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TOXICOLOGY REFERENCE LABORATORY

Laboratory User Guide

ROOM 708, BLOCK P PRINCESS MARGARET HOSPITAL 2-10 Princess Margaret Hospital Road Lai Chi Kok Tel: 2990 1941 Fax: 2990 1942 http://trl.home

Version 6.1 Effective date: 1/July/2014

Contents

Contents ...... 2 Introduction ...... 4 Staff ...... 5 Honorary Medical Staff ...... 5 Scientific Staff ...... 5 Technical Staff ...... 5 Supportive Staff ...... 6

How to Make Laboratory Request ...... 7 Instruction for Referring Clinician ...... 7 Instruction for Referring Laboratory ...... 7 Specimen Collection and Handling ...... 7 Specimen Reception Hours ...... 9 Rejection of Requests ...... 9 Reporting of Results ...... 9

Alphabetical List of Laboratory Tests ...... 10 and Phallotoxins Target Analysis ...... 10 Animal Thyroid Tissue Target Analysis ...... 10 Target Analysis ...... 11 Quantitative Analysis ...... 11 -like Cardiac Target analysis ...... 12 Diuretics and Laxatives Target Analysis ...... 13 of Abuse Target Analysis ...... 13 Drugs and Related Analogues Target Analysis ...... 14 Glycol and Diethylene Glycol Quantitative Analysis ...... 15 General Toxicology Screen...... 15 Glycols Target Analysis ...... 16 Heavy Metals Analysis ...... 16 Herb and Herbal Formula Identification ...... 16 Methaemoglobinaemia-inducing Agents Screen ...... 17 Nitrate and Nitrite Quantitative Analysis ...... 18 Oral Antidiabetic Agents Target Analysis ...... 18 QT-Prolonging Agents Screen ...... 18 and Target Analysis ...... 20 Tetramine Target Analysis ...... 20

2 Therapeutic Monitoring for Psychotropic Drugs ...... 21 Toxic Quantitative/Qualitative Analysis ...... 22 Toxic /Herbal Target Analysis ...... 23 Vitamin A Quantitative Analysis ...... 24 Volatile Organic Compounds Screen ...... 24

Appendix A ...... 26 Cluster Toxicology Laboratories ...... 26

Appendix B ...... 27 Coverage of General Toxicology Screen ...... 27

3 Introduction

Background There are six toxicology laboratories within the Hospital Authority (HA) and on average each serving the needs of a cluster. Details on distribution and the role of cluster toxicology laboratories (CTLs) are listed in Appendix A. To better align service arrangement and enhance quality of service, HA has established a Toxicology Reference Laboratory (TRL) at PMH since March 2004 to support the cluster toxicology laboratories (CTLs), and in conjunction with the CTLs to cater for the toxicology needs in HA.

Objectives of TRL The HA TRL is set up as a tertiary service to serve the following purposes: (i) As a toxicology reference laboratory for HA (ii) To establish a laboratory for herbal products poisoning (iii) To provide diagnostic services for new or uncommon / substances of abuse (iv) In conjunction with the CTLs, to set up a network to cater for toxicology needs in HA

Services provided by TRL The menu of services will be updated from time to time. For suspected toxin not on the list, clinicians are welcome to discuss the needs with TRL. The laboratory request forms are available for download at http://trl.home.

Referral System The TRL works as a team with the CTLs. The CTLs serve to provide the initial screening and supporting on site, with the TRL functions as a back up to the CTLs and provides a referral service. Clinicians are therefore advised to discuss with their corresponding CTLs which will address the clinical needs according to the facility available at the CTL. Cases that required the support of TRL will be directed to TRL accordingly.

TRL Consultation / Enquiry General enquiry – Tel: 2990 1941 Fax: 2990 1942 Intranet website – http://trl.home

4 Staff Post Telephone E-mail address

Medical Staff

Dr Tony Mak Consultant Chemical Pathologist 2990 1987 [email protected] Dr Doris Ching Associate Consultant 2990 1881 [email protected] Dr Sarah Chan Resident 2990 1416 [email protected] Dr Calvin Chong Resident 2990 1946 [email protected] Dr Jasper Wu Resident 2990 1870 [email protected] Dr Candy Ng Resident 2990 1411 [email protected]

Honorary Medical Staff

Dr Sammy Chen Associate Consultant 2990 1871 [email protected] Dr Hencher Lee Associate Consultant 2990 1827 [email protected]

Honorary Scientific Officer Mr CK Lai Scientific Officer (Medical) 2990 1875 [email protected]

Scientific Staff

Ms SW Ng Scientific Officer (Medical) 2990 1998 [email protected] Mr YH Lam Scientific Officer (Medical) 2990 1944 [email protected] Mr Edward Chen Scientific Officer (Medical) 2990 1945 [email protected] Dr Magdalene Tang Scientific Officer (Medical) 2990 1943 [email protected]

Technical Staff

Ms Suzanne Chan Senior Medical Technologist 2990 1976 [email protected] Ms Caroline Lee Medical Technologist 2990 1941 [email protected] Mr Simon Poon Medical Technologist 2990 1990 [email protected] Ms Karen Chung Medical Technologist 2990 1941 [email protected] Ms Lydia Kong Associate Medical Technologist Mr Ben Ho Associate Medical Technologist Mr Andy Law Associate Medical Technologist Ms Manki Yip Associate Medical Technologist

5 Mr Wesley Chan Associate Medical Technologist Ms Phoebe Lo Associate Medical Technologist Mr Dennis Chan Associate Medical Technologist Ms Candy Tam Associate Medical Technologist

Supportive Staff

Ms Fannie Lee Clerk III Ms Ce Ce Li Patient Care Assistant II Ms Mandy Man Patient Care Assistant II Vacant Patient Care Assistant IIIB

6 How to Make Laboratory Request

Instruction for Referring Clinician 1. TRL Request Form and TRL Therapeutic Drug Monitoring Request Form are available for download at http://trl.home 2. The following information is required: (a) Patient’s name / HKID / Sex / Age / DOB / Hospital Encounter Number (b) Requesting location (hospital ward, out-patient clinic etc) (c) Name and contact number of referring clinician (d) Relevant clinical and drug history (e) Date and time of specimen collection (f) Specimen type(s) (g) Test(s) requested (h) Signature of referring clinician 3. Additional information is required for requesting therapeutic drug monitoring. Please refer to the TRL Therapeutic Drug Monitoring Request Form for details. 4. Send the request form and labeled specimens to the Chemical Pathology laboratory in your hospital. The specimens would then be directed to TRL as required.

Instruction for Referring Laboratory

1. The following information is to be provided by the referring laboratory: (a) Report copy to ______laboratory (If the field is not specified, a report copy will be sent to Chemical Pathology laboratory of the requesting location), (b) Specimen laboratory number assigned by the referring laboratory 2. For drug confirmation request, please provide information of the patient and attending clinician as above together with the name and signature of referring laboratory personnel making the request 3. Send the TRL request form and labeled specimens, to the following address: Chemical Pathology Laboratory, 11/F, Block G, Princess Margaret Hospital, Lai Chi Kok With to “Toxicology Reference Laboratory”

Specimen Collection and Handling

 Different laboratory tests require specific specimen containers. Consult this guide for the appropriate specimen containers for a particular test.  All specimens should be tightly capped, checked for leakage and properly labeled with patient’s name and HKID.

7  For non-biological samples, different specimens should be placed in individual container bags. Please stick the patient’s gum label on the individual container bags instead of the specimens

 For drug products, please provide product packaging, insert and multiple pills if available.  For herb/plant, please provide unused herbs/, herbal broth, herbal remnant and herbal formula if available.  All the specimens should be put together into a secondary container bag. TRL request form should be placed in the carrying pocket of secondary container bag.  Do not stick the specimen onto paper or TRL request form.

8 Specimen Reception Hours

Monday – Friday 9:00am – 5:30pm

In case a typhoon signal No. 8 or above, or a ‘Black’ rainstorm warning is hoisted, laboratory service will be suspended. Please contact us for the availability of service before sending specimens.

Rejection of Requests

Specimens with one or more of the following conditions will be rejected:  Spilt specimens or soiled request forms  Biological specimens without specimen collection date  Specimens stuck on request form  Unlabelled or mislabeled specimens  Specimens in wrong containers  Mishandled specimens that are not suitable for processing, e.g. improper transport conditions or outdated specimens  Specimens with insufficient quantity  Requests with insufficient information to identify the patient and the authorized requester  Tests requested not available  Empty or broken containers

Remarks: Difficult to replace or critical specimens will be processed but results not released until the problem has been resolved.

Reporting of Results

 Please refer to individual laboratory tests for turnaround time.  A hardcopy of report will be printed, at the requesting location and referring laboratory respectively, when results are ready.  Patient’s results can be assessed from electronic patient record under “toxicology” directory.  Specimens will be kept for three months after analysis.

