Sign in →

Test Code COKEP Cocaine and Metabolites, Plasma


Ordering Guidance


Additional drug panels and specific requests are available; call 800-533-1710.



Specimen Required


Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube: Gray top (sodium fluoride/potassium oxalate plasma) (PST are not acceptable)

Submission Container/Tube: Plastic vial

Specimen Volume: 1 mL Plasma

Collection Instructions:

1. Within 2 hours of collection, centrifuge at 4° C and aliquot plasma into a plastic vial.

2. Freeze the specimen.


Useful For

Confirming drug exposure involving stimulants such as cocaine, benzoylecgonine, m-hydroxy-benzoylecgonine, and cocaethylene

Method Name

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)

Reporting Name

Cocaine and Metabolites, P

Specimen Type

Plasma

Specimen Minimum Volume

Plasma: 0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
Plasma Frozen (preferred) 28 days
  Refrigerated  6 days

Reject Due To

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Clinical Information

Cocaine is an alkaloid found in Erythroxylon coca, which grows principally in the northern South American Andes and, to a lesser extent, in India, Africa, and Java. Cocaine is a powerfully addictive stimulant drug. Cocaine abuse has a long history, is rooted in the drug culture in the United States and is one of the most common illicit drugs of abuse. Cocaine is rapidly metabolized primarily to benzoylecgonine, which is further metabolized to m-hydroxybenzoylecgonine (m-HOBE). Cocaine is frequently used with other drugs, most commonly alcohol, and the simultaneous use of both can be determined by the presence of the unique metabolite cocaethylene.

Reference Values

Negative

Positive results are reported with a quantitative result.

 

Cutoff concentrations:

Cocaine: 1.0 ng/mL

Benzoylecgonine: 1.0 ng/mL

Cocaethylene: 1.0 ng/mL

m-Hydroxybenzoylecgonine: 1.0 ng/mL

Interpretation

This test will identify patients who have taken cocaine.

Cautions

Specimens collected in serum gel tubes are not acceptable because the drug can absorb onto the gel and lead to falsely decreased concentrations.

Method Description

The plasma sample is extracted through protein precipitation, diluted, and then analyzed by liquid chromatography tandem mass spectrometry for the presence of cocaine and metabolites.(Unpublished Mayo method)

Day(s) Performed

Thursday

Report Available

3 to 9 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

G0480

80353 (if appropriate for select payers)

Clinical Toxicology CPT Code Client Guidance

LOINC Code Information

Test ID Test Order Name Order LOINC Value
COKEP Cocaine and Metabolites, P In Process

 

Result ID Test Result Name Result LOINC Value
624105 Cocaine 3396-9
624106 Benzoylecgonine 3392-8
624107 Cocaethylene 27226-0
624108 m-Hydroxybenzoylecgonine 50593-3