Hausarzt- Facharzt Praxis Dres. Forquignon, Jacobsen, Lübeck Oberdorf 1 24235 Laboe Tel. 04343 7676/6462/6480 www.dr-forquignon.de www.dr-jacobsen.de www.dr-j-luebeck.de Abnehmen Damit aus dem Traum Wirklichkeit wird sind einige Punkte zu beach-ten: Auf jeden Fall sollten Sie Ihre Motivation prüfen. Sollte der Traum zwar da sein, aber die Bereitschaft dafür auch etwas zu geben nicht ausge-prägt vorhanden sein, sollte man den Traum lieber verwerfen. Es sollte einem jedoch klar sein, daß man eine Menge zu gewinnen hat: Viele Gründe das Gewicht zu reduzieren (sofern man übergewichtig oder gar fettleibig (adipös) ist. 1. länger leben. 2. weniger Krankheiten (Bluthochdruck, Diabetes, KHK u.v.m.). 3. besser aussehen. 4. bequemer im Alltag (keine Luftnot, Schuhe schnüren etc.). Für die Bestimmung, ob man überhaupt Übergewichtig ist gibt es einige moderne Methoden: BMI - body mass index: Der "body-mass-index" (BMI) berechnet sich so: Körpergewicht in Kilogramm geteilt durch Körpergrösse in Metern im Quadrat (gilt ab dem 16.Lebensjahr). Einen BMI Rechner können Sie unter (www.praxis-laboe.de/pdf/BMI_Rechner_v1.4.0.exe) her-unterladen. Mit dem BMI scheiden die Ärzte die Menschen in Normalgewichtige und Übergewich-tige. Ab 25 gilt man als übergewichtig. Wer einen BMI von über 30 hat, gilt gemäss Weltgesundheits- Organisation gar als adipös, zu deutsch: krankhaft fettleibig. Ein optimaler BMI liegt zwischen 19 und 25. Es ist aber nicht so klar, wo die Grenze zwischen gesundem und ungesundem Körpergewicht liegt. Und das überrascht, wenn man bedenkt, dass Übergewichtige schon fast wie Aus-sätzige behandelt werden. Unstrittig in der Praxis ist nur, dass ein BMI unter 25 er-freulich ist und dass bei 40 die Alarmstufe Rot beginnt. Dazwischen herrscht Verwir-rung. Zum Beispiel ist auch eine leichte Zunahme des BMI bei zunehmenden Alter normal: 19-24 Jahre: BMI 19-24; 25-34 Jahre: BMI 20-25; 35-44 Jahre: BMI 21-26; 45-54 Jahre: BMI 22-27; 55-64 Jahre: BMI 23-28 und über 65 Jahre: BMI 24-29. viel-leicht. Wenn die Person gleichzeitig einen hohen Blutdruck, Zucker, Arthrose oder erhöhte Cholesterinwerte hat, empfehle ich, das Gewicht zu reduzieren. Ab einem BMI von 30 empfehle ich auf jeden Fall abzunehmen. Bauch / Bauchumfang
Some reviews of clomid noted that the drug can also cause weight gain, hair loss and vision impairment Problems with impregnation Before using the product you should consult with a specialist and to get acquainted with the instructions approved by the manufacturer.Cialis ne doit pas être prise à tous. Il est important que cialis en ligne est prescrit par un médecin, bien se familiariser avec les antécédents médicaux du patient. Ich habe Probleme mit schnellen Montage. Lesen Sie Testberichte Nahm wie cialis rezeptfrei 30 Minuten vor dem Sex, ohne Erfolg. Beginn der Arbeiten nach 4 Stunden, links ein Freund ein trauriges Ja, und Schwanz in sich selbst nicht ausstehen, wenn es keinen Wunsch ist.