9 Alphabetical List of Laboratory Tests

Amatoxins and Phallotoxins Target Analysis

Specimen: - 30 mL spot - 4 mL clotted blood - Non-biological specimen (as much as possible) e.g. Mushroom Container: Plain bottle (no preservative including boric acid) for urine Plain bottle (no gel) for clotted blood Individual container bag for non-biological specimen Request form: TRL request form (PMH710 updated on 01/10/2008) Turnaround time: 3 days Indication: Suspected ingestion of hepatotoxic mushrooms e.g. certain Amanita, Galerina, and Lepiota species Test(s) included: Amatoxins -Amanitin, beta-Amanitin and gamma-Amanitin Phallotoxins and Phallacidin

Animal Thyroid Tissue Target Analysis

Specimen: Non-biological specimen (as much as possible):  Proprietary Chinese medicine  Pharmaceutical products  Health products Container: Individual container bag Request form: TRL request form (PMH710 updated on 01/10/2008) Turnaround time: 1 – 2 weeks Indication: Suspected factitious thyrotoxicosis Test(s) included: DIT (3,5-Diiodo-L-), MIT (3-iodo-L-tyrosine), rT3 (3,3',5'-Triiodo-L-thyronine), T2 (3,5-Diiodo-L-thyronine), T3 (3,3,5-Triiodo-L-thyronine), T4 (L-Thyroxine)

10 Corticosteroids Target Analysis

Specimen: Non-biological specimen (as much as possible):  Proprietary Chinese medicine  Pharmaceutical products  Health products Container: Individual container bag Request form: TRL request form (PMH710 updated on 01/10/2008) Turnaround time: 1 – 2 weeks Indication: Suspected use of exogenous corticosteroids Test(s) included: Alclometasone diproprionate, Beclomethasone, , Betamethasone dipropionate, Betamethasone valerate, , Clobetasol proprionate, Clobetasone butyrate, Cortisone acetate, , Dexamethasone acetate, Diflucortolone valerate, Flucinonide, Flucinolone acetonide, Fludrocortisone acetate, Flumethasone, Fluorometholone, proprionate, Hydrocortisone, Hydrocortisone acetate, Methylprednisolone, furoate, , Prednisolone acetate, Prednisone, Prednisone acetate, and Triamcinolone acetonide

Cyanide Quantitative Analysis

Specimen: 2 mL whole blood (Fill to the blue line mark of the special container, see Notes below) Container: Special fluoride-oxalate bottle with preservative (Available in cluster Chemical Pathology Laboratory and TRL) Request form: TRL request form (PMH710 updated on 01/10/2008) Turnaround time: 1 – 2 days Indication: Suspected cyanide poisoning Test(s) included: Cyanide Blood toxic level: > 0.5 mg/L

Notes: 1. Prior arrangement with the laboratory is necessary. (Tel: 29901941) 2. Contact your cluster Chemical Pathology Laboratory to obtain the special fluoride-oxalate bottle. 3. See the following instruction for sample collection.

11 Instruction for the use of pre-treated bottle for Cyanide determination

** This is a pre-treated fluoride bottle dedicated for the determination of Cyanide. Please do not use it for glucose assay. 1. Label clearly on the tube with patient’s name, HKID number and collection date 2. Fill about 2 mL blood up to the blue line marked on the bottle 3. Invert mix gently for 30 seconds 4. Send in ice bath immediately to the chemical pathology laboratory in your hospital 5. Upon receipt of blood sample by the local laboratory, store the whole blood sample frozen and arrange transport with Toxicology Reference Laboratory 6. ** Sample with even minor clots will affect Cyanide result

Digoxin-like Cardiac Glycosides Target analysis

Specimen: - 30 mL spot urine - Non-biological specimen (as much as possible):  Proprietary Chinese medicine  Pharmaceutical products  Health products Container: Plain bottle for urine Individual container bag for non-biological specimen Request form: TRL request form (PMH710 updated on 01/10/2008) Turnaround time: 1 – 2 weeks Indication: Suspected digoxin-like cardiac glycosides Test(s) included: , Bufalin, , Bufoteninine, , Cinobufotalin, Convallatoxin, Digitoxigenin, , Digoxigenin, Digoxin, Gitoxigenin, Gitoxin, K-Strophanthoside, , Resibufogenin, Strophanthidin, Strophanthidol, Strophanthin K-alpha, Strophanthin G

Related Traditional Chinese medicine and plants include: Venenum Bufonis (蟾酥), Corium Bufonis (干蟾皮), Cortex Periplocae (香加皮), Rhizoma Tupistrae(川三七/開口箭) Strophanthus divaricatus (羊角拗), Nerrium indicum (夾竹桃), Convallaria majalis (鈴蘭), purpurea (Foxglove, 毛地黃)

12 Diuretics and Laxatives Target Analysis

Specimen: 30 mL urine Container: Plain bottle (no preservative including boric acid) Request form: TRL request form (PMH710 updated on 01/10/2008) Turnaround time: 1 – 2 weeks Indication: Suspected concealed or unwitting use of diuretics or laxatives Test(s) included: Diuretics Acetazolamide, , , , Chlorthalidone, Cyclopenthiazide, Eplerenone, Frusemide, Glycyrrhetinic acid, , Indapamide, Methyclothiazide, Metolazone, Probenecid, , Torasemide and Laxatives Aloe-emodin, Bisacodyl metabolites, Chrysophanol, Danthron, Emodin, Phenolphthalein, Physcion and Rhein

Drugs of Abuse Target Analysis

Specimen: 20 mL spot urine Container: Plain bottle (no preservative including boric acid) Request form: TRL Request form (PMH710 updated on 01/10/2008) Turnaround time: 1 week Indication: - Confirmatory testing of drugs of abuse - Suspected use of emerging drugs of abuse Test(s) included: Traditional DOA and metabolites (in alphabetical order) , , , Delta-9- (THC) metabolites (carboxy-THC and Hydroxy-THC), , and metabolites (Benzoylecgonine, Nor-cocaine, ), and metabolite (Nor-codeine), and metabolite (), and metabolite (Nor-diazepam), , and metabolite (7-aminoflunitrazepam), and metabolite (6-Monoacetylmorphine), HMMA (4-hydroxy-3-methoxymethamphetamine; metabolite of ), and metabolite (Nor-ketamine), LSD ( diethylamide) and metabolites (OH-LSD and N-desmethyl-LSD), MDA (Methylenedioxyamphetamine), MDMA (Methylenedioxymethamphetamine), and metabolite (EDDP), , , and metabolites (1-OH-midazolam, 4-OH-midazolam), and metabolite (Nor-morphine), , , ,

13 , , and metabolite (1-OH-triazolam), ,

Emerging DOA and metabolites (in alphabetical order) MDBP [1-(3,4-Methylenedioxybenzyl)], -H (2,5-dimethoxyphenethylamine), 2C-I (2,5-dimethoxy-4-iodo-), 2C-T-2 (2,5-Dimethoxy-4-ethylthiophenethylamine), 2C-T-4 (2,5-dimethoxy-4-isopropylthiophenethylamine), 2C-T-7 (2,5-Dimethoxy-4-propylthiophenethylamine), 2C-B (4-Bromo-2,5-dimethoxy-phenethylamine), 4-fluoroamphetamine, 4-MTA (4-Methylthioamphetamine), 5-methoxy -DIPT (5-methoxy-), alpha-methyl , Bromo-dragonfly, BZP (N-), , Chloroamphetamine, CP 47,497, CP 47,497-C8-homolog, DOB (4-bromo-2,5-dimethoxy-amphetamine), DOET (2, 5-Dimethoxy-4-ethylamphetamine), DOM (4-methyl-2,5-dimethoxy-amphetamine), , JWH-018 and metabolites (4-hydroxyindole and N-5-hydroxypentyl metabolites), JWH-073, MBDB [N-methyl-1-(3,4-methylenedioxyphenyl)-2-butanamine], mCPP (meta-chlorophenylpiperazine), MDEA (3,4-Methylene-dioxy-N-ethyl-amphetamine), MDPV (Methylenedioxypyrovalerone), , , , , , , , N,N-dimethyltryptamine, N-Ethylamphetamine, pFPP (para-fluorophenylpiperazine), PMA (para-methoxyamphetamine), pMeOPP [1-(4-methoxyphenyl)piperazine], PMMA (para-methoxymethamphetamine), , , TFMPP [1-(3-Trifluoromethylphenyl)piperazine],

Erectile Dysfunction Drugs and Related Analogues Target Analysis

Specimen: 30 mL urine Container: Plain bottle (no preservative including boric acid) Request form: TRL request form (PMH710 updated on 01/10/2008) Turnaround time: 1 – 2 weeks Indication: Suspected use of erectile dysfunction drugs / related analogues Test(s) included: Erectile dysfunction drugs , and

14 Erectile dysfunction drug analogues Acetil-acid, , Aminotadalafil, Carbodenafil, Chloropretadalafil, Gendenafil, Hydrolysis product of Vardenafil, Hydroxyhomosildenafil, Hydroxyvardenafil, Imidazosagatriazinone, Norneosildenafil, Piperidenafil and

Ethylene Glycol and Diethylene Glycol Quantitative Analysis

Specimen: 4 mL clotted blood Container: Plain bottle (no gel) Request form: TRL request form (PMH710 updated on 01/10/2008) Turnaround time: 1 – 2 days Indication: Suspected ethylene glycol or diethylene glycol poisoning Tests included: Ethylene glycol, Diethylene glycol Serum toxic level: - Ethylene glycol: > 200 mg/L (Ref: Poisindex® ) Remark: Levels < 200 mg/L may still indicate toxicity if significant time has passed since ingestion. - Diethylene glycol: not available

Note: Prior arrangement with the laboratory is necessary. (Tel: 29901941)

General Toxicology Screen

Specimen: - 30 mL urine - 4 mL clotted blood - Non-biological specimen (as much as possible):  Proprietary Chinese medicine  Pharmaceutical products  Health products  Herbs (unused herb, plant, herbal remnant, herbal broth) Container: Plain bottle (no preservative including boric acid) for urine Plain bottle (no gel) for clotted blood Individual container bag for non-biological specimen Request form: TRL Request form (PMH710 updated on 01/10/2008) Turnaround time: 1 – 2 weeks Indication: Comprehensive toxicology screen and confirmation Test(s) included: Please refer to Appendix B

15 Glycols Target Analysis

Specimen: - 4 mL clotted blood - Non-biological specimen (as much as possible) e.g. Unknown liquid Container: Plain bottle (no gel) for clotted blood Individual container bag for non-biological specimen Request form: TRL Request form (PMH710 updated on 01/10/2008) Turnaround time: 1 – 2 days Indication: Suspected glycol poisoning Tests included: Ethylene glycol, Diethylene glycol, Triethylene glycol, 1,2-Propanediol, 1,3-Propanediol, 1,3-Butanediol, Glycolic acid (metabolite of Ethylene glycol)

Note: Prior arrangement with the laboratory is necessary. (Tel: 29901941)

Heavy Metals Analysis

Specimen: Non-biological specimen (as much as possible):  Facial products  Proprietary Chinese medicine  Health products  Herbs (Unused herb, herbal remnant, herbal broth) Container: Individual container bag Request form: TRL Request form (PMH710 updated on 01/10/2008) Turnaround time: 1 month Indication: To identify the source of exposure in confirmed heavy metal poisoning Test(s) included: , Arsenic, Cadmium, Copper, Lead, Manganese, Mercury, Selenium and

