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Test Code 1667 Ketamine and Metabolite Confirmation, Random, Urine

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Urine


Advisory Information


For chain-of-custody testing, order KETAX / Ketamine and Metabolite Confirmation, Chain of Custody, Urine



Additional Testing Requirements


If urine creatinine is required or adulteration of the sample is suspected, also order ADULT / Adulterants Survey, Urine.



Specimen Required


Supplies: Urine Container, 60 mL (T313)

Collection Container/Tube: Plastic, 60-mL urine container (T313)

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.


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

Day(s) and Time(s) Performed

Tuesday, Thursday

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

80357

G0480 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
KETAU Ketamine Confirmation, U In Process

 

Result ID Test Result Name Result LOINC Value
31128 Norketamine 18322-8
89443 Ketamine Confirmation, U 20537-7
29903 Ketamine Interpretation 69050-3
29904 Chain of Custody 77202-0

Clinical Information

Ketamine has been used in the United States as an anesthetic induction agent since 1972. The drug acts by noncompetitive antagonism of the N-methyl-D-aspartate (NMDA)-type glutamate receptors.(1,2) Ketamine has become a popular street drug because of its hallucinogenic effects.(3)

 

Ketamine has a half-life of 3 to 4 hours, and is metabolized to norketamine.(3) The effects from ketamine last from 1 to 5 hours, and ketamine and norketamine can be detected in the urine for a period of 1 to 2 days following use.(4)

Interpretation

The presence of ketamine or norketamine levels above 25 ng/mL is a strong indicator that the patient has used ketamine.

Clinical Reference

1. Ujhelyi MR, Robert S, Cummings DM, et al: Influence of digoxin immune Fab therapy and renal dysfunction on the disposition of total and free digoxin. Ann Intern Med 1993;119:273-277

2. Goodman and Gilman's: The Pharmacological Basis of Therapeutics. 10th edition. New York. McGraw-Hill Book Company, 2001

3. Baselt RC: Disposition of Toxic Drugs and Chemicals in Man. Seventh edition. Foster City, CA. Biomedical Publications, 2004 pp 1254

4. Mozayani A: Ketamine-Effects on human performance and behavior. Forensic Sci Rev 2002;14:123-131

Method Name

Gas Chromatography-Mass Spectrometry (GC-MS)