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Test Code BARBX Barbiturates Confirmation, Chain of Custody, Random, Urine

Useful For

Detecting drug abuse involving barbiturates such as amobarbital, butalbital, pentobarbital, phenobarbital, and secobarbital

 

Chain of custody is required whenever the results of testing could be used in a court of law. Its purpose is to protect the rights of the individual contributing the specimen by demonstrating that it was always under the control of personnel involved with testing the specimen; this control implies that the opportunity for specimen tampering would be limited.

Additional Tests

Test ID Reporting Name Available Separately Always Performed
COCH Chain of Custody Processing No Yes
ADLTX Adulterants Survey, CoC, U Yes Yes

Testing Algorithm

Adulterants testing will be performed on all chain-of-custody urine samples as per regulatory requirements.

Reporting Name

Barbiturates Confirmation, CoC, U

Specimen Type

Urine


Specimen Required


Supplies: Chain of Custody Kit (T282)

Container/Tube: Chain of custody kit (T282) containing the specimen containers, seals, and documentation required

Specimen Volume: 10 mL

Collection Instructions: Collect specimen in the container provided, seal, and submit with the associated documentation to satisfy the legal requirements for chain-of-custody testing.

Additional Information: Submitting less than 10 mL will compromise the ability to perform all necessary testing.


Specimen Minimum Volume

5 mL

Specimen Stability Information

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

Reject Due To

Gross hemolysis OK
Gross icterus OK

Clinical Information

Barbiturates represent a class of drugs that were originally introduced as sleep inducers. Butalbital is also used to control severe headaches. Mephobarbital and phenobarbital are frequently used to control major motor (grand mal) seizures. These drugs are commonly abused as "downers" to induce sleep after an amphetamine- or cocaine-induced "high."

 

Chain of custody is a record of the disposition of a specimen to document the personnel who collected, handled, and performed the analysis. When a specimen is submitted in this manner, analysis will be performed in such a way that it will withstand regular court scrutiny.

Reference Values

Negative

Cutoff concentrations:

 

IMMUNOASSAY SCREEN

<200 ng/mL

 

GAS CHROMATOGRAPHY MASS SPECTROSCOPY:

Butalbital: <100 ng/mL

Amobarbital <100 ng/mL

Pentobarbital <100 ng/mL

Secobarbital <100 ng/mL

Phenobarbital <100 ng/mL

Interpretation

The presence of a barbiturate in urine indicates use of one of these drugs.

 

Most of the barbiturates are fast acting; their presence indicates use within the past 3 days.

 

Phenobarbital, commonly used to control epilepsy, has a very long half-life. The presence of phenobarbital in urine indicates that the patient has used the drug sometime within the past 30 days.

Cautions

No significant cautionary statements

Method Description

Preliminary screen is performed by immunoassay.

 

The barbiturate assay is based on the kinetic interaction of microparticles in a solution as measured by changes in light transmission. In the absence of sample drug, soluble drug conjugates bind to antibody-bound microparticles causing the formation of particle aggregates. As the aggregation reaction proceeds in the absence of sample drug, the absorbance increases. When a urine sample contains the drug in question, this drug competes with the drug derivative conjugate for microparticle-bound antibody. Antibody bound to sample drug is no longer available to promote particle aggregation, and subsequent particle lattice formation is inhibited. The presence of sample drug diminishes the increasing absorbance in proportion to the concentration of drug in the sample. Sample drug content is determined relative to the value obtained for a known cutoff concentration of drug.(Package insert: BARB. Roche Diagnostics; V 13.0, 09/2021)

 

The specimen is then analyzed by gas chromatography mass spectrometry for confirmation with quantitation.(Unpublished Mayo method)

Day(s) Performed

Monday, Wednesday, Friday

Report Available

3 to 5 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

80345

G0480 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
BARBX Barbiturates Confirmation, CoC, U 53746-4

 

Result ID Test Result Name Result LOINC Value
6668 Barbiturates Immunoassay Screen 70155-7
36143 Butalbital-by GC/MS 16237-0
36144 Amobarbital-by GC/MS 16239-6
36145 Pentobarbital-by GC/MS 16240-4
36146 Secobarbital-by GC/MS 16238-8
36147 Phenobarbital-by GC/MS 16241-2
36148 Barbiturates Interpretation 69050-3
36149 Chain of Custody 77202-0

Method Name

Immunoassay/Gas Chromatography Mass Spectrometry (GC-MS) Confirmation with Quantitation