Herb and Herbal Formula Identification

Specimen: - Herbs (unused herb, plant or herbal remnant) - Herbal formulae - Proprietary Chinese medicine package inserts Container: Individual container bag Request form: TRL Request form (PMH710 updated on 01/10/2008) Turnaround time: 1 – 2 weeks Indication: Suspected herb related toxicity

16 Methaemoglobinaemia-inducing Agents Screen

Specimen: - 30 mL Urine - Non-biological specimen (as much as possible):  Proprietary Chinese medicine  Pharmaceutical products  Health products  Food  Others Container: Plain bottle (no preservative including boric acid) for urine Individual container bag for non-biological specimen Turnaround time: 1 – 2 weeks Indication: Suspected drug, herb, chemical or food-induced methaemoglobinaemia Test(s) included: Urine Aniline, , Chloroquine, Dapsone, 2,4-Dinitrophenol , , Hydroquinone, Indoxacarb, , , , Naphthalene, Nitrate*, Nitrite*, Paraquat*, , Phenazopyridine, , , Primaquine, , Sulfamethoxazole, Sulfapyridine, Sulfathiazole, Trimethoprim and Zopiclone Non-biological specimens Aniline, Benzocaine, Chloroquine, Dapsone, 2,4-Dinitrophenol, Flutamide, Indoxacarb, Lidocaine, Metoclopramide, Naphthalene, Nitrate*, Nitrite*, Nitrobenzene, Paraquat*, Phenacetin, Phenazopyridine Phenytoin, Prilocaine, Primaquine, Procaine, Sulfamethoxazole, Sulfapyridine, Sulfasalazine, Sulfathiazole, Trimethoprim and Zopiclone

* Analytes requiring special test. Please indicate clearly in the request form.

Note: The above list of methaemoglobinaemia-inducing agents is not exhaustive.

17 Nitrate and Nitrite Quantitative Analysis

Specimen: - 4 mL clotted blood (For referring laboratory: please separate serum from red cells by centrifugation as soon as possible and send only serum to TRL. Store serum at 4ºC if sample is not sent out immediately) - 30 mL spot urine - Non-biological specimen (as much as possible) e.g. Vegetables, soup, congee Container: Plain bottle (no gel) for clotted blood Plain bottle (no preservative including boric acid) for urine Plain bottle or original container of food Request form: TRL request form (PMH710 updated on 01/10/2008) Turnaround time: 1 – 2 weeks Indication: Suspected nitrate and/or nitrite induced methaemoglobinaemia Tests included: Nitrate, Nitrite

Oral Antidiabetic Agents Target Analysis

Specimen: 30 mL spot urine Container: Plain bottle (no preservative including boric acid) Request form: TRL Request form (PMH710 updated on 01/10/2008) Turnaround time: 1 week Indication: Suspected unexplained drug-induced hypoglycaemia Test(s) included: , , , , , , Metformin, , Phenformin, Pioglitazone, , and

QT-Prolonging Agents Screen

Specimen: - 30 mL Urine - Non-biological specimen (as much as possible):  Proprietary Chinese medicine  Pharmaceutical products  Health products Container: Plain bottle (no preservative including boric acid) for urine Individual container bag for non-biological specimen

18 Request form: TRL Request form (PMH710 updated on 01/10/2008) Turnaround time: 1 – 2 weeks Indication: Suspected drug/herb induced prolonged QT interval Test(s) included: Urine Albuterol, , , , , Amphetamine, , , , , Chloroquine, , , , , , , , , , , , , , , , Fluconazole, , Halofantrine, , , , , Matrine, , , Metaproterenol, Methadone, , Nilotinib, , , Phentermine, , Probucol, , , , , , , , Sparfloxacin, Sunitinib, , , , Trimethroprim, Vardenafil, ,

Non-biological specimens Albuterol, Alfuzosin, , Amisulpride, Amitriptyline, Amphetamine, Astemizole, Atazanavir, Atomoxetine, Azelastine, Azithromycin, Bepridil, Chloroquine, Chlorpromazine, Cisapride, Citalopram, Clarithromycin, Clemastine, Clomipramine, Clozapine, Diphenhydramine, Disopyramide, Dofetilide, Dolasetron, , Droperidol, Escitalopram, Fexofenadine, Flecainide, Fluconazole, Gemifloxacin, Granisetron, Halofantrine, Haloperidol, Ibutilide, Imipramine, , Lapatinib, Levofloxacin, Maprotiline, Matrine, Mefloquine, Mesoridazine, Metaproterenol, Methadone, Mizolastine, Moxifloxacin, Nilotinib, Nortriptyline, , , Penfluridol, , Phentermine, Pimozide, Probucol, , Quetiapine, Quinidine, Ranolazine, , Ritonavir, , Salbutamol, Sematilide, Sertindole, Sibutramine, Sotalol, Sparfloxacin, Sulfamethoxazole, Sunitinib, Tacrolimus, Terfenadine, Thioridazine, Tizanidine, trimethoprim, Vardenafil, Venlafaxine, Verapamil, Voriconazole,

Agents with known QT prolongation risks that are not covered by our analytical system: Urine: Arsenic trioxide, , Levomethadyl, Pentamidine Non-biological specimens: Arsenic trioxide, Caesium, Levomethadyl

Agents with potential QT prolongation risks that are not covered by our analytical system:

19 Urine: , , Foscarnet, , Grepafloxacin, Lithium, Perflutren lipid microspheres, Ritonavir, Roxithromycin, Sematilide, Sulfamethoxazole, Tacrolimus, Telithromycin, Voriconazole, Ziprasidone Non-biological specimens: Azimilide, Dronedarone, Foscarnet, Fosphenytoin, Grepafloxacin, Lithium, Perflutren lipid microspheres, Telithromycin

Note: The above lists are not exhaustive and would expect to change with time.

Superwarfarins and Warfarin Target Analysis Specimen: - 30 mL spot urine - 4 mL clotted blood - Non-biological specimen (as much as possible) e.g.  For new case of suspected superwarfarins/warfarin poisoning, please send both urine and clotted blood.  For follow-up case of confirmed poisoning, please send clotted blood. Container: Plain bottle (no preservative including boric acid) for urine Plain bottle (no gel) for clotted blood Individual container bag for non-biological specimen Request form: TRL Request form (PMH710 updated on 01/10/2008) Turnaround time: 1 – 2 weeks Indication: Suspected superwarfarins/warfarin poisoning Test(s) included: , , Chlorphacinone, Coumachlor, Coumafuryl, , , Difethalone, Diphacinone, Flocoumafen, , Warfarin and Warfarin metabolite

Tetramine Target Analysis

Specimen: - 30 mL urine - 4 mL clotted blood - Non-biological specimen (as much as possible) e.g. Rodenticides Container: Plain bottle (no preservative including boric acid) for urine

20 Plain bottle (no gel) for clotted blood Individual container bag for non-biological specimen Request form: TRL Request form (PMH710 updated on 01/10/2008) Turnaround time: 1 – 2 days Indication: Suspected tetramine poisoning Test(s) included: Tetramine

Note: Prior arrangement with the laboratory is necessary. (Tel: 29901941)

Therapeutic Drug Monitoring for Psychotropic Drugs

Specimen: 4 mL clotted blood (For referring laboratory: please send only serum to TRL after centrifugation, and store serum at 4ºC if sample is not sent out immediately) Container: Plain bottle (no gel) Collection: Trough level (within 2 h before next dose) at steady state. Acute overdose is an exception. Request form: TRL request form of therapeutic drug monitoring (PM797 Ver.1 11/10) Turnaround time: 7 days (counting from specimen arrival to TRL); 1 – 2 days for urgent cases if clinically indicated Indication: - Poor clinical response with adequate dose - Suspected adverse effects at recommended dose - Suspected non-compliance - Suspected drug interactions - Children and adolescents - Elderly - Co-morbidities that affect drug (e.g. hepatic or renal insufficiency) - Drug overdose / risk of intoxication Test(s) included: Test: Measured analyte(s):

Amitriptyline Amitriptyline + Nortriptyline*

Nortriptyline Nortriptyline

Clomipramine Clomipramine + *

Imipramine Imipramine + *

Clozapine Clozapine *Active metabolite

21 Therapeutic range: Test: Therapeutic Range ^:

Amitriptyline + Nortriptyline 80-200 g/L

Nortriptyline 70-170 g/L

Clomipramine + Norclomipramine 175-450 g/L

Imipramine + Desipramine 175-300 g/L

Clozapine 350-600 g/L ^Ref: Pharmacopsychiatry 2004;37:243-65

Critical call result: Test: Critical Call Result:

Amitriptyline + Nortriptyline >500 g/L

Nortriptyline >500 g/L

Clomipramine + Norclomipramine >500 g/L Imipramine + Desipramine >500 g/L

Clozapine >1000 g/L

Charge: Charges will be incurred for this test. Please contact the laboratory (Tel: 29901941) for details.

