Transcript Mass Spectrometry-Toxicology

Pathology & Laboratory Medicine
Clinical Mass Spectrometry and Toxicology
We Are…
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Who are we ?
A Team Enhancing Patient Care Through “Cutting Edge” LCMS Technologies!
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Make sure to get my
lead level tested
The Clinical Mass Spectrometry/Toxicology Lab has evolved in the last 15 years. Known for our drugs of abuse confirmations, and our comprehensive Urine Drug Screening of prescription and
over the counter drugs, we have expanded our testing. GCMS and thin layer chromatography methods have been replaced by highly sensitive LCMS instrumentation. This cutting-edge LCMS
technology has allowed our lab to include Vitamin D analysis, Therapeutic Drug Monitoring (Tacrolimus, Sirolimus, Cyclosporine and Lamotrigine) and Steroid testing. We are no longer just a
toxicology lab…we consider ourselves to be a Mass Spectrometry Lab! ... uniquely developing and validating our own LCMS methods for each test we perform.
C tacular
Blood
Lead Levels
According to the CDC, 1 in 38 children suffer from
lead poisoning. High levels of lead in children can
severely affect mental and physical development. At
very high levels, lead poisoning can be fatal. There
are no obvious symptoms to lead exposure and
that’s why it is so important to test the lead levels of
children at about a year old. There is no safe lead
level in a person. The CDC recommends public
health action be taken when levels reach 5
micrograms per deciliter or higher.
Lab Facts!
•We are 14 licensed Laboratory Technologists with degree backgrounds in Biology, Chemistry, Forensic Chemistry and Medical Technology.
•The lab is located in the cluster of Clinical Labs on the ground floor near the red elevators, G-1540
•We are open dayshift only, however our mass spec‘s are able to analyze samples throughout the night with interpretation and review the next morning.
•We perform 177,000 tests a year.
•We service transplant patients, drug rehab and pain clinics, doctor’s offices and hospital patients.
Testing
Therapeutic Drug Monitoring: Tacrolimus, Sirolimus, Cyclosporin A and Lamotrigine
Urine Drug Screening and Urine Drug Confirmations
Vitamin Testing: D, A and E
Tumor Markers: VMA & HVA
Blood Lead Levels (by atomic absorption)
Steroid testing : Saliva Cortisol
•Vitamin D testing has become a popular test in the past
few years. We perform about 2100 Vitamin D tests a week
by LCMS.
•The turnaround time is 2-3 days.
•We test for the two major forms of Vitamin D (D2 and D3).
•D2 (ergocalciferol) is found in plant foods.
•D3 (cholecalciferol) is synthesized in the skin from
sunlight and is also consumed via the intake of animalbased foods.
•Both forms are commercially synthesized and found in
dietary supplements or fortified foods. The normal range for
Vitamin D is 30-60 ng/dL.
•Vitamin D has been proven to be important to the body in
many ways. Some of the reasons include reducing the risk
of cancer, type 1 diabetes and multiple sclerosis. It also
protects bones and teeth.
LCMS
LCMS (Liquid Chromatography Mass Spectrometry) is
a chemistry technique used to separate, fragment,
sort and detect compounds by their mass/charge ratio.
We test urine, whole blood, serum and saliva.
We are unique in that we do not run FDA developed
testing but develop and validate our own LCMS
methods.
Our lab has the most mass specs in a clinical lab
setting in the region. Currently we have 6 LCMS's in
our lab used for clinical testing.
Techs in action
Drug Testing
Immunosuppressant Drugs
Strong Memorial Hospital performs many organ transplants every year.
In order to prevent the body from rejecting the new organ, the patient
must take an immunosuppressant drug. Some common
immunosuppressant drugs are Tacrolimus, Sirolimus and Cyclosporine
A. Our lab tests all three of these drugs. This will help the doctor to
determine the proper dose that the patient should be taking in order for
the transplanted organ to perform optimally in the body.
The Toxicology/Mass Spec Lab tests for drugs
of abuse, over the counter drugs and some
prescription drugs. Just a few of the drugs of
abuse that we test for include opiates
(morphine, codeine, heroine, Percocet,
Vicodin), cocaine, marijuana, amphetamines
(including ecstasy and crystal meth) and
benzodiazepines (Xanax, Ativan and Valium).
This testing is done on urine samples by LCMS.