Acon *hcgblurred vision in some users. Its mechanism of action is thought to be via release of the neurotransmitter serotonin. MDMA may also release dopamine, although the general opinion is that this is a secondary ™ One Step Multi-Drug
effect of the drug (Nichols and Oberlender, 1990). The most pervasive effect of MDMA, occurring in Benzodiazepines are medications that are frequently prescribed for the symptomatic treatment of anxiety virtually all people who took a reasonable dose of the drug, was to produce a clenching of the jaws. The Screen Test Card with the Integrated Cup
and sleep disorders. They produce their effects via specific receptors involving a neurochemical called AmeriCup™ Drug Screen Cup yields a positive result when the Methylenedioxymethamphetamine in urine
gamma aminobutyric acid (GABA). Because they are safer and more effective, Benzodiazepines have exceeds 500 ng/mL. Instruction Sheet for testing of any combination of the following drugs: replaced barbiturates in the treatment of both anxiety and insomnia. Benzodiazepines are also used as OPIATE (MOP 300)
sedatives before some surgical and medical procedures, and for the treatment of seizure disorders and THC, COC, METH, OPI, AMPH, BZO, MTD, OXY, PPX, BAR, PCP, MDMA
alcohol withdrawal. Opiate refers to any drug that is derived from the opium poppy, including the natural products, morphine and codeine, and the semi-synthetic drugs such as heroin. Opioid is more general, referring to any drug With Adulteration for Oxidants, Specific Gravity and pH levels.
Risk of physical dependence increases if Benzodiazepines are taken regularly (e.g., daily) for more than a few months, especially at higher than normal doses. Stopping abruptly can bring on such symptoms as that acts on the opioid receptor. Opioid analgesics comprise a large group of substances which control pain by depressing the central A rapid, one step screening test for the simultaneous, qualitative detection of multiple drugs and
trouble sleeping, gastrointestinal upset, feeling unwell, loss of appetite, sweating, trembling, weakness, nervous system. Large doses of morphine can produce higher tolerance levels, physiological dependency drug metabolites in human urine.
anxiety and changes in perception. Only trace amounts (less than 1%) of most Benzodiazepines are excreted unaltered in the urine; most of the in users, and may lead to substance abuse. Morphine is excreted unmetabolized, and is also the major For healthcare professionals including professionals at point of care sites.
concentration in urine is conjugated drug. The detection period for the Benzodiazepines in the urine is 3-7 days. metabolic product of codeine and heroin. Morphine is detectable in the urine for several days after an For forensic use only.
The AmeriCup™ Drug Screen Cup yields a positive result when the Benzodiazepines in urine exceed 300
The AmeriCup™ Drug Screen Cup yields a positive result when the concentration of opiate exceeds the
300 ng/mL cut-off level. COCAINE (COC)
The AmeriCup™ Drug Screen Cup is a lateral flow chromatographic immunoassay for the qualitative
Cocaine is a potent central nervous system (CNS) stimulant and a local anesthetic. Initially, it brings detection of multiple drugs and drug metabolites in urine at the following cut-off concentrations: about extreme energy and restlessness while gradually resulting in tremors, over-sensitivity and spasms. The AmeriCup™ Drug Screen Cup yields a positive result when the morphine in urine exceeds 2,000
ng/mL. This is the suggested screening cut-off for positive specimens set by the Substance Abuse and In large amounts, cocaine causes fever, unresponsiveness, difficulty in breathing and unconsciousness. Cocaine is often self-administered by nasal inhalation, intravenous injection and free-base smoking. It is Mental Health Services Administration (SAMHSA, USA). 4 See opiate (MOP 300) for a summary. Amphetamine (AMP)
excreted in the urine in a short time primarily as Benzoylecgonine 2,3. Benzoylecgonine, a major PHENCYCLIDINE (PCP)
metabolite of cocaine, has a longer biological half-life (5-8 hours) than cocaine (0.5-1.5 hours), and can Benzodiazepines (BZO)
generally be detected for 24-48 hours after cocaine exposure.3 Phencyclidine, also known as PCP or Angel Dust, is a hallucinogen that was first marketed as a surgical anesthetic in the 1950's. It was removed from the market because patients receiving it became delirious Cocaine (COC)