Toxic Alcohols Quantitative/Qualitative Analysis

*Caution : Non-alcoholic germicide solution should be used as disinfectant for blood taking. In case swap is used to sterilse the blood collecction site, the site should be completely dry befrore blood taking. Specimen: - 4 clotted blood (quantitative) - 30 mL urine (qualitative) - Non-biological samples (qualitative) (as much as possible) e.g. detergent, solvent, wine, unknown liquid Container: Plain bottle (no gel) for clotted blood Plain bottle (no preservative including boric acid) for urine Individual container bag for non-biological specimen Request form: TRL Request form (PMH710 updated on 01/10/2008) Turnaround time: 1 – 2 days Indication: Suspected toxic alcohol poisoning

22 Test(s) included: , , Isopropanol and Serum toxic level: Methanol: > 6.24 mmol/L (20 mg/dL) Ethanol: > 17.36 mmol/L (80 mg/dL) Isopropanol: > 6.66 mmol/L (40 mg/dL) Acetone: > 3.44 mmol/L (20mg/dL)

Note: Prior arrangement with the laboratory is necessary. (Tel: 29901941)

Toxic Plant/Herbal Alkaloids Target Analysis

Specimen: - 30 mL urine - 4 mL clotted blood - Non-biological specimen (as much as possible):  Proprietary Chinese medicine  Pharmaceutical products  Health products  Herbs (unused herb, plant, herbal remnant or herbal broth) Container: Plain bottle (no preservative including boric acid) for urine Plain bottle (no gel) for clotted blood Individual container bag for non-biological specimen Request form: TRL Request form (PMH710 updated on 01/10/2008) Turnaround time: 1 – 2 weeks Indication: Suspected herb related toxicity Test(s) included: Aconitum alkaloids: , Mesaconitine, Hypaconitine, Yunaconitine, Crassicauline A, Benzoylaconine, Benzoylmesaconine, Benzoylhypaconine, Deacetyl-yunaconitine, Deacetyl-crassicauline A, Deoxyaconitine Colchicum alkaloids: Solanaceous () alkaloids: / , , , Sophora alkaloids: Matrine, Sophoridine, Oxymatrine, , N-methylcytisine Strychnos alkaloids: ,

23 Vitamin A Quantitative Analysis

Specimen: 4 mL clotted blood Container: Plain bottle (no gel) Request form: TRL Request form (PMH710 updated on 01/10/2008) Turnaround time: 1 – 2 weeks Indication: Suspected vitamin A poisoning Test(s) included: Vitamin A Reference interval: 1-6 y 0.70-1.51 μmol/L 7-12 y 0.91-1.71 μmol/L 13-19y 0.91-2.51 μmol/L Adult 1.05-2.80 μmol/L

Note: 1. Prior arrangement with the laboratory is necessary. (Tel: 29901941) 2. Fasting sample is required. 3. Protect sample from light.

Volatile Organic Compounds Screen

Specimen: - Non-biological liquid specimen (as much as possible) e.g. Unknown liquid; solvent; cleansing agent Container: - Plain bottle (no gel) or original container of the liquid Request form: TRL Request form (PMH710 updated on 01/10/2008) Turnaround time: 1 – 2 days Indication: Suspected volatile organic compounds poisoning Tests included: Acetone, Acetonitrile, , Bromochloromethane, 2-Bromo-1-chloropropane, Bromodichloromethane, 4-Bromofluorobenzene, Bromomethane, 1-Butanol, 2-Butanone, 2-Butoxyethanol, 1-Butoxy-2-propanol, Chlorobenzene, , Chloroethene, 2-Chloroethyl vinyl , Chloromethane, Cyclohexane, Decane, Dibromochloromethane, 1,2-Dichlorobenzene. 1,3-Dichlorobenzene, 1,4-Dichlorobenzene, 1,4-Dichlorobutane, 1,1-Dichloroethane, 1,2-Dichloroethane, 1,1-Dichloroethene, cis-1,2-Dichloroethene, trans-1,2-Dichloroethene, , 1,2-Dichloropropane, cis-1,3-Dichloropropene, trans-1,3-Dichloropropene, N,N-Dimethylformamide, 1,4-Dioxane, Dodecane, Ethanol, 2-Ethoxyethanol, Ethyl acetate, Ethylbenzene, 2-Ethyltoluene, 3-Ethyltoluene, Fluorobenzene, Heptane, Hexadecane, Hexane. 2-Hexanone, , Isopropanol,

24 Methanol, 2-Methoxyethanol, 1-Methoxy-2-propanol, Methylcyclohexane, Methylpyrrolidone, Nitrobenzene, Nitromethane, Nonane. Octane, Pentafluorobenzene, , Propanol (IS), 1-Propoxy-2-propanol, Pyridine, Tetrachloroethene, Tetrachloromethane, Tetradecane, Tetrahydrofuran, Tetralin, , 1,1,2,2-Tetrachloroethane, 1,3,5-Tribromobenzene, Tribromomethane, 1,1,1-Trichloroethane, 1,1,2-Trichloroethane, 2,2,2-Trichloroethanol, Trichloroethene, Trichlorofluoromethane, Trichloromethane, 1,2,4-Trimethylbenzene, p-/ m-xylene, O-Xylene

25 Appendix A

Cluster Toxicology Laboratories

Distribution Cluster Site of CTL Contact Persons Telephone Numbers

HKW QMH Dr Sidney Tam 2255 3249

HKE PYNEH Dr WT Poon 2595 5109

NTE PWH Dr Michael Chan 2632 2326

NTW TMH Mr Michael Lee 2468 6391

KW PMH Dr Sammy Chen 2990 1871

KC & KE QEH Dr Anthony Shek 2958 6784

Roles Emergency toxicology service General toxicology screen Common substances of abuse analysis service Consultation and interpretation related to the above service

26 Appendix B

Coverage of General Toxicology Screen

Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) ACE Inhibitors B Enalapril B, NB Fosinopril B, NB Imidapril B, NB Lisinopril B Moexipril B, NB Perindopril B Ramipril B, NB alpha 1 Blockers Alfuzosin B, NB B, NB B Phentolamine methanesulphonate NB B, NB NB NB Terazosin metabolite B Amphetamines Amphetamine B, NB 4-Hydroxyamphetamine B, NB MDA B, NB ((+)-3,4-Methylene-dioxy-amphetamine) MDMA B, NB ((+)-3,4-Methylene-dioxy-methamphetamine) Methamphetamine B, NB Anabolic B acetate NB Anaesthetics B, NB Amethocaine () B, NB Benzocaine B, NB B, NB B, NB

27 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Anaesthetics B Ketamine B, NB Ketamine metabolites B Lidocaine B, NB Lidocaine metabolite B Oxetacaine B Prilocaine B, NB Procaine B, NB B, NB Propofol metabolite B Quinol B B, NB B, NB Tetracaine (Amethocaine) B, NB Thiopental B, NB (Non-) & Dipyrone NB Antipyretics B, NB B, NB NB B, NB Phenacetin B, NB Phenylsalicylate B, NB B, NB Propyphenazone metabolite B B, NB B, NB Analgesics (Opioid) B, NB Buprenorphine metabolite B Codeine B, NB Codeine metabolite B (Propoxyphene) B, NB B, NB B, NB NB

28 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Analgesics (Opioid) Ethyl morphine B, NB B, NB Fentanyl metabolite B B, NB Hydrocodone metabolite B B, NB Methadone B, NB Methadone metabolite B Morphine B, NB Morphine metabolites B B, NB Oxycodone metabolite B B, NB B, NB (Meperidine) NB Pethidine (Meperidine) metabolite B Propoxyphene (Dextropropoxyphene) B, NB Propoxyphene (Dextropropoxyphene) B metabolite B, NB Tramadol metabolite B & Related B, NB Synthetic Drugs B, NB NB / isocaproate/ B, NB propionate/ phenylpropionate Angiotensin II Antagonists Candesartan cilexetil B, NB Eprosartan B Irbesartan B, NB Irbesartan metabolite B Losartan B, NB Telmisartan B, NB Valsartan B, NB Animal Arenobufagin B, NB

29 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Animal Toxins Bufotalin B, NB Bufotenine B, NB Cantharidin B Cinobufotalin B, NB Antacids, Antireflux Carbenoxolone NB Agents & Antiulcerants B, NB Esomeprazole NB B, NB Lansoprazole B, NB Lansoprazole metabolite B Omeprazole B, NB Oxetacaine B Oxethazaine NB Pantoprazole NB Pantoprazole metabolite B B, NB Rabeprazole B, NB Rabeprazole metabolite B B, NB Ranitidine metabolites B Anthelmintics B, NB Mebendazole B, NB Praziquantel B NB Thiabendazole NB Antiamoebics Diloxanide NB Diloxanide furoate B, NB Emetine B, NB B, NB Anti-Anginal Drugs B, NB Amlodipine metabolite B B, NB B, NB Diltiazem metabolites B

30 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Anti-Anginal Drugs B, NB Isosorbide dinitrate NB Isosorbide mononitrate NB B, NB Nifedipine metabolite B B Ranolazine B, NB B Verapamil B, NB Verapamil metabolite B Antiasthmatic & NB COPD Preparations Beclomethasone NB Betamethasone B, NB Budesonide B, NB B, NB B, NB NB Ipratropium B, NB B, NB B, NB Metaproterenol () B, NB B, NB NB B, NB Salbutamol B, NB NB Terbutaline metabolite B B, NB Tiotropium NB Atropine B, NB Benzhexol B, NB Benzhexol metabolite B Benztropine B, NB Clidinium NB

31 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Anticholinergics NB Dicyclomine B NB B, NB NB Hyoscine methobromide NB Hyoscyamine B Ipratropium B, NB B Pirenzepine NB Propantheline B, NB Scopolamine B, NB NB Tiotropium NB NB NB NB , (Acetylsalicylic Acid) B, NB Antiplatelets & Cilostazol NB Fibrinolytics Clopidogrel B, NB Clopidogrel metabolite B B Dabigatran B Dabigatran etexilate NB Dicoumarol NB B, NB Disopyramide B, NB Ticlopidine B, NB Warfarin B, NB Warfarin metabolite B Acetazolamide B, NB B B, NB Carbamazepine metabolites B

32 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Anticonvulsants B, NB Clobazam metabolite B B, NB Clonazepam metabolite B Diazepam B, NB Diazepam metabolite B NB Fosphenytoin NB B B, NB Lamotrigine metabolite B B, NB B, NB Lorazepam metabolite B Midazolam B, NB Midazolam metabolites B B, NB B, NB Phenytoin B, NB Phenytoin metabolites B B, NB B Valproic acid B Valproic acid metabolite B B, NB B, NB Amitriptyline B, NB Amitriptyline metabolite B / metabolite B, NB B, NB Bupropion metabolite B Citalopram B, NB Citalopram metabolites B Clomipramine B, NB

