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PtProtect® – Testing

Do you know all of the medications your patients take?

Some patients have more than one clinician and may not remember all the medications they take. Patients taking legally prescribed controlled medications may be combining prescriptions from multiple prescribers, putting themselves at risk for adverse drug reactions. Those patients who abuse drugs are more likely to combine them with legal drugs you prescribe, putting them at risk for overdoses and adverse reactions.

The panels in the PtProtect pain medication management program can help protect your patient’s safety by minimizing the risks of unintended drug interactions. Our interpretive report clearly notes any discrepancies between the medications reported taken and the medications detected.

Identify possible diversion

Patients who use drugs of abuse are more likely to abuse pain medications and more likely to divert medication either for financial gain or to fund an addiction to legal or illegal drugs. Family members may pilfer prescription drugs to self-treat or sell on the street.

The detailed PtProtect report, including interpretive comments, will provide you with the documentation needed to address this issue with your patient in a follow-up conversation.

Ensure compliance

Responsibly monitoring patient medication compliance is a challenge. PeaceHealth Laboratories’ pain management panels are designed to monitor patient compliance with commonly used opiates and opioids, as well as to detect common drugs of abuse.

PtProtect’s interpretative report gives a holistic view of the medications and substances the patient has taken and provides documentation needed in managing controlled medication prescribed to chronic pain patients.

Our testing regimen uses cut-off thresholds that reduce false negative results and confirms screened positives of commonly abused drugs.

Cut-off thresholds

Drug Generic Name Retention Time Threshold

Opiates/Opioids by LC/MS/MS

6-monoacetylmorphine Heroin metabolite 1–3 days 5 ng/mL
Codeine Tylenol-3 1–3 days 5 ng/mL
Fentanyl Duragesic, Actiq 1–2 days 2 ng/mL
Hydrocodone Vicodin and others 1–3 days 5 ng/mL
Hydromorphone Dilaudid 2–4 days 5 ng/mL
Meperidine Demerol 1–2 days 5 ng/mL
Morphine MS Contin, Roxanol 1–3 days 5 ng/mL
Norfentanyl Fentanyl metabolite 1–4 days 2 ng/mL
Oxycodone Oxycontin, Tylox, Percocet 1–3 days (SR 2–4 days) 5 ng/mL
Oxymorphone Numorphan, Opana 1–3 days (SR 1–4 days) 5 ng/mL

Drug Screen by EIA and GC/MS

Alcohol Ethanol 2–14 hours 0.02/0.02 g/dL
Amphetamines Amphetamine 1–2 days 300/150 ng/mL
  MDMA, MDA    
  Methamphetamine    
Barbiturates Amobarbital 1–7 days 200/200 ng/mL
  Aprobarbital 1–7 days  
  Butabarbital 1–7 days  
  Butalbital 1–48 hours  
  Pentobarbital 1–24 hours  
  Phenobarbital 1–3 weeks  
  Secobarbital 1–24 hours  
Benzodiazepines Alprazolam metabolite Therapeutic Dose: 200/100 ng/mL
  Chlordiazepoxide metabolite 3 days  
  Clonazepam metabolite    
  Clorazepate metabolite    
  Diazepam metabolite Extended Dosage:  
  Flunitrazepam metabolite 4–6 weeks  
  Flurazepam metabolite    
  Flurazepam metabolite    
  Lorazepam    
  Nordiazepam    
  Oxazepam    
  Temazepam    
Cocaine Cocaine metabolite 1–2 days 150/100 ng/mL
Marijuana THC metabolite Heavy User: 4–6 weeks 20/15 ng/mL
    Moderate User: 2 weeks  
    Light User: 0–4 days  
Methadone Methadone metabolite 3–11 days 150/100 ng/mL
Phencyclidine Phencyclidine 8 days 25/25 ng/mL
    Chronic Use: up to 30 days  
Propoxyphene Propoxyphene metabolite 1–2 days 300/300 ng/mL

Misc by LC/MS/MS

Carisoprodol & metabolite Soma 4 days 0.2 µg/mL
(meprobamate)
Tramadol & metabolite Ultram, Ultracet, Ryzolt 3 days 50 ng/mL
Buprenorphine Buprenex, Subutex, Suboxone 4 days 2 ng/mL