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Test Code KETAU Ketamine and Metabolite Confirmation, Urine

Performing Laboratory

Mayo Medical Laboratories in Rochester

Reporting Name

Ketamine Confirmation, U

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.


Reject Due To

Hemolysis

Mild OK: Gross OK

Lipemia

NA

Icterus

Mild OK: Gross OK

Other

NA

Specimen Stability Information

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

Specimen Minimum Volume

5 mL

Day(s) and Time(s) Performed

Tuesday, Thursday

Specimen Retention Time

2 weeks

Analytic Time

2 days

Reference Values

Negative

Useful For

Detection and confirmation of ketamine use

Method Name

Gas Chromatography-Mass Spectrometry (GC-MS)

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 No LOINC Needed

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.

Cautions

No significant cautionary statements

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 Description

Phencyclidine, norketamine, and ketamine, along with the deuterated internal standards, are extracted from buffered urine using solid-phase extraction techniques. The eluent from the column is dried and then analyzed by gas chromatography-mass spectrometry.(Unpublished Mayo method)