33 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Antidepressants Clomipramine metabolite B Desipramine B, NB Dothiepin () B, NB Dothiepin metabolite B B, NB Doxepin metabolite B NB Escitalopram B, NB B, NB Fluoxetine metabolite B B, NB Imipramine B, NB Maprotiline B, NB B, NB Melitracen metabolite B B, NB B, NB Mirtazapine metabolites B B, NB B Nortriptyline B, NB B, NB Paroxetine metabolite B B, NB Fluoxetine B, NB metabolite B B, NB Trazodone metabolite B B, NB Venlafaxine B,NB Venlafaxine metabolite B Antidiarrheals Atropine B, NB B, NB

34 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) , Detoxifying Atropine B, NB Agents & Drugs Used in beta-Naltrexol B Substance Dependence Deferiprone NB B, NB Flumazenil B, NB B, NB Methadone B, NB Methadone metabolite B B, NB B, NB B, NB (Eserine) B, NB Antiemetics Aprepitant B, NB Chlorpromazine B, NB Chlorpromazine metabolites B Dolasetron B, NB Domperidone B, NB Domperidone metabolite B Granisetron B, NB Metoclopramide B, NB Ondansetron B, NB B NB B, NB B Antifungals Bifonazole B, NB B, NB Fluconazole B, NB Flucytosine NB Isoconazole B, NB NB Ketoconazole B, NB B, NB Sertaconazole NB

35 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Antifungals Terbinafine B, NB Terbinafine metabolite B Tioconazole B, NB Voriconazole NB Antiglaucoma Preparations Acetazolamide B, NB NB B, NB B, NB Brinzolamide NB B B, NB Dorzolamide B, NB B, NB B, NB B, NB Travoprost NB Antihyperprolactinaemic B, NB Agents B, NB Antileprotics Dapsone B, NB Ethionamide B, NB NB Antimalarials Chloroquine B, NB Halofantrine B, NB Hydroxychloroquine B, NB Mefloquine B, NB Primaquine B, NB Pyrimethamine B, NB Quinidine B, NB Quinine B, NB Quinine metabolite B Sulfadoxine B, NB Antimigraine Preparations NB B, NB B, NB

36 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Antimigraine Preparations Metoprolol metabolites B B, NB B, NB Propranolol metabolite B B, NB NB Anti-obesity Agents (Diethylpropion) B, NB 2,4-Dinitrophenol B, NB B, NB NB B, NB Orlistat B Phentermine B, NB B, NB Sibutramine B, NB Sibutramine metabolites B Anti-obesity N-bisdemethyl-sibutramine B, NB Agents Analogues N-desmethyl-sibutramine B, NB Antiparkinsonian Drugs Amantadine B Benzhexol B, NB Benzhexol metabolite B Benztropine B, NB Bromocriptine B, NB Cabergoline B, NB NB Levodopa B B, NB Orphenadrine metabolite B B B, NB Selegiline B, NB Amisulpride B, NB NB Chlorpromazine B, NB

37 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Antipsychotics Chlorpromazine metabolites B Clozapine B, NB Clozapine metabolite B Droperidol B, NB Flupenthixol NB B, NB Haloperidol B, NB Haloperidol metabolites B Loxapine B, NB Mesoridazine B, NB B B, NB Olanzapine metabolites B Paliperidone B, NB Penfluridol B, NB Pericyazine B, NB B, NB B, NB Pimozide B, NB B, NB Quetiapine B, NB Quetiapine metabolite B B, NB Risperidone B, NB Risperidone metabolite B Sertindole B, NB B, NB Thioridazine B, NB Thiothixene B, NB Ziprasidone B, NB metabolite B Triflupromazine NB Ziprasidone B, NB Ziprasidone metabolite B

38 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Antipsychotics B, NB Zuclopenthixol metabolite B NB Chloroxylenol B, NB Dequalinium NB Dichlorobenzyl alcohol NB Alverine NB Atropine B, NB Clidinium NB Dicyclomine B Hyoscine butylbromide NB Hyoscine methobromide NB Hyoscyamine B B, NB Propantheline B, NB Scopolamine B, NB Anti-TB Agents 4-Aminosalicylic acid B Ethambutol B Ethionamide B, NB NB Prothionamide NB Pyrazinamide B, NB Rifampicin B, NB Antithyroid Agents Carbimazole B, NB Methimazole B, NB Propylthiouracil B, NB Antivertigo Drugs NB B, NB Haloperidol B, NB Haloperidol metabolites B Meclozine B, NB Prochlorperazine B, NB B, NB Promethazine metabolites B

39 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Antivirals Amantadine B Amprenavir NB Atazanavir NB Didanosine B, NB B, NB Emtricitabine NB Famciclovir B, NB B, NB Lamivudine B, NB Nevirapine B, NB Oseltamivir (Tamiflu) B, NB Raltegravir NB Ritonavir NB Saquinavir NB Stavudine NB Tenofovir B, NB Valaciclovir NB Zidovudine B, NB B, NB Alprazolam metabolites B B, NB B, NB Chlordiazepoxide B, NB Clobazam B, NB Clobazam metabolite B Clonazepam B, NB Clonazepam metabolites B Diazepam B, NB Diazepam metabolite B Dipotassium NB B, NB Lorazepam B, NB Lorazepam metabolite B B, NB

40 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Anxiolytics B Midazolam B, NB Midazolam metabolites B Nimetazepam B, NB Nimetazepam metabolite B Oxazepam B, NB Oxazepam metabolite B B, NB B, NB B, NB Allobarbital B Amobarbital B, NB NB Butabarbital B, NB B, NB B, NB B, NB Secobarbital B, NB Thiopental B, NB Alprazolam B, NB Alprazolam metabolites B Bromazepam B, NB Chlordiazepoxide B, NB Clobazam B, NB Clobazam metabolite B Clonazepam B, NB Clonazepam metabolite B Diazepam B, NB Diazepam metabolite B Dipotassium Clorazepate NB Estazolam B, NB Estazolam metabolites B Flunitrazepam B, NB Flunitrazepam metabolites B

41 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Benzodiazepines B, NB Flurazepam metabolites B Lorazepam B, NB Lorazepam metabolite B B, NB Medazepam B, NB Midazolam B, NB Midazolam metabolites B Nimetazepam B, NB Nimetazepam metabolite B B, NB Nitrazepam metabolites B Oxazepam B, NB Oxazepam metabolite B B, NB Pinazepam B, NB Prazepam B, NB Temazepam B, NB Temazepam metabolite B Tetrazepam B, NB Triazolam B, NB Triazolam metabolite B Zolpidem B, NB Zolpidem metabolite B beta Blockers B, NB B, NB Atenolol B, NB Betaxolol B, NB B, NB Carteolol B, NB B, NB Carvedilol metabolite B B, NB Esmolol B, NB

42 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) beta Blockers B, NB Labetalol metabolite B Levobunolol B, NB Metoprolol B, NB Metoprolol metabolites B B, NB B, NB Propranolol B, NB Propranolol metabolite B Sotalol B, NB Timolol B, NB beta Metaproterenol (Orciprenaline) B, NB Methoxyphenamine B, NB Isoprenaline B, NB beta-2 Agonists Clenbuterol B, NB Formoterol NB Procaterol B, NB Salbutamol B, NB Terbutaline NB Terbutaline metabolite B Bile acid Chenodeoxycholic Acid B Cholic acid B Deoxycholic acid B Channel Blockers Amlodipine B, NB Amlodipine metabolite B Bepridil B, NB Diltiazem B, NB Diltiazem metabolites B Felodipine B, NB B, NB B, NB B, NB Nifedipine B, NB Nifedipine metabolite B

43 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Blockers B, NB B Nitrendipine metabolite B Verapamil B, NB Verapamil metabolite B Cannabinol B Cannabinol metabolites B Tetrahydrocannabinol B NB NB B, NB Cardiac Drugs Adenosine B Amiodarone B, NB Atropine B, NB tosylate B,NB Cibenzoline B, NB Digitoxin NB Digoxin NB Disopyramide B, NB B, NB Dofetilide B, NB B, NB Dronedarone NB Flecainide B, NB Ibutilide B, NB Isoprenaline B, NB Metaproterenol (Orciprenaline) B, NB NB B, NB Procainamide B, NB Procainamide metabolite B B, NB Quinidine B, NB Sematilide NB

44 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Cardiac Drugs B, NB Cephalosporins Cefaclor NB Cefadroxil B Cefdinir NB Cefepime B Cefixime B, NB Cefoperazone B Cefotaxime B, NB Cefpodoxime NB Ceftazidime B Ceftriaxone (Ceftriazone) B, Cefuroxime NB Cephalothin NB Cephathiamidinum NB

Chloramphenicols Chloramphenicol B, NB

Cholinesterase inhibitors B Carbofuran NB B (Dimpylate) B, NB NB B B, NB B B, NB B, NB B, NB B Methomyl NB NB Physostigmine (Eserine) B, NB Propoxur B, NB NB NB NB

45 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Cocaine Cocaine B, NB Cocaine metabolites B Corticosteroids Alclomethasone dipropionate B, NB Beclomethasone B, NB Beclomethasone dipropionate B Betamethasone B, NB Betamethasone diproprionate B, NB Betamethasone valerate B, NB Budesonide B, NB Clobetasol NB Clobetasol Metabolite B Clobetasol proprionate B, NB Clobetasone butyrate B, NB Cortisone acetate NB Desoximetasone NB, B Dexamethasone B, NB Dexamethasone acetate B, NB Dexamethasone phosphate B, NB Difluorocortolone valerate B, NB Fludrocortisone acetate B, NB Flumethasone B, NB Fluocinolone acetonide B, NB Fluocinonide B, NB Fluocortolone pivalate NB Fluoromethalone NB, B Fluticasone propionate B, NB Halcinonide B, NB Hydrocortisone NB Hydrocortisone acetate B, NB Methylprednisolone B, NB Mometasone furoate NB Prednisolone B, NB Prednisolone acetate NB Prednisone B, NB

