Aripiprazole is a prescription medicine used to treat the symptoms of schizophrenia, bipolar I disorder (manic depression), and major depressive disorder. Aripiprazole-BSA is designed for Aripiprazole Testing, based on the principle of specific immunochemical reaction between antibodies and antigens to analyze compounds in the human urine specimen. The testing relies on the competition for binding antibody between drug conjugate and free drug which may be present in the urine sample being tested.
Benzodiazepines are a class of psychoactive drugs that enhances the effect of GABA, a neurotransmitter, at the GABA-S receptors. The drug, therefore, has sedative action and is prescribed for anxiety, seizures, and muscle spasms over short-term use only. The development of tolerance and dependence occurs after a few days or weeks. Benzodiazepine is a major drug of abuse among poly-drug abusers. Benzodiazepine overdose does not cause severe complications if taken on its own, but if taken with alcohol, opiates, or TCA, its toxicity markedly increases.
Biotin is a form of vitamin B found in certain foods. Most people get the required amount of biotin from a healthy diet. Biotin is also advertised to have many claims such as regulating blood sugar and promoting healthy hair, skin, and nails. While these claims are present, there still isn’t sufficient data to support them. Since biotin is water-soluble, excess biotin will pass through into the urine if present. Biotinylated BSA also acts as a positive control in biotin estimation and can be a competitive inhibitor for anti-biotin antibodies.
Caffeine is a central nervous system stimulant of the methylxanthine class. It is the world's most widely consumed psychoactive drug. It is found in the seeds, nuts, or leaves of several plants native to Africa, East Asia, and South America. According to the American Academy of Sleep Medicine, caffeine’s half-life is up to 5 hours.
Carisoprodol (the active ingredient in SOMA) is a muscle relaxant used to block pain sensations and treat painful musculoskeletal conditions. The mean time for peak concentration of this drug was found to be around 1.5-2 hours. Carisoprodol should only be used for short periods of time (2-3 weeks) as prolonged use has not shown sufficient evidence of effectiveness. Long-term misuse of carisoprodol can cause addiction, overdose, withdrawal symptoms, or even death.
Cathinone is a monoamine alkaloid found in khat leaves. This drug is a stimulant that is chemically similar to many amphetamines. Cathinone is absorbed in the stomach and in the small intestine. The maximum concentration of cathinone in blood plasma is 2.3 hours after ingestion. The mean residence time is ~5.2 hours, and the elimination half-life is ~1.5 hours. Only approximately 7% of cathinone ingested can be recovered from urine.
Cocaine is a very powerful and addictive stimulant drug made from the coca plant. It can be clinically used as a local anesthetic and vasoconstrictor. Most users of cocaine snort the powder into their nose, but it can also be rubbed onto the gums, injected, or smoked as ‘crack’. Cocaine acts on multiple mechanisms in the brain leading to powerful central nervous system effects and stimulation of high levels of dopamine. Continuous abuse of cocaine can lead to strain on the heart thus the most common cause of death in prolonged users of cocaine is a stroke or cardiac arrest.
Codeine is an opioid used to treat mild to moderate pain, cough, and diarrhea. It is generally taken orally while the effect begins after half an hour with a maximum effect of 2 hours; its effect lasts 2 to 4 hours. Codeine can be broken down by the liver into morphine; codeine is produced along the same biosynthetic pathway as morphine. Poppy seeds food can also contain small amounts of codeine. Codeine can be eliminated with a ~1.6 hours terminal half-life after oral administration; it can typically be detected in urine after 1 to 3 days of use. Detection time varies with the frequency of use and conditions of individuals.
Nicotine is a plant alkaloid, derived from the tobacco plant, and is an addictive central nervous system stimulant. One of the major components of cigarettes is nicotine which causes the addictive properties of smoking. Nicotine is metabolized by the liver and forms the primary metabolite cotinine. Measuring the amount of cotinine present in an individual is the most reliable way to determine exposure to nicotine because it has a longer half-life of 15-20 hours compared to the half-life of 1-3 hours for nicotine.
Ethyl glucuronide (EtG) is a direct metabolite of ethanol that is formed in the body by glucuronidation and can be detected in urine for up to 90 hours after consuming alcohol beverages. Consuming alcohol can lead to symptoms such as difficulty walking, blurred vision, slurred speech, slowed reaction times, impaired memory. The conjugation of ETG-BSA has the potential to detect and monitor alcoholic products consumed qualitatively and quantitatively.
Fentanyl is a powerful synthetic opioid that is 50 to 100 times more potent than morphine. It is typically used to treat patients with severe pain; furthermore, it can be used to treat patients with chronic pain who are physically tolerant to other opioids. Synthetic opioids are the most common drugs involved in drug overdose deaths. The terminal elimination half-life is 219 minutes.
Gabapentin is the active substance of Neurontin (and generics), an anti-epileptic drug that affects chemicals and nerves in the body that cause seizures and certain types of pain. Though Gabapentin is not an opioid, it has been known to enhance the effects of other opioids when taken. It is for this reason that gabapentin use may need to be monitored by a medical professional.
