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Test Code BENZU Benzodiazepines Confirmation, Urine

Reporting Name

Benzodiazepines Confirmation, U

Useful For

Detecting drug use involving benzodiazepines such as alprazolam, flunitrazepam, chlordiazepoxide, diazepam, flurazepam, lorazepam, and triazolam

Performing Laboratory

Mayo Medical Laboratories in Rochester

Specimen Type

Urine


Advisory Information


For situations where chain of custody is required, a Chain-of-Custody Kit (T282) is available. For chain-of-custody testing, order BENZX / Benzodiazepines Confirmation, Chain of Custody, Urine.

Additional Testing Requirements


If urine creatinine is required or adulteration of the sample is suspected, the following test should be requested, ADULT / Adulterants Survey, Urine. For additional information, refer to ADULT / Adulterants Survey, Urine.



Specimen Required


Container/Tube: Plastic, 60-mL urine bottle

Specimen Volume: 20 mL

Collection Instructions:

1. Collect a random urine specimen.

2. No preservative.

Additional Information:

1. No specimen substitutions.

2. No STATS are accepted for this procedure.

3. Additional drug panels and specific requests are available. Call Mayo Medical Laboratories at 800-533-1710 or 507-266-5700.

4. Submitting less than 20 mL will compromise our ability to perform all necessary testing.


Specimen Minimum Volume

5 mL

Specimen Stability Information

Specimen Type Temperature Time
Urine Refrigerated (preferred) 14 days
  Frozen  14 days
  Ambient  72 hours

Reference Values

Negative

 

Cutoff concentrations:

NORDIAZEPAM BY GC-MS

<100 ng/mL

 

OXAZEPAM BY GC-MS

<100 ng/mL

 

LORAZEPAM BY GC-MS

<100 ng/mL

 

TEMAZEPAM BY GC-MS

<100 ng/mL

 

OH-ETHYL-FLURAZEPAM BY GC-MS

<100 ng/mL

 

7-NH-CLONAZEPAM BY GC-MS

<100 ng/mL

 

ALPHA OH-ALPRAZOLAM BY GC-MS

<100 ng/mL

 

7-NH-FLUNITRAZEPAM BY GC-MS

<50 ng/mL

 

ALPHA OH-TRIAZOLAM BY GC-MS

<100 ng/mL

Day(s) and Time(s) Performed

Monday through Friday

Test Classification

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

80346

G0480 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
BENZU Benzodiazepines Confirmation, U In Process

 

Result ID Test Result Name Result LOINC Value
21441 Nordiazepam-by GC/MS 16228-9
20655 Oxazepam-by GC/MS 16201-6
20656 Lorazepam-by GC/MS 17088-6
20657 Temazepam-by GC/MS 20559-1
20658 OH-Ethyl-Flurazepam-by GC/MS 20532-8
20659 7-NH-Clonazepam-by GC/MS 51776-3
20670 Alpha OH-Alprazolam-by GC/MS 16348-5
20660 7-NH-Flunitrazepam-by GC/MS 51777-1
20661 Alpha OH-Triazolam-by GC/MS 49876-6
20663 Benzodiazepines Interpretation 69050-3
20664 Chain of Custody No LOINC Needed

Clinical Information

Benzodiazepines are any of a group of compounds having a common molecular structure and acting similarly as depressants of the central nervous system. As a class of drugs, benzodiazepines are among the most commonly prescribed drugs in the western hemisphere because of their efficacy, safety, low addiction potential, minimal side effects, and high public demand for sedative and anxiolytic agents.

Interpretation

Benzodiazepines are extensively metabolized, and the parent compounds are not detected in urine. This test screens for (and confirms) the presence of:

-Nordiazepam, oxazepam (metabolites of chlordiazepoxide)

-Nordiazepam, oxazepam and temazepam (metabolites of diazepam)

-Lorazepam

-Hydroxyethylfluorazepam (metabolite of flurazepam)

-Alpha hydroxyalprazolam  (metabolite of alprazolam)

-Alpha hydroxytriazolam (metabolite of triazolam)

-7-aminoclonazepam (metabolite of clonazepam)

-7-aminoflunitrazepam (metabolite of flunitrazepam)

 

The clearance half-life of long-acting benzodiazepines is more than 24 hours. It takes 5 to 7 half-lives to clear 98% of a drug dose. Therefore, the presence of a long-acting benzodiazepine greater than the limit of quantification indicates exposure within a 5 to 20-day interval preceding specimen collection. Following a dose of diazepam, the drug and its metabolites appear in the urine within 30 minutes. Peak urine output is reached between 1 and 8 hours. See Mayo Medical Laboratories Drugs of Abuse Testing Guide at http://www.mayomedicallaboratories.com/test-info/drug-book/index.html for additional information including metabolism, clearance (half-life), and approximate detection times.

Clinical Reference

1. Disposition of Toxic Drugs and Chemicals in Man. Eighth edition. Edited by RC Baselt. Foster City, CA: Biomedical Publications, 2008

2. Porter W: Clinical toxicology. In Tietz Textbook of Clinical Chemistry. Edited by CA Burtis, DE Bruns. Fourth edition. St. Louis, MO. Elsevier Saunders, 2006, pp 1287-1369

Analytic Time

2 days

Reject Due To

Hemolysis

Mild OK; Gross OK

Lipemia

NA

Icterus

Mild OK; Gross OK

Other

NA

Method Name

Gas Chromatography-Mass Spectrometry (GC-MS) Confirmation with Quantitation

Forms

Chain-of-Custody Request Form is included in the Chain-of-Custody Kit (T282). A copy of this form is also available at http://www.mayomedicallaboratories.com/it-mmfiles/chain-of-custody-request-form.pdf.

Secondary ID

80370