Urine toxicology screen - Revision history

Danbot: Add Category:Labs

2026-03-22T06:44:05Z

← Revisión anterior		Revisión del 06:44 22 mar 2026
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	[[Category:Toxicology]]		[[Category:Toxicology]]
			[[Category:Labs]]

Imogen: Change "there" to "the".

2025-06-28T23:13:18Z

Change "there" to "the".

← Revisión anterior		Revisión del 23:13 28 jun 2025
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	==Background==		==Background==
	*Urine drug screen (UDS / UTOX) is typically ordered in trauma, psych, and altered mental status patients where ~~there~~ results can assist inpatient management.		*Urine drug screen (UDS / UTOX) is typically ordered in trauma, psych, and altered mental status patients where the results can assist inpatient management.
	*Cooperative psych patients do not require Utox as part of the ED screen<ref>Lukens, TW, et al. Clinical Policy: Critical Issues in the Diagnosis and Management of the Adult Psychiatric Patient in the Emergency Department. Annals of Emergency Medicine. 2006; 47(1):79-99.</ref> (unless local policy dictates)		*Cooperative psych patients do not require Utox as part of the ED screen<ref>Lukens, TW, et al. Clinical Policy: Critical Issues in the Diagnosis and Management of the Adult Psychiatric Patient in the Emergency Department. Annals of Emergency Medicine. 2006; 47(1):79-99.</ref> (unless local policy dictates)
	*Routine testing of activated traumas is reasonable, but discretionary testing of nonactivated traumas should be adopted<ref>Dunham CM, Chirichella, TJ. Trauma Activation Patients: Evidence for Routine Alcohol and Illicit Drug Screening. PLoS ONE. 2012; 7(10): e47999.</ref>		*Routine testing of activated traumas is reasonable, but discretionary testing of nonactivated traumas should be adopted<ref>Dunham CM, Chirichella, TJ. Trauma Activation Patients: Evidence for Routine Alcohol and Illicit Drug Screening. PLoS ONE. 2012; 7(10): e47999.</ref>

ClaireLewis at 17:54, 16 August 2019

2019-08-16T17:54:31Z

← Revisión anterior		Revisión del 17:54 16 ago 2019
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	! Screen !! Drugs		! Screen !! Drugs
	\|-		\|-
	\| [[Amphetamines]] \|\| Amantadine, bupropion, chlorpromazine, desipramine. fluoxetine, L-methamphetamine, labetalol, methylphenidate, phentermine, phenylephrine, phenylpropanolamine, promethazine, pseudoephedrine, ranitidine, thioridazine, trazodone		\| [[Amphetamines]] \|\| [[Amantadine]], [[bupropion]], [[chlorpromazine]], desipramine. [[fluoxetine]], L-[[methamphetamine]], [[labetalol]], [[methylphenidate]], phentermine, [[phenylephrine]], phenylpropanolamine, [[promethazine]], [[pseudoephedrine]], ranitidine, thioridazine, [[trazodone]]
	\|-		\|-
	\| [[Benzodiazepines]] \|\| Oxaprozin, sertraline		\| [[Benzodiazepines]] \|\| Oxaprozin, sertraline
	\|-		\|-
	\| [[Cannabinoids]] \|\| Dronabinol, nonsteroidal anti-inflammatory drugs, proton pump ~~inhibitors~~		\| [[Cannabinoids]] \|\| Dronabinol, [[nonsteroidal anti-inflammatory drugs]], [[proton pump inhibitor]]s
	\|-		\|-
	\| [[Cocaine]] \|\| Topical anesthetics containing cocaine		\| [[Cocaine]] \|\| Topical anesthetics containing cocaine
	\|-		\|-
	\| [[Opiates]] \|\| Dextromethorphan, [[diphenhydramine]], fluoroquinolones, poppy seeds, quinine, rifampin, verapamil		\| [[Opiates]] \|\| [[Dextromethorphan]], [[diphenhydramine]], [[fluoroquinolones]], poppy seeds, [[quinine]], [[rifampin]], [[verapamil]]
	\|-		\|-
	\| [[Phencyclidine]] \|\| Dextromethorphan, [[diphenhydramine]], ibuprofen, imipramine, ketamine, meperidine, thioridazine, tramadol, venlafaxine		\| [[Phencyclidine]] \|\| [[Dextromethorphan]], [[diphenhydramine]], [[ibuprofen]], imipramine, ketamine, meperidine, thioridazine, [[tramadol]], [[venlafaxine]]
	\|}		\|}

Kearny89: /* Background */

2019-06-05T01:44:54Z

Background

← Revisión anterior		Revisión del 01:44 5 jun 2019
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	*Unlikely to have any significant impact on the management of ED patients<ref>Tenenbein M. Do you really need that emergency drug screen? Clin Toxicol (Phila). 2009 Apr;47(4):286-91. PMID:19514875</ref>		*Unlikely to have any significant impact on the management of ED patients<ref>Tenenbein M. Do you really need that emergency drug screen? Clin Toxicol (Phila). 2009 Apr;47(4):286-91. PMID:19514875</ref>
	*Drug testing alone never significantly better than history<ref>Perrone J, De Roos F, Jayaraman S, Hollander JE. Drug screening versus history in detection of substance use in ED psychiatric patients. Am J Emerg Med. 2001 Jan;19(1):49-51. PMID: 11146019.</ref>		*Drug testing alone never significantly better than history<ref>Perrone J, De Roos F, Jayaraman S, Hollander JE. Drug screening versus history in detection of substance use in ED psychiatric patients. Am J Emerg Med. 2001 Jan;19(1):49-51. PMID: 11146019.</ref>
			*Appropriate in pediatric altered mental status workup, determining brain death, management of psychiatric disease (dual diagnosis treatment), and in trauma victim patients (substance abuse counseling).