The AmeriCup™ Drug Screen Cup yields a positive result when the cocaine metabolite in urine exceeds
and experienced hallucinations. Marijuana (THC)
300 ng/mL. This is the suggested screening cut-off for positive specimens set by the Substance Abuse Phencyclidine is used in powder, capsule, and tablet form. The powder is either snorted or smoked after Methadone (MTD)
and Mental Health Services Administration (SAMHSA, USA). 4 mixing it with marijuana or vegetable matter. Phencyclidine is most commonly administered by inhalation Methamphetamine (mAMP)
but can be used intravenously, intra-nasally, and orally. After low doses, the user thinks and acts swiftly THC (∆9--tetrahydrocannabinol) is the primary active ingredient in cannabis (marijuana). When smoked or and experiences mood swings from euphoria to depression. Self-injurious behavior is one of the D,L Methylenedioxymethamphetamine
oral y administered, THC produces euphoric ef ects. Users have impaired short term memory and slowed devastating effects of Phencyclidine. Morphine (MOP 300)
learning. They may also experience transient episodes of confusion and anxiety. Long-term, relatively heavy PCP can be found in urine within 4 to 6 hours after use and will remain in urine for 7 to 14 days, Opiates (OPI 2000)
use may be associated with behavioral disorders. The peak ef ect of marijuana administered by smoking depending on factors such as metabolic rate, user's age, weight, activity, and diet.5 Phencyclidine is Phencyclidine (PCP)
occurs in 20-30 minutes and the duration is 90-120 minutes after one cigaret e. Elevated levels of urinary excreted in the urine as an unchanged drug (4% to 19%) and conjugated metabolites (25% to 30%).6 Tricyclic Antidepressants (TCA)
metabolites are found within hours of exposure and remain detectable for 3-10 days after smoking. The main The AmeriCup™ Drug Screen Cup yields a positive result when the phencyclidine level in urine exceeds
metabolite excreted in the urine is 11-nor-∆9-tetrahydrocannabinol-9-carboxylic acid (∆9-THC-COOH). 25 ng/mL. This is the suggested screening cut-off for positive specimens set by the Substance Abuse and Configurations of the AmeriCup™ Drug Screen Cup come with any combination of the above listed
The AmeriCup™ Drug Screen Cup yields a positive result when the concentration of THC-COOH in urine
Mental Health Services Administration (SAMHSA, USA). drug analytes. This assay provides only a preliminary analytical test result. A more specific
exceeds 50 ng/mL. This is the suggested screening cut-off for positive specimens set by the Substance alternate chemical method must be used in order to obtain a confirmed analytical result. Gas
TRICYCLIC ANTIDEPRESSANTS (TCA)
Abuse and Mental Health Services Administration (SAMHSA, USA). 4 chromatography/mass spectrometry (GC/MS) is the preferred confirmatory method. Clinical
TCA (Tricyclic Antidepressants) are commonly used for the treatment of depressive disorders. TCA consideration and professional judgment should be applied to any drug of abuse test result,
overdoses can result in profound central nervous system depression, cardiotoxicity and anticholinergic particularly when preliminary positive results are indicated.
Methadone is a narcotic analgesic prescribed for the management of moderate to severe pain and for the effects. TCA overdose is the most common cause of death from prescription drugs. TCAs are taken orally or sometimes by injection. TCAs are metabolized in the liver. Both TCAs and their metabolites are treatment of opiate dependence (heroin, Vicodin, Percocet, Morphine). The pharmacology of oral Methadone is very different from IV Methadone. Oral Methadone is partially stored in the liver for later excreted in urine mostly in the form of metabolites for up to ten days. The AmeriCup™ Drug Screen Cup is a rapid urine screening test that can be performed without the use
use. IV Methadone acts more like heroin. In most states you must go to a pain clinic or a Methadone The AmeriCup™ Drug Screen Cup yields a positive result when the concentration Tricyclic
of an instrument. The test utilizes monoclonal antibodies to selectively detect elevated levels of specific maintenance clinic to be prescribed Methadone. Antidepressants in urine exceeds 1,000 ng/mL. drugs in urine.