46 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Corticosteroids Prednisone acetate NB Triamcinolone B, NB Triamcinolone acetonide NB Cough & Cold Preparations Ambroxol B, NB Bromhexine B, NB Bromhexine metabolite B Carbetapentane NB Codeine B, NB Codeine metabolite B Cyclopentolate NB Dextromethorphan B, NB Dihydrocodeine B, NB Diphenoxylate NB Guaifenesin B, NB Hydrocodone B, NB Hydrocodone metabolite B Morphine B, NB Morphine metabolites B B, NB B, NB Papaverine metabolite B B, NB B, NB B, NB B, NB Pholcodine metabolite B B, NB Pseudoephedrine metabolite B Cytotoxic Chemotherapy Amsacrine NB Aminopterin NB Capecitabine B, NB Carmustine NB 2-Chloroquinoxaline NB Cyclophosphamide B

47 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Cytotoxic Chemotherapy Cytarabine B, NB Dacarbazine B, NB Daunorubicin B, NB Doxorubicin B, NB Etoposide B, NB Epirubicin NB Fludarabine NB Fluorouracil NB Gemcitabine B, NB Hydroxyurea B Idarubicin B Ifosfamide B Irinotecan NB Lomustine NB Melphalan B, NB Methotrexate B, NB Mitoxantrone NB Paclitaxel B, NB NB Tegafur NB Teniposide B, NB Thioguanine B Topotecan B, NB Vinblastine B, NB Vincristine B, NB Vinorelbine NB Depot Contraceptives NB Medroxyprogesterone NB -Modifying Chloroquine B, NB Anti-Rheumatic Drugs Leflunomide B, NB (DMARDs) Sulfasalazine NB Diuretics Acetazolamide B, NB Amiloride B, NB Bumetanide B, NB

48 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Diuretics Canrenone B, NB Chlorthalidone B, NB Cyclopenthiazide B, NB Eplerenone B, NB Ethacrynic acid B, NB Frusemide B, NB Hydrochlorothiazide B, NB Indapamide B, NB Methyclothiazide B, NB Metolazone B, NB Spironolactone B, NB Spironolactone metabolite B Torasemide B, NB Triamterene B, NB Drugs Acting on Uterus NB B, NB Drugs for Bladder & Alfuzosin B, NB Prostate Disorders Doxazosin B, NB Finasteride B, NB Flavoxate NB Oxybutynin B Prazosin B, NB Tamsulosin NB Terazosin B, NB Terazosin metabolite B Tolterodine NB Dyslipidaemic Agents Atorvastatin B, NB B, NB Bezafibrate B, NB Ezetimibe NB Fenofibrate B Fluvastatin NB Gemfibrozil B, NB Gemfibrozil metabolites B

49 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Dyslipidaemic Agents Lovastatin B, NB Pravastatin NB Probucol B Rosuvastatin B, NB Simvastatin B, NB Ectoparasiticides Benzyl benzoate B, NB Crotamiton NB Malathion B, NB NB Emerging Drugs of abuse Benzylamine B, NB Bromo-dragonfly B, NB BZP (1-Benzylpiperazine) B, NB Bufotenine B, NB B, NB Cathinone B, NB 2C-B B, NB (4-Bromo-2,5-dimethoxy-phenethylamine) 2C-H B, NB (2,5-dimethoxyphenethylamine) 2C-I B, NB (2,5-dimethoxy-4-iodo-phenethylamine) 2C-T-2 B, NB (2,5-Dimethoxy-4-ethylthiophenethylamine) 2C-T-4 (2,5-Dimethoxy-4-isopropylthiophenethylami B, NB ne) 2C-T-7 B, NB (2,5-Dimethoxy-4-propylthiophenethylamine) Chloroamphetamine B, NB 1-(3-chlorobenzyl) piperazine B, NB mCPP (meta-chlorophenylpiperazine) B, NB CP 47,497 B, NB CP 47,497-C8-homolog B CP 55,940 B, NB

50 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Emerging Drugs of abuse DBP (1,4-) B, NB NB 2, 5- B, NB 3, 4-Dimethoxyamphetamine B, NB N,N-Diethyl-cathinone NB N,N-Dimethyl-cathinone NB N,N-Dimethyltryptamine B, NB DOB (4-Bromo-2,5-dimethoxy-amphtamine) B, NB DOET (2, 5-Dimethoxy-4-ethylamphetamine) B, NB DOM B, NB (4-Methyl-2,5-dimethoxy-amphetamine) NB N-Ethylamphetamine B, NB Ethylone B, NB 4-Fluoroamphetamine B, NB 1-(4-Fluorobenzyl) piperazine B, NB 2-Fluoromethamphetamine B, NB 4-Fluoromethamphetamine NB 3-Fluoromethcathinone NB 4-Fluoromethcathinone NB 4-Fluorotropacocaine B, NB pFPP (para-fluorophenylpiperazine) B, NB HMMA B (4-Hydroxy-3-methoxymethamphetamine ) HU-210 B HU-211 (Dexanabino) B JWH-015 B, NB JWH-018 B JWH-018 metabolite B JWH-019 B JWH-020 B, NB JWH-073 B, NB JWH 081 B JWH-200 B, NB

51 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) LAMPA Emerging Drugs of abuse B, NB (Lysergic acid N,N-methylpropylamide) Mescaline B, NB MBDB [N-methyl-1-(3,4-methylenedioxyphenyl)-2-b B, NB utanamine] MDBP B [1-(3,4-Methylenedioxybenzyl) piperazine] MDDMA B, NB (3,4-methylenedioxydimethylamphetamine) MDEA B, NB (3,4-Methylene-dioxy-N-ethyl-amphetamine) MDPV (Methylenedioxypyrovalerone) B, NB MDPPP (3,4-Methylenedioxy-α-pyrrolidinopropiophe B none hydrochloride Mephedrone B, NB pMeOPP [1-(4-methoxyphenyl)piperazine] B, NB Methcathinone B, NB Methedrone B, NB Methoxetamine B, NB 1-(4-Methoxybenzyl) piperazine B, NB 5-Methoxy-N,N-diallytryptamine B, NB 5-Methoxy-N,N-dimethyltryptamine B, NB 5-Methoxy-DIPT B, NB (5-methoxy-diisopropyltryptamine) 5-Methoxy-α-methyltryptamine B 5-Methyl-N,N-dimethyltryptamine B, NB 5, 6-Methylenedioxy-2-aminoindan B, NB 3, 4 Methylenedioxyphenethylamine B, NB 4-Methylethyl-cathinone NB cis-3-Methyl-fentanyl B, NB B 2-Methyl-methcathinone NB

52 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Emerging Drugs of abuse Methylone B, NB 4-Methyl-pyrrolidinopropiophenone B, NB α-Methyl tryptamine B, NB Mitragynine B, NB 4-MTA (4-Methylthioamphetamine) B, NB B, NB 4-(1-Piperazinyl)phenol B, NB PMA B (para-methoxyamphetamine) PMMA (para-Methoxymethamphetamine) B, NB B, NB PPP B (α-Pyrrolidinopropiophenone hydrochloride) N- B, NB Salvinorin A B, NB TFMPP B, NB [1-(3-Trifluoromethylphenyl) piperazine] Tiletamine B, NB trans- B, NB 3,4,5- B, NB Erectile Dysfunction Drugs Papaverine B, NB Papaverine metabolites B Sildenafil B, NB Sildenafil metabolites B Tadalafil B, NB Tadalafil metabolite B Vardenafil B, NB Vardenafil metabolites B Erectile Dysfunction Drugs Acetil acid B, NB Analogues B, NB Aildenafil B, NB Aminotadalafil B, NB Carbodenafil B, NB Chloropretadalafil NB

53 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Erectile Dysfunction Drugs Desethylacetildenafil NB Analogues N-Desethyl vardenafil B, NB Des-(4-methylpiperazin-1-ylsulfonyl) B, NB desmethylsildenafil Desmethylthiosildenafil NB Gendenafil B, NB NB Hydroxyvardenafil B, NB Hydroxyacetildenafil NB Hydroxyhomosildenfil NB Hydroxythiohomosildenafil NB Norneosildenafil NB Piperiacetildenafil NB Piperidenafil B, NB Thioaildenafil NB Thiohomosildenafil NB Thiosildenafil NB Udenafil NB Vardenafil hydrolysis product NB Xanthoanthrafil NB GIT Regulators, 4-Aminosalicylic acid B Antiflatulents & 5-Aminosalicylic acid B Anti-inflammatories Cisapride B, NB Domperidone B, NB Domperidone metabolite B Metoclopramide B, NB Sulfasalazine NB Trimebutine NB H1 Antagonists B, NB B, NB Astemizole B, NB B, NB Azelastine B, NB B, NB

54 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) H1 Antagonists Brompheniramine metabolite B B, NB B, NB Cetirizine metabolite B Chlorpheniramine B, NB Chlorpheniramine metabolite B Cinnarizine B, NB Clemastine B, NB B, NB B, NB Cyproheptadine metabolite B Dioxopromethazine NB Diphenhydramine metabolite B Diphenhydramine / B, NB B, NB Emedastie difumarate NB Fexofenadine B, NB B, NB Hydroxyzine B, NB Hydroxyzine metabolite B Ketotifen B, NB B, NB Meclozine B, NB NB Mizolastine B, NB B, NB Phenyltoloxamine B, NB Piprinhydrinate NB Promethazine B, NB Promethazine metabolites B Pyrilamine B Terfenadine B, NB Trimeprazine B, NB B, NB

55 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) H1 Antagonists B, NB H2 Antagonists Cimetidine B, NB Famotidine B, NB Ranitidine B, NB Ranitidine metabolites B Haemorrheologicals Oxpentifylline NB B Pentoxifylline metabolite B Haemostatics (Vit K1) NB Tranexamic acid B Herbal Markers / Abrine B, NB Herbal Extract 13-Acetyl-9-dihydrobaccatin III NB Aconitine B, NB B, NB Aloe-emodin B, NB Aloin B, NB alpha-Amanitin B, NB beta-Amanitin B, NB gamma-Amanitin B, NB Alisol C monoacetate B, NB Alpinetin NB B, NB Andrographolide B, NB p-Anisaldehyde NB Anisodamine B Anisodine B, NB B, NB Arabinose B Arbutin NB B, NB B Aristolochic acid A B, NB Aristolochic acid B B, NB Aristolochic acid C NB

