Fentanyl and Metabolite

CPT: 80354
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Test Details

Use

Relief of pain adjunct to general or regional anesthesia moderate to moderately-severe pain. Indications for monitoring include the following: to confirm or identify suspected drug toxicity in chronic use, therapeutic misadventure, or accidental or intentional acute overdose; to aid in the identification of an unknown drug ingested in unknown quantities, drug identification and/or quantitation may be performed as an adjunct for patient management; to monitor selected patient groups at greater risk for analgesic drug toxicity or drug-to-drug interaction; to confirm complete drug absorption and adequate drug elimination as an adjunct to overdose management.

Methodology

Liquid chromatography/tandem mass spectrometry (LC/MS-MS)

Specimen Requirements

Specimen

Serum, plasma, or whole blood

Volume

0.25 mL

Minimum Volume

0.05 mL

Container

Red-top tube, lavender-top (EDTA) tube, or green-top (heparin) tube. Do not use a gel-barrier tube. The use of gel-barrier tubes is not recommended due to slow absorption of the drug by the gel. Depending on the specimen volume and storage time, the decrease in drug level due to absorption may be clinically significant.

Collection

Separate serum or plasma within two hours of collection and transfer to a plastic transport tube.

Storage Instructions

Maintain specimen at room temperature.

Stability Requirements

Temperature

Period

Room temperature

14 days

Refrigerated

14 days

Frozen

14 days

Causes for Rejection

Gel-barrier tube

Clinical Information

References

Drug Information Handbook. 24th ed. Hudson, OH: Wolters Kluwer Clinical Drug Information, Inc; 2015; 857-868.
White S, Wong SH. Standards of laboratory practice: Analgesic drug monitoring. National Academy of Clinical Biochemistry. Clin Chem. 1998 May; 44(5):1110-1123. 9590395

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
071543 Fentanyl and Metabolite 071539 Fentanyl ng/mL 3636-8
071543 Fentanyl and Metabolite 071541 Norfentanyl ng/mL 11074-2

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