Methadone is a long acting pain reliever producing ef ects that last from twelve to forty-eight hours. Ideal y, S.V.T. SUMMARY
Methadone frees the client from the pressures of obtaining il egal heroin, from the dangers of injection, and from the emotional rol er coaster that most opiates produce. Methadone, if taken for long periods and at large doses, The strip contains chemically treated reagent pads. 3-5 minutes following the activation of the reagent Amphetamine is a Schedule II controlled substance available by prescription (Dexedrine®) and is also can lead to a very long withdrawal period. The withdrawals from Methadone are more prolonged and pads by the urine sample, the colors that appear on the pads can be compared with the printed color available on the illicit market. Amphetamines are a class of potent sympathomimetic agents with troublesome than those provoked by heroin cessation, yet the substitution and phased removal of methadone is chart card. The color comparison provides a semi-quantitative screen for oxidants/pyridinium therapeutic applications. They are chemically related to the human body's natural catecholamines: an acceptable method of detoxification for patients and therapists.1 chlorochromate (PCC), specific gravity and pH in human urine which can help assess the integrity of the epinephrine and norepinephrine. Acute higher doses lead to enhanced stimulation of the central nervous The AmeriCup™ Drug Screen Cup yields a positive result when the Methadone in urine exceeds 300 ng/mL.
system and induce euphoria, alertness, reduced appetite, and a sense of increased energy and power. Cardiovascular responses to Amphetamines include increased blood pressure and cardiac arrhythmias. METHAMPHETAMINE (mAMP)
WHAT IS ADULTERATION?
More acute responses produce anxiety, paranoia, hallucinations, and psychotic behavior. The effects of Methamphetamine is an addictive stimulant drug that strongly activates certain systems in the brain. Adulteration is the tampering of a urine specimen with the intention of altering the test results. The use of Amphetamines generally last 2-4 hours following use and the drug has a half-life of 4-24 hours in the Methamphetamine is closely related chemically to amphetamine, but the central nervous system effects adulterants can cause false negative results in drug tests by either interfering with the screening test body. About 30% of Amphetamines are excreted in the urine in unchanged form, with the remainder as of Methamphetamine are greater. Methamphetamine is made in illegal laboratories and has a high and/or destroying the drugs present in the urine. Dilution may also be employed in an attempt to produce hydroxylated and deaminated derivatives. potential for abuse and dependence. The drug can be taken orally, injected, or inhaled. Acute higher false negative drug test results. The AmeriCup™ Drug Screen Cup yields a positive result when Amphetamines in urine exceed 1,000
doses lead to enhanced stimulation of the central nervous system and induce euphoria, alertness, One of the best ways to test for adulteration or dilution is to determine certain urinary characteristics such ng/mL. This is the suggested screening cut-off for positive specimens set by the Substance Abuse and reduced appetite, and a sense of increased energy and power. Cardiovascular responses to as pH and specific gravity and to detect the presence of oxidants/PCC, specific gravity and pH in urine. Mental Health Services Administration (SAMHSA, USA). 4 Methamphetamine include increased blood pressure and cardiac arrhythmias. More acute responses • Oxidants (Pyridinium chlorochromate) tests for the presence of oxidizing agents such as bleach and
produce anxiety, paranoia, hallucinations, psychotic behavior, and eventually, depression and exhaustion. hydrogen peroxide. Pyridinium chlorochromate (sold under the brand name UrineLuck) is a commonly The effects of Methamphetamine generally last 2-4 hours and the drug has a half-life of 9-24 hours in the used adulterant.9 Normal human urine should not contain oxidants or PCC. Barbiturates are central nervous system depressants. They are used therapeutically as sedatives, body. Methamphetamine is excreted in the urine as amphetamine and oxidized and deaminated • Specific gravity tests for sample dilution. The normal range is from 1.003 to 1.030. Values outside