	==Detection Interval==		==Detection Interval==

Ostermayer: /* Detection IntervalCourtesy Kishan Kapadia and UMEM derived from Goldfrank's Toxicologic Emergencies, 9th ed; Table 6-10 */

2019-05-01T17:10:32Z

Detection IntervalCourtesy Kishan Kapadia and UMEM derived from Goldfrank's Toxicologic Emergencies, 9th ed; Table 6-10

← Revisión anterior		Revisión del 17:10 1 may 2019
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	*Drug testing alone never significantly better than history<ref>Perrone J, De Roos F, Jayaraman S, Hollander JE. Drug screening versus history in detection of substance use in ED psychiatric patients. Am J Emerg Med. 2001 Jan;19(1):49-51. PMID: 11146019.</ref>		*Drug testing alone never significantly better than history<ref>Perrone J, De Roos F, Jayaraman S, Hollander JE. Drug screening versus history in detection of substance use in ED psychiatric patients. Am J Emerg Med. 2001 Jan;19(1):49-51. PMID: 11146019.</ref>

	==Detection Interval<ref>Courtesy Kishan Kapadia and UMEM derived from Goldfrank's Toxicologic Emergencies, 9th ed; Table 6-10</ref>==		==Detection Interval==
			This is the estimated time a drug is detectable on urine drug screen after last use.<ref>Courtesy Kishan Kapadia and UMEM derived from Goldfrank's Toxicologic Emergencies, 9th ed; Table 6-10</ref>
	{\| class="wikitable"		{\| class="wikitable"
	\|-		\|-

Rossdonaldson1: /* Cross Reactivity */

2017-03-12T04:49:42Z

Cross Reactivity

← Revisión anterior		Revisión del 04:49 12 mar 2017
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	==Cross Reactivity==		==Cross Reactivity==
	Many non illicit drugs cross react with common drugs screened on the traditional urine drug screen <ref>Standridge, JB, et al. Urine Drug Screening: A Valuable Office Procedure. Am Fam Physician. 2010; 81(5):635-640.</ref><ref>Brahm N. et al.Commonly prescribed medications and potential false-positive urine drug screens Am J Health Syst Pharm August 15, 2010 67:1344-1350;</ref>		Many non-illicit drugs cross react with common drugs screened on the traditional urine drug screen <ref>Standridge, JB, et al. Urine Drug Screening: A Valuable Office Procedure. Am Fam Physician. 2010; 81(5):635-640.</ref><ref>Brahm N. et al.Commonly prescribed medications and potential false-positive urine drug screens Am J Health Syst Pharm August 15, 2010 67:1344-1350;</ref>
	{\| class="wikitable"		{\| class="wikitable"
	\|-		\|-

Rossdonaldson1: /* True Positives and False Negatives */

2016-09-26T07:30:22Z

True Positives and False Negatives

← Revisión anterior		Revisión del 07:30 26 sep 2016
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	! Screen !! TP !! FN		! Screen !! TP !! FN
	\|-		\|-
	\| '''Amphetamines''' \|\| \|\| MDA & MDMA		\| '''[[Amphetamines]]''' \|\| \|\| MDA & MDMA
	\|-		\|-
	\| '''Benzodiazepines''' \|\|Oxazepam, temazepam, diazepam, alprazolam, triazolam \|\| Lorazepam, clonazepam, midazolam		\| '''[[Benzodiazepines]]''' \|\|Oxazepam, temazepam, diazepam, alprazolam, triazolam \|\| Lorazepam, clonazepam, midazolam
	\|-		\|-
	\| '''Cannabinoids''' \|\| \|\| Synthetics		\| '''[[Cannabinoids]]''' \|\| \|\| Synthetics
	\|-		\|-
	\| '''Cocaine''' \|\| \|\| Unlikely		\| '''[[Cocaine]]''' \|\| \|\| Unlikely
	\|-		\|-
	\| '''Opiates''' \|\| Morphine, Codeine, Heroin \|\| Fentanyl, tramadol, meperidine, methadone, oxycodone, buprenorphine, hydrocodone, hydromorphone		\| '''[[Opiates]]''' \|\| Morphine, Codeine, Heroin \|\| Fentanyl, tramadol, meperidine, methadone, oxycodone, buprenorphine, hydrocodone, hydromorphone
	\|-		\|-
	\| '''Phencyclidine''' \|\| New screens are very specific \|\|		\| '''[[Phencyclidine]]''' \|\| New screens are very specific \|\|
	\|}		\|}