Kratom (Mitragyna speciosa) is a tropical tree. Its leaves have two compounds (mitragynine and 7-α-hydroxymitragynine) that interact with opioid receptors in the brain and have been consumed for medical and recreational use as a stimulant or as a sedative. The legal status of Kratom still remains uncertain in many countries. The average half-life of kratom is around 24-40 hours. A urine test can identify the drug’s presence after around six hours, and traces may be detected for up to 9 days.
Methadone is an opioid used for opioid maintenance therapy in opioid dependence and for chronic pain management. Detoxification using methadone can be achieved in less than 1 month or gradually over 6 months. A single dose has a rapid effect; however, maximum effect can be reached after 5 days of use. The pain-relieving effect of a single dose lasts about 6 hours; effects can last 8 to 36 hours after long-term use. Methadone is usually taken orally but can be injected intramuscularly or intravenously. It can be detected in urine after 3 days of use.
Methamphetamine is a derivative of amphetamine. Methamphetamine is an addictive stimulant drug that strongly activates certain systems in the brain. Methamphetamine is typically detectable in urine for one to four days but may be detectable for up to a week after heavy, chronic use. A urine test typically shows a higher concentration of meth than other drug tests because the drug's metabolites are eliminated through urine.
Methylenedioxymethamphetamine known as MDMA, is a synthetic drug that acts as a stimulant and hallucinogen. It produces an energizing effect, distortions in time and perception, and enhanced enjoyment from sensory experiences. The hallucinogenic effects of MDMA usually last 3 to 5 hours. But the drug can be found in urine for longer than that, especially for a regular user. This test shows if someone has used MDMA in the last 1 to 3 days by finding it in the urine.
Morphine is a pain medication that acts directly on the central nervous system to decrease the feeling of pain. It is frequently used for pain from myocardial infarction and during labor; it can be administered orally, intramuscularly, intravenously or subcutaneously. Its maximum effect is reached after about 20 minutes when administered intravenously and 60 minutes when administered orally, while the duration of its effect is 3 to 7 hours. The presence of morphine may also occur due to eating baked goods containing poppy seeds, which naturally contain small amounts of morphine. It can typically be detected in urine after 1 to 3 days of use.
Oxycodone is an opioid medication used to alleviate severe or chronic pain. When oxycodone is taken orally, it is roughly 1.5 times more potent than morphine. It is intended to be taken every 12 hours on a controlled basis to relieve cancer pain, trauma pain, or pain due to major surgery. In high doses, oxycodone can cause decreased heart rate and blood pressure, difficulty breathing, circulatory collapse, and death. Oxycodone overdose has been described to cause spinal infarction and ischemic damage to the brain due to prolonged hypoxia. Oxycodone is detectable in urine after 1 to 4 days of use, up to 48 hours in saliva.
Phenytoin is used to prevent and control seizures (also called an anticonvulsant or antiepileptic drug). It works by reducing the spread of seizure activity in the brain.
Barbiturates are central nervous system depressants. Barbiturates are a group of compounds in the class of drugs known as sedative-hypnotics, which generally describes their sleep-inducing and anxiolytic effects. Barbiturates can be extremely dangerous because of their high potential to overdose. Even a slight increase in dosage can cause coma or death. Barbiturates are also addictive and can cause life-threatening withdrawal syndrome.
Synthetic cannabinoids are designer drugs that attach to the same receptors as THC and CBD. In the recreational drug market, they are sold and bought to circumvent the laws surrounding marijuana. Although they are designed to be similar to THC, they usually have a much stronger affinity to the receptors. It is much easier to overdose on synthetic cannabinoids because they are more potent than marijuana. Synthetic cannabinoids cannot be identified by the typical marijuana drug tests which test for THC and its metabolites. The detection window for the parent drug is quite small because the drug is not only taken in small doses due to its high potency, but it also metabolized quickly by the body. Serum concentrations of synthetic cannabinoids are generally 1-10ug/L a few hours after usage, and little to no parent drug is present in the urine.
Tetrahydrocannabinol (THC) is the active component of cannabis or marijuana. With the legalization of medical cannabis in North America, and concern about the effects of THC on a person's ability to perform such tasks as driving, flying, or operating machinery, the THC testing market is also growing.
Tramadol is an opioid medication used to treat moderate to severe pain. Relief begins within an hour and a 2- to 4-hour peak after oral administration. Tramadol has about one-tenth the potency of morphine. Severe side effects may include seizures and it is not recommended for those who are suicidal or pregnant. Tramadol is detectable in urine after 1 to 4 days of use, up to 48 hours in saliva, 12 to 24 hours in blood.
Tricyclic antidepressants (TCA) are sometimes prescribed to those with depressive disorders. Although TCA is largely being replaced in clinical use by other antidepressants, its overdose is still prevalent. TCA is not considered addictive, but its overdose is a significant cause of fatal drug overdose due to its high cardiovascular and neurological toxicity. It is absorbed rapidly by the GI tract in the small intestines with its effects becoming apparent after the first hour of overdose. Poison control measures must be sought immediately in the event of a known or suspected overdose.
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