hypnotics, and anticonvulsants. Barbiturates are almost always taken orally as capsules or tablets. The derivatives. However, 10-20% of Methamphetamine is excreted unchanged. Thus, the presence of the this range may be the result of specimen dilution or adulteration. effects resemble those of intoxication with alcohol. Chronic use of barbiturates leads to tolerance and parent compound in the urine indicates Methamphetamine use. Methamphetamine is generally • pH tests for the presence of acidic or alkaline adulterants in urine. Normal pH levels should be in the
physical dependence. detectable in the urine for 3-5 days, depending on urine pH level. range of 4.0 to 9.0. Values outside of this range may indicate the sample has been altered. Short acting Barbiturates taken at 400 mg/day for 2-3 months can produce a clinically significant degree The AmeriCup™ Drug Screen Cup yields a positive result when the Methamphetamine in urine exceeds
of physical dependence. Withdrawal symptoms experienced during periods of drug abstinence can be PRINCIPLE
severe enough to cause death. The AmeriCup™ Drug Screen Cup with the integrated cup is an immunoassay based on the principle of
Only a small amount (less than 5%) of most Barbiturates are excreted unaltered in the urine. competitive binding. Drugs which may be present in the urine specimen compete against their respective The approximate detection time limits for Barbiturates are: Methylenedioxymethamphetamine (ecstasy) is a designer drug first synthesized in 1914 by a German drug conjugate for binding sites on their specific antibody. Short acting (e.g. Secobarbital) 100 mg PO (oral) drug company for the treatment of obesity.8 Those who take the drug frequently report adverse effects, Long acting (e.g. Phenobarbital) 400 mg PO (oral) such as increased muscle tension and sweating. MDMA is not clearly a stimulant, although it has, in During testing, a urine specimen migrates upward by capillary action. A drug, if present in the urine The AmeriCup™ Drug Screen Cup yields a positive result when the Barbiturates in urine exceed 300 ng/mL.
common with amphetamine drugs, a capacity to increase blood pressure and heart rate. MDMA does specimen below its cut-off concentration, will not saturate the binding sites of its specific antibody. The produce some perceptual changes in the form of increased sensitivity to light, difficulty in focusing, and antibody will then react with the drug-protein conjugate and a visible colored line will show up in the test line region of the specific drug strip. The presence of drug above the cut-off concentration will saturate all the binding sites of the antibody. Therefore, the colored line will not form in the test line region. A drug-positive urine specimen will not generate a colored line in the specific test line region of the strip PCP Phencyclidine because of drug competition, while a drug-negative urine specimen will generate a line in the test line TCA Nortriptyline region because of the absence of drug competition. The following results are tabulated from these clinical studies: To serve as a procedural control, a colored line will always appear at the control line region, indicating %Agreement with Commercial Kit
that proper volume of specimen has been added and membrane wicking has occurred. REAGENTS
97% >99% 90% 95% 98% 99% The test contains a membrane strip coated with drug-protein conjugates (purified bovine albumin) on the INTERPRETATION OF RESULTS
test line, a goat polyclonal antibody against gold-protein conjugate at the control line, and a dye pad (Please refer to the illustration above) 100% >99% 97% >99% 100% >99% which contains colloidal gold particles coated with mouse monoclonal antibody specific to Amphetamine, Cocaine, Methamphetamine, Methylenedioxymethamphetamine, Morphine, THC, Phencyclidine, NEGATIVE:* Two lines appear. One red line should be in the control region (C), and another apparent
98% 99% 94% 98% 99% >99% Benzodiazepine, Methadone, Barbiturate or Tricyclic antidepressants. red or pink line adjacent should be in the test region (Drug/T). This negative result indicates that the drug S.V.T. REAGENTS
concentration is below the detectable level.
*NOTE: The shade of red in the test line region (Drug/T) will vary, but it should be considered negative
whenever there is even a faint pink line. Adulteration Pad Reactive indicator Buffers and non-reactive ingredients POSITIVE: One red line appears in the control region (C). No line appears in the test region
Oxidants/PCC 0.36% 99.64% (Drug/T). This positive result indicates that the drug concentration is above the detectable level.