56 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Herbal Markers / Asarone, B-(SG) B, NB Herbal Extract beta-Asarone NB Atractylenolide III B Atractyloside B, NB Auramine O NB Baccatin III NB B, NB NB Bakkenolide B, NB Bakuchiol B Belamcandin NB Benzoylaconine B Benzoylhypaconine B Benzoylmesaconine B, NB B, NB Bergapten B, NB Bergenin NB Bifendate B, NB Biochanin A B, NB Boldtine NB / Isoborneol B Brucine B, NB Buddleoside NB Bufalin B, NB Bullatine A B, NB Bullatine B (Neoline) B, NB Bulleyaconitine (Crassacauline A) B, NB Caffeoyl ethyl ester B, NB Calycosin B, NB Calycosin-7-O-β-D-glucoside NB Camptothecin B, NB B, NB Cardamonin B, NB Caryophyllene oxide B

57 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Herbal Markers / (Vitexicarpin) B, NB Herbal Extract B, NB Catharanthine B, NB Cavidine NB Cepharanthin B, NB Chelerythrine NB Chlorogenic acid NB B, NB Chrysophanol B, NB Chuangxiongzine NB Cianidanol B Cimifugin B, NB Cinnamic acid B, NB Cinobufagin B, NB Citric acid B Cochinchinenin C NB Columbianadin B, NB Coniine B Convallatoxin B, NB Cordycepin B, NB NB Corynoxine (Rhynchophylline) B, NB p-Coumaric acid B, NB Crassicauline A B Crotaline (Monocrotaline) B Cryptotanshinone B Curcumenol NB NB NB B, NB Cynanchagenin NB Cytisine B, NB B, NB Daidzin B, NB

58 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Herbal Markers / Danshensu B, NB Herbal Extract Daphnetin NB Deacetylbaccatine III NB Deacetylcrassicauline-A B Desacetyl Lappaconitine B Deacetylyunaconitine B Dehydroabietic acid B Dehydroandrographoline B, NB 13-Dehydroxyindaconitine B, NB Deoxyaconitine B Deoxyschizandrin (Schizandrin A) B, NB Dictamnine B, NB Digitoxigenin B, NB Digoxigenin B Dihydrocapsaicin B, NB B, NB Dihydrolycorine B, NB NB Dihydrotanshinone I B, NB 1,8-Dihydroxyanthraquinone (Danthron) B, NB Dracohodin NB Emodin B, NB B, NB Epimedin C NB Esculin B, NB B Evodiamine B Evodin B, NB Fangchinoline (HanfangchinB) B, NB Fargesin B, NB Farrerol B, NB Ferulic acid B, NB Foresaconitine B Formononetin B, NB

59 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Herbal Markers / Forsythin NB Herbal Extract Fraxetin B, NB Fraxinellone B, NB B, NB Ganoderic acid A B, NB Gastrodin NB Gaultherin NB Gelsemine B, NB Gelsenicine NB Gelsevirine B, NB B, NB Genistin B Germacrone B, NB Gingerol B A B, NB Ginsenoside NB Gitoxigenin B, NB Gitoxin NB Glycitein B, NB Glycitin NB Glycyrrhetinic acid B, NB Glycyrrhizic acid B, NB Gomisin A B, NB Grayanotoxin III B Griseofulvin B, NB Griseofulvin metabolite B Hanfangchin B (Fangchinoline) B, NB B, NB B, NB Harpagoside NB Hederagenin B Hesperidin B, NB NB B

60 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Herbal Markers / Humantenmine B, NB Herbal Extract Hupehenine B NB Huperzine B NB 2-(4-Hydroxyphenyl)ethanol B, NB Hydroxysafflor yellow NB 1-Hydroxy-3,4,5-trimethoxyxanthone B, NB Hyoscyamine B Hypaconitine B, NB NB B NB B, NB Imperatorin B, NB Indaconitine B Ingenol NB Irisflorentin B, NB Isocolumbin B, NB Isofraxidin B, NB Isoferulic acid NB Isoliquiritigenin B, NB Isopimpinellin NB Isopsoralen B, NB Isorhynchophylline B, NB Isovincoside lactone (Strictosamide) B, NB Jervine B Jujuboside A NB Jujuboside B NB B, NB B, NB Koumine B, NB Lamprolobine B Lappaconitine B Licochalcone A NB

61 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Herbal Markers / Liensinine NB Herbal Extract Ligustrazine (Tetramethylpyrazine) NB Linderane B, NB Liquidambaric acid B Loureirin A B, NB Loureirin B B, NB NB B, NB Lysionotin B, NB B Magnoshinin B, NB Mangiferin NB Matrine B, NB Menthol B Mesaconine B Mesaconitine B, NB 4-Methoxysalicylaldehyde B, NB N-Methylcytisine B, NB N-Methylephedrine B, NB Methyl hesperidin NB Methyleugenol B, NB B, NB Methylpseudoephedrine B NB Mogroside V NB B B Muscone B B B, NB Naringin B, NB Nefrine perchlorate NB Neoline (Bullatine B) B, NB Nitidine NB

62 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Herbal Markers / B, NB Herbal Extract Norcantharidin B, NB Norephedrine B Notoginsenoside R1 B, NB NB Obacunone B Oleandrin B, NB Oleanolic acid B Oridonin B, NB Osthole B, NB Oxymatrine B, NB Oxysophocarpine NB Paeoniflorin B, NB Paeonol B, NB Palmatine B, NB Praeruptorin A B, NB Praeruptorin C B, NB Perivine NB Physcion B, NB Picfeltarraenin IA NB Picrinine B, NB Picroside I NB Picrotin B Picrotoxinin B Pimpinellin B, NB Piperine B, NB Podophyllotoxin B, NB Polydatin NB Polygalacic acid NB Poncirin NB Protopine B, NB Prunasin B, NB Pseudoephedrine B,NB Pseudolaric acid B NB

63 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Herbal Markers / Psilocin B, NB Herbal Extract Psilocybine B, NB Psoralen / Isopsoralen B, NB Puerarin B, NB NB NB Raddeanin A NB Resibufogenin B, NB B, NB Retrorsine B Rhein B, NB Rhynchophylline (Corynoxine) B, NB Ricinine B NB Rotundine B, NB Rutaecarpine B, NB Rutin NB Saikosaponin A NB Saikosaponin C NB Saikosaponin D NB NB Salidroside B Salvianolic acid A NB Sanguinarine NB Schisandrin B, NB Schisandrin C B Schisantherin A B, NB Schizandrin A (Deoxyschizandrin) B, NB Scoparone B, NB Scopolamine B, NB Scopoletin B, NB NB Senecionine B, NB Seneciphylline B, NB

64 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Herbal Markers / Sesamine B, NB Herbal Extract Shikimic acid NB Shikonin NB 6-Shogoal B Silybin NB Silymarin NB B, NB B Sophoricoside NB Sophoridin B, NB B, NB Strictosamide (Isovincoside lactone) B, NB Strophanthidin B, NB Strophanthidol B, NB Strophanthin G NB Strychnine B, NB Synephrine B, NB Syringin NB NB Tanshinone I B, NB Tanshinone II A B, NB Tectorigenin B, NB B, NB Tetrahydropalmatine metabolite B 3', 4' 5, 7-Tetramethoxyflavone NB Tetrahydroxystilbene glucoside B B, NB Teucrin A B Thevetin B B Triptolide NB Triptonide NB Triptophenolide B, NB beta-turmerone B Umbelliferone B, NB

65 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Herbal Markers / Usnic acid B, NB Herbal Extract Vanillin B, NB Veratric acid B, NB B, NB Veratrine B Vindoline NB Vitexicarpin (casticin) B, NB B, NB B, NB Yunaconitine B, NB Herbicides Diquat NB Methabenzthiazuron NB Paraquat (Special test is required. Please indicate NB clearly in the request form) Hormonal Chemotherapy Anastrozole NB B, NB Buserelin NB NB B, NB Flutamide B, NB Letrozole NB Medroxyprogesterone NB Megestrol B, NB B, NB Tamoxifen metabolites B Hyperuricemia & Allopurinol B, NB Gout Preparations Colchicine B, NB Probenecid B, NB Hypnotics & Allobarbital B Amobarbital B, NB Barbital NB Butabarbital B, NB Butalbital B, NB

66 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Hypnotics & Sedatives Estazolam B, NB Estazolam metabolites B Flunitrazepam B, NB Flunitrazepam metabolites B Flurazepam B, NB Flurazepam metabolites B B, NB Hexobarbital B, NB Lormetazepam B, NB Midazolam B, NB Midazolam metabolites B Nimetazepam B, NB Nimetazepam metabolite B Nitrazepam B, NB Nitrazepam metabolite B Pentobarbital B, NB Phenobarbital B, NB Secobarbital B, NB Temazepam B, NB Temazepam metabolite B Tetrahydropalmatine metabolite B Triazolam B, NB Triazolam metabolite B Zolpidem B, NB Zolpidem metabolite B Zopiclone B. NB Zopiclone metabolite B Immunosuppressants Azathioprine B, NB Methotrexate B, NB Mycophenolate NB Mycophenolate mofetil NB Mycophenolic acid B Mycophenolic acid metabolite B NB

67 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Immunosuppressants Tacrolimus NB Thalidomide NB Keratolytics Salicylic acid NB Laxatives Bisacodyl B, NB Bisacodyl metabolites B Oxyphenisatin B Phenolphthalein B, NB Phenolphthalein metabolite B Sennoside A B, NB Sennoside B B, NB Macrolides Azithromycin B, NB Clarithromycin B, NB Clarithromycin metabolite B B Roxithromycin B, NB Spiramycin NB Derivatives Ammelide B Ammeline B Methylxanthines Aminophylline NB B, NB Theophylline B, NB Miscellaneous Adenine NB D&C Orange no.4 NB B, NB Melatonin metabolite B Metyrapone B, NB Phenethylamine B, NB Muscle Relaxants Atracurium B, NB Atracurium metabolite B B, NB B NB B, NB B, NB

