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• HOW TO DISPOSE OF DEXTRO AMPHETAMINE AMPHETAMINE VERIFICATION

See Figure 4 for an example of how mixed d- and l-methamphetamine results are displayed on an Aegis report.

HOW TO DISPOSE OF DEXTRO AMPHETAMINE AMPHETAMINE VERIFICATION

For the most accurate interpretation, prescription verification and/or assessment of the PDMP are important in determining the potential source(s) of the D/L isomer test results and to rule out illicit methamphetamine use. In this case, the patient would need to provide proof of having a valid prescription for both a d- and l- product, or a prescription for a d-product and report using an OTC nasal decongestant vapor inhaler containing levmetamfetamine. However, combining a predominantly l-product with a predominantly d-product may result in such a finding as well. If the d- percentage is between 5 and 95 % (a mixture of isomers), the most likely source is illicit methamphetamine. Illicit methamphetamine can be any percentage of d-, given it is manufactured illicitly and the contents are not controlled.

4,5 See Figure 3 for an example of how 0-5% d-methamphetamine (otherwise known as 95-100% l-methamphetamine) results are displayed on an Aegis report. 2,3 There have been case reports of illicit methamphetamine composed of predominantly l-methamphetamine however, illicit methamphetamine would be expected to be predominantly d-methamphetamine given the desire for stimulant effects with illicit use. After controlled administration of an OTC nasal decongestant vapor inhaler containing levmetamfetamine in a study, the maximum concentrations of l-methamphetamine in urine and oral fluid were 1,440ng/mL and 380ng/mL, respectively. Also, some over the counter (OTC) nasal decongestant vapor inhalers contain predominantly levmetamfetamine as the active ingredient. Selegiline, known by brand names Eldepryl®, EMSAM®, and Zelapar®, is prescribed for the treatment of Parkinson’s disease and major depression, and metabolizes to levmetamfetamine ( l-methamphetamine). If the reported d- percentage is between 0 and 5%, the potential sources would be predominantly l-methamphetamine products. See Figure 2 for an example of how 95-100% d-methamphetamine results are displayed on an Aegis report.Ġ-5% d-methamphetamine results (otherwise known as 95-100% l-methamphetamine) Prescription verification and/or assessment of Prescription Drug Monitoring Program (PDMP) records are important to rule out legitimate prescription use before considering illicit methamphetamine as a potential source. Benzphetamine is a Schedule III controlled substance prescribed for the treatment of obesity and metabolizes to d-methamphetamine. Desoxyn® is a schedule II controlled substance prescribed for attention deficit disorder with hyperactivity and for short-term treatment of obesity. If the reported d- percentage is between 95 and 100%, potential sources would be prescription methamphetamine (brand name Desoxyn®), prescription benzphetamine, and illicit methamphetamine. The vice versa is not true – amphetamine does not metabolize to methamphetamine. Side note: Methamphetamine metabolizes to amphetamine and we will occasionally see amphetamine present as a metabolite of methamphetamine.

See Figures 2, 3, and 4 for example reports with both methamphetamine “Medication Compliance” result interpretations. If D/L Isomer testing is ordered through one of our testing profiles, there will be two “Medication Compliance” result interpretations for methamphetamine: 1) concentration of methamphetamine in ng/mL and 2) percentage of d-methamphetamine. Following exposure, methamphetamine is detectable in urine for up to 5 days, up to 48 hours in oral fluid, and up to 24 hours in blood.Īt Aegis, we report out the results of the D/L isomer test according to the concentration/quantification of methamphetamine in nanograms per milliliter (ng/mL) and the percentage of the detected amount that is the d-isomer (0-100%). The D/L isomer test offered by Aegis helps narrow down the potential source(s) of a methamphetamine positive result. d-methamphetamine is more stimulating and psychoactive and, therefore, has a higher abuse potential, while l-methamphetamine is less CNS-active, vasoconstrictive, and has a lower abuse potential. The slight variation in chemical structure produces different properties for each enantiomer, or isomer. Each has the same chemical formula, but a different arrangement of atoms in the molecule making them mirror images of each other (see Figure 1).

Methamphetamine exists in two different forms known as enantiomers: levo-methamphetamine ( l-methamphetamine) and dextro-methamphetamine ( d-methamphetamine). Methamphetamine is a well-known central nervous system (CNS) stimulant that is abused recreationally and, infrequently, prescribed as a stimulant or appetite suppressant. What Did My Patient Actually Take? An Overview of Methamphetamine Results Friday, July 12, 2019