100% 99% 100% >99% 100% >99% Specific Gravity INVALID: Control line fails to appear. Insufficient specimen volume or incorrect procedural techniques
are the most likely reasons for control line failure. Review the procedure and repeat the test using a new PRECAUTIONS
test panel. If the problem persists, discontinue using the lot immediately and contact your manufacturer. %Agreement with GC/MS
For healthcare professionals including professionals at point of care sites. SVT/ADULTERANT INTERPRETATION
• For forensic use only. Do not use after the expiration date. AMP BAR BZO COC THC MTD (Please refer to the color chart) • The test cup should remain in the sealed pouch until use. 97% >99% 96% 96% 97% 99% • All specimens should be considered potentially hazardous and handled in the same manner as an Semi-quantitative results are obtained by visually comparing the reacted color blocks on the strip to the printed color blocks on the color chart. No instrumentation is required. infectious agent. 95% >99% 96% >90% 88% >94% • The used test cup should be discarded according to federal, state and local regulations. QUALITY CONTROL
STORAGE AND STABILITY
A procedural control is included in the test. A red line appearing in the control region (C) is considered an 96% 99% 96% 93% 91% >96% internal procedural control. It confirms sufficient specimen volume, adequate membrane wicking and Store as packaged in the sealed pouch at 2-30°C. The test is stable through the expiration date printed correct procedural technique. on the sealed pouch. The test devices must remain in the sealed pouch until use. DO NOT FREEZE. Do Control standards are not supplied with this kit. However, it is recommended that positive and not use beyond the expiration date. negative controls be tested as good laboratory practice to confirm the test procedure and to verify 99% 96% 100% >99% 100% >99% SPECIMEN COLLECTION AND PREPARATION
proper test performance. Urine Assay
The urine specimen must be collected in a clean and dry container. Urine collected at any time of the day LIMITATIONS
may be used. Urine specimens exhibiting visible precipitates should be centrifuged, filtered, or allowed to 1. The AmeriCup™ Drug Screen Cup provides only a qualitative, preliminary analytical result. A
settle to obtain a clear specimen for testing. secondary analytical method must be used to obtain a confirmed result. Gas chromatography/mass Specimen Storage
spectrometry (GC/MS) is the preferred confirmatory method. 3,4,7 Forty (40) clinical samples for each drug were run using each of the AmeriCup™ Drug Screen Cup by an
Urine specimens may be stored at 2-8°C for up to 48 hours prior to testing. For prolonged storage, specimens 2. There is a possibility that technical or procedural errors, as well as other interfering substances in the untrained operator at a Professional Point of Care site. Based on GC/MS data, the operator obtained may be frozen and stored below -20°C. Frozen specimens should be thawed and mixed well before testing. urine specimen may cause erroneous results. statistically similar Positive Agreement, Negative Agreement and Overall Agreement rates as trained laboratory personnel. MATERIALS
3. Adulterants, such as bleach and/or alum, in urine specimens may produce erroneous results regardless of the analytical method used. If adulteration is suspected, the test should be repeated with *Note: TCA was based on HPLC data. Materials Provided
another urine specimen. Precision
• AmeriCup™ Drug Screen Cups has a Fahrenheit temperature strip affixed to aid in the determination
4. A Positive result does not indicate level or intoxication, administration route or concentration in urine. A study was conducted at three physician offices by untrained operators using three different lots of of specimen validity. Please use this temperature strip in conjunction with your Drug Free Policy (if 5. A Negative result may not necessarily indicate drug-free urine. Negative results can be obtained when product to demonstrate the within run, between run and between operator precision. An identical panel of drug is present but below the cut-off level of the test. coded specimens, containing drugs at the concentration of ± 50% and ± 25% cut-off level, was labeled, • Chain of Custody Forms with Security Seals included 6. Test does not distinguish between drugs of abuse and certain medications. blinded and tested at each site. The results are given below: 7. A positive test result may be obtained from certain foods or food supplements. AMPHETAMINE (AMP)
• Adulteration color brochure S.V.T. ADULTERATION LIMITATIONS
Materials Required But Not Provided
1. The adulteration tests included with this product are meant to aid in the determination of abnormal conc. (ng/mL)
specimens. While comprehensive, these tests are not meant to be an all-inclusive representation of possible adulterants. 2. Oxidants/PCC: Normal human urine should not contain oxidants or PCC. The presence of high levels DIRECTIONS FOR USE
of antioxidants in the specimen, such as ascorbic acid, may result in false negative results for the Allow the test cup, urine specimen, and/or controls to equilibrate to room temperature (15-30°C)
oxidants/PCC pad. prior to testing.