68 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Muscle Relaxants Cyclobenzaprine metabolite B Dantrolene NB Mivacurium NB Orphenadrine B, NB Orphenadrine metabolite B Rocuronium B Tizanidine B, NB B, NB Mydriatic Drugs Atropine B, NB Homatropine B, NB Phenylephrine B, NB Tropicamide NB Nasal B, NB B, NB Phenylephrine B, NB B, NB B, NB Neurodegenerative Donepezil B, NB Disease Drugs Galantamine B, NB Rivastigmine NB Neuromuscular Disorder Distigmine B Drugs Neostigmine NB Pyridostigmine NB B, NB Nootropics & Neurotonics Nimodipine B, NB B B, NB NSAIDs B, NB B, NB Aspirin (Acetylsalicylic Acid) B, NB B, NB B, NB Celecoxib metabolite B B, NB

69 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) NSAIDs Diclofenac metabolites B Dipyrone NB B, NB Etoricoxib metabolite B B, NB Ibuprofen metabolite B Indomethacin B, NB Indomethacin metabolite B B, NB Ketoprofen metabolite B B, NB Ketorolac metabolite B B, NB Mefenamic acid metabolite B B, NB B, NB B, NB Naproxen metabolite B B, NB B, NB Phenazone metabolite B B, NB B, NB NB B, NB B, NB B, NB B, NB Oestrogens & B & NB Related Synthetic Drugs Ethinyloestradiol NB B, NB Levonorgestrel NB Medroxyprogesterone NB

70 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Oestrogens & B, NB Progesterones & B Related Synthetic Drugs B, NB Ophthalmic Decongestants Naphazoline B, NB Phenylephrine B, NB Synephrine B, NB Tetryzoline B, NB 6-Acetylcodeine B Buprenorphine B, NB Buprenorphine metabolite B Codeine B, NB Codeine metabolite B Dextropropoxyphene (Propoxyphene) B, NB Dihydrocodeine B, NB Dihydromorphine B, NB Diphenoxylate NB Ethyl morphine B, NB Fentanyl B, NB Fentanyl metabolite B Heroin (Diamorphine) B, NB Heroin metabolites B Hydrocodone B, NB Hydrocodone metabolite B Hydromorphone B, NB Methadone B, NB Methadone metabolite B Morphine B, NB Morphine metabolites B Oxycodone B, NB Oxycodone metabolite B Oxymorphone B, NB Pentazocine B, NB Pethidine (Meperidine) B, NB Pethidine (Meperidine) metabolite B

71 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Opioids Pholcodine B, NB Pholcodine N-oxide B Propoxyphene (Dextropropoxyphene) B, NB Propoxyphene (Dextropropoxyphene) B metabolite B, NB Tramadol B, NB Tramadol metabolite B Oral Antidiabetic Agents B, NB Buformin NB Chlorpropamide B, NB Glibenclamide B, NB Glibenclamide metabolite B Gliclazide B, NB Gliclazide metabolites B Glimepiride B, NB Glimepiride metabolites B Glipizide B, NB Glipizide metabolite B Gliquidone B, NB Metformin B, NB Nateglinide B, NB Phenformin B, NB Phenformin metabolite B Pioglitazone B, NB Pioglitazone metabolites B Repaglinide B, NB Repaglinide metabolites B Rosiglitazone B, NB Rosiglitazone metabolites B Sitagliptin B, NB Tolazamide B, NB Tolbutamide B, NB Tolbutamide metabolites B

72 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Oral Contraceptives Cyproterone NB Ethinyloestradiol NB Gestodene B, NB Levonorgestrel NB Norethisterone NB Acephate B Chlorpyrifos B Diazinon (Dimpylate) B, NB Dichlorvos NB Ethion B Fenitrothion B, NB Malathion B, NB Methidathion B Tetrachlorvinphos NB Other Agents B, NB Affecting Metabolism Other Aztreonam NB Chlorquinaldol NB B Clindamycin B, NB Fusidate NB Lincomycin B, NB NB Meropenem B Metronidazole B, NB Nifuroxazide NB Nitrofurantoin NB Rifabutin NB Trimethoprim B, NB Other Antihypertensives Bendazol (Dibazol) B, NB B, NB B, NB Diazoxide B, NB B, NB

73 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Other Antihypertensives Hydralazine metabolite B B B, NB NB Phentolamine B Phentolamine methanesulphonate NB Prazosin B, NB Reserpine B, NB Terazosin B, NB Terazosin metabolite B Other Antiprotozoal Agents Pentamidine B, NB Other CNS Drugs & Atomoxetine B, NB Agents for ADHD NB B, NB Methylphenidate metabolite B Other Dermatologicals Finasteride B, NB Hydroquinone B Imiquimod B, NB Minoxidil B, NB Other Drugs Acting on Carbachol B the Genito-Urinary System B, NB Phenazopyridine B, NB Solifenacin NB Other Drugs of Abuse Iso-LSD B Ketamine B, NB Ketamine metabolites B Lysergic acid diethylamide (LSD) B, NB LSD metabolites B Mescaline B, NB Methaqualone B, NB 2-Oxo-3-hydroxy-LSD B. NB B, NB Phentermine B, NB Psilocin B, NB

74 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Other Drugs of Abuse Psilocybine NB Other Insecticides Aldrin B NB B, NB Camphor B Cyromazine NB o,p'-DDD NB B N,N-Diethyl-m-toluamide B, NB 2,4-Dinitrophenol B, NB B Fenvalerate NB Fipronil B, NB Heptachlor B Heptachlor epoxide B Imidacloprid B, NB Indoxacarb B, NB Naphthalene B, NB Paradichlorobenzene B Piperonyl butoxide B, NB Pirimiphos methyl NB B, NB Penicillins /Amoxycillin B Ampicillin B, NB Bacampicillin B, NB B, NB Cloxacillin B, NB Cloxacillin B, NB Dicloxacillin NB Flucloxacillin B, NB Oxacillin B, NB Penicillin G B Phenoxymethylpenicillin B, NB Piperacillin B, NB

75 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Penicillins Sultamicillin NB Peripheral Vasodilators & Betahistine NB Cerebral Activators Cinnarizine B, NB NB NB NB Ethamivan NB Etofylline NB Hexobendine B, NB NB B, NB Nimodipine B, NB Papaverine B, NB Papaverine metabolites B Raubasine NB B, NB Vincamine B Piperazine Derivatives Benzylamine B BZP (1-Benzylpiperazine) B, NB mCPP (meta-chlorophenylpiperazine) B, NB 1-(3-chlorobenzyl) piperazine B, NB DBP (1,4-Dibenzylpiperazine) B, NB 1-(4-Fluorobenzyl) piperazine B, NB pFPP (para-fluorophenylpiperazine) B, NB pMeOPP [1-(4-methoxyphenyl)piperazine] B, NB MDBP B [1-(3,4-Methylenedioxybenzyl)piperazine] 1-(4-Methoxybenzyl) piperazine B, NB 4-(1-Piperazinyl)phenol B, NB TFMPP B, NB [1-(3-Trifluoromethylphenyl) piperazine] Preservatives Benzoic acid NB Ethylparaben NB 2-Phenylphenol B, NB

76 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Preservatives Propylparaben NB Psoriasis, Seborrhea & Acitretin NB Ichthyosis Preparations Methoxsalen (Xanthotoxin) B, NB Pyrethroids Allethrin B, NB Cyfluthrin B Cypermethrin B Deltamethrin B Empenthrin B Esbiothrin B, NB Fenpropathrin B, NB Imiprothrin B, NB B, NB 3-Phenoxybenzoic acid B Pyrethrin NB S-Bioallethrin NB Tetramethrin B, NB Quinolones NB Ciprofloxacin metabolite B Clinafloxacin NB Gatifloxacin NB Gemifloxacin NB Levofloxacin NB Moxifloxacin NB Nalidixic acid B, NB Norfloxacin B, Ofloxacin B, NB Pefloxacin NB Pipemidic acid B, NB Sparfloxacin B, NB Respiratory Almitrine B, NB B, NB Rodenticides ANTU (alpha-naphthylthiourea) B, NB Brodifacoum B, NB Bromadiolone B, NB

77 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Rodenticides B, NB Coumachlor NB Coumafuryl NB Coumatetralyl B, NB Difenacoum NB NB Diphacinone NB Flocoumafen B, NB Pindone NB Tetramine NB Warfarin B, NB Warfarin metabolite B Selective Clomiphene B, NB Modulator Raloxifene NB Somatostatin Analogues NB Sulphonamides Sulfadiazine B, Sulfapyridine B, NB Sulfathiazole B, NB Sulphamethoxazole B, NB Sulphamethoxazole metabolite B Superwarfarins & Warfarin Brodifacoum B, NB Bromadiolone B,NB Chlorophacinone B, NB Coumachlor NB Coumafuryl NB Coumatetralyl B, NB Difenacoum NB Difethialone NB Diphacinone NB Flocoumafen B, NB Pindone NB Warfarin B, NB Warfarin metabolite B Targeted Erlotinib B, NB

78 Specimen Type Coverage Test Class ( B: Biological specimen) (parent compound or metabolite) ( NB: Non-biological specimen) Targeted Cancer Therapy Gefitinib B NB Lapatinib NB Nilotinib B, NB Sorafenib NB Sunitinib B, NB NB NB B, NB Oxytetracycline B, NB B, NB Thyroid Hormones Di-iodothyronine (T2) NB Thyroxine (T4) NB Tri-iodothyronine (T3) NB Thyroid Hormones Tri-iodothyroacetic acid (T3A) NB Analogues Anabasine B, NB B, NB Nicotine metabolite B Vasoconstrictors Ephedrine B, NB B, NB Norephedrine B B Phenylephrine B, NB Vitamins Acetomenaphthone NB Biotin B Calciferol B (Niacinamide) B, NB Phytomenadione (Vit K1) NB Pyridoxine (Vit B6) B, NB Riboflavine (Vit B2) NB Thiamine (Vit B1) NB Volatile Organic Compounds Toluene metabolite (Hippuric acid) B

79