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 Bleep 3289.
Please note, if you are investigating possible illict drug use, a urinary drugs of abuse screen may be a more appropriate test.
First pass urine / blood sample taken as soon as possible from onset of symptoms.
Please refer all requests to either:
Dr Alex Lawson (0121 424 0870)
Miss Briony Johnson (0121 424 1392)
Dr Alan Jones (0121 424 0199)
Or the duty biochemist (bleep 2506)
Urine is prefered specimen but both urine and serum should be collected if possible.
As much information as possible should be obtained about the suspected toxic substance ingested.
A toxicology screen is qualitative result and as such, an interpretative report will be issued.
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The Trust Laboratories at Heartlands Hospital, Good Hope Hospital and Solihull Hospital were awarded UKAS (United Kingdom Accreditation Service) accreditation to the internationally recognised ISO 15189 standard in May 2015. For a list of accredited tests and other information please visit the test database http://www.heftpathology.com/frontpage/test-database.html.
Tests not appearing on this scope are either under consideration or in the process of accreditation and so currently remain outside of our scope of accreditation. However, these tests have been validated to the same high standard as accredited tests and are performed by the same trained and competent staff.
For further information contact Louise Fallon, Quality Manager, 0121 424 1235