3. Specific Gravity: Elevated levels of protein in urine may cause abnormally high specific gravity values. 1. Bring the pouch to room temperature before opening it. Remove the test from the sealed pouch and PERFORMANCE CHARACTERISTICS
insert it into the cup. Accuracy
2. Use the test as soon as possible. 3. Donor provides specimen and secures the cap tightly. A side-by-side comparison was conducted using the AmeriCup™ Drug Screen Cup and commercially
available drug rapid tests. Testing was performed on approximately 300 specimens per drug type 5. Check the temperature label (Temp Label) up to 4 minutes after specimen collection. A green color previously collected from subjects presenting for Drug Screen Testing. Presumptive positive results were will appear to indicate the temperature of the urine specimen. The proper range for an unadulterated confirmed by GC/MS. The following compounds were quantified by GC/MS and contributed to the total specimen is 32-38°C (90-100°F). [See image (1)].
amount of drugs found in presumptive positive urine samples tested. 6. Peel off the label on the multi-drug test cup to view results. [See image (2).]
Compounds Contributed to the Totals of GC/MS
7. Read the adulteration strip between 3 and 5 minutes. Compare the colors on the adulteration strip to the enclosed color chart. If the specimen indicates adulteration, refer to your Drug Free Policy for Secobarbital, Butalbital, Phenobarbital, Pentobarbital guidelines on adulterated specimens. We recommend not to interpret the drug test results and either Oxazepam, Nordiazepam, a-OH-Alprazolam, retest the urine or collect another specimen. Desalkylflurazepam 8. The results should be read at 5 minutes. Results remain stable for up to sixty minutes. See the COC Benzoylecgonine illustration below. [See image (3).]
mAMP Methamphetamine site - + - + - +
Cyclopentobarbital PHENCYCLIDINE (PCP)
a-Hydroxyalprazolam 1,262 conc. (ng/mL)
Chlordiazepoxide Chlordiazepoxide HCI Clorazepate dipotassium TRICYCLIC ANTIDEPRESSANTS (TCA)
Desalkylflurazepam MARIJUANA (THC)
COOH conc. (ng/mL)
RS-Lorazepam glucuronide Norchlordiazepoxide METHADONE (MTD)
A drug-free urine pool was spiked with drugs at concentrations listed. The results are summarized below. Methadone
AMP BAR BZO COC conc. (ng/mL)
11-nor-Δ9 -THC-9 COOH +50% Cut-off
11-nor-Δ8-THC-9 COOH METHAMPHETAMINE (mAMP)
THC MTD mAMP MDMA Cut-off Range
D-Methamphetamine 1,000 ρ-Hydroxymethamphetamine METHYLENEDIOXYMETHAMPHETAMINE (MDMA)
L-Methamphetamine 8,000 Cut-off Range
D,L-3,4-Methylenedioxymethamphetamine HCI (MDMA) 3,4-Methylenedioxyamphetamine HCI (MDA) +25% Cut-off
3,4-Methylenedioxyethyl-amphetamine (MDE) +50% Cut-off
OPIATE 300 (MOP)
The following table lists the concentration of compounds (ng/mL) that are detected positive in urine by OPIATE (OPI 2000)
AmeriCup™ Drug Screen Cup at 5 minutes.
