serum is accredited by UKAS under flexible scope.

Reference Range

A toxicology screen is qualitative result and as such, an interpretative report will be issued.

Specifications

EQA Scheme?: Yes
EQA Status: LGC QUARTZ, LGC CLIN TOX