Rossdonaldson1: /* Cross Reactivity */

2016-09-26T07:29:41Z

Cross Reactivity

← Revisión anterior		Revisión del 07:29 26 sep 2016
Línea 32:		Línea 32:
	! Screen !! Drugs		! Screen !! Drugs
	\|-		\|-
	\| Amphetamines \|\| Amantadine, bupropion, chlorpromazine, desipramine. fluoxetine, L-methamphetamine, labetalol, methylphenidate, phentermine, phenylephrine, phenylpropanolamine, promethazine, pseudoephedrine, ranitidine, thioridazine, trazodone		\| [[Amphetamines]] \|\| Amantadine, bupropion, chlorpromazine, desipramine. fluoxetine, L-methamphetamine, labetalol, methylphenidate, phentermine, phenylephrine, phenylpropanolamine, promethazine, pseudoephedrine, ranitidine, thioridazine, trazodone
	\|-		\|-
	\| Benzodiazepines \|\| Oxaprozin, sertraline		\| [[Benzodiazepines]] \|\| Oxaprozin, sertraline
	\|-		\|-
	\| Cannabinoids \|\| Dronabinol, nonsteroidal anti-inflammatory drugs, proton pump inhibitors		\| [[Cannabinoids]] \|\| Dronabinol, nonsteroidal anti-inflammatory drugs, proton pump inhibitors
	\|-		\|-
	\| Cocaine \|\| Topical anesthetics containing cocaine		\| [[Cocaine]] \|\| Topical anesthetics containing cocaine
	\|-		\|-
	\| Opiates \|\| Dextromethorphan, [[diphenhydramine]], fluoroquinolones, poppy seeds, quinine, rifampin, verapamil		\| [[Opiates]] \|\| Dextromethorphan, [[diphenhydramine]], fluoroquinolones, poppy seeds, quinine, rifampin, verapamil
	\|-		\|-
	\| Phencyclidine \|\| Dextromethorphan, [[diphenhydramine]], ibuprofen, imipramine, ketamine, meperidine, thioridazine, tramadol, venlafaxine		\| [[Phencyclidine]] \|\| Dextromethorphan, [[diphenhydramine]], ibuprofen, imipramine, ketamine, meperidine, thioridazine, tramadol, venlafaxine
	\|}		\|}

Nmanus: /* Background */

2016-09-25T23:46:56Z

Background

← Revisión anterior		Revisión del 23:46 25 sep 2016
Línea 1:		Línea 1:
	==Background==		==Background==
	*~~Utox~~ is typically ordered in trauma, psych, and altered mental status patients where there results can assist inpatient management.		*Urine drug screen (UDS / UTOX) is typically ordered in trauma, psych, and altered mental status patients where there results can assist inpatient management.
	*Cooperative psych patients do not require Utox as part of the ED screen<ref>Lukens, TW, et al. Clinical Policy: Critical Issues in the Diagnosis and Management of the Adult Psychiatric Patient in the Emergency Department. Annals of Emergency Medicine. 2006; 47(1):79-99.</ref> (unless local policy dictates)		*Cooperative psych patients do not require Utox as part of the ED screen<ref>Lukens, TW, et al. Clinical Policy: Critical Issues in the Diagnosis and Management of the Adult Psychiatric Patient in the Emergency Department. Annals of Emergency Medicine. 2006; 47(1):79-99.</ref> (unless local policy dictates)
	*Routine testing of activated traumas is reasonable, but discretionary testing of nonactivated traumas should be adopted<ref>Dunham CM, Chirichella, TJ. Trauma Activation Patients: Evidence for Routine Alcohol and Illicit Drug Screening. PLoS ONE. 2012; 7(10): e47999.</ref>		*Routine testing of activated traumas is reasonable, but discretionary testing of nonactivated traumas should be adopted<ref>Dunham CM, Chirichella, TJ. Trauma Activation Patients: Evidence for Routine Alcohol and Illicit Drug Screening. PLoS ONE. 2012; 7(10): e47999.</ref>

Rossdonaldson1: Text replacement - " diphenhydramine" to " diphenhydramine"

2016-08-04T00:05:10Z

Text replacement - " diphenhydramine" to " diphenhydramine"

← Revisión anterior		Revisión del 00:05 4 ago 2016
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	\| Cocaine \|\| Topical anesthetics containing cocaine		\| Cocaine \|\| Topical anesthetics containing cocaine
	\|-		\|-
	\| Opiates \|\| Dextromethorphan, diphenhydramine, fluoroquinolones, poppy seeds, quinine, rifampin, verapamil		\| Opiates \|\| Dextromethorphan, [[diphenhydramine]], fluoroquinolones, poppy seeds, quinine, rifampin, verapamil
	\|-		\|-
	\| Phencyclidine \|\| Dextromethorphan, diphenhydramine, ibuprofen, imipramine, ketamine, meperidine, thioridazine, tramadol, venlafaxine		\| Phencyclidine \|\| Dextromethorphan, [[diphenhydramine]], ibuprofen, imipramine, ketamine, meperidine, thioridazine, tramadol, venlafaxine
	\|}		\|}