D,L-Amphetamine sulfate 6-Monoacetylmorphine 400 Morphine 3-β-D-glucuronide OPIATES (OPI 300)
O-Hydroxyhippuric acid p-Hydroxyamphetamine p-Hydroxytyramine Ibuprofen Iproniazid D/L-Isoproterenol Isoxsuprine Ketamine Ketoprofen Labetalol Loperamide Meperidine 6-Monoacetylmorphine 5,000 Meprobamate Methoxyphenamine Morphine 3-β-D-glucuronide Methylphenidate Nalidixic Naloxone Naltrexone Naproxen Niacinamide Nifedipine Norethindrone D-Norpropoxyphene Noscapine D/L-Octopamine Oxalic Papaverine Penicillin-G Pentazocine hydrochloride Phenelzine Trans-2-phenylcyclo-propylamine β-Phenylethylamine 4-Hydroxyphencyclidine 12,500 Phenylpropanolamine Prednisolone Prednisone D/L-Propranolol D-Propoxyphene D-Pseudoephedrine Quinacrine Quinine Quindine Ranitidine Sulfamethazine Sulindac Tetracycline Tetrahydrocortisone Tetrahydrocortisone 3 (β-D-glucuronide) Tetrahydrozoline Thiamine Thioridazine D/L-Tyrosine Tolbutamide Triamterene Trifluoperazine Trimethoprim Tryptamine D/L-Tryptophan Tyramine Effect of Urinary Specific Gravity
Fifteen (15) urine samples of normal, high, and low specific gravity ranges (1.000-1.037) were spiked with drugs at 50% below and 50% above cut-off levels respectively. The AmeriCup™ Drug Screen Cup was
*Parent compound only; metabolizes into amphetamine and methamphetamine in the body. tested in duplicate using fifteen drug-free urine and spiked urine samples. The results demonstrate that varying ranges of urinary specific gravity does not affect the test results. Effect of the Urinary pH
1. Tietz NW. Textbook of Clinical Chemistry. W.B. Saunders Company. 1986; 1735. The pH of an aliquoted negative urine pool was adjusted to a pH range of 5 to 9 in 1 pH unit increments 2. Stewart DJ, Inaba T, Lucassen M, Kalow W. Clin. Pharmacol. Ther. April 1979; 25 ed: 464, 264-8. and spiked with drugs at 50% below and 50% above cut-off levels. The spiked, pH-adjusted urine was 3. Ambre J. J. Anal. Toxicol. 1985; 9:241. tested with the AmeriCup™ Drug Screen Cup. The results demonstrate that varying ranges of pH does
4. Hawks RL, CN Chiang. Urine Testing for Drugs of Abuse. National Institute for Drug Abuse (NIDA), not interfere with the performance of the test. Research Monograph 73, 1986. 5. FDA Guidance Document: Guidance for Premarket Submission for Kits for Screening Drugs of Abuse to be Used by the Consumer, 1997. A study was conducted to determine the cross-reactivity of the test with compounds in either drug-free 6. Robert DeCresce. Drug Testing in the workplace, 114. urine or drug positive urine containing Amphetamine, Barbiturates, Benzodiazepines, Cocaine, Marijuana, 7. Baselt RC. Disposition of Toxic Drugs and Chemicals in Man. 2nd Ed. Biomedical Publ., Davis, CA Methadone, Methamphetamine, Methylenedioxymethamphetamine, Opiate, Phencyclidine or Tricyclic antidepressants. The following compounds show no cross-reactivity when tested with the AmeriCup™
8. Winger, Gail, A Handbook of Drug and Alcohol Abuse, Third Edition, Oxford Press, 1992, page 146. Drug Screen Cup at a concentration of 100 μg/mL.
9. B. Cody, J.T., "Specimen Adulteration in drug urinalysis. Forensic Sci. Rev., 1990, 2:63. Non Cross-Reacting Compounds
Acetaminophen Acetophenetidin Manufactured by: N-Acetylprocainamide Acetylsalicylic Aminopyrine Amoxicillin AmeriDrug Diagnostics Ampicillin L-Ascorbic Loveland, CO 80537 Apomorphine Aspartame Atropine Benzilic Bilirubin D/L-Brompheniramine Caffeine Cannabidol Chloralhydrate Chloramphenicol Chlorothiazide D/L-Chloropheniramine Chlorpromazine Chloroquine Cholesterol Clonidine Cortisone L-Cotinine Rev. Date: 2006-07-27 Creatinine Deoxycorticosterone Dextromethorphan Diclofenac Diflunisal Digoxin Ecgonine methyl ester Estrone-3-sulfate Ethyl-p-aminobenzoate [1R,2S] (-) Ephedrine L(–)-Epinephrine Erythromycin Fenoprofen Furosemide Gentisic Hemoglobin Hydralazine Hydrochlorothiazide Hydrocortisone
Gebrauchsinformation: Information für den Anwender Citalopram Vitabalans 20 mg Filmtabletten Wirkstoff: Citalopram Lesen Sie die gesamte Packungsbeilage sorgfältig durch, bevor Sie mit der Einnahme dieses Arzneimittels beginnen, denn sie enthält wichtige Informationen. Heben Sie die Packungsbeilage auf. Vielleicht möchten Sie diese später